Introduction: The DRGs system is considered one of the most important reforms in the field of health worldwide in the last 30-40 years, and is a modern mechanism for compensation and control of hospital costs, which is used by most developed countries in the world with individual variants. At the beginning of 2012, this method was introduced in Greece in the form of Hospital Consolidated Cost (KEN). Aim: To study the implementation of DRGs in Greece and to investigate the possibility of their use as a tool for coordinating Financial Management in the country’s hospitals. Case report: This study included the entire set of discharges from surgical departments of the “Theagenio” Anticancer Hospital of Thessaloniki in 2019. The reimbursement values of the examined KEN as well as their standard length largely strongly deviate from the actual figures leading to a simple proposal already made by other researchers: the application of micro-costing techniques better reflects the actual cost of treatment. It was also observed misclassifications hidden under the usual practice at public hospitals to link many cases to a few KEN codes or even one. The analysis also revealed differences in productivity and efficiency among surgical departments. It is rather complicated to assess the KEN system as a genuine DRG system as it has not followed its basic principles (cost weight, base rate, case mix index). However, the upcoming Gr-DRG system could be used as an important tool for coordinating financial management in Greek hospitals, presupposing the development of controlling and monitoring processes, internal and external comparison of hospitals (benchmarking), and adaptation of production processes for the benefit of the patient and the hospital. Thus, the new system should “reward” high-performance and high-profile hospitals treating more complex cases.
Background: Kidney Transplant Recipients (KTRs) are a high-risk group as far as SARS-CoV-2 disease is concerned. The object of this study was to evaluate the immune response of a cohort of KTRs after 2 doses of mRNA BNT16b2 and to determine if there is any correlation between the immune response and immunosuppressive therapy. Material – Methods: Our patient cohort consists of 83 KTRs of an Organ Transplant Unit of a General Hospital of Greece and included 60 men and 23 women (mean age 54,7 range 22-73 years). Two measurements of SARSCoV- 2 antibodies were conducted: a) after the initial 2dose vaccination (first measurement) and b) before the second booster dose (second measurement). The antibody response was measured using chemiluminescent microparticle immune assay (CMIA). Dividing line for the antibodies was value 50, KTRs with value ≥50 was considered fully immunized. Furthermore, structured interviews were conducted to obtain information about the medical history of KTRs, their treatment and vaccination’s adverse reactions. Results: Even though the immune response increased after the second measurement it continued to be poor. A 39,8% (n=33) of KTRs had antibodies ≥50 after the first measurement and this percentage became 43,4% after the second measurement. This difference was not statistically important (p=0,664). As far as the immunosuppressive treatment is concerned, none of the medications affected the change in the antibody titers in the two measurements with p value for all medications being bigger than 0,05. Conclusions: Immune response of KTRs decreased. For this reason, boosters are needed to protect this group.
Despite the development of palliative care at the European level, citizens remain highly concerned about the quality of care provided at the end of life. Palliative care needs vary from country to country. A primarily narrative review was undertaken with the aim of documenting the current status and outlining the development trends in the field of palliative care across various European countries, as well as its relationship to fundamental human rights. Nineteen European countries were studied across three areas: the provision of palliative care services, access to analgesic treatments, and the management of end-of-life practices. In summary, it was found that access to palliative care is generally universal across nearly all countries studied, though there is unequal distribution depending on the patients’ specific conditions. Inequalities also exist in terms of geographical distribution, and only a few countries have palliative care programs for pediatric patients. Most deaths occur in hospital or hospice settings in all studied countries, despite patients’ preferences to the contrary. There was insufficient management of chronic pain using opioid medications, especially in Eastern European countries. Finally, in the area of euthanasia and assisted suicide, there is no unified strategy across Europe. This review is narrative in nature and is not intended for analytical synthesis. However, it provides a comprehensive foundation for understanding the current state of palliative care across Europe.
Introduction: Type 1 diabetes mellitus often occurs in children, highlighting the importance of safety in the school environment for good progress. Children with T1D require specialized medical care, including diabetes nurses. Adolescents with T1D are at risk of poor glycemic control, highlighting the importance of the role of school nurses in managing the disease. Nurses’ knowledge needs to be assessed regularly to prevent complications, and it is essential that they maintain up-to-date and reliable knowledge about diabetes care and management. Aim: The aim of this research is to investigate and evaluate the level of knowledge of School Nurses regarding the management of children with Type 1 Diabetes Mellitus. Material – Methods: The sample of this research includes 150 nurses of the field PE 87.02 or PE25 from all over Greece. The information was collected through an anonymous questionnaire, which included questions about demographics and questions related to the management of Type 1 Diabetes Mellitus care. The questionnaire was structured in google forms, the duration to answer the questionnaire was one month, more precisely from mid- November 2023 to mid-December 2023. For the analysis of the data, the Statistical Package for Social Sciences (SPSS v26.0) was used. Results: The survey reveals that School Nursing is predominantly female-dominated (91%) with an average age of 33.36 years. 58.6% have a master’s degree, with an average experience of 4.4 years. School Nurses work mainly in primary education (66.6%). In the second part, 89.3% consider insulin deficiency to be the main cause of Type 1 Diabetes Mellitus. About 69% are concerned about managing students with Type 1 Diabetes Mellitus in their absence. There are differences in answers depending on educational attainment and further training. Conclusions: School Nurses who have a Master’s degree in the care and management of Type 1 Diabetes Mellitus are superior in knowledge compared to School Nurses who have either attended a seminar or KEDIVIM or have consulted parents. The years of experience do not contribute to a similar degree to the issue of the knowledge of School nurses who are called to take care of children with Type 1 Diabetes Mellitus.
Introduction: Blood transfusion centres have faced very difficult times during the global COVID-19 pandemic. In response to this unprecedented pandemic in our country, governments and health authorities have taken measures to reduce the transmission of the coronavirus and implemented measures to increase blood supply and protect health workers, blood donors and patients who needed transfusion. Aim: The aim of this research study was to investigate the attendance of blood donors before, after and during the period of the COVID-19 pandemic. Material and Methods: This retrospective study was approved by the Scientific Council of the General and University Hospital of Attica with protocol number 526 and date 12/7/2023. The sample of the study was voluntary blood donors who had come to donate blood from January 2018 to December 2023. Significant levels were two-sided and statistical significance was set at 0.05. The statistical program STATA 13.0 was used for the data analysis. Results: In total, data was recorded from 54,168 people who came to donate blood from 2018 to 2023. 34.9% of them came in the pre-Covid period (2018-2019), 28.2% in the Covid period (2020-2021) and 36.9% post-Covid (2022-2023). These percentages differed significantly from each other (p<0.001). Conclusions: The attendance rate for blood donation after Covid was significantly higher compared to what was pre-Covid, a fact that allows us to conclude that the preventive measures to protect the community won the trust of blood donors whoshow their social sensitivity and support the noble institution of blood donation.
Introduction: Healthcare professionals are 16 times more likely to experience workplace violence than other work groups. Verbal abuse is the most common type of abuse. However, in recent years it has been found that healthcare professionals, especially nurses, are sexually harassed in their workplace. Aim: To explore the frequency of verbal abuse and sexual harassment among the medical and nursing staff of public hospitals in the prefecture of Attica. Material – Methods: A cross-sectional study was conducted from May to July 2023 in 342 doctors and nurses of two public hospitals. The Verbal Abuse Scale was used to assess verbal violence, while the Sexual Experiences Questionnaire (SEQ) was used for sexual harassment. Results: The 82.1% of participants were nurses. The 88.9% of the sample was the recipient of verbal abuse at least once a year. Abusers were relatives of patients (36.8%), patients (33.0%), someone superior (28.3%) and the direct supervisor (20.70%). The most common behaviors were harsh criticism, blaming and blaming, and insults disguised as a joke. Furthermore, 70.2% of the participants had received at least one of the 24 sexually harassing behaviors of the SEQ questionnaire. The perpetrators were mainly a male doctor (48.3%), a patient (28.5%), an accompanying patient (20.5%), and a male nurse (17.9%). Only 7.9% reported the incident. Furthermore, 38.4% faced some physical problems, 46.7% some mental problems, while 43.8% had their work performance affected. Conclusions: A large percentage of medical and nursing staff suffer verbal violence and sexual harassment without mention it. This highlights the need to implement drastic measures on the part of health policy makers to help victims speak out without fear of negative consequences. Hospital administrations are urged to implement effective policies against sexual harassment and verbal abuse.
Hellenic studies as well as international studies demonstrate the importance of proper human resource management for the development of the quality of health care services. One of the main responsibilities of human resource management is the evaluation of performance for the purpose of the professional development of employees. Performance appraisal is the evaluation of an employee’s current or past performance against the performance standards set for the position. It is connected, among other things, to the better utilization of human resources, their motivation and further development. The weakness of evaluation as a human resource management tool implies insufficient utilization of highly qualified human resources, but also the absence of reward even as a form of moral motivation. To be reliable, the evaluation system should be clear, objective, efficient and acceptable. Assessors should be certified, well trained, competent and experienced. Subsequently, for the evaluation of the work achieved, each department of the hospital (nursing, medical, administrative, technical) should have a clearly defined plan with individual realistic, measurable and applicable goals that should be communicated to the staff in time. In recent years a lot of energy has been consumed around the issue of assessment with intense debates and many amendments. The rating system has undergone only marginal modifications in relation to experience and essentially repeats variations of earlier arrangements. However, health professionals today expect a meaningful assessment that could be a human resources management tool, which will be linked to the effort of differentiation and motivation.
Introduction: The recent COVID-19 pandemic tested the resilience of health systems, with potential impact on safety culture. Aim: To assess patient safety culture in a Greek tertiary hospital during the COVID-19 pandemic. Material – Methods: A cross-sectional study with the Hospital Survey on Patient Safety Culture (HSOPSC) version 1.0. was conducted during the spring of 2022. Results: The overall level of patient safety was moderate to good and was mainly predicted by adverse event reporting frequency, management support for safety, and overall safety perception. «Collaboration and teamwork within hospital departments» and «supervisors’/ managers’ expectations and actions regarding patient safety» scored the highest, while «staffing» the lowest. Conclusions: The pandemic magnified preexisting problematic issues, like shortage of staff, but also had a positive impact by enabling reinforcement of cooperation among health workers and jointed actions regarding patient safety. Building on the lessons learnt in patient safety in the post- COVID-19 era is a global challenge.
Antibiotic abuse leads to the development of antibiotic resistance mechanisms. The misuse of antibiotics has been identified by the World Health Organization and the European Union as one of the most serious threats to public health due to its association with increased disease duration, mortality rate and health care costs. Thus, the over-registration and overuse of antibiotics is considered a matter of utmost importance in the global community. The factors found to affect the correct antibiotic usage were age, gender and education level. People older than 60 years of age were found more likely to misuse antibiotics compared to younger people. Most antibiotics were found to be used by women and people with a lower level of education. According to a European study, the average antibiotic consumption was 21.8 doses / day per 1000 inhabitants in the community, while in Greece it was found to be 36.3 doses / day. 26.7% of Greeks are supplied with non-prescription antibiotics, while 56% of those are supplied by pharmacies and 30% selfmedicate. Distribution of antibiotics occurs mainly through medical prescription, however 69% of doctors questioned declared to being pressured to prescribe antibiotics without need. At the same time, 65% of pharmacists admitted to giving antibiotics without a prescription, while 46% of those state that they received intense pressure by patients. Community Nurses provide a reliable source of information on this topic, while also excel at informing and educating the masses on the proper use of antibiotics. Intervention using awareness campaigns and introductory programs for the adoption of proper practices regarding antibiotics, organized by Primary Health Care Nurses, should be aimed at health professionals and the general population, thus minimizing the current situation.
Introduction: Attachment theory, a psychological framework by J. Bowlby, explains the bond between infants and their caregivers, emphasizing the importance of a secure base for exploration. It has significant implications in psychology, education, and parenting, explaining how early experiences shape personality and behavior. In sports, attachment theory is underutilized, with most research focusing on the relationship between coaches and athletes. Secure attachments with coaches lead to positive performance, motivation, and overall well-being, with individual and team sports athletes scoring higher on autonomy and conscientiousness. Aim: The aim of the study was to explore whether there may be a correlation between the type of attachment and the sport choice. Material & Methods: It was an observational, cross-sectional study. For the study, the Greek adaptation of Inventory of Parent and Peer Attachment for Children was used to assess the attachment to parents and peers. One hundred twenty questionnaires were distributed to swimmers and water-polo athletes in Attica, Greece, competitively. Results: In the study participated 29 females and 38 males, where no statistically significant correlation was found between the choice of sport and attachment type. The participant’s gender had an impact on the sport they chose. Conclusion: The results of the study didn’t confirm the initial hypothesis, and this is most likely relating to the research’s limitations. Thus, the survey should be administered again with several adjustments to the structure. This study provides a well starting point for further analysis.
Introduction: Society has gone through a rapid development due to the progress of Information Technology. The efficacy of Technology and Information applications affects the development of the economy and industry. The consequence of all above is the emergence of effects in the Health sector and of course consequently also in Health Professionals. Health services rely no longer on information systems programs, which bring only benefit. Aim: The promotion of the applications of Health Information Technology and Telemedicine in the work of Nurses. Material - Methods: A search for scientific articles, published in the English language on the topic of the use of digital health systems and applications during the last six years, was carried out in the electronic databases Pubmed and Springerlink. Results: According to the findings searched n=82 studies. Many e-Health applications work in devices with a daily use such as Smartphone and portable tablets. Remote nursing monitoring can bring a sense of stability in patients and satisfaction of Health Professionals regarding the provision of care. A remote nursing care program, to be accepted by nursing staff and patients, should be characterized by affordability and high protection of personal data. Conclusions: Hospital centers, in the past created barriers hindering the introduction of telehealth services, while in recent years they have sought to implement strategies for their adoption. The implementation of telenursing programs will reduce costs in health systems. Health units tend to implement telemedicine programs locally by using their own resources.
Natural disasters are events that will occur in an increasing rate during the following years since they are inextricably linked to climate change. They usually leave behind them huge material damages and an important number of injured, too. Consequently, it is as necessary for the nurses as it is for the healthcare personnel and the rest of the paramedical staff to be trained accordingly, so that they will be able to handle situations like these. Specifically, regarding the response stage, it is essential that they will be trained in the dynamic triage procedure in terms of population. It is equally important that they will be prepared for the challenges they may come across in the case they will be asked to apply it while being equipped with minimal available resources. The aim of the following research was the presentation of triage and the elevation of the nurse’s role at the site of the incident.
Introduction: Phenomena such as ageing population and the development of chronic, life-threatening diseases have created the need for specialized healthcare services for both patients and their caregivers. Additionally, Information and Communication Technologies (ICT) have entered people's daily lives, serving the needs, with a plethora of new, digital interventions. Methodology: This review aims to establish the purpose of the development, methodology, and effectiveness of the interventions aimed at empowering people experiencing traumatic events of illness and bereavement. The study is a systematic literature review of a total of 58 randomized controlled trials. Data were analyzed using thematic analysis. Results: The interventions described aimed to improve the quality of life of patients and caregivers with a variety of disorders, the main ones being cancer and diabetes mellitus. Studies related to bereavement were less common. The most common interventions developed were web-based and smart phone applications. Most publications showed statistically significant differences in favor of the intervention group in all or part of the initial objectives. The most common limitation of the studies was the inability to generalize the results due to various methodological reasons. Conclusions: The implementation of online services to empower people experiencing a traumatic event is a realistic alternative in most cases, and further exploration of this field is worthwhile.
Diabetes Mellitus (D.M) is one of the most common chronic diseases and implementation of management strategies is important for patients with D.M. in order to achieve stable blood glucose levels. Patients' compliance with the therapeutic recommendations of health professionals plays a decisive role in the successful outcome of the therapeutic intervention. The aim of this review is to explore the effect of patients' adherence to their treatment in the treatment of the disease. PubMed, Medline, Scopus, Embase and Google Scholar databases were searched for reviews and clinical studies over the past decade. A restriction was placed according to the language of publication of the articles and books and those published in English and Greek were used. Regarding the results, the correct compliance of the diabetic patient to the treatment seems to have beneficial effects in terms of the proper treatment of the condition, as it contributes to the reduction of complications, hospitalizations and contributes to the better quality of life of the patients. In conclusion, it becomes evident that the correct compliance of the diabetic patient to the treatment has beneficial effects in three main areas. First it reduces the occurrence of long-term complications, then it improves the financial indicators related to D.M and finally it contributes to improving the productivity - quality of life of the diabetic patient.
The work load being carried out by nursing staff in the care of individuals who have undergone limb amputation serves as a key catalyst in post-operative recovery, return to normalcy, and restoration of their quality of life. This review gathers relevant articles from the decade starting in 2014, focusing on the types and causes of amputation while highlighting the multifaceted role that nurses must assume in supporting the amputee not only physically but also psychosocially. Therefore, the primary aim is to examine the preoperative and postoperative contribution of nurses to individuals with amputated limbs. Our research demonstrated that the nurse's role in the rehabilitation of individuals with amputated limbs must be central and spans various areas, such as wound care, complication prevention, proper management of phantom limb pain, and handling of prosthetic limbs. Most importantly, it includes educating the amputee and their family on the aforementioned aspects, as well as placing nursing staff within the framework of holistic, interdisciplinary care. In conclusion, academic gaps were identified in recent literature regarding nursing support and care stereotypes for individuals with amputated limbs, particularly in the Greek academic field, which could be addressed through focused, up-to-date research.
The homogeneous diagnostic grouping system is a system of classifying patients based on diagnoses, clinical procedures, and resource utilization. It aims at rationalizing the management of available resources, ensuring effective and efficient care. The aim of this review was to investigate the need to incorporate nursing complexity into existing health care reimbursement coding systems. Through a brief description of the system of homogeneous diagnostic groups (DRGS), it proposes ways to substantially upgrade them, through the recognition of the complex contribution of nursing to the quality of the health services provided. Assessing the complexity of nursing care involves understanding, quantifying, and strategically managing all factors associated with ensuring high-quality care for patients. Existing reimbursement coding models are based almost exclusively on medical care provided, ignoring all factors that affects the quality of nursing care provided. According to the literature, the complexity of nursing care is a dynamic phenomenon and at the same time an important indicator both for the planning and management of human and material resources as well as the overall evaluation of the provided nursing care. In today's dynamically changing environment, the universal coverage of citizens' health needs and the rational distribution of available resources are basic conditions for the sustainability of health systems internationally. This in turn requires that hospital care reimbursement models, and DRGS in particular, reflect the holistic nature of hospital care provided, incorporating the multidimensional and complex role of nursing at all levels.
Clostridium difficile infection (CDI) is a major problem nowadays, due to its increased occurrence both in the general population and in the group of people suffering from Idiopathic Inflammatory Bowel Disease (IBD). The infection is related to the administration of a wide range of antibiotics and can cause serious complications as well as worsening of the course of IBD. The aim of present retrospective study was to record the prevalence of CDI infection in patients with Idiopathic Inflammatory Bowel Disease. A retrospective review study was carried out through an electronic search in the databases PubMed, Google Scholar and Scopus, regarding the presence of CDI infections in people with IBD, using published articles, researches and studies of the last decade in the Greek and international literature. Upon review of the literature, it was found that C. difficile is responsible for 20-30% of hospital-acquired diarrhea. The causes of CDI infection in frequency and mortality are a spectrum of multiple factors with the main ones being prolonged hospitalization, reckless use of antibiotic preparations, vulnerable groups and co-existing diseases. The present review highlighted that individuals with IBD are susceptible to C. difficile infection which complicates the course of the disease. Key words: inflammatory bowel disease; infection clostridium difficile; coexistence of infection C. difficile-IBD
This study addresses the imperative need to modernize educational approaches in higher education, with a specific emphasis on adult education in the Nursing Department at the University of Ioannina. It provides a detailed analysis of the nursing curriculum and its implementation, showcasing the method of clinical training and practice for nursing students at the university. The paper illustrates how the department has successfully integrated collaborative, reflective, and exploratory learning practices into its clinical training program. The curriculum employed in the Nursing Department effectively merges theoretical knowledge with practical skills, prioritizing active student participation. A distinctive feature of this program is the transition from the traditional, extended training model to a more intensive, 13-day immersive experience in a variety of healthcare settings, including primary healthcare institutions, mental health facilities, and the University General Hospital of Ioannina. Students are required to register their attendance electronically at their respective sites daily. Simultaneously, they electronically document their application of clinical skills, thus enabling a thorough evaluation of both their academic achievements and professional competencies. The assessment process comprehensively evaluates the students’ academic performance, professional behavour, and practical skills. The program’s educational philosophy, grounded in active, inquiry-based learning, draws inspiration from the theories of Bruner and Rogers. This methodological approach not only augments the students’ knowledge and skillsets but also fosters cognitive development and professional readiness, thereby significantly contributing to the advancement of nursing education.
