Analysis of medication administration in relation to food and beverages in inpatients.

Proper medication administration in relation to beverage or food is one of the essential tools to achieve the pharmacotherapy goals. It is not known whether this is also considered in the care of inpatients. The aim of this study was to describe and analyse the current practice of medication administration in relation to food and beverages to patients hospitalized in four hospitals in the Czech Republic. This study was conducted based on the results of the first phase of a prospective observation study focused on the safety of medication administration performed by nurses. All data, including the timing of medication administration in relation to food and the data on beverages used, were obtained by the method of direct observation. The team of observersaccompanied the nurse during medication administration. The appropriateness of the medication administration in relationto food/beverages was assessed according to the summary of product characteristics and the published literature. In total, the administration of 5718 oral medications and 198 insulins were analysed. Unproper food timing wasobserved in 15.7% of oral medication administrations and 26.8% of insulin administrations. The highest number ofunproper food timing occurred in the proton pump inhibitors, antihypertensives, and prokinetics. Tea (63.4%) was the most used beverage. Errors with clinically serious impact have been observed in some groups of drugs. The necessity of a systemic approach in management of medication administration is required including interdisciplinary cooperation.

Safety of drug administration from the perspective of hospitalized patients in selected hospitals of the South Bohemia Region.

Drug administration is one of the riskiest areas of healthcare provision, accompanied by several possible mistakes. Patient and family involvement is crucial for patient safety in a hospital environment. The research study aimed to evaluate the subjective perception of the safety of the drug administration process from hospitalized patients point of view and their involvement in drug administration. A structured questionnaire of its own design was used to obtain data. Three hundred twenty-nine respondents from 4 hospitals in the South Bohemian Region in the Czech Republic were included in the research, including patients hospitalized in the internal medicine, surgery, and follow-up and rehabilitation care departments. We found different perceptions and individual understandings of the safety of the drug delivery process by other groups of patients. Interest in participating in drug administration also varies between groups of patients. Women control the medication given to them by the nurse to a much greater extent than men. Patients under the age of 60, patients with higher professional and university education, and patients from the surgical department would like to be more involved in deciding which aplikovadrugs to use. Patients with a low level of education want to involve their family members more in their treatment decisions. Both healthcare professionals and patients should be led by hospital management to increase patient involvement in the hospitalization process.

Evaluation of medication errors in the hospital environment.

INTRODUCTION: Healthcare is inherently associated with a risk to patient health. One risk is associated with medication-related errors, which are commonly reported adverse events. By analyzing the root causes of medication errors, effective preventive measures can be proposed to reduce their likelihood. This study aimed to identify the reasons of medication administration errors, determine the number of medication administration errors reported, and describe the barriers hindering reporting. METHODOLOGY: The study used a standardized Questionnaire Medication Administration Error Survey (MAE survey) that was quantitatively analyzed. The study involved 112 nurses from four hospitals in the South Bohemian Region. RESULTS: Risk factors that increase the likelihood of medication administration errors include similarity of drug names (3.7 ± 1.3) and packaging (3.9 ± 1.5), frequent prescription changes for patients (3.2 ± 1.5), illegibility of written prescriptions (3.1 ± 1.6), a lack of clarity of medical records (2.6 ± 1.5). Only a proportion of medication administration errors are reported by nurses (16% to 21%). The reluctance of nurses to report medication administration errors is linked to fear of being blamed for the deterioration of the patients health (3.3 ± 1.7), fear of the doctors reaction to a medication administration error (2.6 ± 1.4), and repressive responses from hospital management to reported misconduct (2.9 ± 1.5). CONCLUSION: Measures to reduce the likelihood of medication administration errors include building a non-punitive system for reporting adverse events and medication errors, introducing electronic prescription systems, promoting open communication within the team, involving clinical pharmacists in the pharmacotherapy process, and regular comprehensive training of nursing staff.

Causes and interventions of medication errors in healthcare facilities.

A medication error is one of the most common causes of patients complications or death in healthcare facilities. In the United States, 7,000 out of 9,000 patients die because of medication errors each year. Known factors are generally divided into four groups - human factor, intervention, technical factor, and system. Our study includes 17 studies from the OVID, Web of Science, Scopus, and EBSCO databases, in the range of 2015-2020. After a selection of professional publications, 2 categories were created - factors leading to medication errors and interventions to reduce medication error and testing their effectiveness. It has been found that human factor always plays a role, often supported by a poorly set-up system. The most mistakes are made in documentation, administration technique or accidental interchange of patients. The most frequently mentioned factors include nurses overload, high number of critically ill patients, interruptions in the preparation or in the administration of medications, absence of the adverse event reporting system, non-compliance with guidelines, fear, and anxiety. Another evidence of medication error is in the application of intravenous drugs, where an interchange of drugs or patients due to interruption occurs as well. Sufficient education of nurses and an adequate system of preparation and administration of drugs, for example using bar codes, are considered as an appropriate intervention.

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia.

This study aimed to analyze the effect of fall risk-increasing drugs (FRIDs) and drug-related factors relative to falls through clinical pharmacy service in hospitalized patients, focusing on the relevance of clinical pharmacist evaluation in the context of physician assessment. A prospective study of inpatient falls was conducted in 2017 retrieving data from 4 hospitals in South Bohemia, Czech Republic. An online database was developed to collect patient and fall-related data, and fall evaluation records. Healthcare professionals classified the overall effect of drugs on falls using Likert scale. Univariate and multivariate correlations were performed with a significance level of p < 0.05. Out of the total 280 falls (mean age of patients 77.0 years), a mean of 2.8 diagnoses with fall-related risk, 8.8 drugs, and 4.1 FRIDs per fall were identified. Incidence of falls decreased quarterly (p < 0.001). Use of FRIDs were positively associated with increasing age (p = 0.007). Clinical pharmacists were more likely to identify pharmacotherapy as the relevant fall-related risk, compared to physicians evaluation (p < 0.001). An increasing total number of prescribed drugs as well as higher number of FRIDs increased the suspicion in both professionals in the context of drug-related causes of falls.

Clinical pharmacist involvement in fall management in a polymorbid geriatric patient with a history of recurrent falls.

Patient falls represent a significant burden on healthcare facilities, particularly by prolonging hospitalization and increasing the cost of subsequent healthcare. In most cases, fall is caused by a combination of several modifiable and unmodifiable risk factors. The pharmacotherapy, which is often unreasonably administered in relation to patient health condition and drug combination, belongs among the modifiable risk factors. In this case report, the potential effect of pharmacotherapy on the patient fall-related risk as well as clinical pharmacy service that can contribute to reducing the risk of falls by engaging of clinical pharmacist in a multidisciplinary team with focus on the risks of pharmacotherapy and their management are shown.

[New ways towards the improvement of the seniors health literacy]. / Nové cesty pro zlepsení zdravotní gramotnosti senioru.

The elderly population is one of the vulnerable groups due to their low health literacy. Health literacy represents a way of effective ensuring, comprehension and utilization of health information to be able to make the best possible decisions in the care of one's health. The presented systematic overview study was compiled using the analysis of 38 database publications. The goal was to find relevant resources concerning the relation between health literacy and compliance in the treatment of adult and elderly individuals. Another goal was to describe the influence of tools and the possibility of using e-health to improve the seniors' health literacy. The source analysis proves that limited health literacy correlates with the decrease of cognitive functions. Some studies show that health literacy directly correlates with the level of education and age. The elderly individuals who show higher health literacy observe their doctors' advice more frequently and are, moreover, active recipients of health care. One of the tools of how to improve health literacy is e-health technology using internet, mobile phones, tablets or other information media.Key words: health literacy, health care, patient, senior, compliance, e-health.

Retrospective analysis of falls in selected hospitals of the Czech Republic.

INTRODUCTION: Hospitals strive, over the long term, to reduce the incidence of falls of hospitalized patients. Falls are monitored, analyzed, and regularly evaluated and corrective and preventive actions are established based on the findings. To establish preventive actions, it is essential to determine the circumstances under which the patient fell and in what type of health care facility. OBJECTIVES: The goal of the study consisted in retrospectively analyzing falls in selected hospitals of the South Bohemian Region in 2014 and 2015. METHODS: Our retrospective analysis of 1101 patient falls was reported by the health care staff from 4 hospitals of the South Bohemian Region. The data from the reported incidents (i.e., falls) from individual hospitals were encoded and entered in a database using the SASD statistical program and subsequently subjected to statistical analysis. RESULTS: The highest frequency of falls was found on internal wards, 565 (51.3%) with the second highest frequency found on subsequent care wards, 267 (24.3%). The study showed that the risk of falls increases with patient age; more than 60% the hospitals, in the monitored period, involved patients over 70 years of age. Falls occurred most frequently in patient rooms and in bathrooms. Statistically significant relationships were identified between the type of ward and the time of the fall, between the type of the ward and the location of the fall, between patient age and the time of the fall, between patient age and the location of the fall, between the time of fall and the location of fall, and between the location of fall and the patient mobility before the fall. CONCLUSION: Intensive monitoring of patient falls and the circumstances under which the falls occurred are needed to fully understand the epidemiology of hospital falls.

Selected aspects of health literacy among seniors.

OBJECTIVES: This study aimed to map the selected indicators of health literacy in the senior population via a qualitative survey that focused specifically on its relationship with autonomy in the context of health literacy among seniors. METHODS: A qualitative survey focused on the selected indicators of health literacy of seniors living in the South Bohemian Region of the Czech Republic (R1-19). The snowball sampling method was intentionally selected. Completed interviews were transcribed and data was reduced, analyzed, and categorized. The identified categories were 1) information comprehension, 2) decision-making in healthcare, and 3) compliance with nonpharmacologic treatment. RESULTS: The 'information comprehension' category clearly shows that the seniors involved in this study rated the comprehensibility of information provided by medical professionals as being good. An especially positive finding was that seniors do seek information through the internet, print sources, or other media, even though, as one senior (80-year-old woman) said, comprehension of medical information is becoming "more and more complex". The 'decision-making in healthcare' category touched upon opinions regarding informed consent and opinions regarding seniors' own involvement in healthcare. Results from this category suggest that seniors accept informed consent as a routine necessity. Inhibition regarding personal involvement in healthcare was also apparent: "... I come from a family accustomed to not bothering the doctor unnecessarily, so I just stick out my arm..." The last category of 'compliance with nonpharmacologic treatment' clearly shows that respondents are informed regarding lifestyle modifications that would benefit their treatment, although, few respondents had achieved the desired lifestyle changes. CONCLUSION: Results of this qualitative research show clear health literacy limits among seniors. As shown in this study, age itself could also be a limiting factor of health literacy.

Risk management in inpatient units in the Czech Republic from the point of view of nurses in leadership positions.

OBJECTIVES: The goal of this study was to assess specific features of risk management from the point of view of nurses in leadership positions in inpatient units in Czech hospitals. METHODS: The study was performed using a quantitative research strategy, i.e., a questionnaire. The data sample was analyzed using SPSS v. 23.0. Pearson's chi-square and analysis of adjusted residues were used for identifying the existence associations of nominal and/or ordinal quantities. 315 nurses in leadership positions working in inpatient units of Czech hospitals were included in the sample. The sample was created using random selection by means of quotas. RESULTS: Based on the study results, statistically significant relations between the respondents' education and the utilization of methods to identify risks were identified. Furthermore, statistically significant relationships were found between a nurse's functional role within the system and regular analysis and evaluation of risks and between the type of the healthcare facility and the degree of patient involvement in risk management. CONCLUSION: The study found statistically significant correlations that can be used to increase the effectiveness of risk management in inpatient units of Czech hospitals. From this perspective, the fact that patient involvement in risk management was only reported by 37.8% of respondents seems to be the most notable problem.

Risk Factors for Malnutrition in Seniors Aged 75+ Living in Home Environment in Selected Regions of the Czech Republic.

BACKGROUND AND AIM: Nutrition is an important social determinant of health that influences the ageing process. The aim of this study was to evaluate the nutritional condition of a group of seniors and identify the bio-psycho-social factors that increase the risk of malnutrition. METHODS: The research was conducted using a quantitative method. The standardised scales Mini Nutritional Assessment - Short Form (MNA-SF) and the Geriatric depression scale (GDS-5) were used to evaluate the nutritional condition and tendency towards depression of the tested group. This group consisted of seniors aged 75 and above living in home environment in the Ceské Budejovice region. The group was comprised of 320 seniors, 115 men (35.9%) and 205 women (64.1%), which corresponds to the composition of the population in the chosen region of the Czech Republic. Statistical data analysis was conducted using SASD 1.4.10 and SPSS 15.0 programs. Pearson's chi-squared test (Χ²) and Cramér's V were chosen for statistical testing. The significance level was set at 5%. RESULTS: The average BMI value of the seniors was 26.2 kg/m² (overweight). This value decreased with age. More than one third of the respondents were evaluated as being at risk of malnutrition (36.3%). Unintended weight loss was determined as the strongest risk factor of malnutrition. Seniors who had lowered their food intake stated unintended weight loss 10 times more often than respondents with no noticeable reduction in food intake. Seniors who showed signs of depression indicated weight loss three and a half times more often than respondents without depression. Meanwhile acute illness increased the risk by three times. Depression was found to be the cause and also the consequence of malnutrition. CONCLUSION: Despite the high prevalence of overweight and obesity, a large proportion of the respondents were running the risk of malnutrition. It was concluded that the strongest risk factors for malnutrition in the respondents were unintended weight loss, depression and lowered food intake. Compared to biological factors, social and economic factors were less significant in causing malnutrition in seniors.

Selected areas of health and health care utilization by immigrants living in the Czech Republic.

OBJECTIVE: This investigation examined to what extent a selected group of immigrants in the Czech Republic receive healthcare for primary prevention and inpatient care. A partial aim of the research was to confirm the connection between immigrant health and their social situation. METHODS: Using a quantitative study technique, 1,014 legally established immigrants (Vietnamese, Polish, Ukrainian, Russian, and Slovak) between 18-65 years of age were interviewed. The selection of respondents was conducted using purposive selection. The stratification of the group was determined by nationality, age, and gender. RESULTS: Long-term illnesses were found significantly more frequently among Ukrainian immigrants and less frequently among Vietnamese immigrants. About half of the respondents had visited a GP and dentist in the previous year and 11.5% of respondents had been hospitalized in inpatient departments. Most of the surveyed immigrants had public health insurance (77.9%), one-fifth had contractual health insurance (19.6%) and 2.5% did not have health insurance. In statistical terms, Vietnamese, Ukrainian, and Russian immigrants had commercial insurance more often than Polish and Slovak immigrants. The utilization of public health insurance and healthcare among immigrants grew significantly in correlation with length of residency. The use of GPs for preventive health care also grew in correlation with knowledge of the Czech language. We found that less than nine percent of immigrants reported needing hospitalization for an illness, but were not hospitalized. CONCLUSION: Currently, immigration represents one of the most burning and sensitive global challenges. The outcome of this research clearly shows that improving immigrant Czech language skills and giving all legally established immigrants access to Czech public health insurance are important steps needed to increase access to healthcare for immigrants in the Czech Republic.

Socioeconomic status and health of immigrants.

The aim of this article is to acquaint the general public with select socioeconomic status (SES) parameters (type of work, education level, employment category, and net monthly income) of select nationalities (Ukrainians, Slovaks, Vietnamese, Poles, and Russians) from a total of 1,014 immigrants residing in the Czech Republic. It will also present a subjective assessment of socioeconomic status and its interconnection with subjective assessment of health status. This work was carried out as part of the "Social determinants and their impact on the health of immigrants living in the Czech Republic" project (identification number LD 13044), which was conducted under the auspices of the European Cooperation in Science and Technology (COST) agency. Quantitative methodology in the form of a questionnaire was selected to facilitate the research aim. Data was processed using the Statistical Package for Social Sciences (SPSS), version 16.0 (SPSS, Inc., Chicago, IL, USA). Statistical analyses were performed using the Pearson chi-square test, adjusted residual analysis, and multivariate correspondence analysis. The results of these tests demonstrated a statistically significant relationship between subjective assessments of socioeconomic status and the following related select characteristics: type of work performed (manual/intellectual), employment categories, education, and net monthly income. Results indicate that those situated lowest on the socioeconomic ladder feel the poorest in terms of health; not only from a subjective perspective, but also in terms of objective parameter comparisons (e.g. manual laborers who earn low wages). As the level of subjective SES assessment increases, the level of subjective health assessment increases, as well. Thus, the relationship has a natural gradient, as was described by Wilkinson and Marmot in 2003. Our study found no evidence of a healthy immigrant effect. Therefore, it was not possible to confirm that health status deteriorates with length of residence, or that the health status of immigrants with a residence duration of less than 5 to 10 years is statistically significantly better than immigrants who have resided in the Czech Republic for 10 years or more. We conclude that, by increasing the education levels of immigrants, or actively selecting qualified foreign workers (according to set criteria), the number of people in the Czech Republic who positively assess their health status will surge. In terms of prevention, it is essential to focus on manual laborers and to differentiate specific methods to improve their health status (e.g. awareness-raising campaigns in large plants and factories), given that they comprise the weakest group in this regard.

Selected aspects of "safety culture" in hospitals of the Czech Republic.

THEORETICAL BACKGROUND: Patient safety is a strategic goal of managers of all health care facilities in the Czech Republic. The development of a safety culture in the facility helps to ensure high quality health care. GOAL OF THE SURVEY was to assess the safety culture with regard to patient safety and team cooperation. A partial goal was to confirm the hypothesis that team cooperation among health care staff significantly influences patient safety. METHODOLOGY: 772 nurses took part in a quantitative survey. The respondents were nurses working shifts in inpatient departments of hospitals in the Czech Republic. RESULTS: Patient safety was described as excellent by 17.5% of nurses. It is described as very good by 60.2% of nurses and described as acceptable by 20.5% nurses. 78% of respondents agreed with the statement that patient safety was never neglected at the expense of increased workload. More than 10% of nurses reported that there were problems with patient safety. 19.8% of respondents were reported that efforts to prevent errors were not practiced at their clinic, and, therefore, and only chance had prevent more errors from occurring. According to 64.9% of respondents, the staff on the wards supported each other and a similar number of respondents reported that they showed respect for each other (60.2%). Respondents reported that intra-ward support increased the degree of patient safety. CONCLUSION: Results from the survey show that team cooperation is a precondition for providing safe patient care, which cannot be underestimated and must be refined and improved through good hospital management.

Patient misidentification in nursing care.

GOAL: The goal of the study was to assess the opinions of nurses regarding patient safety associated with patient misidentification. The investigation was focused on actual patient misidentification as well as loss of patient materials (e.g., blood samples, X-rays, etc.). These are problems often associated with patient identification methods and/or confusing patients with the same surname assigned to the same ward. The risks of misidentification incidents pose a considerable threat to patient health especially when the confusion extends to the operating room. Our objective was to identify the potential causes of patient misidentification and offers solutions to correct the issue. METHODS: A survey as part of a sociological investigation was carried out through the use of questionnaires. The selected sample included, in accordance with the needs of the project and methodology of the Institute for Health Care Information and Statistics of the Czech Republic, registered nurses working shifts on inpatient wards. The study took place across the Czech Republic between Sept. 15 and 30, 2013. The sample consisted of 772 registered nurses. RESULTS: The potential for patient misidentification (PM) was described as negligible by 73.8% of respondents. Only 9.1% of nurses admitted problems associated with patient misidentification. Respondents reported that the greatest potential for patient misidentification was associated with patients having the same surname staying on the same ward. An absolute majority of nurses responded that patient identification wristbands were the most frequently used method to prevent PM. Over 90% (90.6%) of nurses reported that patient ID wristbands were used for all patients. Almost 80% (77.4%) reported the use of positive verbal identification in addition to ID wrist bands. Respondents reported (76.2%) that the most frequently used method to avoid PM in the operating room involved a review of patient documentation. Almost the same number of repondents (74.1%) reported the use of verbal confirmation as a method to avoid PM. Another mechanism included verification of the surgical procedure. ID wristbands and completion of an 'identification protocol' rank among other options mentioned most frequently by respondents. CONCLUSION: The study shows that registered nurses regard patient misidentification as a very rare and unlikely event. Nonetheless, statistics suggest otherwise and education, changes in protocols, and new technologies are needed to improve the precision of patient identification.

Prevention of patient falls in hospitals in the Czech Republic.

THEORY: The prevention of patient falls is one of the safety goals set forth by the Ministry of Health of the Czech Republic. GOAL: A sociological survey was carried out to (1) determine to what extent nurses identify the risk of patient falls at admission, (2) if the risk is reassessed and at what intervals, (3) what preventive measures were taken, and (4) in what way are patient falls reported. METHODOLOGY: A representative sample consisting of general nurses working shifts on inpatient wards at hospitals in the Czech Republic was surveyed. Altogether 772 nurses took part in the study. RESULTS: The survey showed that at admission, most nurses assessed the risk of falls (91.6%). Nonetheless, it should stand as a stark warning that nearly one fifth of the respondents (16.2%) did not reassess the risk of falls after admission! On the other hand, it can be perceived as a positive that most nurses (70.1%) use a multifaceted program of preventive measures for at risk patients and immediately reported fall events to the doctor in charge (71.4%). During statistical testing, the predication that a working atmosphere supporting a culture of patient safety would significantly decrease the probability of patient falls and increases the willingness of nurses to use preventive programs in daily practice. CONCLUSION: Results from the survey showed that a system to minimalize fall risks has been successfully introduced into the hospitals of the Czech Republic. The system is based on the recommendations of the Ministry of Health of the Czech Republic.

Subjective Social Status in select Ukrainians, Vietnamese, and Mongolians living in the Czech Republic.

OBJECTIVES: This article discusses methods of examining subjective social status (SSS), which is based on the concept of social determinants of health described by Wilkinson and Marmot in 1998. METHODS: SSS research was conducted with Cooperation from the Scientific and Technical Research (COST) program, with financial support from the Czech Ministry of Education, Youth and Sports. This study is part of a project entitled the "Health and Social Status of Immigrants and Asylum Seekers in the Czech Republic" (registration number OC 10031), which was started in 2010 and concluded in May 2011. The study included 246 respondents of which: 69 (28.1%) had emigrated from Vietnam; 93 (37.8%) from the Ukraine; and 84 (34.1%) from Mongolia. In terms of qualitative strategies, 13 individual immigrants and asylum seekers were personally interviewed. This research was thus conceived as being both quantitative-qualitative, which included the use of the appropriate technical tools (i.e., questionnaires and interviews with select immigrants and asylum seekers). SSS was determined using the Pearson's chi-square test, as well as through correspondence and cluster analyzes. Sign schemes were used to detect select significant relationships in contingency tables. The minimum significance level chosen was α ≤ 0.05. RESULTS: When examining the SSS of select nationalities, differences were observed in the perception of subjective social status. The correspondence analysis results clearly show that Ukrainians best perceived their social status (within the selected parameters). One measure of subjectively perceived social status related to Czech language proficiency (i.e., one criterion was the comprehension of spoken Czech; e.g., whether the respondent could read or speak Czech, or how they assessed their own Czech proficiency). CONCLUSION: The SSS study clearly revealed typical links among select nationalities living in the Czech Republic, and highlighted risks related to the degree of integration (and its relationship to social exclusion). This study served as a pilot project for follow-up research conducted by the second COST project entitled: "Social Determinants of Health and their Impact on the Health of Immigrants Living in the Czech Republic" (registration number LD 13044 COST). The follow-up study included 1 000 respondents of Slovak, Vietnamese, Ukrainian, Russian and Polish nationality and is currently underway at the Faculty of Health and Social Studies at the University of South Bohemia in the Czech Republic. The methodological tools used were taken from the COST pilot project (which is the topic of this article) and were adjusted as needed (i.e., both objective and subjective criteria were used for examining social status).

The hospitalized patient as a partner in the survey on safe care in the Czech Republic.

OBJECTIVES: The study examined the extent to which patients in the Czech Republic are involved in decisions regarding their treatment and whether they are interested in ensuring safety during hospitalization. METHODS: Patients were interviewed to determine their perspectives regarding the previously stated objectives. The sample consisted of 514 patients who had been admitted to hospital for a minimum of three days. RESULTS: It is clear that patients in the Czech Republic are unaware of safety issues associated with provided care, but 52.2% of respondents expressed a desire to be more involved in decisions pertaining to their treatment. Widowed patients, as well as those hospitalized for more than six days, expressed less of a desire for such involvement. Half of the patients enrolled in the study stated that health care professionals had encouraged them to ask questions about their treatment. With regard to errors associated with surgical reversals, 58.3% of respondents stated that nursing staff had performed checkups to avoid confusion in surgery. Another patient safety issue is nosocomial infection acquired through improper hand-washing techniques of medical personnel. 73.5% of patients said they would not have the courage to ask medical staff (doctors or nurses) whether they had washed their hands prior to examination. CONCLUSION: Patients in the Czech Republic are unaware of the safety issues associated with provided care, but more than half expressed a desire to be more involved in decisions that pertain their treatment.

Social predictors of breastfeeding and the impact of interventions on breastfeeding of preterm infants: A longitudinal study.

INTRODUCTION: The multifaceted benefits of breastfeeding for mothers and infants include enhanced neurodevelopment and immune function in preterm infants. However, more research is needed to understand the unique factors affecting breastfeeding practices in preterm infants. This study aimed to identify key social predictors of breastfeeding in preterm infants and assess the effectiveness of specific interventions on their feeding practices during the first six months postpartum. METHODS: A prospective, monocentric, longitudinal study involving a cohort of 201 preterm infants was executed at the Neonatology Department, Ceske Budejovice Hospital, Czech Republic, from January 2020 to January 2023. The STROBE guidelines were used. RESULTS: The study results elucidated a transition from breastfeeding to bottle feeding and formula within the infants' first six months. Notable social predictors of breastfeeding encompassed factors such as the number of children in the household, the mother's marital status, and the nature of housing. Certain interventions, including immediate skin-to-skin contact between mother and child, and initiation of nutritive feeding within the first half-hour post-birth, significantly influenced the probability of breastfeeding. CONCLUSIONS: The data underscored that social predictors and nursing interventions substantially shape the breastfeeding practices of preterm infants during the first six months postpartum. Inequities in health outcomes among premature infants can be effectively curbed through comprehensive care models that account for socioeconomic factors influencing breastfeeding.

Self-reported medication administration errors in clinical practice of nurses: a descriptive correlation study.

BACKGROUND: Medication administration errors (MAE) are a worldwide issue affecting the safety of hospitalized patients. Through the early identification of potential causes, it is possible to increase the safety of medication administration (MA) in clinical nursing. The study aimed to identify potential risk factors affecting drug administration in inpatient wards in the Czech Republic. MATERIAL AND METHODS: A descriptive correlation study through a non-standardized questionnaire was used. Data were collected from September 29 to October 15, 2021, from nurses in the Czech Republic. For statistical analysis, the authors used SPSS vers. 28 (IBM Corp., Armonk, NY, USA). RESULTS: The research sample consisted of 1205 nurses. The authors found that there was a statistically significant relationship between nurse education (p = 0.05), interruptions, preparation of medicines outside the patient rooms (p < 0.001), inadequate patient identification (p < 0.01), large numbers of patients assigned per nurse (p < 0.001), use of team nursing care and administration of generic substitution and an MAE. CONCLUSIONS: The results of the study point to the weaknesses of medication administration in selected clinical departments in hospitals. The authors found that several factors, such as high patient ratio per nurse, lack of patient identification, and interruption during medication preparation of nurses, can increase the prevalence of MAE. Nurses who have completed MSc and PhD education have a lower incidence of MAE. More research is needed to identify other causes of medication administration errors. Improving the safety culture is the most critical challenge for today's healthcare industry. Education for nurses can be an effective way to reduce MAEs by enhancing their knowledge and skills, mainly focusing on increasing adherence to safe medication preparation and administration and a better understanding of medication pharmacodynamics. Med Pr. 2023;74(2):85-92.