Influence of the work environment of nurses on the 30-day mortality of patients hospitalized in Polish hospitals. cross-sectional studies.

BACKGROUND: An optimal work environment for nurses is characterized primarily by appropriate staffing, good team relations, and support from the management staff. These factors are consistently associated with a positive assessment of patient safety by a hospital's employees and a reduction in hospital mortality rates. AIM: To understand the relationships between the work environment as perceived by nurses on the 30-day mortality of patients treated in Polish hospitals. BACKGROUND: An optimal work environment for nurses is characterized primarily by appropriate staffing, good team relations, and support from the management staff. These factors are consistently associated with a positive assessment of patient safety by a hospital's employees and a reduction in hospital mortality rates. MATERIAL AND METHODS: The analysis used discharge data from 108,284 patients hospitalized in internal medicine and surgery departments in 21 hospitals (with 24/7 operations) in Poland. Administrative data included coded data to estimate 30-day mortality. A Nurses' satisfaction questionnaire, including the PES-NWI scale and the SAQ questionnaire, was used to assess the work environment of nurses (n = 1,929). Correlations between variables were assessed using the Pearson coefficient. The analysis used a Poisson regression model, which belongs to the class of generalized linear models. RESULTS: A lower 30-day mortality rate amongst patients was found among those treated in hospitals where the personnel feel that they may question the decisions or actions of their superiors regarding the care provided (r = - 0.50); nurses are informed about changes introduced on the basis of reports about negligence and mistakes (r = - 0.50); the ward nurse is a good manager (r = - 0.41); nurses receive timely information from the head of the department that may have an impact on their work (r = - 0.41). CONCLUSIONS: Factors related to care during hospital stay such as the organization of care at the ward level, analysis of care errors, the number of staff providing direct patient care, informing nurses about mistakes without punishment, and the possibility of nurses challenging the decisions or actions of superiors, which concerns care providing, affect the 30-day mortality of patients after the end of hospitalization in Polish hospitals.

Healthcare-Associated Infections and Prevention Programs in General Nursing versus Residential Homes-Results of the Point Prevalence Survey in Polish Long-Term Care Facilities.

Background and Objectives: The number of residents of long-term care facilities (LTCFs) is expected to increase. Determining the epidemiological situation in the context of organizational conditions is therefore extremely important for planning the necessary future activities in the field of infection prevention. The aim of this study was to analyze the prevalence rates in Polish nursing vs. residential homes, in the context of the medical and functional burdens of residents and the organizational conditions of both types of units. Material and Methods: the data that were analyzed came from a point prevalence survey of infections and antibiotic consumption in LTCFs, conducted in accordance with the HALT-3 protocol in Poland in 2017, between April and June. Results: This study included a total of 2313 residents in 24 LTCFs. The most common risk factors for infections in the study population were urinary and fecal incontinence (77.0%), impaired mobility (the patient was in a wheelchair or lying down) (68.7%), and impaired spatial and temporal orientation (52.5%). The median prevalence in nursing homes (NHs) was 3.2% and that in residential homes (RHs) was 0.7%, but without statistical significance. The median for the entire group was 2.6%. A total of 93 healthcare-related infections were detected in 91 residents. The most frequently reported forms of infections were urinary tract infections, lower respiratory tract infections, and skin infections. A statistically significant positive correlation was found only between the percentage of residents with pressure ulcers and other wounds and the incidence of gastrointestinal infections (correlation coefficient = 0.413, p < 0.05). Infection prevention and control measures were implemented mainly in nursing homes, and in residential homes, only hand hygiene procedures were commonly available. Conclusions: For the two types of LTCFs, the epidemiological situation in terms of nosocomial infections is diverse. Consequently, both types of facilities require different approaches to infection control and prevention and outcomes analysis.

Nurses' attitudes towards factors determining the safety of patients treated in intensive care units: Cross-sectional study.

BACKGROUND: The goal of health care systems is to ensure high quality of medical services provided, including patient safety. The intensive care unit (ICU) is an environment conducive to the occurrence of adverse events and medical errors because of the complexity of the care provided, the severity of the conditions of patients treated in these units and work often performed under stressful conditions. AIMS: Assessment of attitudes of nurses working in ICUs towards patient safety. STUDY DESIGN: A cross-sectional, descriptive study was conducted in a group of 214 nurses employed in ICUs in hospitals located in the southern part of Poland. METHOD: The study used the Polish version of the Attitudes towards safety: (SAQ-SF PL) questionnaire and an original questionnaire consisting of questions on socio-demographic and professional data. RESULTS: The overall SAQ score for the whole group was 61.89, 57.29 for adult ICU nurses and 68.20 for children's ICU. The surveyed nurses in general obtained the highest average results in terms of teamwork climate (TC)-66.92, while the lowest scores were given to the management-hospital management (PM)-45.08 and working conditions (WC)-57.56. job satisfaction (JS) positively correlated with the assessment of the TC, the assessment of the safety climate (SC), the assessment of the management staff (Head of Department) (PM), the assessment of the management staff (hospital management) (PM) and the assessment of work conditions (WC). A statistically significant, negative correlation was found between the assessment of JS and the assessment of stress recognition (SR) (r = -.20; p < .01). CONCLUSIONS: In the surveyed ICU branches, there is a low SC, and it is related, among others, to the perception of WC and the role of the management staff. The level of JS among nursing staff mainly depends on the SC, the TC, WC and the support of the management staff. RELEVANCE TO CLINICAL PRACTICE: The results of the research presented here provide valuable assistance in identifying areas related to patient safety in ICUs. Managers' awareness of the importance of coping with occupational stress, WC or effective teamwork can help to improve staff attitudes and attitudes towards patient safety. When shaping a safe culture in a health care organization, it is important to remember that ensuring safe patient care is not only about programmes, standards or procedures, but safety is primarily about human resources-the staff involved in the treatment process-doctors, nurses, paramedics and physiotherapists. High awareness of safety at work, cooperation in an interdisciplinary team, assessment of safety culture at work and analysis and drawing conclusions may result in a real increase in quality and safety, and the patient will feel safer in 'XX' hospitals.

Opinion of nurses of internal medicine wards regarding factors determining their work - observational and cross-sectional studies.

OBJECTIVES: The aim of the study was to assess the factors determining the work of nurses in internal medicine departments. METHODS: The study was multicentre, cross-sectional, and observational. The selection of the research group was intentional. The subject of the study were 209 nurses working in 11 internal medicine departments in 10 hospitals in the region of southern Poland. RESULTS: The number of patients cared for by one nurse, nurses' participation in the decision-making process, and nurses' age were shown to be direct predictors of emotional exhaustion. The number of patients cared for by a single nurse, nurses' participation in the decision-making process, and age were direct predictors of depersonalization. It was shown that significant (p < 0.05) independent (multivariate analysis) variables of the job satisfaction subscale were information on support for nurses at work by managerial staff and nurses' participation in the decision-making process. After analysing the impact of socio-demographic factors on the nurses' working environment, it was found that the participation of nurses in the decision-making process was significantly lower in the youngest group than in the other age groups (p = 0.006). CONCLUSIONS: Participation of nurses in the decision-making process is a direct determinant of occupational burnout. A higher number of patients under the care of a nurse, lack of participation in the decision-making process and a higher age of nurses are predictors of emotional exhaustion and depersonalization.

Evaluating Polish nurses' working conditions and patient safety during the COVID-19 pandemic.

AIM: To study the relationship between Polish nurses' working conditions and their attitudes towards patient safety during the COVID-19 pandemic. BACKGROUND: Facing the COVID-19 pandemic, caused by the SARS-CoV-2 virus, healthcare worldwide has been reorganised. How these changes affected patient safety for hospitalised persons is not well understood. INTRODUCTION: Difficult working conditions related to the outbreak of the COVID-19 pandemic may affect the provision of safe and effective care by healthcare staff. METHODS: This observational research was performed on the group of 577 nurses working during the COVID-19 pandemic in isolation infection wards (n = 201) and non-infectious diseases wards (n = 376) in Polish hospitals. The evaluation of working conditions was performed with an author's questionnaire, while the evaluation of factors influencing attitudes towards safety of the hospitalised patients was performed using Safety Attitudes Questionnaire. The STROBE checklist was used to report this study. RESULTS: The procedures developed by management in advance for COVID-19 patient treatment had a statistically significant influence on nurses' 'evaluation of teamwork climate, safety climate, job satisfaction, perception of management and work conditions'. Providing management with the ability to perform a swab polymerase chain reaction SARS-CoV-2 test for hospital staff in the workplace, and psychological support from professionals and employers were statistically significant for higher ratings of 'teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and work conditions' by the Polish nurses. Hospital workload during the COVID-19 pandemic was significantly correlated with lower evaluation of work conditions. DISCUSSION: Our study reinforces the existing literature on many fronts and demonstrates how even when operating under the COVID-19 pandemic conditions, some factors remain critical for fostering a culture of patient safety. Reinforcing patient safety practices is a imperative under these conditions. CONCLUSIONS AND IMPLICATIONS FOR NURSING: Working conditions influence nurses' attitudes towards safety of the hospitalised patients. These are largely modifiable factors related to the workplace and include prior preparation of procedures, restrictions to extending daily work hours and psychological counselling for the staff.

Coffee consumption and colorectal cancer risk: a dose-response meta-analysis on prospective cohort studies.

Evidence regarding the influence of coffee drinking on colorectal cancer (CRC) is limited, and it remains unclear whether coffee consumption is associated with the risk of the disease. To clarify this association, a comprehensive meta-analysis was performed. The risk of CRC was compared between the categories of coffee consumption, and a dose-response relationship was studied using restricted cubic splines. We did not find evidence for the association between coffee consumption and CRC risk. Among alternative study inclusions, when using pooled projects, coffee consumption was related with a decreased risk of colon cancer in a subgroup analysis of never-smokers and in Asian countries, and with an increased risk of rectal cancer in an analysis of the general population and after restriction to women, never-smokers, and European countries. In conclusion, the association between coffee consumption and CRC risk is controversial and should be clarified in further cohort studies.

Assessment of the occurrence of nosocomial infections in the Intensive Care Unit in the St. Lukas District Hospital in Tarnów in 2012-2016

INTRODUCTION: Healthcare-Associated Infections (HAI) are the cause of complications in the treatment process. The possibility of infecting a sick person in the Intensive Care Unit (ICU) is many times greater than in other hospital departments OBJECTIVES: The objective of the study was to investigate the epidemiological indicators and to determine the clinical types of HAI that are present in the ICU during the 5-year period in the St. Lukas District Hospital in Tarnów MATERIALS AND METHODS: HAI has been detected and documented in patients in ICU in the years 2012-2016 by the use of the active monitoring method. We studied patients who spent over 2 days in ICU with a general profile. These studies were conducted in accordance with the methodology recommended by Healthcare-Associated Infections Surveillance Network (HAI-Net) European Center for Disease Prevention and Control (ECDC) RESULTS: Among 886 patients who were hospitalized for a total of 6711 days, HAI was diagnosed in 195 patients (22.0% incidence rate), the incidence density rate was 29.1 per 1000 person-days of hospitalization. The rate for Ventilator-Associated Pneumonia (VAP) was 12.5 per 1000 ventilator days, for Central Line Associated Bloodstream Infection (CA-BSI) the rate was 8.2 per 1000 central line days, for Catheter-Associated Urinary Tract Infection (CA-UTI) the rate was 3.3 per 1000 urinary catheter days. The average duration of a patient stay in ICU was 24 days (19 days for patients without HAI and 43 days for patients with HAI). The following microorganisms isolated from HAI were prevailing: Acinetobacter baumannii 46 (27%), Staphylococcus aureus 12 (21%), Enterococcus faecalis 17 (10%) CONCLUSIONS: A five-year HAI study in ICU showed that the most common types of infections were bloodstream infections and pneumonia. The incidence rate of VAP remained at similar levels in subsequent years. The CA-BSI rates were reduced over the next three years of the study, but their rise in the last year can prove the lack of stability of the preventive actions. CA-UTI was detected twice less frequently, which can suggest poor detection of this type of infection

Emotional states and sleep disorders in adolescent and young adult cystic fibrosis patients.

The aim of the study was to evaluate level of anxiety, depression and aggression and the sleep quality among Polish adolescent and young adult suffering from cystic fibrosis including the evaluation of their FEV1. The study involved 70 patients both male and female aged between 14 and 25 and suffering from cystic fibrosis. Anxiety, depression and aggression were evaluated by means of Hospital Anxiety and Depression Scale and the quality of sleep was examined following Athens Insomnia Scale another aspect taken into consideration was patients' FEV1. The data analysis was carried out by means of Chi2, Kolmogorov-Smirnov test, Student's t-test, Fisher-Snedecor test, Pearson correlation coeficient. The level of statistical significance was set at p <0.05. Anxiety was observed in 27 (38.6%) cases, depression in 17 (24.3%) and aggression in 46 (65.7%) cases. Anxiety (p = 0.017) and aggression (p = 0.004) were significantly higher among women than among men. 37 (52.8%) patients reported sleep disorders. The findings proved that there is a connection between the quality of sleep and anxiety (r = 0.631; p = 0.000), depression (r = 0.621; p = 0.000) and aggression (r = 0.293; p = 0.014). No significant relationship was found between the quality of sleep and patients' expiratory volume. Emotional disorders such as anxiety, depression and aggression as well as sleep disorders are commonly reported in patients suffering from cystic fibrosis.

The risk factors for hospital-acquired pneumonia in the Intensive Care Unit.

INTRODUCTION: Patients in the intensive care units (ICU) are exposed to many factors that may cause hospital acquired pneumonia (HAP), a particular type of which is ventilator-associated pneumonia (VAP). The specific risk factors for developing VAP affect patients already on the day of their admission to a unit and are associated with their underlying diseases and invasive medical procedures, which they undergo. The aim of this study was to evaluate the risk factors for VAP associated with a patient and the used invasive treatment. MATERIAL AND METHODS: 1227 patients were subject to the retrospective analysis. These patients were hospitalized between 2010 and 2014 in Intensive Care Unit (ICU) in the St. Luke District Hospital in Tarnów. Data about procedures used in ICU were obtained from the electronic hospital registration system and the decursus from each day when a patient stayed in the hospital, while information about hospital infections was obtained from the periodic department reports prepared by the Infection Control Team. In the diagnosis of VAP infections the definitions of nosocomial infections issued by CDC (Centers for Disease Control and Prevention) and ECDC (European Center for Disease Prevention and Control) were used. RESULTS: In the analyzed unit, 58 cases of VAP were detected in patents who underwent mechanical ventilation. Infections were more common among men (43 cases, that is 6%) than in women (15 cases, that is 3%). Mechanical ventilation longer than 20 days was a major determinant of VAP (p < 0.001). Patient's underlying diseases (which are the reason for patient's admission to a unit) had an impact on the incidence of VAP, and the most important of them are: multiple trauma (20 cases of VAP per 217 patients (9.2% incidence)), sepsis (3 cases of VAP per 31 patients (9.7% incidence)), central nervous system disease (10 cases of VAP per 124 patients (8.1% incidence)), endocrine system (1 case of VAP per 12 patients (8.3% incidence)), respiratory diseases (11 cases of VAP per 168 patients (6.5% incidence)). Invasive medical procedures performed in the patients' respiratory tract were significant risk factors (p < 0.001) for developing VAP: reintubation (R=0.271), tracheostomy (R=0.309) and bronchoscopy (R=0.316). In the period from 2010 to 2014 VAP incidence was 4.7% and incidence density per 1000 ventilation-days was 10.5 and the mortality rate with VAP was 32.8%. The most common etiological factors of VAP were Acinetobacter Baumannie (21 isolates, that is 36.4%), Pseudomonas aeruginosa (8 isolates, that is 13.8%), Escherichia coli (7 isolates, that is 12%).

Level of knowledge among medical personnel about infections transferred through direct contact--results of questionnaire survey.

INTRODUCTION: Nosocomial infections are an important issue all over the world. The most important vector for transmitting infections in a hospital are the hands of the medical personnel, which is why their adequate hygiene is an essential prevention method. THE AIM OF THE STUDY: was to evaluate the medical personnel's level of knowledge on the prevention of nosocomial infections transferred through direct contact. MATERIAL AND METHODS: The diagnostic survey method with a proprietary questionnaire was used for the research. The research was conducted between May and June 2013 on a group of 100 randomly chosen medical workers of one of Cracow hospitals (nurses, doctors and paramedics). The age of the interviewees ranged from 23 to 60 years old. RESULTS: Despite the fact that most of the respondents took part in courses related to nosocomial infections and declared the will to take part in more courses related to this issue, the level of knowledge of the medical personnel on the prevention of nosocomial infections transferred through direct contact and the post-exposure procedures is insufficient. Only 28.0% of the respondents knew that the dominant hand decontamination method according to WHO is disinfection, 22.0% of the surveyed medical personnel admitted that they put covers on needles after they performed the injection and 11.0% of the interviewees mentioned that they change the gloves before contact with the patient only sometimes. CONCLUSIONS: The surveyed group has not demonstrated a sufficient knowledge of the rules of preventing infections transferred through direct contact and the post-exposure procedures. The level of knowledge of the surveyed medical personnel was dependent on, e.g., years of experience and taking part in courses on nosocomial infections.

Gender differences in the quantitative and qualitative assessment of chronic pain among older people.

Background: Pain, regardless of its causes, is a subjective and multidimensional experience that consists of sensory, emotional and cognitive factors that cannot be adequately captured by a single number on a pain scale. The aim of the study was to understand gender differences in the assessment of quantitative and qualitative chronic pain among older people. Methods: The study used a questionnaire that included questions about demographic and social characteristics as well as the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Depression Scale (GDS-15), McGill Pain Questionnaire (MPQ). Results: The pain rating index based on rank values of adjectives was higher among women than men (18.36 ± 7.81 vs. 17.17 ± 9.69, p = 0.04). The analysis of the frequency of selection of individual adjectives describing the sensory aspects of pain showed that men described the pain as "stabbing" more often than women (26.1% vs. 14.3%, p < 0.05). Women chose adjectives from the emotional category more often than men (59.8% vs. 75.4%, p < 0.05), describing the pain as "disgusting" (8.9% vs. 1.4%, p < 0.05), "unbearable" (19.6 vs. 4.3, p < 0.05). In the subjective category, there was a difference between women and men in terms of describing pain as "terrible" (23.2% vs. 7.2%, p < 0.05) and as "unpleasant" (11.6% vs. 23.3%, p < 0 0.05). Conclusion: When referring to pain, women tend to employ more detailed and factual language, indicative of heightened emotional sensitivity. Men tend to use fewer words and focus on the sensory aspects of pain. Subjective aspects of pain were demonstrated by both women and men.

Professional challenges of nurses working during the SARS-CoV-2 virus pandemic.

OBJECTIVES: The diverse list of tasks and needs related to the SARS-CoV-2 pandemic may lead to different professional experiences in nurses working with patients infected with and not infected with SARS-CoV-2. The aim of the study was to measure the professional challenges of nurses working during the SARS-CoV-2 pandemic in Poland. MATERIAL AND METHODS: The study was conducted in 2021 in a group of 151 nurses. The following scales were used: the Perceived Stress Scale (PSS-10), the General Self-Efficacy Scale (GSES), the Impact of Event Scale - Revised (IES-R), the Minnesota Satisfaction Questionnaire (MSQ-SF), the Areas of Worklife Survey (AWS) and the Maslach Burnout Inventory - Human Services Survey (MBIHSS). RESULTS: Nurses working with patients infected with SARS-CoV-2 showed a positive correlation between workload and emotional exhaustion (ρ = 0.26, p = 0.02), as well as positive correlations among control, community and depersonalization (ρ = 0.25, p = 0.02; ρ = 0.23, p = 0.04). Among nurses working with uninfected patients, positive correlations were found among control, community, fairness and emotional exhaustion (ρ = 0.40, p = 0.000; ρ = 0.41, p = 0.000; ρ = 0.25, p = 0.03), as well as correlations between control and depersonalization (ρ = 0.33, p = 0.01), and among control, community and personal accomplishment (ρ = 0.23, p = 0.05; ρ = 0.27, p = 0.02). CONCLUSIONS: Nurses working during the SARS-CoV-2 pandemic with infected and uninfected patients both experienced a variety of psychosocial challenges in coping with the demands of their work, social relationships and personal life. Int J Occup Med Environ Health. 2023;36(1):112-24.

Nurses' intention to leave their jobs in relation to work environment factors in Polish hospitals: Cross-sectional study.

BACKGROUND: The lack of nursing staff is a current problem not only in Poland, but also in the world. The decision of nurses to leave the workplace, apart from the financial aspect, often results from unfavourable working conditions related to the work environment. MATERIAL AND METHODS: The study was multicentre, cross-sectional. The study was conducted among a group of 1509 nurses employed in surgical and internal medicine wards in 21 hospitals in Poland. The key variables of the study were: the intention of the nurses to leave their jobs, the nurses' working environment, the level of satisfaction, the level of occupational burnout and the number of patients cared for on the last shift, the number of nurses on the last shift. The Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Maslach Burnout Inventory (MBI) questionnaire were used in the research. RESULTS: Almost half of the surveyed nurses (48.84%) declared their willingness to leave their current workplace. The statistical analysis showed that nurses declaring their willingness to quit their job in the hospital where they were employed were significantly younger (42.88 vs. 45.04, p = 0.000), had shorter total length of service overall (19.96 vs. 23.20), and also in the hospital where they were employed (15.86 vs. 18.50, p = 0.000). The increase in the number of patients by one was significantly associated with a 1% increase in the risk of leaving work (OR = 1.01, 95% CI 1.00-1.02). An increase in emotional exhaustion significantly increased the risk of leaving work by 2% (OR = 1.02, 95% CI 0.99-1.03). CONCLUSIONS: Younger age of nurses, greater workload resulting from more patients and occupational burnout - emotional exhaustion is correlated with the risk of leaving work in the hospital. A lower risk of leaving the job is associated with a higher level of job satisfaction in the hospital, salary and promotion opportunities. Med Pr Work Health Saf. 2023;74(5):377-87.

Comparative Analysis of the Incidence of Selected Sexually Transmitted Bacterial Infections in Poland in 2010-2015: A Retrospective Cohort Study.

Sexually transmitted infections are common infectious diseases. The main aim of this study was to perform a comparative analysis of the incidence of bacterial sexually transmitted infections in 2010-2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and constituted information being the epidemiological surveillance system in Poland. The analysis included data on the incidence of primary and secondary syphilis, gonorrhoea and non-gonococcal urethritis and genital infections. The overall incidence rates were disproportionately lower than European rates and those presented in studies from other countries. Young people, between 20 and 29 years of age, were the key groups at the highest risk of infection. The incidence rate of primary and secondary syphilis was lower in Poland than in Europe or America, but some regions, such as Mazovia and Lodz provinces, were found to have a higher incidence rate than other European rates. The reported incidence of gonorrhoea in Poland was also significantly lower compared with other countries, with a significantly higher number of infections in males than in females, and this was also one of the highest rates in EU countries. During the study period, the number of non-gonococcal genital infections systematically decreased, while in other countries of the European region, the incidence was among the highest of all sexually transmitted infections.

Nutritional Status Disorders and Selected Risk Factors of Ventilator-Associated Pneumonia (VAP) in Patients Treated in the Intensive Care Ward-A Retrospective Study.

INTRODUCTION: The development of pneumonia in patients treated in intensive care wards is influenced by numerous factors resulting from the primary health condition and co-morbidities. The aim of this study is the determination of the correlation between nutritional status disorders and selected risk factors (type of injury, epidemiological factors, mortality risk, inflammation parameters, age, and gender) and the time of pneumonia occurrence in patients mechanically ventilated in intensive care wards. MATERIAL AND METHOD: The study included 121 patients with injuries treated in the intensive care ward who had been diagnosed with pneumonia related to mechanical ventilation. The data were collected using the method of retrospective analysis of patients' medical records available in the electronic system. RESULTS: Ventilator-associated pneumonia (VAP) occurred more frequently in patients over 61 years of age (40.4%), men (67.8%), after multiple-organ injury (45.5%), and those with a lower albumin level (86%), higher CRP values (83.5%), and leukocytes (68.6%). The risk of under-nutrition assessed with the NRS-2002 system was confirmed in the whole study group. The statistical analysis demonstrated a correlation between the leukocytes level (p = 0.012) and epidemiological factors (p = 0.035) and the VAP contraction time. Patients infected with Staphylococcus aureus had 4% of odds for the development of late VAP in comparison to Acinetobacter baumannii (p < 0.001), whereas patients infected by any other bacteria or fungi had about four times lower odds of the development of late VAP in comparison to Acinetobacter baumannii (p = 0.02). Patients with results in APACHE from 20 to 24 and from 25 to 29 had 13% and 21%, respectively, odds of the development of late VAP in comparison to patients with APACHE II scores ranging from 10 to 19 (respectively, p = 0.006; p = 0.028). CONCLUSIONS: The development of VAP is impacted by many factors, the monitoring of which has to be included in prophylactics and treatment.

Hematopoietic and Lymphoid Cell Neoplasms in Children as a Factor Inducing Negative Emotions and Toxic Stress in Parents.

Parents whose children suffer from cancer experience chronic negative emotions, which may have a detrimental influence on their mental health. The aim of this study, conducted with a group of parents whose children were hospitalized for leukemia or lymphoma, was to assess stress, anxiety, depression, aggression and stress coping strategies as well as the correlations that take place between them. The study was conducted with a group of 101 parents of early school children (aged between 7 and 12) who were hospitalized for cancer in three medical centers in southern Poland. The HADS -M, PSS-10 and COPE questionnaires were used in the study. Mothers were found to experience higher levels of anxiety, depression and stress as compared to fathers. It was more common for men to resort to the strategy of substance use. Socio-demographic variables did not determine the examined emotions, the level of stress and the choice of stress coping strategies, with the exception of the strategy of suppression of competing activities. A positive relationship was found between the incidence of negative emotions and the selected strategies of coping with stress. Early diagnosis of disorders and assessment of parents' strategies of coping might help to counteract long-term consequences of trauma.

Comparative Analysis of the Incidence of Selected Sexually Transmitted Viral Infections in Poland in 2010-2015: A Retrospective Cohort Study.

Sexually transmitted infections (STIs) represent a major cause of morbidity in women and men worldwide. The main aim of this study was to perform a comparative analysis of the incidence of sexually transmitted viral infections in 2010-2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and the National Institute of Public Health-National Research Institute and constituted information from the epidemiological surveillance system in Poland. We collected data on the incidence of the following diseases: genital herpes (HSV), genital warts, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). The key groups with the highest risk of infection were young people between 20 and 29 years of age. The reported data on the incidence of genital herpes in Poland (n = 3378; 1.5/100,000) showed a downward trend, which does not coincide with global trends. Genital warts were the most frequent genital infections in Poland (n = 7980; 3.46/100,000), with significant regional variation. Over the analysed period, the situation of newly detected HIV infections seemed to be stable (n = 7144; 3.1/100,000). The incidence of these infections appeared to be highly correlated with urbanisation rates, which was not confirmed in the case of other analysed infections. The worsening epidemic situation with respect to sexually transmitted infections, the inefficiency of the current surveillance system and the reduction in funding for diagnosis and prevention, combined with inadequate legal solutions, make it necessary to undertake new legal and organisational measures aimed at improving the reproductive health in Poland in terms of sexually transmitted infections.

Factors Influencing the Rationing of Nursing Care in Selected Polish Hospitals.

Introduction: The rationalization of nursing care can be a direct consequence of the low employment rate or unfavorable working environment of nurses. Aim: The aim of the study was to learn about the factors influencing the rationing of nursing care. Methods: The study group consisted of 209 nurses working in internal medicine departments. The study used the method of a diagnostic survey, a survey technique with the use of research tools: the BERNCA-R questionnaire and the PES-NWI questionnaire (which includes the occupational burnout questionnaire). Results: The mean total BERNCA score for rationing nursing care was 1.94 ± 0.75 on a scale from 0 to 4. A statistically significant relationship was demonstrated between the work environment and the rationing of nursing care. The results of the BERNCA-R scale correlated statistically significantly and positively (r > 0) with two (out of three) subscales of the occupational burnout questionnaire (MBI­Maslach Burnout Inventory): emotional exhaustion and depersonalization (p < 0.001), and with all types of adverse events analyzed (p < 0.05). Conclusions: The higher the frequency of care rationing, the worse the assessment of working conditions by nurses, and, therefore, more frequent care rationing determined the more frequent occurrence of adverse events. The more frequent the care rationing, the more frequent adverse events occur.

Caring Ability and Professional Values of Polish Nursing Students-A Cross-Sectional Study.

Caring ability and professional values developed and shaped during nursing university studies are often recognised as fundamental components of education and professional nursing attitudes. The aim of this study was to analyse the relationship between caring ability and professional values among nursing students and their correlation with selected sociodemographic variables. A cross-sectional study was conducted among a convenience sample of 379 nursing students. During the research, the Polish versions of the Caring Ability Inventory and the Professional Values Scale were used. The overall result in the Professional Values Scale was 108.78 (SD = 16.17)-which is considered average, and in the Caring Ability Inventory 189.55 (SD = 18.77)-which is considered low. Age correlated negatively with the professional values of students in total and in the subscale "care"; in contrast, "gender", "place of residence" and "financial situation" did not show any correlation with the level of students' professional values and caring ability. The professional values and caring abilities of nursing students depended on the year and mode of study and the type of university. The results of the study revealed that the caring ability and professional values of nursing students undergo changes during their education.

Cytotoxicity of Aspergillus fungi isolated from hospital environment.

The majority of mycotoxins produced by Aspergillus fungi are immunosuppressive agents, and their cytotoxicity may impair defense mechanisms in humans. The objective of the study was evaluation of the cytotoxicity of fungi isolated from an environment where inpatients with impaired immunity were present. The materials comprised 57 fungal strains: Aspergillus fumigatus, Aspergillus niger: Aspergillus ochraceus, Aspergillus flavus, Aspergillus versicolor and Aspergillus ustus isolated from hospital rooms in Cracow. The cytotoxicity of all the strains was evaluated using the MTT test (3-(4,5-dimethylthiazol-2-yl) 2,5 diphenyltetrazolium bromide). To emphasize the differences in cytotoxicity among the particular strains, variance analysis (ANOVA) and Tukey's difference test were used. Out of 57 Aspergillus strains tested, 48 (84%) turned out to be cytotoxic. The cytyotoxicity was high (+++) in 21 strains, mainly in A. fumigatus. The least cytotoxic were A. niger fungi, this being statistically significant (p<0,05). To protect a patient from the adverse effects of mycotoxins, not only his or her immunity status should be evaluated but also the presence of fungi in hospital environment and their cytotoxicity should be monitored (possible exposure).