Journal of Nursing Theory and Practice

[The role of nurses and their tasks in early sepsis management]

VÁRADI Annamária, FEHÉR Gábor, FÖMÖTÖR Péter

JUNE 30, 2019

Journal of Nursing Theory and Practice - 2019;32(03)

[The Surviving Sepsis Guideline (SSG) is a document that proposed new solutions in the diagnostics and treatment of sepsis. The methods identified were the 100% oxygen therapy, fluid resuscitation, blood culture and microbiological analysis, empiric combination antibiotic therapy, lactate monitoring, comparison of PCT and CRP, and surgical opening. Using the above mentioned methods has proven to improve the quality of sepsis treatment and the safety of patients. Sepsis -6 protocol has been highlighted by the authors as a process that is easy to implement in terms of cost while remaining highly beneficial. This recommendation should also be well known for nurses that do not work in emergency units. This will help recognise sepsis at an early stage, and provide guideline in the analytical examination and the possibilities within the competence. ]



Further articles in this publication

Journal of Nursing Theory and Practice

[Understanding the past may help to shape the future (’Medical tasks, delegation and nursing’ - the past, present and the way forward)]

SÖVÉNYI Ferencné

[The history of nursing in Hungary has an aspect that has often been addressed but never looked into to the required depth and detail. This aspect concerns the regulation by law of certain specific relations between medicine and nursing from the mid-twentieth century to date. This issue has now come to the fore due partly to amendments to the legal framework and partly to changes in nursing education. ]

Journal of Nursing Theory and Practice

[Postoperative pain management today in Hungary - Part 2 ]

LOVASI Orsolya, LÁM Judit

[According to the literature, the practice of postoperative pain relief in Hungary is an area to be developed. Postoperative pain is a key issue for patients. Surveys show that more than 59% of patients are worried about postoperative pain. Their concerns are not baseless, as recent studies have consistently shown that pain has not been properly treated after surgery. It has also been shown that postoperative pain can lead to a deterioration in the quality of life of patients. The aim of our study was to assess the degree of postoperative pain in patients and their satisfaction with pain relief. We conducted interviews based on personal inquiries with a total of 168 patients, with the involvement of certain surgical departments of three Hungarian institutions. Based on our results, we found that patients report remarkable pain after surgery, so the practice of postoperative pain relief is in many cases unsatisfactory. Comparing the results and the international literature, postoperative analgesic practice can be considered as an area to be developed. ]

Journal of Nursing Theory and Practice

Nurses‘ competences in preventive cardiology

IVANA Chloubová, VALÉRIE Tóthová

Introduction: The nurse education in the Czech Republic is based on the recommendations of the European Union, respecting the outcoming knowledge and skills of general nurses, formulated in basic competence criteria. Cardiovascular diseases rank among the main causes of death not only in many developed countries, but also in developing countries. Accent should be put on prevention of these diseases and the nurses should provide for efficient education. Goals and methods: The goal of the article consists in presenting the results of the analysis of the available sources focused on nurse education and the resulting competences in the field of cardiology, as well as in describing the system of health-educational activities of nurses in preventive cardiology in selected EU countries. The methods of research and structured interview were used. Results: The nurse‘s task in prevention of cardiovascular diseases consists in educating the public on influenceable risk factors which have significant impact on the incidence of cardiovascular diseases, but also on people‘s quality of life. It is important to alert the people to changes in their own risk behaviours and to motivate them to activities leading to improved life style. Conclusion: It can be concluded that the nurses in preventive cardiology make use of the competences acquired through pregradual studies. However, the current practice requires increasing competences within postgradual education.

Journal of Nursing Theory and Practice

[Regulation of the Legal and Extent Competence for Nurse’s at Healthcare in Slovakia ]


[The nursing competencies changed in Slovakia during 2018. One of the main goals of today’s nursing training is to ensure that nurses fully meet the needs of today’s society. According to the new regulation in Slovakia, it divided nurses into three categories. The aim of this article is, to explain what changes occurred in the competencies over the past year. ]

Journal of Nursing Theory and Practice

[Primary Health Care experts and practitioners discussed in Pécs - 3rd National Conference on Primary Health Care]

HIRDI Henriett Éva, LUKÁCS Miklós, IZSÁK Szekeresné Margit, BALOGH Zoltán

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[Assessment of severity and time course of critical illness neuropathy in septic patients: a prospective observational study]


[Objective - In this prospective observational study we investigated electrophysiological alterations in the early phase of critical illness and correlated electrophysiological findings with the clinical picture and outcome. Methods - We enrolled 21 critically ill surgical patients having ≥12 Acute Physiology and Chronic Health Evaluation (APACHE) II scores on admission. Routine non-invasive bilateral electroneurography (ENG) examination of median and ulnar nerves was done on five consecutive days starting in two days after admission. Then weekly follow-up was performed. Motor and sensory nerve conduction indices were calculated and correlated with APACHE II and Simplified Acute Physiology Score II severity scores. Results - On the first examination 18/21 patients had >20% reduction in the motor and sensory nerve conduction indices. Severity score systems showed significant negative correlation with the daily change of CMAP and SNAP amplitudes and calculated nerve conduction indices (Spearman’s correlation, p<0,001). Mortality was higher in the patients with worse admission ENG and/or stagnant electrophysiological status or declining tendency in the first week. Conclusions - Electrophysiological alterations appeared soon after the development of critical illness. Early phase alterations showed a strong correlation with patients’ general condition and more severe electrophysiological alterations predisposed to higher mortality. In several cases early alterations proved to be reversible. ]

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[Assessment of multidisciplinary teams in psychiatric care – Lessons of three focus groups ]

MOLNÁR László, ZANA Ágnes, GYŐRFFY Zsuzsa, SZVATH Petra

[Our research group, has studied psychiatric and psycho­the­ra­peutic teams since 2015. The aim of the present research was to identify the Hun­garian characteristics of team composition and operation. Qualitative focus group survey has been conducted on the operation of multidisciplinary teams at the annual conferences of the Hungarian Psychiatric Society in 2017, 2018 and 2019. These three groups focused on the issues of leadership, communication within the team, and competencies. The groups of an average of 17 people formed spontaneously by participation of professionals with different qualifications. The main results of the focus groups were as follows: 1. The various ty­pes of leadership within the team require the distribution and allocation of res­pon­si­bilities and roles and stop the dest­­ruc­tions. 2. Wi­thin the teams there are pre­vai­ling the informal channels of communication. 3. It is im­portant to clarify com­petencies and responsibilities. 'Actually, psy­chiat­ric spe­cia­lists' list of competencies there is not available in Hungary. It seems necessary to define more precisely and reconsider the professional competences of the specialized training in psychiatry and integrating these in the education, further promote the development of „list of competences in psychiatric specialization” by the legislators. The second phase of the research continues as a quantitative study based on the foregoing results gained by questionnaires. ]

Journal of Nursing Theory and Practice

[Practical role of nurses in early recognition in sepsis and curing process]

TÓTH Zoltánné

[Aim of the research: The aim of my research is to show detailed analysis of clinical categorizing of sepsis and clarifying its diagnostic difficulties. The study shows the elements of diagnostic and monitoring methodology during attendance including the importance of triage. Research and sampling methods: The research was done in a III progressive level hospital in the capital at the Emergecy Department emphasizing one group of illness: sepsis. 81 patients were analysed according to the 2013 data turnover. The method of the research is based on different document analysis and data gathering. In parallel with it, in the following parts of the study I was examining the competences of nurses with different qualifications at the department who were doing triage activity during attendance.Evaluation of the summarized results was created by SPSS 14.0 programme. Results: It was proved from the summarized data that triage activity done by nurses with septic patients was not influenced neither by professional experience nor by qualification of the nurses. More than half of the patients at the departments was not given the correct classification so they were not given the therapy in time. Conclusions: Nurses at the emergency department do not have the necessary knowledge on classification system of triage , that is why each nurse at the department must have the opportunity to improve their knowledge on triage or those not having it must acquire both theoretical and practical knowledge. ]

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[Critical illness associated neuromuscular disorders - Keep them in mind]

NEMES Réka, MOLNÁR Levente, FÜLEP Zoltán, FEKETE Klára, BERHÉS Mariann, FÜLESDI Béla

[Neuromuscular disorders complicating sepsis and critical illness are not new and scarce phenomena yet they receive little attention in daily clinical practice. Critical illness polyneuropathy and myopathy affect nearly half of the patients with sepsis. The difficult weaning from the ventilator, the prolonged intensive care unit and hospital stay, the larger complication and mortality rate these disorders predispose to, put a large burden on the patient and the health care system. The aim of this review is to give an insight into the pathophysiological background, diagnostic possibilities and potential preventive and therapeutic measures in connection with these disorders to draw attention to their significance and underline the importance of preventive approach.]

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[In our current understanding sepsis is a systemic inflammatory response syndrome to infections mediated by cytokines, an uncontrolled progression which may result in multiorgan failure and in the final stage septic shock. There are no pathognomic clinical signs or laboratory parameters in the early stage of sepsis and the diagnosis can be easily missed if the possibility is overlooked. One of the crucial points of therapy is early diagnosis: the mortality rate of severe sepsis is about 20% and that of septic shock is about 40-50%. The cornerstones of the therapy are the eradication of the focus of sepsis (surgical intervention and antimicrobial treatment), standard intensive care and the intervention in the pathophysiological process of sepsis. For successful treatment a multidisciplinary approach is required: only the early diagnosis and the teamwork of different specialists can decrease the mortality rate that is higher in Hungary than the international average.]