ANALYSIS OF PATIENTS WITH HEART FAILURE IN YEAR 2008

Srčno popuščanje povzroča veliko zbolevnost in umrljivost. Prognozo lahko izboljšamo s hitro diagnostiko in pravilnim farmakološkim in nefarmakološkim zdravljenjem (Keber, 2003, str. 135). V prvem delu diplomske naloge smo predstavili zgradbo in delovanje krvnih obtočil, značilnosti srčnega popuščanja, diagnostično obravnavo in zdravljenje pacientov s srčnim popuščanjem, ter najpogostejše pridružene bolezni pri srčnemu popuščanju. Opisali smo tudi vlogo medicinske sestre in življenje pacientov v domačem okolju. V drugem delu diplomskega dela smo opravili analizo, ki je zajela 250 naključno izbranih pacientov s srčnim popuščanjem, ki so bili v letu 2008 obravnavani na Internistični prvi pomoči v Splošni bolnišnici Celje. Zanimali so nas: spol, starost, čas pregleda, zdravstveno stanje pacientov ob pregledu, najpogosteje opravljene preiskave, pridružene bolezni, število sprejetih pacientov na oddelek in umrljivost pacientov s srčnim popuščanjem. Za obdelavo podatkov o pacientih s srčnim popuščanjem, smo uporabili retrospektivno analizo. Podatke smo pridobili iz informacijskega sistema Splošne bolnišnice Celje (Birpis 21), iz sprejemne zdravstvene dokumentacije pacientov. Diplomsko delo smo razširili z raziskavo, ki je temeljila na kvantitativni metodologiji. Izdelali smo anonimni anketni vprašalnik, ki je bil sestavljen iz 18-ih vprašanj zaprtega tipa. Ankete smo razdelili med 80 diplomiranih medicinskih sester in zdravstvenih tehnikov. Želeli smo ugotoviti, kakšna je seznanjenost medicinskih sester in zdravstvenih tehnikov s simptomi in znaki srčnega popuščanja ter kakšno je poznavanje lestvic za oceno srčnega popuščanja. Z analizo pridobljenih podatkov smo ugotovili, da je bil odstotek pacientov sprejetih na intenzivni interni oddelek nizek. Iz tega lahko sklepamo, da je za najbolj ogrožene paciente ustrezno strokovno poskrbljeno že na terenu in kasneje tudi na Internistični prvi pomoči. Ugotovili smo tudi, da je nižji odstotek opravljenih ultrazvočnih preiskav in določanja BNP v krvi pri pacientih, katere smo obravnavali, kar bi lahko pripisali pomanjkanju specialistov kardiologov na Internistični prvi pomoči. Z anketo smo želeli ugotoviti tudi splošno seznanjenost medicinskih sester in zdravstvenih tehnikov s srčnim popuščanjem in njihovo poznavanje lestvic za oceno srčnega popuščanja. Odgovori so nas je presenetili, saj smo v povprečju dobili nizke rezultate pravilnih odgovorov. Ugotovili smo, da medicinske sestre in zdravstveni tehniki lahko le z dobrim strokovnim znanjem in usposobljenostjo pomembno pripomorejo k čim boljši obravnavi pacientov s srčnim popuščanjem.Heart failure causes severe morbidity and mortality. Prognosis can be improved with rapid diagnosis and proper pharmacological and non pharmalcological treatment (Keber, 2003, page. 135). In the first part of the thesis, we presented the structure and functioning of the circulatory system of blood, heart failure characteristics, diagnostic treatment and treatment of patients with heart failure and the most common disease associated with heart failure. We also described the role of nurses and patients living at home. In the second part of the thesis, we conducted the analysis, which covered 250 randomly selected patients with heart failure who were treated in 2008 at the first aid Internal General Hospital Celje. We were interested in: sex, age, time of examination, the health status of patients at review, the most commonly performed tests, associated diseases, the number of patients taken to the department and mortality in patients with heart failure. The processing of data on patients with heart failure, we used a retrospective analysis. Data were obtained from the information system of the General Hospital of Celje (Birpis 21), in patients receiving medical documentation. The thesis was expanded to the survey, which was based on qualitative methodology. We developed an anonymous questionnaire, which consisted of 18-s closed questions. Surveys were distributed among 80 nurses and medical technicians. We wanted to find out what knowledge nurses and medical technicians the symptoms and signs of heart failure, and how it scales to assess knowledge of heart failure. By analyzing the data obtained, we found that the percentage of patients taken to house low-intensive section. It can be concluded that the most vulnerable patients have adequate professional care in the field and later on internal first aid. We have also found that a lower percentage of ultrasound examinations and determination of blood BNP in patients who were treated, which could be attributed to a lack of specialist cardiologists of internal first aid. The survey was to determine the general awareness of nurses and medical technicians with heart failure and their knowledge of scales for the assessment of heart failure. The responses surprised us, because we got low results of correct answers. We found that nurses and medical technicians can with the help of their professional knowledge and skills help to optimize the treatment of patients with heart failure