ASSESSMENT OF THE KNOWLEDGE AND ATTITUDES OF NURSES ON THE SKIN CONDITION AND TREATMENT OF DAMAGE

Iskustva iz prakse i brojna istraživanja pokazuju da prvostupnici sestrinstva nakon završenog studija nisu sigurni u samostalnoj procjeni i tretiranju rana. Čini se da je tijekom sestrinskog obrazovanja potrebno više usko specijaliziranih nastavnih sadržaja u tom području, više praktičnih vještina te povezanosti prvostupnika sa stručnjacima iz prakse koji prate standarde i smjernice iz područja cijeljenja rana. Cilj ovog istraživanja je procjena znanja putem testa znanja i stavova medicinskih sestara/studenata studija sestrinstva o stanju kože i tretmanu oštećenja. Također je cilj ovog rada spoznati moguće smjernice u budućem sadržaju kurikuluma studija sestrinstva u Hrvatskoj. Istraživanje je provedeno na uzorku od 71 studenta Studija sestrinstva Sveučilišta Sjever (M 6 - 8,5 %), (Ž 65 - 91,5 %). Ispitanici su dobrovoljno i anonimno ispunili anketu elektronskim putem. Korišten je polustrukturirani standardizirani upitnik “Test znanja o osnovama dekubitusa u gerijatrijskih bolesnika” koji je izradio Centar za zdravstvenu gerontologiju NZJZ „Dr. Andrija Štampar” – Referentni centar Ministarstva zdravlja Republike Hrvatske za zaštitu zdravlja starijih osoba. Provedeno ispitivanje znanja na uzorku studenata sestrinstva pretežno mlađe dobi (18-25 godina) (64, 8%) pokazuje točnost odgovora na 12 postavljenih pitanja testa znanja u rasponu od 17,9 % do 100 % (med. 60,6 %, st.dev. 24,1, Q1 53,8 %, Q3 81 %). Odgovori na 13. pitanje „u svakodnevnom radu s pacijentima“ 39,4 % studenata poznaje i često koristi suvremeni pristup prevenciji i tretmanu dekubitusa, podjednaki postotak studenata rijetko koristi suvremeni način prevencije i liječenja dekubitusa, 26,8 % ne poznaje navedenu tematiku, a 2,8 % nije zainteresirano. Na 14. pitanje „S obzirom na postojeće sadržaje o tretmanu dekubitusa u obrazovanju studenata sestrinstva“ 47,9 % ispitanika smatra da im je potrebno više praktičnih vještina u zbrinjavanju i prijevoju dekubitusa, 45,1 % smatra da je potrebno u redovne kolegije uvesti sadržaje o tretmanu dekubitusa, a 8,5 % ispitanika smatra da nije potrebno uvoditi dodatne sadržaje, jer ima dovoljno znanja o tretiranju rana. Rezultati ukazuju da postoji relativno zadovoljavajuće djelomično znanje o procjeni stanja kože, preventivnim mjerama i tretiranja dekubitusa kod osoba starije dobi, no i da je potrebno više praktičnih vještina u zbrinjavanju i prijevoju dekubitusa suvremenim oblogama, što se može smatrati smjernicama za buduće obrazovne sadržaje Studija sestrinstva. Temeljem jednostavnog i standardnog upitnika, na relativno širokom uzorku studenata sestrinstva Sveučilišta Sjever, može se prilično dobro procijeniti znanje studenata o prevenciji i tretmanu dekubitusa suvremenim metodama. Defi citarno praktično znanje na polju suvremenog tretmana dekubitusa, nedostatak revizije stručne literature u smislu suvremenih smjernica i teorija te oskudna suradnja znanstveno-obrazovnih i zdravstvenih institucija, ključni su problemi nedovoljnog znanja prvostupnika sestrinstva u svakodnevnom ranu s tretmanom kroničnih rana. Nesigurnost u preventivnim i terapijskim mjerama suvremenog tretmana dekubitusa kod prvostupnika sestrinstva pokazuje mogući smjer za buduće obrazovne sadržaje Studija sestrinstva. Potrebna su daljnja slična istraživanja s ciljem detaljnijeg uvida u procjenu praktičnog i teorijskog znanja prvostupnika o suvremenoj skrbi pacijenata s kroničnim ranama.Practical experience and numerous studies have shown that, after fi nishing their studies nursing graduates are not sure in their independent assessment and treatment of wounds. It appears that nursing education lacks narrowly specialized educational content in this area, practical skills and connection between graduates and experts who follow the standards and guidelines in the area of wound healing. The aim of this study was to assess the knowledge through tests and attitudes of nurses/nursing graduates on the condition of the skin and damage treatment. In addition, the study was also aimed at learning about possible guidelines for the future content of the nursing curriculum studies in Croatia. The study was conducted on a sample of 71 students (six (8.5%) male and 65 (91.5%) female of Nursing Studies at University North. The subjects voluntarily and anonymously completed the survey electronically. A semi-structured standardized questionnaire was used, “Knowledge test about the basis of pressure ulcers in geriatric patients”, designed by Dr Andrija Štampar Department of Health Gerontology, Reference Center for Health Care of the Elderly of the Ministry of Health of the Republic of Croatia. The test administered to the sample of students of nursing, mostly aged 18-25 (64.8%) showed correct answers to 12 questions asked, in a range of 17.9% to 100% (median 60.6%, SD 24.1, Q1 53.8%, Q3 81%). Answers to question 13 (daily work with patients) revealed that 39.4% of students knew and often used modern approach to the prevention and treatment of pressure ulcers; the same percentage of students rarely used modern method of prevention and treatment of pressure ulcers, 26.8% were not familiar with the issue, while 2.8% were not interested in it. As for question 14 (given the existing contents on the treatment of pressure ulcers in the educational program for students of nursing), 47.9% of study subjects believed they needed more practical skills in treating pressure ulcers, 45.1% considered it necessary to introduce more contents on the treatment of pressure ulcers in regular courses, while 8.5% believed it was not necessary to introduce additional contents because there was enough knowledge on wound treatment. The results indicated that there was a relatively satisfactory partial knowledge to assess skin condition, prevention measures and treatment of pressure ulcers in the elderly, but also that more practical skills were needed in the treatment and modern dressing application, which can be considered as guidelines for future educational contents in the nursing studies. Based on the simple and standardized survey in a relatively broad sample of students of Nursing Studies at University North, student knowledge on the prevention and treatment of pressure ulcers with modern methods can be well assessed. Scarce practical knowledge in the fi eld of modern pressure ulcer treatment, the lack of professional literature revision in terms of modern guidelines and theories, as well as poor collaboration of scientifi c educational and health institutions are the key problems of insuffi cient knowledge of nursing graduates in daily work of treating chronic wounds. Student insecurity related to prevention and therapy in modern treatment of pressure ulcers show a possible direction for future educational contents of nursing studies. Additional similar studies are warranted in order to get a more detailed insight into assessment of practical and theoretical knowledge of graduates about modern care of patients with chronic wounds