Abstract: The growing complex of organizations and the new demand for people's health care lead to a planned and personalized care solution. Primary nursing (PN), is a new model of care focused on the people to be treated and, at the same time, restores responsibility, autonomy and role to the nursing staff. The study was based on an analysis of the wellbeing climate following the implementation of the PN in emergency surgical ward in the General Hospital in Piacenza. In the emergency surgery ward of the General Hospital Guglielmo Da Saliceto in Piacenzathe results of organization remodulation and model of care are being analyzed. In this job the observations are been focussed on wellbeing of nursing staff. The Mc Closkey Mueller Satisfaction Scale (MMSS) is used for the study before and after the change, The Team Climate Inventory (TCI), used after thepractices changes and the staff satisfaction survey after the implementation of PN. At the beginning, with the MMSS methods, the results show impatience with some contractual and remunerative aspects; instead, after the introduction of the PN, the results show a satisfaction for teamwork, the interaction between the team personnel and with patients. Similarly, it alsoincreases the perception of the degree of autonomy of contribution in decision making and in the authoritativeness of the role covered. The new assistance model also shows good results from TCI and Focus Group to achieve the goals of assistance and organization. The increased satisfactions of the nursing staff show a better quality care.Abstract: The growing complex of organizations and the new demand for people's health care lead to a planned and personalized care solution. Primary nursing (PN), is a new model of care focused on the people to be treated and, at the same time, restores responsibility, autonomy and role to the nursing staff. The study was based on an analysis of the wellbein...Show More
Abstract: Despite the introduction of H2 receptor and proton pump antagonists into the therapeutic arsenal of the Peptic Ulcer Disease, gastric perforation remains the most common surgical emergery for the upper gastrointestinal tract. The present study aims to describe the particularities of the management of Perforated Peptic Ulcer which underwent surgery in the University Hospital Center Joseph Ravoahangy Andrianavalona Antananarivo (CHU-JRA) and to identify its morbidity and mortality factors. This is a retrospective analysis performed over a period of 33 months from January 2017 to September 2019 on Perforated Peptic Ulcer operated in CHU-JRA. Demographic, clinical and therapeutic parameters were studied and analyzed in relation to the morbidity and mortality rate. Altogether 158 patients operated for perforated Gastric or Duodenal Ulcer were included with an age ranging from 16 to 78 years old, a mean age of 39.05±15.03 years and a Sex Ratio estimated to 18.75. Repeated unexplored epigastralgia was noted in 70.89% of cases and 33.54% of patients used NSAIDs and/or corticosteroids before the onset of the pain. At admission, 9.4% of cases were immediately in shock. A laparotomy for exploration and repair was performed for a suspicion of a hollow-organ perforation on a X-ray of an Unprepared Abdomen. Antral perforation predominated in our serie (75.95%) and the main repair procedure consisted in a simple surgical suture. To conclude, our stude reflects the difficulty of the management of Peptic Ulcer Disease and its complications in our daily practice. Strenghtening the awareness of the population about the potiential severity of this disease is essential.Abstract: Despite the introduction of H2 receptor and proton pump antagonists into the therapeutic arsenal of the Peptic Ulcer Disease, gastric perforation remains the most common surgical emergery for the upper gastrointestinal tract. The present study aims to describe the particularities of the management of Perforated Peptic Ulcer which underwent surgery ...Show More