The aim of the study was to evaluate the prevalence of health care-associated infections, risk factors, and antimicrobial use. Material and Methods. The study was carried out as a point-prevalence study in acute care wards, i.e., intensive care, surgical, and medical wards, at Vilnius University Hospital Santariškių Klinikos in April 2010. The study variables included the patient’s general data, indwelling devices, surgery, infection and its microbiological investigation, and antimicrobial use. All the variables that were logically related or had a P value of <0.25 in the univariate analysis were included in the stepwise logistic regression in order to study the factors potentially associated with health careassociated infections. Results. A total of 731 patients were surveyed. The overall prevalence rate of health care-associated infections was 3.8%. The prevalence of health care-associated infections differed by hospital wards (range 0.0%–19.2%). The lower respiratory tract (32.2%), urinary tract (28.5%), and surgical site infections (32.1%) were the most common health care-associated infections. Moreover, 89.3% of the cases of health care-associated infections were microbiologically investigated. Staphylococcus aureus (28.6%) and Escherichia coli (19.1%) were the most frequently isolated microorganisms. The use of one or more invasive devices was recorded in 332 patients (45.4%). Of the surveyed patients, 20.2% received antimicrobial agents. The most commonly prescribed antimicrobial agents were fluoroquinolones (21.1%), broad-spectrum penicillins (19.1%), and first- or second-generation cephalosporins (18.6%). Conclusions. The prevalence of health care-associated infections was found to be similar to the reported overall prevalence rate of health care-associated infections in acute care hospitals in Lithuania.

Reikšminiai žodžiai: preanalizės periodas, analitė, ėminių technika, venos punkcija. Tikslas. Šiuo tyrimu buvo siekiama išanalizuoti klinikinių laboratorinių veninio kraujo tyrimų preanalizės periodu slaugytojų dažniausiai daromas klaidas. Tyrimo medžiaga ir metodai. Tyrime buvo stebėti 104 laboratorinių tyrimų preanalizės periodo etapai renkant kraują skirtingiems tyrimams. Tyrimo metodus apima: veninio kraujo ėminių preanalizės periodų stebėjimas bei slaugytojų atliekamų veiksmų fiksavimas, medicininės paciento dokumentacijos nagrinėjimas. Slaugytojų atliekamiems veiksmams fiksuoti buvo sudarytas stebėjimo dienynas, paruoštas remiantis moksline literatūra bei galiojančiais Lietuvoje teisės aktais. Stebėjimo dienynas apima: analitės paskirtį, slaugytojų veiksmus iki veninio kraujo ėminio, punkcijos vietos parinkimą ir paruošimą, ėminių saugojimo laiką ir sąlygas, transportavimo būdas. Duomenų analizė atlikta naudojant „SPSS Windows (v. 20.0)“, „Excel 2010“ (v. 14.0) programas. Kintamųjų ir klaidų dažnių pasiskirstymui vertinti sudarytos dažnių lentelės, kuriose pateiktas absoliutus skaičius ir procentinės reikšmės. Kokybinių bei kiekybinių kintamųjų reikšmių grupėms palyginti sudarytos požymių dažnių kryžminės lentelės. Statistinio ryšio stiprumui nustatyti skaičiuotas Spirmeno koreliacijos koeficientas (rs). Skirtumai laikyti statistiškai reikšmingi, kai paklaidos tikimybės reikšmė p ≤ 0,05. Rezultatai ir išvados. Ruošdamosi paimti kraujo slaugytojos padarė 220 klaidų, iš jų priemonių paruošimo etape 186 (84,5 proc.), vertinant ir pažymint tyrimą veikiančius veiksnius – 34 (15,5 proc.). Dažniausiai daromos klaidos (n = 104): priemonių galiojimo termino netikrinimas (100 proc.), netinkamas mėgintuvėlių skaičius (45,2 proc.), tyrimą veikiančių veiksnių ignoravimas (25,9 proc.). Kraujo ėminio paėmimo metu padaryta 971 klaida. Dažniausios klaidos (n = 104): punkcijos vietos valymas netinkama kryptimi (91,3 proc.), mažo kiekio tamponų naudojimas (88,5 proc.), pripildytų mėgintuvėlių guldymas horizontaliai (79,8 proc.). Daugiau klaidų darė vyresnės nei 35 metų, dirbusios daugiau nei 10 metų bei turinčios aukštąjį neuniversitetinį išsilavinimą (p 0,0001) slaugytojos. Saugant ir transportuojant ėminius į laboratoriją, padarytos 178 klaidos. Dažniausiai daromos klaidos: mėgintuvėlių saugojimas horizontalioje padėtyje (65,4 proc.), įvyniotų į lydraštį mėgintuvėlių transportavimas rankoje (46,2 proc.), mėgintuvėlių transportavimas rankoje (n = 7; 6,7 proc.). Saugant ėminius, daugiau klaidų darė vyresnės, ilgiau dirbančios ir turinčios aukštąjį neuniversitetinį išsilavinimą slaugytojos (p 0,001).

The article analyzes the causes of incontinence, which affect the quality of life of men and women and are often related to the phenomenon of aging. Objective. To examine the causes of urinary incontinence among elderly based on the results of the scientific literature. Research methods. Data was collected in: Am J Obstet Gynecol, Clin Geriatric Med, Am J of nursing, BMC, PubMed database. Full-text articles on urinary incontinence were used for the analysis, when their title, keywords: incontinence, cause of urinary incontinence, elderly people, lack of knowledge about urinary incontinence (incontinenza urinaria) met the purpose of the review. Only publications in English, which were published in the period 2017–2022, were analyzed 27 scientific papers on the subject are included and analyzed in the systematic review. Research results and conclusions. The results showed that incontinence is associated with age, overweight, chronic diseases, bad habits, post-menopausal hormone replacement therapy. Incontinence increases social isolation, anxiety, and depression. Non-invasive methods are used to eliminate the causes of incontinence: psychological training, giving up bad habits, promoting a healthy and balanced diet, regulating body weight. Botulinum toxin injections, urological surgery or sacral nerve stimulation are used to enhance the treatment effect. The knowledge of patients and medical staff about the urinary incontinence is fundamental.

Cancer is the most common cause of death worldwide. Nursing services provided in the late stage of cancer complications improve the quality of life of patients, accelerate the recovery process or help them find inner spiritual peace. The ability of nurses to express empathy and apply motivational interviews has an impact on patients becoming stronger psychologically and physically. The psychological need is effective when a teamwork model is used. The aim of the research – to analyze scientific literature on the needs of patients in the stage of late complications of cancer treatment. Methods of research. Systematic research of the scientific literature was conducted using PubMed, BMJ, Elsevier, The Lancet oncology, IMJ, Google Scholar, World Health Organisation electronic databases. The results showed that the side effects of treatment can last for years in cancer patients in the late stage of complications. The nursing needs are directed to the continuous care of oncological patients, assessment of health status. Teamwork helps to involve the patient in the services provided, to motivate the patient's actions, feedback is important too. Educational activities of the nursing staff are aimed at promoting a healthy lifestyle, planning daily activities that help reduce fatigue, pain, and maintain muscle mass.

Imunoprofilaktika yra viena svarbiausių užkrečiamųjų ligų valdymo priemonių. Siekiant suvaldyti skiepais val­domas infekcijas, būtina užtikrinti moksliniais įrodymais pagrįstą informaciją besiskiepijantiems. Slaugytojų funkcijų išplėtimas imunoprofilaktikos sri­tyje praplėtė jų žinias, susijusias su skiepų derinimu, ne­pageidaujamomis reakcijomis. Slaugytojų dalyvavimas imunoprofilaktikos procese neapsiriboja vien tik skiepi­jimo procedūra. Slaugytojai patys gali paskirti imuno­profilaktiką, pakviesti skiepytis, prisidėti prie mokslu pagrįstos informacijos apie skiepus sklaidos, nes yra pati­kimi atskirų bendruomenių partneriai. Tyrimai rodo, kad pacientai labai pasitiki medicinos personalo nuomone ir patarimais, paaiškinimu apie galimą šalutinį poveikį, kartais padeda apsispręsti dėl skiepijimo. Tyrimo tikslas − išanalizuoti slaugytojų vaidmenį imu­noprofilaktikos srityje. Nagrinėti penkių sveikatos įstaigų slaugytojų, turinčių skiepijimo patirties, veiksmai bei informacijos apie vak­cinaciją teikimas, skiepijimo vietos priežiūra. Nustatyta, kad 28,4 proc. (n=88) respondentų skiepija skirtingo amžiaus pacientus. 18,2 proc. slaugytojų buvo įtraukti į skiepijimus COVID-19 ligos pandemijos metu. Keturios sveikatos priežiūros įstaigos turi skiepų koordinatorius. 36,4 proc. respondentų prieš skiepijimą įvertina kon­traindikacijas, naudodami standartinį klausimyną, 13,6 proc. apklausia žodžiu. Penktadalis respondentų kon­traindikacijų vertinimą deleguoja gydytojui arba skie­pus koordinuojančiam sveikatos priežiūros darbuotojui. Dauguma respondentų išsamiai informuoja apie skiepo vietos priežiūros taktiką, daugiau nei pusė padeda paci­entui apsispręsti dėl vakcinacijos.

The external appearance, especially that of women, is very important and cellulite is an aesthetically unacceptable cosmetic defect (S. A. Abosabaa, 2020). Genetics, lifestyle, gender determines development of cellulite (N. Sadick, 2018). The aim. To evaluate the effect of thermal procedures on skin affected by cellulite. Methods. The analysis of 2010–2022 scientific literature in Journal of Cosmetic and Laser Therapy, Clinical, Cosmetic and Investigational Dermatology, Archives of Dermatological Research, PubMed electronic database was performed. The keywords helped to achieve the goal: cellulite, thermal procedures, cosmetic products. Ten scientific sources containing keywords were examined. A non-standardized interview method was used to examine eating habits, medications used, age, effectiveness of cosmetic products and a standardized customer card. Results. Thermal procedures decreased the volume of the abdomen by 11 cm, that of the buttocks and thighs affected by cellulite by 9 cm. Conclusions. 1. Cellulite mainly affected the skin of buttocks, thighs, and abdominal areas, the damage was influenced by the age, hormonal imbalance, diet, and a lack of physical activity. 2. The effectiveness of a thermal effect was observed after five procedures. After coordinating procedures with participants, changing eating habits and passive physical activity to active, cellulite stages decreased from stage III to stage II. 3. After ten thermal procedures, the participant reduced areas of the body affected by cellulite, restored the moisture level and firmness of the skin, however, cellulite did not disappear completely.

The World Health Organisation has given recommendations about frequency, intensity, type of physical activity, which are necessary seeking to avoid chronical diseases. Recommendations are directed towards increasing a general physical activity in the least active human populations. Worldwide, as many as 23 % of adults are not sufficiently physically active. The lifestyle of 40–60 % of people living in the European Union is largely sedentary, therefore it is necessary to encourage people to change their sedentary lifestyle to a healthier and more active one. Aim. To analyse factors of physical activity which have an effect on health and quality of life of inactive people. Methods. To review scientific literature related to human health, quality of sleep, physical activity and to provide insights. A search for sources of literature on the topic under consideration was carried out using the electronic academic research databases of the World Health Organisation, ClinicalKey, PubMed, Google Scholar. Articles in the English language published between 2012 and 2022, which were in line with the research subject, were used for the review. The search was carried out using the key words and world combinations with them (physical activity, health, insomnia, prevention). The total of 26 full text sources on the theme under consideration were included in a systematic review. Results. Physical activity has an effect on the quality of sleep and through certain physiological mechanisms decreases the risk of insomnia. Levels of physical activity are of importance to health strengthening. Too weak, passive physical activity reduces the quality of sleep and is related to the risk of insomnia. Conclusions. 1. A continuing stressful situation has a negative effect on the quality of people’s sleep. Physical activity, which does not comply with the WHO recommendations can have a negative impact on psychical, mental health and the quality of sleep. 2. Regular physical activity has a positive impact on mental health, activates neurobiological systems, encourages secretion of hypnogenic substances which improve the quality of people’s sleep.

Research background. Hygiene of the surfaces means a clean environment of a hospital, especially that of a patient, which consists of constant basic cleaning and disinfection. The registration, analysis and storage of data on cleaning, disinfecting the surrounding objects is a successful stage in ensuring clean surfaces. The registration of documents and the cleaning and disinfecting schedule help to determine the tender spots in the surface cleaning. It makes easy to establish the surface hygiene violations, participation of the nursing and auxiliary staff in disinfecting the surfaces, problems related to the surface disinfection, and make the analysis of the mistakes made easier. The aim of the study. To assess a 2009–2011 hygienic preparation of medical surfaces, which have an effect on the transmission of the hospital-acquired infection, and the efficiency of the preventative measures. Methods. The survey was conducted in university hospital in 2009–2011. To evaluate the surface hygiene of the environmental objects the test of the remains of biological contamination was chosen using the chemical means HemoCheck-S™. The accuracy of the test is 0.1 µq of the remains of biological contamination on the surfaces under investigation. The results are evaluated by calculating the amount of denatured biological contamination from the highest concentration to 0. The surface contamination is evaluated in points from “0” to “5”, where “0” is no contamination (medical surface is fully prepared for a procedure), and “5” is maximum contamination (100 µq, maximum contamination shown by the HemoCheck-S™ test). Results. Investigation shows that the surfaces belonging to the low-risk group are contaminated most heavily. The analysis of the investigations carried out during three years leads us to the conclusion that during the time of cleaning the surface, the staff fails to observe the sequence and do not change soft inventory (napkins) intended for cleaning. This is testified by presence of biological contamination in the low-risk group: switch-boards on the patients’ beds, cupboards and drip mounts. Conclusions. Insufficient hygiene of high, medium risk and often touched surfaces and surfaces of nursing measures was established. The inadequate preparation of the medical surfaces was most often made in the Intensive Care Intensive Therapy units.Keywords: hygienic preparation; medical surfaces; the hospital-acquired infection.