Rostrum of Asclepius Vol 17, No. 1 (2018): January - March 2018

Introduction: Diabetic leg ulcers occur in at least 15% of patients with diabetes mellitus and are associated with frequent hospitalizations, high cost of care, amputation and death. Purpose: The purpose of the present review was to explore the impact of the psychology of diabetic patients on the development, severity and prognosis of diabetic ulcers, and vice versa, their effect on psychology and quality of life. Material and Method: A review of the literature and search in the international databases (PubMed, Google Scholar, Medscape, Ovid, Cochrane Collaboration, Elsevier, NICE guidelines, Heal. Link) was carried out, with a limitation on publication time (after 2000) and language (Greek and English). According to the criteria, 27 publications were included. Results: There is a positive correlation of depression and other mental disorders with the pathogenic causes of diabetic ulcers, but also with their development (greater severity and frequent relapses). It has also been confirmed that the bi-directional nature of association, as diabetic ulcers affect the psychology and quality of life of patients. Conclusions: Regardless of the causality between psychology and diabetic ulcers, holistic - personalized support from a multidisciplinary team, from diagnosis to diabetes and the provision of appropriate education, improves the prognosis of ulcers, psychology and quality of life of patients and leads reduced amputation and mortality due to disease.

Keywords: Diabetic ulcers, mental disorders, depression, quality of life

Introduction: Satisfying the expectations of the client/patient determines the quality of the Health Service provided thereby ensuring the viability of the organisation. In today’s competitive environment putting into practice Total Quality Management is of the utmost importance. Purpose: The promotion, understanding and analysis of the need for an effective leadership in the workplace in the putting into practice of Total Quality Management. Method/Material: The research material in this article is based on scientific articles from international databases (Scopus, Medline, Google Scholar), using keywords in English and Greek such as Management, Total Quality, quality, leadership, health. Studies before 2000 and those with limited access to the complete contents were omitted. Results: In a Total Quality environment the management synthesises a vision of quality and pledges, by example, to deliver it by inspiring the workforce to achieve common aims and by developing conditions for good cooperation amongst the members of the team. This will in turn encourage communication and fruitful interaction between different hierarchical levels. Any management which adopts the Total Quality philosophy seeks to involve the workforce in decision making by means of the formulation of creative ideas and practices. Likewise the role of effective leadership in education of the workforce and in the development of suitable skills in the workplace for the purpose of improving work efficiency is absolutely crucial. The recognition of the contribution of the employee to the productivity and his subsequent reward constitutes an incentive for continuous improvement. Conclusions: In a Health Organisation the desire to embrace Total Quality philosophy demands long term plans and actions and continuous endeavours on the part of the management to achieve long term positive results.

Keywords: Quality, total quality management, leadership, health, objectives

3rd of December Worldwide is dedicated to People with Disabilities. The number of people with disabilities is estimated at around 15% of the world's population, and in Greece the number of people with disabilities is about 1 million. Although the Convention on the Rights of Persons with Disabilities defines the needs of people with disabilities across the globe, however, in Greece, people with disabilities have a low level of health and education, high mortality and unemployment, and often receive social exclusion. Existing rehabilitation and rehabilitation centers - both public and private - cannot meet the needs of people with disabilities in health care and hospitalization and their smooth integration into society. This article proposes decisions to improve the existing public structure "Aristeus" in Larissa, which aim to upgrade the provision of appropriate medical care and rehabilitation services for people with disabilities. Subsequently, the stakeholders were mentioned, the hierarchy of their influence on the development of the improved restoration structure and the analysis of communication objectives to create the appropriate climate for public opinion to support the implementation of the proposed structure.

Keywords: Disabled people, Aristeus, stakeholders, communication goals, decision making

Νursing is a dynamic science that encompasses concepts of quality, safety and excellence. The rapidly changing health care environment consists a challenge for nurses and raises questions related to quality maintenance and excellence achievement in clinical practice. Issues such as personal development, enhancement of education, creativity and appropriate decision-making, can act positively in creating and maintaining a quality health care environment. The new social reality creates deadlocks that have a serious impact on both citizens’ health and the way in which healthcare is provided. Νurse’s professional life is related to patient safety, provision of quality care and best practice. The awareness and activation of human emotional forces and the subsequent control of deficits and exaggerations and the orientation to the ultimate goal of nursing science, namely, the acquisition of health and well-being, appear to be the basis for excellence in modern clinical practice.

Keywords: Nursing care, quality of care, excellence, health care environment

Introduction: Effective organization and operation of the emergency departments (EDs) is a modern challenge for the Greek health system as heterogeneity can be observed in their operation. Although in some hospitals EDs are housed in modern facilities with high hygiene and safety standards as well as with organized screening systems, unfortunately, this is not a common pattern that can be observed in most cases. Aim: The aim of the present study was to explore and compare the EDs of Thessaloniki, regarding their infrastructure, procedures and health and safety status. Methodology: The study sample consists of eight hospitals of Thessaloniki. The study is based on mixed methodology. Initially, a qualitative approach was undertaken through personal observation of the site and the operation of the EDs via a strictly structured observation form. The recordings were then quantified and were used for grading the hospitals which were subsequently grouped according to similar characteristics. Results: The average score is 0.74 with a range from 0.50 to 0.92. The best-performance was recorded in the health and safety category (0.81), while the lower recordings were related to facilities (0.69) and results for organizational issues (triage) were satisfactory (0.72). Hospitals were categorized into four different groups based on their functional characteristics, indicating apparent heterogeneity in the management and organization. Conclusions: Results suggest the need to identify the degree of divergence of EDs in aspects of organization and explore further ways of achieving convergence. It is therefore necessary to extend this study to the rest of Greece in order to establish the differences further in order to be able to propose the implementation of nation-wide triage method and single mode of management in EDs.

Keywords: Emergency department, triage, organizing