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Adverse events lead to the emergence of several groups of victims, among which the second victims are medical staff involved in them. The suffering of second victims can lead to new adverse events and new victims. This study describes the cycle of an adverse event and its victims. Using the example of the largest Croatian hospital centre, authors try to understand how deep medical staff experience adverse events, and how different groups of medical staff (by profession, gender, qualification, and position) perceive adverse events. With the help of a special survey using the Bonferroni method from ANOVA, it was established that males feel more mental stress after adverse events than females. The results indicate that medical staff of different professions perceive adverse events differently, e.g. they are the least painful for psychiatrists and microbiologists and the most stressing for emergency and intensive care workers. In addition, nurses are more vulnerable to adverse events and experience various types of mental disorders more deeply than doctors. However, qualifications do not seem to affect the extent to which medical staff perceive adverse events. The results of this study differ from previous data for other countries and suggest new implications. [ABSTRACT FROM AUTHOR]

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Medical activity is assumed to be service activity the effects of which can be measured. The SERVQUAL scale was used as a starting point for our research, which resulted in a new, adopted scale called MEDQUAL. The MEDQUAL scale aims to measure the quality of healthcare provided by medical staff of one hospital department instead of the overall quality of hospital services or parts of services on which medical staff in one department has no influence. The study was conducted in a clinical hospital department in Croatia and included 300 respondents (169 patients and 131 medical staff members). The MEDQUAL scale, designed and tested in the study, showed high reliability in all established dimensions, i.e. trust in doctors (Cronbach's Alpha 0.923), nursing professionalism (0.913), medical professionalism (0.938), and departmental organization (0.810). The scale proposed evaluates both patient satisfaction with the quality of healthcare received and medical staff satisfaction with the quality of healthcare provided. The results were comparable to the groups of respondents, departments, and institutions with potential longitudinal studies of this phenomenon. MEDQUAL is a simple, repeatable and cost-effective scale, applicable to almost all departments and used for measuring the quality of healthcare services both provided and received, the aim of which is to contribute to the assessment of healthcare quality and its improvement.

Because of progressive development and extended use of interventional radiology (IR) procedures it is highly recommended that all individuals involved in the process should be aware of the potential for both stochastic and deterministic effects due to occupational exposure. IR procedures are performed in such a manner that certain number of medical staff are always needed near the patient, near the X-ray unit. The new challenge to regular radiation protection is to ensure 'safe' working environment in such radiation X-ray field geometry. In this work the patient is physically regarded as a secondary radiation source emitting scattered X-rays. Passive dosemeters will give us clear data only about the monthly integrated occupational dose; there is concern over the frequency and duration, actual pattern of receiving this dose. We have developed active electronic dosemeter (AED) device, which provides additional dosimetry data about the frequency and duration of professional low level X-ray exposure burden.

The alkaline comet assay was used to evaluate the genotoxicity towards peripheral blood lymphocytes of medical personnel regularly handling various antineoplastic drugs with different safety precautions. The study population consisted of 50 exposed subjects working in the oncology, pulmonology, gynaecology and haematology units of nine Croatian hospitals and 20 unexposed control subjects. Peripheral blood lymphocytes from the subjects were embedded in agarose on a microscope slide and lysed; the DNA was unwound and subjected to electrophoresis at pH 13. Staining with a fluorescent dye was used to identify cells with DNA damage, as judged by increased migration of genetic material from the cell nucleus. DNA damage was quantified by measuring the displacement between the genetic material of the nucleus and the resulting tail using an image analysis system. Three parameters were used as indicators of DNA damage: i.e. tail length, percentage of DNA in the tail and tail moment. Statistically significant differences in all three parameters were observed between the exposed and control groups. Within the exposed group, there were marked differences between individuals in the comet tail parameters. In the majority of exposed subjects an effect on DNA damage of age or duration of occupational exposure could be excluded. In the exposed group, the highest level of DNA damage was recorded in subjects who used only latex gloves in their work with antineoplastic drugs. The observed DNA damage was lower in exposed subjects who used more than one type of protective equipment and who worked in a well-ventilated safety cabinet. No statistically significant differences were found between the mean values of comet tail parameters for smoking and non-smoking subpopulations from the exposed group. In view of the results obtained, the alkaline comet assay, as a simple, rapid and sensitive method, appears to be a promising additional test for biomonitoring purposes in human populations.