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Introduction: Hospitalized patients have an increased risk of developing infections caused by Clostridioides difficile. Due to the changing epidemiology of C. difficile, it is necessary to educate nurses about the implementation of prevention measures, but also about the criteria for obtaining a quality sample of feces in order to establish an etiological diagnosis in a timely manner. The aim of the study was to assess gaps and flaws in C. difficile infection (CDI) prevention policies and practices, and to determine whether a nurses knowledge about early identification and isolation of CDI patients improved after education. Methods: The research was conducted in a quasi-experimental study at the University Clinical Center of the Republka Srpska (UKC RS) in the period from May 2020 to December 2021 on a sample of 60 nurses. A survey questionnaire Centers for Disease Control and Prevention (CDC) was used as a research instrument and it was intended for the assessment of knowledge, attitudes and understanding about procedures for the prevention of infection with C. difficile. The applied strategy to prevent hospital CDI was based on the introduction of the concept of "package of care", which was based on scientific evidence. For the education of nurses, interactive educational modules were used that contained detailed prevention measures CDI in hospital conditions in accordance with the guidelines. Before and after the education, the participants completed a knowledge test about C. difficile and prevention CDI.The study was approved by the Ethics Committee of the UKC RS. Results: Only 5 (8.3%) respondents stated that they were informed about CDI prevention during the visit of a nurse from the infection control team. Most of the shortcomings during the assessment of CDI prevention at the observed clinics were related to the practice of sending feces samples for laboratory testing for C. difficile. Nurses showed highly statistically significant (p

Background: The pandemic of severe acute respiratory syndrome by coronavirus 2 (SARS-CoV-2) is a multi-system disease caused by a diffuse systemic process involving a complex interaction of the inflammatory, immunological and coagulative cascades. This study aims to identify the most effective biomarkers to predict poor outcome in intensive care unit (ICU) patients with severe COVID-19 disease. Methods: A single-centre retrospective observational study enrolled 69 deceased and 20 recovered patients treated in the ICU of the General Hospital Gradiska in the period from March 1, 2021. until April 1, 2022. We evaluated the leukocytes (WBC), lymphocytes (LYM), neutrophils (NEU), platelets (PLT), haemoglobin, neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). In addition, we evaluated the IL-6, ferritin, CRP, D-dimer, magnesium, bilirubin and lactate dehydrogenase. Results: Between deceased and recovered patients on admission to the ICU, there was a significant difference between the following parameters: WBC x109/L 11.50 (8.86-14.75) vs. 9.40 (5.90-11.90), p =0.026; NEU x109/L 10.15 (7.81-12.74) vs. 8.60 (4.80-10.30) p=0.022; NLR 15.01 (10.60-24.33) vs. 9.45 (5.10-14.90) p=0.02; SII 3712 (2240-6543) vs. 1949 (993-3720) p=0.003. The magnesium level increased significantly over time in the patients who died, while the haemoglobin level and platelet count decreased. ROC analysis showed the following AUC values: WBC 0.774; NEU 0.781; NLR 0.786; SII 0.776; D-dimer 0.741, and bilirubin 0.713. Conclusion: In this retrospective study WBC, NEU, NLR, SII, D-dimer, and bilirubin determined at hospital admission had a high value in predicting death among patients with severe COVID-19.

Introduction/Objective. Unintentional injuries is a global health issue among children and adolescents. The aim of this study was to examine the characteristics of unintentional injuries divided according to different age groups and sex among the children and adolescents who have been hospitalized in public hospitals of the Republic of Srpska, Bosnia and Herzegovina. Methods. A retrospective analysis of the e-base of the Agency for Certification, Accreditation and Health Care Quality Improvement of the Republic of Srpska data were collected from 10 public hospitals for patients aged ≤ 19 years, who have been hospitalized for unintentional injuries in the period of January 2018 and December 2020. Results. The study identified 1336 patients who were hospitalized for unintentional injuries, most of whom were boys (67.4%). Falls were the most frequent cause of hospitalization in children of all age categories (aged 1 (70.6%), 1–4 (59.1%), 5–9 (68.5%)) and adolescents aged 10–14 (64.1%), while road traffic injuries were the leading cause of hospitalization in adolescents aged 15–19 (62.6%). The cause of injury for the hospitalized patients were significantly related to age (p < 0.001) and sex (p < 0.05) groups. According to the nature of the injury in relation to the area of the body, the most frequent injuries were to the head (41.1%), caused by traffic accidents and falls. Conclusion. Since falls and road traffic injuries were the leading causes of hospitalization, preventive measures should be taken to reduce the frequency of these injuries.

Background/Aim: Diarrhoea that occurs as a result of the presence of Clostridium difficile (reclassified as Clostridioides difficile) is usually manifested as a hospital infection, usually after antibiotic treatment. The study aim was to assess the incidence, characteristics and outcomes of hospitalised patients with healthcare - associated Clostridioides difficile infection (HA - CDI) before and during the COVID-19 pandemic. Methods: This retrospective cohort study included patients older than 18, who met the HA - CDI case definition. The CDI diagnosis was made by demonstrating toxins A and B in stool samples using an immunochromatographic assay test and polymerase chain reaction (PCR). Results: The incidence of HA - CDI has significantly decreased from the preCOVID-19 period to the COVID-19 period (11.04 per 10,000 vs 6.49 per 10,000, p < 0.001). Before establishing the HA - CDI diagnosis, 41.4 % of patients used one antibiotic, 25.9 % used two and 11.2 % were treated with three or more antibiotics. Almost one half of the applied antibiotics were from the group that represents high risk for the development of HA - CDI. Multivariable logistic regression analysis showed that older age (OR = 3.4; 95 % CI = 0.9-12.4; p = 0.038) and complicated disease course (OR = 11.8; 95 % CI = 2.6-53.6; p ≤ 0.001) were associated with a higher risk of death. Conclusion: The incidence of HA - CDI has decreased during the observed period of the COVID-19 pandemic, however, no clear connection between the impact of the pandemic and incidence reduction was found. Due to unfavourable outcome of the treatment of HA - CDI patients during COVID-19 pandemic, the rational use of antibiotics is necessary.

Introduction: Unintentional falls are the leading cause of traumatic injuries, without fatal consequences, with significant morbidity in the population of children and adolescents. Goal: The main goal of this research was to analyze the manner of falling in relation to age and gender, and to assess the type of injury and the anatomical region of the body affected by the injury sustained during a fall in patients ≤19 years of age treated in the emergency medical services in the Republic of Srpska. Material and methods: A cross-section study with retrospective analysis of the national e-database WebMedic from 11 emergency medical services between January 2018 and December 2020 was conducted. Research included patients with diagnosis of unintentional injury caused by a fall, aged ≤19 years. Descriptive statistics and the Chi-square test were used for comparisons between groups. Results: During the observed period, 857 cases of unintentional falls were identified, where 87.5% were referred for hospitalization. The group of children aged 0 to 9 years (55.7%) was more often treated for falls (p

Background/Aim: Unintentional injuries among children and adolescents have become a common issue in public healthcare. The study objective was to analyse the characteristics and identify predictors associated with unintentional injuries in children and adolescents treated in emergency medical services (EMS) in the Republic of Srpska, Bosnia and Herzegovina. Methods: A cross-section study with retrospective analysis of WebMedic e-database from 14 EMS, in the period between January 2018 and December 2020 was conducted. Research included patients with unintentional injuries, aged ≤ 19 years, of both sexes. For comparison between groups, Chi-squared and multivariate logistic regression were used in risk factor analysis. Results: A total of 1,856 cases were identified, most injuries resulted from falls (46.7 %) and traffic injuries (26.9 %). Boys were significantly more affected by injuries than girls (p < 0.001). Falls were the major cause for reporting to EMS among age groups of children (0-9 years) and adolescents (10-14 years), whereas injuries in traffic were dominant in adolescents aged 15 to 19. The most common injuries were head injuries (35.7 %). Risk factors of unintentional injuries were age (p < 0.001), sex (p = 0.046), weekday (p = 0.016), winter (p = 0.014), body region (head, abdomen, lower and upper limbs (p < 0.001), thorax (p = 0.009)). Conclusions: There were significant differences in characteristics of unintentional injuries according to age and sex. Chances for occurrence of unintentional injuries among children increased with their age, especially for boys. These differences might indicate areas where preventive measures should be undertaken.

Faecal microbiota transplantation (FMT), known equally well as faecal transplantation or faecal bacteriotherapy, is the process of implanting the faecal suspension containing balanced microbiota from a healthy donor to the colon of a recipient patient. Excessive growth of Clostridioides difficile (C difficile) in the intestinal microbiota resulting from antibiotic consumption is currently a rising threat to public health. FMT is one of the most important, newer approaches to treating C difficile infections. Since C difficile is regarded as an opportunistic bacterium triggering disease in conditions of disturbed homeostasis of the intestinal microbiota, restoration of healthy intestinal microflora facilitates suppression of toxic strain of C difficile by anaerobic bacteria of normal intestinal microflora with concomitant cure. Nurses have important role in caring for patients after faecal transplantation.

The epidemic of the COVID-19 disease presented a great threat to the public health. The SARS-CoV-2 virus is still spreading on a global level, so the accurate global number of the infected or deceased from the COVID-19 disease is yet to be estimated or correctly counted. The nurses have always played a great role in the prevention and control of infections, isolations and public health protection. The nurses' work during the COVID-19 epidemic has created a history of nursing. Nurses have been on the front line of defense from the SARSCov-2 virus for over a year now and many of them are already on the edge of endurance, both mentally and physically. The professional security is the key for the work of nurses who are facing the danger of infection on a daily basis. The aim of this paper is to show the actions and measures taken by the nurses in Republika Srpska that could help in the decrease of the global transmission of the infection. Compared with some European countries and their fight with the epidemic, Republika Srpska has maintained the number of confirmed cases on a level which can be controlled. The prevention measures are the only thing that can stop the spread of this new infectious disease. In our biggest healthcare institution of a tertiary level, a large number of COVID procedures for nurses and other healthcare workers have been released. Nurses are, together with other healthcare professionals, actively involved in the interventions around the COVID-19 and will be one of the key factors that will stop the pandemic.

Introduction: The level of education quality of medical health care graduates (Bachelors of Health care and Nursing) depends on curriculum quality. Knowing what motivates students to enroll medical health care studies and development of professional and academic career are of great importance for education as well as the practice. Aim of the study: To see if there is a difference in attitudes and opinions between 1st year students and 4th year students about health care study program and nursing as a profession, students motivations for enrolling the program and their expectations about possibilities to develop personally, professionally and scientifically after graduating. Patients and Methods: 55 Health care students of Medical Faculty University of Banja Luka (1st year 37 and 2nd year 18 students) were a sample. Research was conducted by using anonymous, original questionnaire which was written for the needs of this research. SPSS (Statistical Product and Service Solutions) version 20. was used for data processing, and Windows, operating system, for data analysis. Results: Conducted research shows that material component, with possibility of finding better job and willingness to care for other people are major criteria which motivate students to choose nursing study. Health care students of both generations graded study program with 3,22 ± 0,76, and there was statistically significant difference (p

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Introduction: During the last two and a half years, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread around the world. Most of the SARS-CoV-2 vaccines are designed to produce anti-SARS-CoV-2 immunoglobulin G (IgG) against the viral S-glycoprotein. The aim of this study was to measure the anti-S antibody titres among the medical personnel who had been fully vaccinated with different types of vaccines, and to compare them with those who were COVID-19 convalescents., Material and Methods: In this study serum was collected from 261 healthcare workers, of whom 227 were vaccinated, while 34 were recovered participants who were not immunised. Serum samples were collected 21 days after the first dose and 60 and 180 days after the second dose of the vaccines and tested with a commercial ELISA kit., Results: The highest antibody level (12 AU/ml) was measured in the Pfizer-BioNTech group, followed by Sinopharm (9.3 AU/ml), Sputnik V (5.9 AU/ml), Sinovac (4.6 AU/ml) and Oxford/Astra- Zeneca vaccine (2.5 AU/ml) 60 days after the second dose of the vaccines (90 days after the first dose). The seropositivity rate for mRNA vaccine was 88.5%, for vector vaccines 86.2% and for inactivated vaccines 71.4%. When comparing these antibody levels with COVID-19 convalescents, higher antibody titres were found in vaccinated participants (5.76 AU/ml vs 7.06 AU/ml), but the difference was not significant (p = 0.08)., Conclusions: Individuals vaccinated with mRNA and vector vaccines had a higher seroconversion rate compared to the group vaccinated with inactivated vaccines, or convalescents., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Termedia.)