Úroveň řízení lidských zdrojů ve zdravotnictví je jedním z klíčových faktorů, které ovlivňují kvalitu a bezpečí poskytované zdravotní péče. Článek obsahuje výsledky celonárodní studie provedené v lůžkových zdravotnických zařízeních ČR. Cílem studie bylo jak kvantitativně, tak kvalitativně zhodnotit současnou situaci v oblasti řízení lidských zdrojů s důrazem na kompetence lékařského personálu. Výsledky kvantitativní části byly podrobeny křížové analýze za účelem zjistit souvislost úrovně řízení kompetencí se třemi externími motivačními faktory – akreditací, certifikací a akreditací pro postgraduální vzdělávání lékařů. Výsledky studie prokázaly, že všechny tři typy externích motivačních faktorů souvisejí s vyšší kvalitou řízení kompetencí lékařů v lůžkových zdravotnických zařízeních ČR., The level of human resource management of the healthcare staff is one of the key factors influencing the quality and safety of the healthcare services provided by such staff. The following article contains the result of the national study carried out in the Czech Republic. The goals of the study were to both quantitatively and qualitatively evaluate current situation of the management of competencies (privileging) in inpatient healthcare facilities in the Czech Republic, with focus on privileging of physicians. The quantitative findings from individual facilities were then cross-analyzed with 3 external motivational factors - accreditation, certification, teaching status – to see whether those facilities appraised by one or more external systems mentioned above have obtained higher score in the quantitative part of the study corresponding to more sophisticated system of privileging of physicians. All three examined types of external appraisal showed statistically significant correlation with higher score in the level of sophistication of privileging of physicians. In other words, those inpatient healthcare facilities which are accredited, ISO certified or have teaching status show more sophisticated level of privileging of physicians., František Vlček, Kateřina Ivanová, Petr Sadílek, David Marx, and Lit.: 12
Aim: to improve treatment results of colorectal cancer, complicated carcinomatosis of abdominal cavity, by associated using of endolymphatic chemotherapy (ELCT) and local extremely high frequency (EHF) therapy. Igroup 21 people (33.3%) performed colostomy, then neoadjuvant systemic chemotherapy by the scheme FOLFOX4. It was held two cycles, after two cycles their were received cytoreductive surgery; II group 26 people (41,3%) received cytoreductive operations with early postoperative intraabdominal chemotherapy by oxaliplatin (200 mg/m(2) at day 1 and 5FU 650 mg/m(2) from days 1 to 4. III group 16 people (25,4%) also performed colostomy, then used 2 courses of ELCT with local EHF therapy and all patients were received cytoreductive operations. ELCT was carried out injecting oxaliplatin100 mg/m(2) a day during 12 hours and then 5 FU in doze of 600 mg/m2 a day during 72 hours by the instrumentality of the dozer and LV200 mg/m(2) (2h intravenous infusion). During ELCT patients received local EHF therapy in abdominal cavity for an hour. After chemotherapy the partial regress of tumor observed in 1st group in 4,8 % and in 3rd 37,5 %, stabilization of process noted in 28,6 and 50% cases, progressing 66,7 and 12,5% cases correspondingly to groups. Histomorphologic study of malignant foci after ELCT+EHF therapy showed reduction of specific area of parenchyma cancer cell from 57 till 39% simultaneous growth of stroma from 40 till 58% and in necrosis area from 1,8 till 2,5%. Mitotic activity of tumor cells in the 1st group decreased (average in 22 un.), but in 3rd group it decreased until 11 units. Analysis of life span showed that in 1st group of patients 2year survival rate was 66,7%. In 2nd group of patients 2year survival rate was 42,3%. ELCH+EHFtherapy has high clinic efficacy and promotes to decrease terms of progression of tumor process, increases life span from 0 till 24% and quality of life of the patients. ELCH+EHFtherapy brings to reduction of specific area of parenchyma in cancer cells from 57 till 39% with simultaneous growth of stroma area from 40 till 58% and necrosis area from 1,8 till 2,5%. ELCT+EHFtherapy lowers mitotic activity of tumor cells, activates apoptosis, hemodynamic and metabolic rates., Akbarov E.T., Navruzov S.N., Abdujapparov S.B., Islamov H.D., and Literatura
Autoři na základě zkušenosti, literárního review a doporučení mezinárodních společností podávají evidence based přehled této problematiky., Based on their experience, literature review and recommendations of international organizations, the authors provide an evidencebased review of this issue., Pavel Lovas, Zuzana Lovasová, Jana Garčicová, and Lit.: 33