PIELĘGNIARSTWO POLSKIE POLISH NURSING. KWARTALNIK / QUARTERLY Nr 4 (58) 12/2015

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1 Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu Poznan University of Medical Sciences Wydział Nauk o Zdrowiu Faculty of Health Sciences PIELĘGNIARSTWO POLSKIE POLISH NURSING KWARTALNIK / QUARTERLY Nr 4 (58) /5 Indeksowane w / Indexed in: Ministerstwo Nauki i Szkolnictwa Wyższego/ Ministry of Science and Higher Education 3,; Index Copernicus Value (ICV) 68,75 (6,8)

2 PIELĘGNIARSTWO POLSKIE POLISH NURSING Skrót tytułu czasopisma/abbreviated title: Piel Pol. Copyright by Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu ISSN (Druk) ISSN (Online) Korekta/Proofreading: Renata Rasińska Grażyna Dromirecka Korekta tekstów w j. ang./language editor: Agata Dolacińska-Śróda Skład komputerowy/desktop publishing: Beata Łakomiak Projekt okładki/cover project: Bartłomiej Wąsiel Sprzedaż/Distribution and subscription: Punkt Sprzedaży Wydawnictw Naukowych UMP Poznań, ul. Przybyszewskiego 37a tel. (phone)/fax: sprzedazwydawnictw@ump.edu.pl Redakcja deklaruje, że wersja papierowa Pielęgniarstwa Polskiego jest wersją pierwotną (referencyjną) Editorial Staff declares that printed version of Polish Nursing is the original version (reference) WYDAWNICTWO NAUKOWE UNIWERSYTETU MEDYCZNEGO IM. KAROLA MARCINKOWSKIEGO W POZNANIU 6-8 Poznań, ul. Bukowska 7 tel./fax: Ark. wyd. 8,. Ark. druk.,3. Format A4. Zam. nr 78/5. Druk ukończono w grudniu 5.

3 PIELĘGNIARSTWO POLSKIE POLISH NURSING KOLEGIUM REDAKCYJNE Redaktor Naczelny dr hab. Maria Danuta Głowacka Zastępcy Redaktora Naczelnego dr hab. Krystyna Jaracz prof. dr hab. Włodzimierz Samborski prof. dr hab. Jacek Wysocki Sekretarz Naukowy dr inż. Renata Rasińska Sekretarz Redakcji dr inż. Renata Rasińska RADA NAUKOWA dr Vincenzo Antonelli prof. Antonio Cicchella dr hab. n. med. Agata Czajka-Jakubowska dr hab. Antoni Czupryna dr hab. Danuta Dyk dr hab. Jolanta Jaworek prof. Lotte Kaba-Schönstein doc. Helena Kadučáková prof. Christina Koehlen dr hab. Maria Kózka dr hab. Anna Ksykiewicz-Dorota, prof. UM prof. Mária Machalová dr hab. Piotr Małkowski dr hab. Ewa Mojs, prof. UM dr Jana Nemcová prof. dr hab. Grażyna Nowak-Starz prof. dr hab. n. med. Marek Ostrowski prof. Hildebrand Ptak prof. dr hab. Jerzy Stańczyk prof. dr hab. Piotr Stępniak dr Frans Vergeer prof. dr hab. Krzysztof Wiktorowicz dr hab. Maciej Wilczak, prof. UM prof. dr hab. n. med. Zbigniew Włodarczyk dr Katarína Žiaková LUISS Guido Carli di Roma (Włochy) University of Bologna (Włochy) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Jagielloński Collegium Medicum (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Jagielloński Collegium Medicum (Polska) Hochschule Esslingen (Niemcy) Katolícka Univerzita v Ružomberku (Słowacja) Evangelische Hochschule Berlin (Niemcy) Uniwersytet Jagielloński Collegium Medicum (Polska) Uniwersytet Medyczny w Lublinie (Polska) Prešovská Univerzita (Słowacja) Warszawski Uniwersytet Medyczny (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Comenius University in Bratislava (Słowacja) Uniwersytet Jana Kochanowskiego w Kielcach (Polska) Pomorski Uniwersytet Medyczny w Szczecinie (Polska) Evangelische Hochschule Berlin (Niemcy) Uniwersytet Medyczny w Łodzi (Polska) Uniwersytet Adama Mickiewicza w Poznaniu (Polska) Fontys Hogescholen (Holandia) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy (Polska) Comenius University in Bratislava (Słowacja) ADRES REDAKCJI Pielęgniarstwo Polskie Wydział Nauk o Zdrowiu Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu ul. Smoluchowskiego, 6-79 Poznań tel.: wew. 9, fax: pielegniarstwopolskie@ump.edu.pl

4 PIELĘGNIARSTWO POLSKIE POLISH NURSING REDAKTORZY TEMATYCZNI PIELĘGNIARSTWO KLINICZNE dr Joanna Stanisławska dr Dorota Talarska dr hab. Maria Danuta Głowacka NAUKI O ZARZĄDZANIU W PIELĘGNIARSTWIE dr Ewa Jakubek dr Agnieszka Persona-Śliwińska PIELĘGNIARSTWO ŚRODOWISKOWE mgr Agnieszka Jopa mgr Luiza Mendyka NAUKI O ZDROWIU W PIELĘGNIARSTWIE dr Małgorzata Posłuszna REDAKTOR STATYSTYCZNY dr inż. Renata Rasińska Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) NZOZ Specjalistyczne Centrum Medyczne PRO FEMINA Niepubliczny Specjalistyczny Zakład Opieki Zdrowotnej MEDISANA Państwowa Wyższa Szkoła Zawodowa im. Jana Komeńskiego w Lesznie Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) LISTA RECENZENTÓW dr Grażyna Bączyk prof. Antonio Cicchella dr Józefa Czarnecka dr Grażyna Czerwiak dr hab. Joanna Gotlib dr Grażyna Iwanowicz-Palus doc. Helena Kadučáková dr Ewa Kobos dr Halina Król dr n. med. Włodzimierz Łojewski prof. Mária Machalová prof. Anders Møller Jensen pof. dr hab. Henryk Mruk dr Jana Nemcová dr inż. Iwona Nowakowska dr Jan Nowomiejski dr Piotr Pagórski prof. dr hab. Mariola Pawlaczyk dr Zofia Sienkiewicz dr Ewa Szynkiewicz dr Dorota Talarska dr hab. Monika Urbaniak dr Aleksandra Zielińska dr Katarína Žiaková mgr Klaudia J. Ćwiękała-Lewis Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) University of Bologna (Włochy) Warszawski Uniwersytet Medyczny (Polska) Uniwersytet Jana Kochanowskiego w Kielcach (Polska) Warszawski Uniwersytet Medyczny (Polska) Uniwersytet Medyczny w Lublinie (Polska) Katolícka Univerzita v Ružomberku (Słowacja) Warszawski Uniwersytet Medyczny (Polska) Uniwersytet Jana Kochanowskiego w Kielcach (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Prešovská Univerzita (Słowacja) VIA University College Denmark (Dania) Uniwersytet Ekonomiczny w Poznaniu (Polska) Comenius University in Bratislava (Słowacja) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Warszawski Uniwersytet Medyczny (Polska) Collegium Medicum w Bydgoszczy UMK w Toruniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Uniwersytet Medyczny im. K. Marcinkowskiego w Poznaniu (Polska) Comenius University in Bratislava (Słowacja) International Healthcare Leadership and Development (IHLD) Association (USA)

5 PIELĘGNIARSTWO POLSKIE POLISH NURSING EDITORIAL BOARD Editor-in-Chief Maria Danuta Głowacka Scientific Secretary Renata Rasińska Vice Editor-in-Chief Krystyna Jaracz Włodzimierz Samborski Jacek Wysocki Editorial Secretary Renata Rasińska EDITORIAL ADVISORY BOARD Vincenzo Antonelli Antonio Cicchella Agata Czajka-Jakubowska Antoni Czupryna Danuta Dyk Jolanta Jaworek Lotte Kaba-Schönstein Helena Kadučáková Christina Koehlen Maria Kózka Anna Ksykiewicz-Dorota Mária Machalová Piotr Małkowski Ewa Mojs Jana Nemcová Grażyna Nowak-Starz Marek Ostrowski Hildebrand Ptak Jerzy Stańczyk Piotr Stępniak Frans Vergeer Krzysztof Wiktorowicz Maciej Wilczak Zbigniew Włodarczyk Katarína Žiaková LUISS Guido Carli di Roma (Italy) University of Bologna (Italy) Poznan University of Medical Sciences (Poland) Jagiellonian University Collegium Medicum (Poland) Poznan University of Medical Sciences (Poland) Jagiellonian University Collegium Medicum (Poland) Hochschule Esslingen (Germany) Katolícka Univerzita v Ružomberku (Slovakia) Evangelische Hochschule Berlin (Germany) Jagiellonian University Collegium Medicum (Poland) Medical University of Lublin (Poland) Prešovská Univerzita (Slovakia) Medical University of Warsaw (Poland) Poznan University of Medical Sciences (Poland) Comenius University in Bratislava (Slovakia) Jan Kochanowski University in Kielce (Poland) Pomeranian Medical University in Szczecin (Poland) Evangelische Hochschule Berlin (Germany) Medical University of Lodz (Poland) Adam Mickiewicz University (Poland) Fontys Hogescholen (Holland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Ludwik Rydygier Collegium Medicum in Bydgoszcz (Poland) Comenius University in Bratislava (Slovakia) EDITOR S ADDRESS Polish Nursing The Faculty of Health Sciences Poznan University of Medical Sciences Smoluchowskiego Str., 6-79 Poznań, Poland phone: int. 9, fax: pielegniarstwopolskie@ump.edu.pl

6 PIELĘGNIARSTWO POLSKIE POLISH NURSING THEMATIC EDITORS CLINICAL NURSING Joanna Stanisławska Dorota Talarska Maria Danuta Głowacka MANAGEMENT IN NURSING Ewa Jakubek Agnieszka Persona-Śliwińska COMMUNITY NURSING Agnieszka Jopa Luiza Mendyka HEALTH SCIENCES IN NURSING Małgorzata Posłuszna STATISTICAL EDITOR Renata Rasińska Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Medical Centre PRO FEMINA (Poland) Private Healthcare Clinic MEDISANA (Poland) Jan Amos Komensky University of Applied Sciences in Leszno (Poland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) THE LIST OF THE REVIEWERS Grażyna Bączyk Antonio Cicchella Józefa Czarnecka Grażyna Czerwiak Joanna Gotlib Grażyna Iwanowicz-Palus Helena Kadučáková Ewa Kobos Halina Król Włodzimierz Łojewski Mária Machalová Anders Møller Jensen Henryk Mruk Jana Nemcová Iwona Nowakowska Jan Nowomiejski Piotr Pagórski Mariola Pawlaczyk Zofia Sienkiewicz Ewa Szynkiewicz Dorota Talarska Monika Urbaniak Aleksandra Zielińska Katarína Žiaková Klaudia J. Ćwiękała-Lewis Poznan University of Medical Sciences (Poland) University of Bologna (Italy) Medical University of Warsaw (Poland) Jan Kochanowski University in Kielce (Poland) Medical University of Warsaw (Poland) Medical University of Lublin (Poland) Katolícka Univerzita v Ružomberku (Slovakia) Medical University of Warsaw (Poland) Jan Kochanowski University in Kielce (Poland) Poznan University of Medical Sciences (Poland) Prešovská Univerzita (Slovakia) VIA University College Denmark (Denmark) Poznan University of Economics (Poland) Comenius University in Bratislava (Slovakia) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Medical University of Warsaw (Poland) Nicolaus Copernicus University Collegium Medicum (Poland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Poznan University of Medical Sciences (Poland) Comenius University in Bratislava (Slovakia) International Healthcare Leadership and Development (IHLD) Association (USA)

7 SPIS TREŚCI Od redaktora PRACE ORYGINALNE Anna Kaczyńska, Marta Rozińska, Alicja Kucharska, Beata Sińska, Zofia Sienkiewicz, Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Joanna Gotlib Ocena poziomu wiedzy pielęgniarek Wojewódzkiego Szpitala Specjalistycznego w Radomiu na temat przepisów prawnych dotyczących wykonywania zawodu pielęgniarki Anna Kaczyńska, Aleksandra Kostro, Alicja Kucharska, Beata Sińska, Grażyna Dykowska, Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Joanna Gotlib Ocena wiedzy położnych na temat odpowiedzialności zawodowej Emilia Zientarska, Anna Kaczyńska, Jarosława Belowska, Mariusz Panczyk, Grażyna Dykowska, Zofia Sienkiewicz, Joanna Gotlib Próba oceny wiedzy pielęgniarek na temat wybranych aspektów resuscytacji krążeniowo-oddechowej Ewa Kempista, Anna Kaczyńska, Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Zofia Sienkiewicz, Joanna Gotlib Ocena przebiegu wizyt patronażowych realizowanych przez położne rzeczywistość czy fi kcja? Dorota Żołnierczuk-Kieliszek, Ewelina Piwko, Mariola Janiszewska, Teresa Kulik, Katarzyna Pawlikowska-Łagód, Aneta Kryk Świadomość uczniów klas licealnych na temat zagrożenia anoreksją i bulimią Aleksander Zarzeka, Mariusz Panczyk, Bożena Ścieglińska, Jarosława Belowska, Lucyna Iwanow, Joanna Gotlib Postawy pielęgniarek oddziałowych wobec rozszerzenia uprawnień zawodowych w zakresie wystawiania recept oraz samodzielnego kierowania na badania diagnostyczne wstępne badanie jakościowe Aleksander Zarzeka, Mariola Sajkowicz, Mariusz Panczyk, Jarosława Belowska, Łukasz Samoliński, Joanna Gotlib Wiedza pacjentów na temat Karty Praw Pacjenta wśród pacjentów Nowodworskiego Centrum Medycznego.. 45 Joanna Stanisławska, Dorota Talarska, Danuta Lewandowska, Maria Stachowska, Elżbieta Drozd-Gajdus Problem alkoholizmu w aglomeracji wiejskiej a zadania pielęgniarki podstawowej opieki zdrowotnej Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Barbara Kot-Doniec, Halina Żmuda-Trzebiatowska, Joanna Gotlib Wiedza i postawy pielęgniarek po ukończeniu szkolenia specjalizacyjnego z pielęgniarstwa opieki paliatywnej wobec praktyki zawodowej opartej na dowodach naukowych PRACE POGLĄDOWE Klaudia J. Ćwiękała-Lewis Matka Teresa pielęgniarka i uzdrowicielka Klaudia J. Ćwiękała-Lewis, Brandon H. Parkyn, Kinga Modliszewska Zagadnienia dotyczące procesu podejmowania decyzji przez pacjenta w ujęciu koncepcyjnym Marta Polowczyk-Michalska, Ewa Mojs Postawa ciała jako odzwierciedlenie działania fi zycznych mechanizmów psychogenności i ich znaczenie w procesie zdrowienia w koncepcjach Lowena Justyna Deręgowska Rola wychowawcy zajęć pozalekcyjnych w opiece nad dzieckiem hospitalizowanym w świetle refl eksji nad teorią i praktyką 44 PRACA KAZUISTYCZNA Aleksandra Persona-Śliwińska Prenatalnie rozpoznana ustępująca in utero wrodzona torbiel woreczka łzowego opis przypadku

8 INFORMACJE Polskie Towarzystwo Nauk o Zdrowiu. Deklaracja członkowska Wskazówki dla autorów

9 CONTENTS Editor s note ORIGINAL PAPERS Anna Kaczyńska, Marta Rozińska, Alicja Kucharska, Beata Sińska, Zofia Sienkiewicz, Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Joanna Gotlib Assessment of knowledge of nurses from the Voivodeship Specialist Hospital in Radom on legal regulations in the nursing profession Anna Kaczyńska, Aleksandra Kostro, Alicja Kucharska, Beata Sińska, Grażyna Dykowska, Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Joanna Gotlib Assessment of modwives knowledge of professional liability Emilia Zientarska, Anna Kaczyńska, Jarosława Belowska, Mariusz Panczyk, Grażyna Dykowska, Zofia Sienkiewicz, Joanna Gotlib The attempt to assess nurses knowledge on selected aspects of cardiopulmonary resuscitation Ewa Kempista, Anna Kaczyńska, Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Zofia Sienkiewicz, Joanna Gotlib Assessment of the course of patronage visits by midwives reality or fi ction? Dorota Żołnierczuk-Kieliszek, Ewelina Piwko, Mariola Janiszewska, Teresa Kulik, Katarzyna Pawlikowska-Łagód, Aneta Kryk High school students awareness of anorexia and bulimia threats Aleksander Zarzeka, Mariusz Panczyk, Bożena Ścieglińska, Jarosława Belowska, Lucyna Iwanow, Joanna Gotlib Attitudes of ward nurses towards extending professional powers with respect to writing out prescriptions and independent referrals for diagnostic tests a preliminary qualitative study Aleksander Zarzeka, Mariola Sajkowicz, Mariusz Panczyk, Jarosława Belowska, Łukasz Samoliński, Joanna Gotlib The attempt to assess the knowledge of the Charter of the Patient s Rights among patients of the Nowodworskie Medical Centre Joanna Stanisławska, Dorota Talarska, Danuta Lewandowska, Maria Stachowska, Elżbieta Drozd-Gajdus The problem of alcoholism in rural agglomeration and tasks of primary health nurses Jarosława Belowska, Aleksander Zarzeka, Mariusz Panczyk, Barbara Kot-Doniec, Halina Żmuda-Trzebiatowska, Joanna Gotlib Knowledge and attitudes of nurses after completion of specialist training in palliative nursing care against evidence- -based professional practice REVIEW PAPERS Klaudia J. Ćwiękała-Lewis Mother Teresa Nurse and Woman Healer Klaudia J. Ćwiękała-Lewis, Brandon H. Parkyn, Kinga Modliszewska Patient decision making process: Conceptual paper Marta Polowczyk-Michalska, Ewa Mojs Body posture as a refl ection of psychogenetic physical mechanisms and their meaning in the curing process within Loewen conceptions Justyna Deręgowska The role of a teacher in extracurricular activities for hospitalized children in the light of refl ections on theory and practice CASE STUDY Aleksandra Persona-Śliwińska Prenatal diagnosis of transient congenital dacryocystocele case report

10 INFORMATION Polish Society of Heath Sciences. Member s declaration Guidance for contributors

11 OD REDAKTORA Szanowni Czytelnicy, w imieniu Komitetu Naukowego mamy przyjemność zarekomendować Państwu kolejny numer Pielęgniarstwa Polskiego. Treści zawarte w tym tomie mają bardzo zróżnicowany charakter, odzwierciedlają jednak obszary zainteresowań poznawczych i klinicznych personelu pielęgniarskiego, jak i kadr nauki uniwersytetów medycznych. Wśród prezentowanych prac polecamy cykl prac dotyczących wiedzy pielęgniarek i położnych m.in. na temat przepisów prawnych oraz odpowiedzialności zawodowej. Wśród prac poglądowych polecamy artykuł poświęcony Matce Teresie. Autorka zidentyfikowała osiągnięcia Matki Teresy jako uzdrowicielki i pielęgniarki środowiskowej. W numerze tym znalazł się również artykuł, w którym opisano przypadek prawidłowo prenatalnie zdiagnozowanej torbieli kanalika łzowego, która na krótko przed końcem ciąży samoistnie się zmniejszyła a następnie całkowicie zaniknęła nie wymagając leczenia i w krótkim okresie po porodzie nie pozostawiła żadnego śladu u dziecka. Oprócz życzeń owocnej lektury składamy Państwu najserdeczniejsze życzenia z okazji Świąt Bożego Narodzenia. Natomiast na Nowy Rok 6 życzymy Państwu tę odrobinę szczęścia, która sprawi, że wszystkie podjęte działania zakończą się sukcesem Dr hab. Maria Danuta Głowacka Redaktor Naczelny Dr inż. Renata Rasińska Sekretarz Naukowy POLISH NURSING NR 4 (58) 5 EDITOR S NOTE 377

12 EDITOR S NOTE Dear Readers, on behalf of the Scientifi c Committee, we have a pleasure to recommend to you the current issue of the Polish Nursing The contents of this volume are diverse in character, yet they express the scope of clinical and scientifi c interests of medical personnel and research workers of medical universities and other colleges. From among presented articles we recommend a series of manuscripts concerning knowledge of nurses and midwives on legal regulations and professional liability. From among review papers, we recommend an article devoted to Mother Teresa. The author presented the accomplishments made by this healer and a public health nurse. In this issue you can also find the paper reporting the case of properly prenatally diagnosed dacryocystocele which self-regressed shortly before delivery. The infant examination did not reveal any malformations in the facial and other structures. There was no sign of the cyst without any treatment in the neonatal period shortly after delivery. Wishing you fruitful reading, we as well would like to wish you a Merry Christmas and a Happy New Year. May all the actions taken by you in 6 be successful. Assoc. Prof. Maria Danuta Głowacka, PhD Editor in Chief Renata Rasińska, PhD (Eng) Scientific Secretary 378 POLISH NURSING NR 4 (58) 5 EDITOR S NOTE

13 ASSESSMENT OF KNOWLEDGE OF NURSES FROM THE VOIVODESHIP SPECIALIST HOSPITAL IN RADOM ON LEGAL REGULATIO IN THE NURSING PROFESSION OCENA POZIOMU WIEDZY PIELĘGNIAREK WOJEWÓDZKIEGO SZPITALA SPECJALISTYCZNEGO W RADOMIU NA TEMAT PRZEPISÓW PRAWNYCH DOTYCZĄCYCH WYKONYWANIA ZAWODU PIELĘGNIARKI Anna Kaczyńska, Marta Rozińska, Alicja Kucharska 3, Beata Sińska 3, Zofia Sienkiewicz 4, Jarosława Belowska 5, Aleksander Zarzeka 5, Mariusz Panczyk 5, Joanna Gotlib 5 Field Nursing, Medical University of Warsaw, Poland Voivodeship Specialist Hospital in Radom, Poland 3 Division of Human Nutrition, Medical University of Warsaw, Poland 4 Division of Community Nursing, Medical University of Warsaw, Poland 5 Division of Teaching and Outcomes of Education, Medical University of Warsaw, Poland ABSTRACT Introduction. The knowledge of legal regulations in the nursing profession is of essential importance for people actively performing this job. Aim. The aim of the study was to assess the relation between the level of education and nurses knowledge of currently effective legal regulations concerning the nursing profession. Material and methods. The study covered nurses employed in the Voivodeship Specialist Hospital in Radom. 6 respondents had higher education, 3 medium-level education. The mean age of respondents was 37.5 years (min 3, max. 5 years, SD = 6.54). The mean work experience: 7 years. A voluntary and anonymous questionnaire survey study was conducted using a questionnaire of the authors own design. Statistical analysis: STATISTICA., nonparametric Mann-Whitney U Test (p<.5) Results. No signifi cant infl uence of the level of education on the knowledge of legal regulations concerning the nursing profession was disclosed in the study group. Nevertheless, statistical signifi cance showing differences between the study groups was found, among others, in questions concerning the date of being awarded the right to perform the profession (p<.4), the source document regulating professional liability (p<.44), the scope of bearing professional liability (p<.34) as well as the body keeping the register of nurses and midwives penalised (p<.5). Conclusions.. The knowledge of legal acts regulating the performance of the nursing profession among nurses is insuffi cient and requires to be complemented.. The overall knowledge of legal acts regulating the performance of the nursing profession was not dependent on the respondents level of education though nurses with higher education represented a slightly higher level of knowledge of professional liability. 3. The insuffi cient knowledge of legal issues concerning the profession practised in the studied group of nurses requires that actions be undertaken to expand this knowledge in the course of various forms of permanent education, pursuant to the principle of life-long education. KEYWORDS: knowledge, nurses, law, legal, civil, professional liability. POLISH NURSING NR 4 (58) 5 STRESZCZENIE Wstęp. Znajomość przepisów prawnych dotyczących wykonywania zawodu pielęgniarki ma bardzo istotne znaczenie dla osób czynnie wykonujących ten zawód. Cel. Celem pracy była ocena wiedzy pielęgniarek na temat aktualnie obowiązujących przepisów prawnych dotyczących wykonywania zawodu pielęgniarki w zależności od posiadanego wykształcenia. Materiał i metody. W badaniach udział wzięło pielęgniarek zatrudnionych w Wojewódzkim Szpitalu Specjalistycznym w Radomiu, 6 badanych posiadało wykształcenie wyższe, 3 wykształcenie średnie. Średnia wieku badanych wyniosła 37,5 lat (min. 3, maks. 5 lata, SD=6,54). Średni staż pracy w zawodzie: 7 lat. Przeprowadzono dobrowolne i anonimowe badania ankietowe, autorski kwestionariusz ankiety. Analiza statystyczna: STATISTICA., nieparametryczny test U Manna-Whitneya (p<,5). Wyniki. W badanej grupie nie stwierdzono istotnego wpływu poziomu wykształcenia na stan wiedzy na temat przepisów prawnych dotyczących wykonywania zawodu pielęgniarki. Mimo to istotność statystyczną wykazującą różnice pomiędzy badanymi grupami zauważono m.in. w pytaniach dotyczących: terminu wydania praw wykonywania zawodu (p<,4), dokumentu źródłowego regulującego odpowiedzialność zawodową (p<,44), zakresu ponoszenia odpowiedzialności zawodowej (p<,34) oraz organu prowadzącego rejestr ukaranych pielęgniarek i położnych (p<,5). Wnioski.. Wiedza pielęgniarek na temat uregulowań prawnych dotyczących wykonywania zawodu pielęgniarki jest niewystarczająca i wymaga uzupełnienia.. Ogólna znajomość aktów prawnych regulujących wykonywanie zawodu pielęgniarki nie była zależna od poziomu wykształcenia ankietowanych, jednakże nieznacznie wyższym poziomem wiedzy z zakresu odpowiedzialności zawodowej wykazały się pielęgniarki posiadające wykształcenie wyższe. 3. Niewystarczająca znajomość zagadnień prawnych dotyczących wykonywanego zawodu w badanej grupie pielęgniarek wymaga podjęcia działań zwiększających tę wiedzę podczas różnych form kształcenia ustawicznego, zgodnie z zasadą kształcenia się przez całe życie. SŁOWA KLUCZOWE: wiedza, pielęgniarki, prawo, odpowiedzialność prawna, cywilna, zawodowa. ORIGINAL PAPER 379

14 Introduction Changes in legal regulations concerning the nursing profession were made in Poland after 989, following systemic changes taking place in the country [ 5]. In 99 a law on the professional self-government of nurses and midwives was adopted and in 996 a law on the profession of a nurse and a midwife [6, 7]. In 5 regulations were introduced with respect to registers of nurses and midwives, practising the profession in the territory of the Republic of Poland [8, 9], and two years later a decree of the Minister of Health of 7 November 7 on the type and scope of preventive, diagnostic, therapeutic and rehabilitation services, rendered by the nurse and the midwife on their own without a doctor s order (Journal of Laws No. Item 54), which had not been amended until then [,, ]. Since January, the legal status of the profession of the nurse and the midwife has been governed by new laws: the law of 5 July on the professions of a nurse and a midwife (Journal of Law of 3 August ) and the law on the self-government of nurses and midwives of July (Journal of Laws of 3 August of ). Aim The aim of the study was to assess the level of nurses knowledge of current legal regulations concerning the performance of the profession depending on education. Material The study covered nurses employed in the Voivodeship Specialist Hospital in Radom. The inclusion criteria were: oral consent to participation in the study and employment on the basis of an employment contract. Women constituted % of the respondents. 5 people (5%) with professional specialty were excluded from the study in order to have a study group uniform in terms of education. Finally, the study group consisted of 85 people. 3 nurses (Group ) had medium-level education (7.5%) while 6 nurses (Group ) higher education (7.94%). The age of the nurses studied ranged from 3 to 5 years (mean age: 37.5 yrs). The length of professional work of the nurses ranged from 3 months to 3 years (mean length of work: year). Methods The voluntary and anonymous questionnaire survey was conducted from November to January 3. The study instrument was a survey questionnaire designed by the authors themselves which consisted of 4 closed questions (6 multiple choice questions) and was divided into three parts. The first part concerned the level of general knowledge of the legal regulations applicable to nurses and midwives. In the second part the respondents answered questions concerning the law on the profession of a nurse and a midwife, the law on the professional self-government and the decree of the Minister of Health on the independent provision of preventive, diagnostic, therapeutic and rehabilitation services by a nurse without a doctor s order. In the third part the respondents were asked to provide selfassessment of their knowledge of legal regulations concerning the performance of the profession. Statistical analysis of the obtained results The collected results were subjected to a statistical analysis made in the Division of Teaching and Outcomes of Education at the Faculty of Health Science, Medical University of Warsaw, with the use of the STATISTICA. programme (MUW license). Two independent groups of nurses, formed depending on the level of education held, were compared. The analyzed data were qualitative, nonparametric and did not have a normal distribution (p>.5, Shapiro-Wilk Test). The nonparametric Mann-Whitney U Test was used to perform a statistical analysis. The p<.5 level was adopted as statistically significant. Results In the study group, education did not affect the level of nurses knowledge of the law applicable to the performance of the profession. Statistical signifi cance was found only in the question concerning the date of being awarded the right to perform the profession, which indicated a difference between the study groups (p<.4). Detailed results are presented in Table. Table. Knowledge of the right to practise the profession of a nurse in the study group No. Question Answer What constitutes the condition of being awarded the right to practise the profession? Who awards the right to practise the profession? Certifi cate or diploma of completing a nursing school Full legal capacity State of health allowing to practise the profession Postgraduate internship I do not know Regional Board of Nurses and Midwives Regional Chamber of Nurses and Midwives Supreme Board of Nurses and Midwives I do not know Not later than within 3 months Not later than within Within what time is the month 3 right to practise the Not later than within profession awarded? 4 days I do not know Group as a whole 6 (7%) 6 (9%) 6 (7%) 53 (6%) 4 (5%) 35 (4%) 48 (56%) (%) (%) 35 (4%) 33 (39%) (3%) 6 (7%) Group Group p (8%) 6 (6%) 5 (65%) 3 (57%) 9 (39%) (4%) 6 (7%) 4 (7%) 3 (3%) 4 (7%) (6%) 6 38 (6%) 4 (7%) (35,5%) 39 (63%) (,5%) 9 (3%) 9 (47%) p<.4 (8%) 3 (5%) 38 POLISH NURSING NR 4 (58) 5

15 4 Can the right to practise the profession expire or be limited? Does the expiration or limitation of the right to practise the profession result in a loss of 5 professional qualifi cations acquired? Yes No I do not know Yes No I do not know 83 (98%) (%) 8 (95%) 4 (4%) 3 (%) (9%) (8%) 6 (97%) (3%) 6 (97%) (3%) The majority of respondents knew that the legal act regulating the principles of the professional liability of a nurse was the law on the professional self-government of July. However, education affected the replies given by respondents (p<.44). Moreover, a signifi cant group of respondents knew that a nurse bore professional liability before a professional court (p<.34). Detailed results are presented in Table. Table. Level of knowledge of professional liability among the respondents No. Question Answer 3 4 Code of Professional Ethics of a Nurse and a Midwife What document specifi es the professional Penal Code liability of nurses? Law on the Professional Self-government of 5 July I do not know Towards whom do nurses bear professional liability? Do proceedings before a professional court exclude initiation of proceedings before the common court? What penalties are foreseen for violating professional liability? the patient the employer Professional Court of Nurses and Midwives I do not know Yes No I do not know Admonition Reprimand Cash penalty Withdrawal of the right to practise the profession Public works Limitation of personal freedom I do not know Group as a whole 37 (43,5%) 3 (3,5%) 39 (46%) 6 (7%) 5 (6%) (%) 76 (89,5%) 3 (3,5%) 7 (8%) 7 (8%) 8 (9%) 8 (95%) 8 (95%) 69 (8%) 77 (9,5%) (%) 3 (7%) (%) Group Group 4 (56%) 8 (3%) (4%) (4%) (87%) (8%) 3 (3%) 9 (8%) (4%) (9%) (96%) 9 (8%) (9%) 4 (7%) (4%) 3 (37%) 3 (5%) 3 (5%) 5 (8%) 4 (6%) (%) 56 (9%) (%) 4 (6%) 5 (8%) 7 (%) 6 (97%) 59 (95%) 5 (8%) 56 (9%) (3%) 9 (3%) p p<.44 p<, What cash penalties are adjudicated for the violation of professional liability? PLN - PLN - PLN 5- I do not know Regional Chamber of Nurses and Midwives Who keeps the Supreme Council of register of penalised Nurses and Midwives nurses and midwives? Minister of Health What medical services can a nurse provide on her own in accordance with the Decree of the Minister of Health of 7 November 7? When can a nurse administer a drug to a patient on her own, without a doctor s order? I do not know Prophylactic Diagnostic Therapeutic Dietetic I do not know In an emergency situation In palliative therapy I do not know 58 (68%) 3 (3.5%) 4 (5%) (3,5%) 3 (37,5%) 44 (5%) (%) 7 (8,5%) 84 (99%) 6 (7%) 5 (6%) 37 (43.5% 7 (85%) (3%) (%) 8 4 (78%) (64,5%) 3 (5%) 3 (4%) (5%) 4 6 (7%) (6%) 3 9 (3%) (47%) 9 5 (8%) (4%) p<,5 (3%) 6 (4%) 3 6 (%) (98%) 4 (87%) (66%) 6 34 (7%) (55% 9 8 (39%) (45%) 5 (9%) (8%) (4%) (6%) (4%) (%) Replying to the question about the source of knowledge on the legal regulations governing the performance of the nursing profession, the majority of the respondents indicated school/university, followed by the Internet. The remaining two answers (from another nurse p<. and at school/university p<.) were statistically signifi cant. Midwives with higher education gave the largest number of correct answers to the remaining questions from the table below. Detailed results can be seen in Tables 3 and 4. Table 3. Knowledge of legal regulations concerning the performance of the profession in the studied group of nurses (Part I) No. Question Answer Have you got acquainted with the legal acts regulating the performance of the nursing profession? If so, where did you gain the knowledge of the legal regulations concerning the performance of the nursing profession? Yes No From another nurse At school/university From press From the Internet Others Do you consider Yes knowledge of the legal acts 3 in question No necessary in the professional work I have no opinion of a nurse? The whole group 75 (88%) (%) 6 (3,5%) 64 (75%) (3,5%) 33 (7%) 5 (6%) 77 (9,5%) (%) 7 (8.5%) Group Group P 9 (8%) 4 (8%) 3 (56,5%) (5%) 8 (35%) (43,5%) (4%) (88%) (4%) (8%) 56 (9%) 6 3 (%) 5 (84%) (9%) 3 (37%) 4 (6%) 57 (9%) 5 (8%) p<. p<. ASSESSMENT OF KNOWLEDGE OF NURSES FROM THE VOIVODESHIP SPECIALIST HOSPITAL IN RADOM ON LEGAL REGULATIO... 38

16 Which of the legal acts listed regulate the performance of the nursing profession? How long has the Law on the Profession of a Nurse and a Midwife been in force? Type and scope of medical services rendered by a nurse without a doctor s order is specifi ed in the form of How long has the Law on the Professional Selfgovernment been in force? What does the Law on the Profession of a Nurse and a Midwife refer to? Law on the Profession of a Nurse and a Midwife of 5 July Law on the Professional Selfgovernment of July Civil Code Penal Code Decree of the Minister of Health of 7 November 7 January 5 July July 5 July 996 I do not know A decree A resolution A law I do not know Since July Since 7 July 99 Since January I do not know Performance of the profession of a nurse and a midwife Being awarded the right to practise the profession of a nurse and a midwife Professional education of a nurse and a midwife Principles of the professional self-government functioning Professional liability of a nurse and a midwife I do not know 8 (96%) 36 (4%) 4 (5%) 7 (8%) 9 (34%) 37 (43%) (6%) (6%) 4 (5%) 7 (8%) 5 (6.5%) 3 (3.5%) 7 (8%) 3 (5%) 7 35 (4%) 9 (%) 8 (95%) 59 (69%) 6 (7.5%) 37 (43.5%) 36 (4% 3 (%) 9 (39%) (8%) (8%) (44%) (4%) 4 (6%) 8 (3%) (4%) 8 (79%) (4%) 4 (7%) (9% 5 (%) 9 (39%) 7 (3%) (96%) 6 (69.5%) (87%) (9%) (48%) 59 (95%) 7 (43.5%) (3%) 5 (8%) 8 (9%) 7 (43.5%) 8 (9%) 4 (.5%) 3 (5%) 5 (84%) 4 (6%) 3 (5%) 3 (5%) (8%) (9%) 6 (43%) (9%) 59 (95%) 43 (69%) 4 (64.5%) 35 (56%) 5 (4%) Table 4. Knowledge of legal regulations concerning the performance of the profession in the studied group of nurses (Part II) No. Question Answer Is the profession of a nurse an independent profession? Yes Partly No I do not know The group as a whole 7 (85%) (4%) (%) Group Group p (9%) (4.5%) (4.5%) 5 (8%) (6%) (%) A nurse providing health services enjoys legal protection foreseen for Can a nurse provide a patient with information about the patient s health status? How can a nurse practise the profession? What law regulates the performance of the profession of a nurse under a contract? Can a nurse provide additional nursing care in the same therapeutic unit, such as a hospital? What form of a contract must a nurse providing additional nursing care conclude? How long is the retraining of a nurse with a 6-year break in practising the profession? Does the retraining of a nurse with a break in practising the profession require the supervision of another nurse? How do you assess the level of your knowledge concerning the performance of the nursing profession? A public offi cer A medical offi cer A social offi cer I do not know Yes Yes within a scope necessary to provide nursing care No I do not know Under a work contract Under a service contract Under a civil law contract As a volunteer Under a professional practical placement Under a contract I do not know Labour Code Civil Code Law on the Profession of a Nurse and a Midwife of 5 July I do not know Yes No I do not know Work contract Civil law contract Contract agreement I do not know No less than 6 months No longer than 6 months No less than 3 months No longer than 3 months I do not know Yes I know very little I know little I know a lot I know more than a lot 7 (8%) 3 (5%) (%) (%) 75 (89%) 6 (7%) (%) 83 (98%) 35 (4%) 6 (73%) 67 (79%) 5 (6%) 56 (66%) (%) 8 (9,5%) 4 (47%) 3 (36.5%) 6 (7%) 6 (73%) 3 (5%) (%) 9 (,5%) 48 (56%) (3.5%) 8 (9%) 54 (63.5%) 4 (6,5%) 4 (6.5%) 3 (3,5%) 84 (99%) (%) 38 (45%) 4 (49%) 4 (5%) 9 (83%) 3 (3%) (4%) (4%) 7 (78%) (8%) (8%) (96%) (43.5%) 5 (65%) (87%) (5%) 5 (65%) (4%) (4%) 9 (39%) (48%) (8%) 8 (78%) (8%) 3 (3%) (8%) (5%) 6 (6%) 3 (3%) 4 (6%) 4 (7%) 5 (%) (96%) (4%) (5%) (4%) 5 (84%) (6%) (%) (%) 58 (9%) 4 (6%) 6 (98%) 5 (4%) 47 (76%) 47 (76%) 39 (63%) 4 (66%) 7 (%) 3 (5%) (3%) 4 (7%) 44 (7%) (8%) 7 (%) 7 (%) 36 (58%) 4 (3%) 5 (8%) 4 (64,5%) (6%) 9 (4,5%) 3 (5%) 6 (%) 6 (4%) 3 (5%) 4 (6%) 38 POLISH NURSING NR 4 (58) 5

17 Education had no influence on the respondents answers to the question about updating professional knowledge and skills (Table 5). Table 5. Assessment of the nurses knowledge concerning postgraduate education Group as a No. Question Answer whole Is a nurse 85 Yes obliged to keep (%) updating her No professional knowledge and I do not know skills? 5 Yes (3%) 3 Is a nurse entitled to a training leave for the purpose of postgraduate training? How long must a nurse work for an employer referring her to postgraduate training? 56 (66%) No (%) I do not know (%) 6 3 years (7.5%) Till reaching the retirement age There is no obligation of this kind I do not know Yes but only when she is referred to it by the employer Specialist training Specialist What types of course postgraduate Qualifi cation 4 education do you course know? Complementary course Specialist course What length of work in the profession makes years 5 years 5 a nurse eligible There are no for undertaking requirements specialty education? in this respect I do not know After what period of time can a nurse apply for 6 admission to another specialty 5 years study subsidized from public funds? 4 (6.5%) (3%) 53 (6%) 73 (86%) 79 (93%) 58 (68%) 43 (5%) 7 (85%) 6 (7%) 4 (5%) 3 (3%) 56 (66%) Group Group p 3 (%) 9 (39%) 4 (6%) 4 (6%) 5 (%) 4 (8%) 7 (78%) (87%) (96%) 7 (78%) 3 (57%) 9 (83%) (8%) (8%) 9 (83%) 6 (%) 6 (6%) 4 (68%) (3%) (3%) 46 (74,5%) 9 (4,5%) 7 (%) 36 (58%) 53 (85%) 57 (9%) 4 (66%) 4 (64%) 53 (85%) 6 (3%) (%) (3%) Respondents with medium-level education gave more correct answers to the question about the legal act regulating the activity of nurses chambers, membership in professional self-government, duration of the term of nurses chambers and the sense of duty to pay contributions than nurses with higher education. Detailed results are presented in Table 6. Table 6. Assessment of nurses knowledge on the organization of the professional self-government of nurses and midwives No. Question Answer What legal act regulates the activity of nursing chambers? Is it obligatory to belong to the professional self-government? Law on the Profession of a Nurse and a Midwife of 5 July Decree of the Minister of Health of 7 November 7 Law on the Professional Self-government of July I do not know Yes No I do not know Supreme Chamber of Nurses and Midwives Regional Chamber What is the organization unit of the profes- of Nurses and Midwives sional self-government on the national level? National Professional Union of Nurses and Midwives I do not know How long is the term of the organs of chambers of nurses? Is it obligatory to pay membership fees? 4 years years 5 years I do not know Yes No I do not know The group as a whole 9 (.5%) 6 (7%) 6 (73%) 8 (9.5%) 64 (75%) (3%) (%) 54 (63%) 7 (8%) (6%) (%) 65 (76%) 4 (5%) 6 (7%) (%) 8 (94%) 4 (5%) (%) Group Group p (4%) (4%) (87%) (4%) (87%) (4%) (8%) 4 (6%) (4%) 7 (8%) (4%) 9 (8%) (4%) 3 (3%) 3 (%) 8 (3%) 5 (8%) 4 (68%) 7 (%) 44 (7%) (6%) 8 (3%) 4 (64%) 6 5 (4%) (%) 46 (74%) 4 (6%) 5 (8%) 7 (%) 57 (9%) 4 (6%) (%) Discussion In literature, there are plenty of studies referring to legal acts concerning the nursing profession [3 9]. The largest number of publications concerns the knowledge of the Code of the Professional Ethics of Nurses and Midwives and the Law on the Profession of a Nurse and a Midwife. The updating in January of the two most important laws concerning the performance of the nursing profession, i.e. the Law on the Profession of a Nurse and a Midwife as well as the Law on the Professional Self- Government, gave an impulse to the commencement of research on the level of knowledge of current legal regulations concerning the nursing profession among nurses. The study by Rozwadowska et al. analysed the duty of a nurse to extend assistance in case of the life-threat danger and injury to the patient s health status accord- ASSESSMENT OF KNOWLEDGE OF NURSES FROM THE VOIVODESHIP SPECIALIST HOSPITAL IN RADOM ON LEGAL REGULATIO

18 ing to the professional qualifi cations held. In the study referred to, almost all the respondents, 84% of whom were professionally active nurses, gave a correct answer. Another question considered the possibility of resuming work in the profession of the nurse or the midwife after an over 5-year long break in practising the profession. The study revealed that 76% of professionally active nurses were not able to indicate the correct answer, which reflected a signifi cant lack of knowledge in respondents. Also, the awareness of the duty of a nurse to inform patients about their rights was found to be inadequate, with 86% of the nurses aware of having the duty to inform patients about their rights. Rozwadowska et al. also analysed the respondents knowledge of the organ and time of lodging an appeal in case of receiving a decision of their right to practice the profession having been suspended. Professionally active nurses showed signifi cant knowledge as 6% of the respondents indicated the correct answer. In the subject area of professional protection foreseen for a public offi cer, 65% of the nurses studied gave the correct answer. Studying the nurses awareness of the question concerning the refusal to perform a doctor s order, 96% of the respondents revealed having knowledge of the subject. A similar percentage result (88%) was obtained in answering the question about the nurse s refusal to perform health services non-compliant with her conscience. Analysing the collected results, the authors concluded that the prevailing majority of the respondents showed good knowledge of the regulations applying to nurses and midwives. Our own study investigated the knowledge of the provisions of the law on the profession of a nurse extending the subject so as to cover issues resulting from the new contents included in the laws on the profession of a nurse and a midwife as well as on the professional self-government. The respondents were also asked about the duration of the nursing training with a 6-year break in practising the profession. The respondents revealed signifi cant lack of knowledge as only 6% of the nurses studied gave the correct answer. The state of knowledge of the respondents as regards legal protection in the course of rendering medical services by the nurse proved high as 85% of the respondents correctly indicated a public offi cer. Asked what constitutes the organizational unit of the professional selfgovernment on the national level, 64% of the respondents disclosed knowledge of the subject indicating the Supreme Chamber of Nurses and Midwives. The majority of the respondents (76%) knew the term of nursing chambers. Grochans et al. carried out assessment of the knowledge of legal acts which were applicable to nursing. The study covered professionally active nurses from different regions of Poland and took into account the level of respondents education. Analysing the results, the authors concluded that the knowledge of legal acts among nurses with medium-level education was the same as among nurses holding a master s degree. Nurses with higher education (bachelor s degree) showed the best knowledge of the legal acts. Our own study presented dependence between the knowledge of respondents and the level of education. Analysis of the obtained results indicates that the knowledge of legal acts concerning the performance of the nursing profession is better among nurses with higher education. This is reflected in the knowledge of issues related to obtaining the right to practise the profession and to professional liability. The knowledge of the remaining questions related to legal acts among nurses with both medium-level and higher education was on the same level. Another issue addressed in domestic literature was the question of professional liability connected with the performance of the nursing profession. Gaweł et al. using a questionnaire of their own design, carried out a study on nurses employed in the Gorzów Centre of Paediatrics and Oncology with the purpose of assessing the awareness level of professional liability among nurses. In addition, the authors studied the knowledge of the legal acts regulating the profession of a nurse in force as well as the bodies responsible for issuing judgments in cases related to professional liability. Another issue analysed was the knowledge of proceedings before nurses and midwives courts in cases of adjudicating penalties concerning professional liability. The majority of the nurses did not know what body examined cases concerning professional liability 7%. Moreover, not all the nurses were familiar with legal acts regulating the performance of the profession and professional liability. The majority, that is 79%, indicated the Law on the Profession of a Nurse and a Midwife. Only % pointed to the Decree of the Minister of Health of 7 on the scope and type of preventive, diagnostic, therapeutic and rehabilitative services provided by the nurse independently, without the doctor s order. Analysing the results of the research carried out, the authors of the study showed that nurses knowledge of normative acts concerning the performance of the profession and professional liability was unsatisfactory and required to be complemented. Reference to the research carried out is also contained in our own research in assessment of the nurses knowledge regarding professional liability. Merely 45% of the nurses studied indicated correctly the source of professional liability the Law on the Professional Self-government of July. 89% of the respondents expressed a belief that professional liability was borne before the professional court of nurses and midwives. The penalties applied by the professional 384 POLISH NURSING NR 4 (58) 5

19 court of nurses and midwives most frequently indicated by respondents included admonitions (95%), reprimand (95%), withdrawal of the right to practise the profession (9%) and only in the last place the financial penalty (8%). The amount of the financial penalty for the violation of professional liability was correctly indicated by 68% of the respondents. The analysis of the results showed that the nurses knowledge of professional liability is suffi cient. In comparison with studies carried out earlier, the knowledge of the legal aspects of the nursing profession still seems to suggest a need for updating and permanent education of nurses in this area. Conclusions. Nurses knowledge of legal regulations concerning the performance of the nursing profession is insufficient and requires to be complemented.. The overall knowledge of legal acts regulating the performance of the nursing profession was not dependent on the level of respondents education, with nurses with higher education showing a slightly higher level of knowledge in the area of professional liability. 3. Insufficient knowledge of legal issues concerning the nursing profession in the studied group of nurses requires that actions aimed at expanding this knowledge be undertaken during various forms of permanent education, in accordance with the principle of life-long education. References. Górajek-Jóźwik J. Kalendarium Pielęgniarstwa Polskiego. Warszawa: Wydawnictwo OVO; Łukasz-Paluch K, Franek GA. Ruch zawodowy i przemiany w kształceniu podstawowym pielęgniarek na przełomie wieków. Problemy Pielęgniarstwa 8; 6 (/): Wolska-Lipiec K. Polskie Towarzystwo Pielęgniarskie na tle historycznym. Problemy Pielęgniarstwa 7; 5 (-3): Karkowska D. Zawody Medyczne. Warszawa: Wydawnictwo Wolters Kluwer; Bukowska A. Maria Babicka-Zachertowa twórczyni Ustawy o pielęgniarstwie. Problemy Pielęgniarstwa 9; 7 (): Kiliańska D. Sprawozdanie z Międzynarodowej Jubileuszowej Konferencji z okazji 5-lecia Polskiego Towarzystwa Pielęgniarskiego. Problemy Pielęgniarstwa 7; 5 (4): Krzyżanowska-Łagowska U. Idea samorządności zawodowej pielęgniarek i położnych. Dwadzieścia lat, a nawet więcej! Magazyn Pielęgniarki i Położnej ; 4: Rozporządzenie Ministra Zdrowia z dnia 5 czerwca 5 r. w sprawie Centralnego Rejestru Pielęgniarek i Położnych Dz. U. nr poz Ustawa z dnia 9 kwietnia 99 r. o Samorządzie Pielęgniarek i Położnych Dz.U. nr 9 poz. 78 z późn. zm.. Tkaczyk E. Samorząd zawodowy w świetle Konstytucji Rzeczypospolitej Polskiej. Przegląd Sejmowy ; 6(7): Kieczka K. Opieka profesjonalna i zakres kompetencji pielęgniarek w Polsce w świetle prawa w ostatnim stuleciu. Pielęgniarstwo XXI wieku ; (3 3): Glińska J, Lewandowska M. Autonomiczność zawodu pielęgniarskiego w świadomości pielęgniarek z uwzględnieniem pełnionych funkcji zawodowych. Problemy Pielęgniarstwa 7; 5 (4): Zimmermann A, Banasik P. Wpływ nowych regulacji prawnych na zasady wykonywania zawodu przez pielęgniarki (część I). Problemy Pielęgniarstwa ; (3): Karkowska D. Granice Twojej samodzielności. Magazyn Pielęgniarki i Położnej ; : Kilińska-Pękacz A. Jesteś funkcjonariuszem publicznym. Magazyn Pielęgniarki i Położnej ; 4: Jacek A i wsp. Odpowiedzialność personelu medycznego. Magazyn Pielęgniarki i Położnej ; 9: Rozwadowska E i wsp. Ocena znajomości ustawy o zawodzie pielęgniarki i położnej przez studentów pielęgniarstwa i położnictwa oraz pielęgniarki i położne. Problemy Pielęgniarstwa ; 8 (4): Grochans E i wsp. Wpływ poziomu wykształcenia pielęgniarek na znajomość wybranych aktów prawnych wykorzystywanych w pielęgniarstwie. Problemy Pielęgniarstwa ;9 (4): Gaweł G i wsp. Świadomość odpowiedzialności zawodowej wśród pielęgniarek. Problemy Pielęgniarstwa ; 8(): 5. The manuscript accepted for editing: The manuscript accepted for publication: Funding Sources: This study was not supported. Confl ict of interest: The authors have no confl ict of interest to declare. Address for correspondence: Joanna Gotlib Żwirki i Wigury 8-9 Warsaw, Poland phone: joanna.gotlib@wum.edu.pl Division of Teaching and Outcomes of Education Medical University of Warsaw ASSESSMENT OF KNOWLEDGE OF NURSES FROM THE VOIVODESHIP SPECIALIST HOSPITAL IN RADOM ON LEGAL REGULATIO

20 ASSESSMENT OF MIDWIVES KNOWLEDGE ON PROFESSIONAL LIABILITY OCENA WIEDZY POŁOŻNYCH NA TEMAT ODPOWIEDZIALNOŚCI ZAWODOWEJ Anna Kaczyńska, Aleksandra Kostro, Alicja Kucharska 3, Beata Sińska 3, Grażyna Dykowska 4, Jarosława Belowska 5, Aleksander Zarzeka 5, Mariusz Panczyk 5, Joanna Gotlib 5 Field Nursing, Medical University of Warsaw, Poland Field Midwifery, Medical University of Warsaw, Poland 3 Division of Human Nutrition, Medical University of Warsaw, Poland 4 Division of Community Nursing, Medical University of Warsaw, Poland 5 Division of Teaching and Outcomes of Education, Medical University of Warsaw, Poland ABSTRACT Introduction. The changes in the Polish legislation regulating the performance of the professions of a nurse and a midwife which have taken place since January generate a necessity to analyse the level of knowledge of the legal conditions of practising the profession in these professional groups. Aim. The aim of the study is the attempt to assess the knowledge of the principles of professional liability as dependent on education held among midwives. Material and methods. The study included midwives from Warsaw hospitals as well as primary health care units. Respondents were divided into two groups. Group I covered 5 midwives with a completed medical vocational school/secondary school, Group II 5 midwives with completed midwifery studies. The mean age in Group I 55 years, in Group II 9 years. The study was conducted between October and 7 January 3 using a questionnaire of the authors own design. The participation in the study was voluntary and anonymous. Midwives received the survey questionnaire. The questionnaire 34 questions, 3 single or multiple choice closed questions, semi-open questions and open questions (age, length of work). Results. No signifi cant infl uence of the level of education on the state of knowledge of legal regulations concerning the performance of the nursing profession was disclosed in the study group. Nevertheless, statistical signifi cance showing differences between the study groups was found, among others, in questions concerning the date of being awarded the right to practise the profession (p<.4), the source document regulating professional liability (p<.44), the scope of bearing professional liability (p<.34) as well as the body keeping the register of nurses and midwives penalised (p<.5). Conclusions.. In the study group the knowledge of professional liability regulated by legal acts currently in force was insuffi cient and requires to be complemented.. In the study group of midwives the level of education affected the level of knowledge of the professional liability of nurses and midwives midwives with higher education showed a higher level knowledge of professional liability than the study group of midwives with medium-level education. KEYWORDS: midwives, professional liability, knowledge. STRESZCZENIE Wstęp. Zmiany, które nastąpiły od stycznia roku w ustawodawstwie polskim regulującym wykonywanie zawodów: pielęgniarki i położnej powodują konieczność analizy poziomu wiedzy tych grup zawodowych na temat aktualnych uwarunkowań prawnych dotyczących wykonywania zawodu. Cel. Celem pracy jest próba oceny wiedzy położnych na temat zasad odpowiedzialności zawodowej w zależności od posiadanego wykształcenia. Materiał i metody. W badaniach udział wzięło położnych z warszawskich placówek szpitalnych oraz POZ. Podział badanych na dwie grupy. Grupa I obejmowała 5 położnych, które skończyły studium/liceum medyczne, Grupa II 5 położnych, które ukończyły studia wyższe na kierunku położnictwo. Średnia wieku Grupy I 55 lat, a Grupy II 9 lat. Badanie przeprowadzono od października roku do 7 stycznia 3 roku za pomocą kwestionariusza własnego autorstwa. Udział w badaniu był dobrowolny i anonimowy. Położne otrzymały kwestionariusz ankiet z rąk osoby przeprowadzającej badanie. Ankieta 34 pytania, 3 pytań zamkniętych jednokrotnego lub wielokrotnego wyboru, pytania półotwarte i pytania otwarte (wiek, staż pracy). Wyniki. Większość respondentek (85%) nie wiedziała jaki zakres obejmuje postępowanie w przedmiocie odpowiedzialności zawodowej. 45% położnych oceniła stan swojej wiedzy na temat zasad ponoszenia odpowiedzialności zawodowej jako dostateczny, zaś 33% twierdziło, że jest on na poziomie niedostatecznym. W badanej grupie położnych wykształcenie miało wpływ na poziom wiedzy na temat aktualnych przepisów prawnych: osoby z wykształceniem wyższym posiadały wyższy poziom wiedzy dotyczący odpowiedzialności zawodowej. Wnioski.. W badanej grupie wiedza na temat zakresu odpowiedzialności zawodowej regulowanej aktualnymi aktami prawnymi była niewystarczająca i wymaga pilnego uzupełnienia.. W badanej grupie położnych poziom wykształcenia miał wpływ na poziom wiedzy na temat zakresu odpowiedzialności zawodowej pielęgniarek i położnych położne z wykształceniem wyższym posiadały wyższy poziom wiedzy dotyczącej odpowiedzialności zawodowej, niż badana grupa położnych z wykształceniem średnim. SŁOWA KLUCZOWE: położne, odpowiedzialność zawodowa, wiedza. 386 POLISH NURSING NR 4 (58) 5 ORIGINAL PAPER