News

• Workshops

• Projects from Pleven municipality

•  Projects from the PSBHN workshop from the St. Georgi University Hospital in Plovdiv

Site Visits and Meetings

NEWS

WORKSHOPS

An Initiative for Better Children’s Health workshop was held in Pleven on March 24-26^th. The workshop was a further step to improve children’s health in Pleven municipality in a collaborative effort with Dreyfus Health Foundation, Children’s Help Net Foundation, Medical University – Pleven, Pleven Municipality and the Association for Better Health.

The workshop is a continuation of two PSBHN workshops that took place in 2004, after which more than 60 projects were started in crèches, kindergartens and schools on the territory of Pleven Municipality. Thanks to the active follow up and guidance on behalf the Health Department of the Municipality of Pleven, most of these projects have continued as routine programs, and are funded by the municipality. In 2005, PSBH project activities were included in the job description of nurses working in crèches, kindergartens and schools.

Group picture and a small group (PSBHI workshop for Better Children’s Health, Pleven, 2007)

The participants in the Initiative for Better Children’s Health workshop were addressed by Dr. Plamen Kerekovski, paediatrician and a Deputy Mayor of Pleven, Dr. Irina Kovacheva from the Department of Children’s Health at the National Center of Public Health Control and Assoc. Prof. Daniel Levine, Director of Children’s Help Net Foundation.

Dr. Irina Kovacheva, chief expert at the Department of Public Health of the Ministry of Health, presented health problems, identified in children (0-18 years) in Bulgaria. She analysed the problems in their complexity, outlining problems related to behaviour, low level of knowledge, problems associated with unhealthy diet, sedentary life styles, etc.

Most helpful to participants were solutions offered by Dr. Kovatcheva - health education for children and their parents, providing information to form proper attitudes and skills, and raising the awareness of the importance of healthy lifestyles, as well as early diagnosis and treatment as part of prevention and control of chronic non-infections diseases.

Under the guidance of the local team of facilitators – Assoc. Prof. Maria Alexandrova, Assoc. Prof. Angelika Velkova, Mrs. Yanka Tzvetanova, Mrs. Evgeniya Dimitrova, Dr. Emilia Kanyovska and Mrs. Makretta Draganova (all employed by Medical University – Pleven), Mrs. Gergana Momova (Medical University – Varna), Mrs Polya Zhivkova (Alexandrovska Hospital – Sofia) and Assoc. Prof. Daniel Levine (USA), the participants – nurses, paediatricians, social workers, health promoters, psychologists, NGO representatives and medical students from Pleven municipality developed plans of action addressing children’s health, rehabilitation, health promotion and health education for children and their parents:

·        A program to facilitate transition from liquid to solid food in newly admitted children - Snezhana Rousinova

·        Information and training program to reduce trauma incidents because of incorrect warming up before sports activities - Toni Nikolova

·        Training computer skills to blind children - Yordanka Valakova

·        A health education program for parents on fitness activities in crèche children - Hristinka Totova

·        Art therapy for improvement of psycho-emotional development and integration of disabled children - Albena Dimitrova

·        A training program for children aged 12-14 for the purposes of peer education on the relationship between environment and human health - Dr. Hristana Totolanova

·        Introducing hydrotherapy in rehabilitation procedure for children with motor deficits - Denitza Troolieva

·        A health education program on prevention of parasitic diseases - Veselina Miteva

·        A health education program for parents to shorten the period of adaptation to crèche regimen in newly admitted children - Desislava Kalenska

·        A health educational and therapeutic program to improve quality of life of allergic children - Dr. Violeta Hristova

·        Sexual education for children and youths with disabilities - Yavor Anzarov

·        A health educational program to prevent aggressive behaviour in 20 crèche children n education - Todorka Doncheva

·        A health educational and training program to reduce acute respiratory infections - Pepa Krasteva

·        Setting up a network of to promote of healthy life styles and reduction of risk behaviour in children aged 12-19 by training of 30 school health workers - Irena Penkova

·        Flat foot prevention for children aged 1-3 - Natalia Yotova

·        A health educational program for 15 overweight children and their parents - Kamelia Makshoutova

·        A health education program on prevention HIV and STIs - Dr. Irina Djikova

·        A health educational and training program to reduce acute respiratory infections - Miroslava Dimitrova

·        A program to improve psychomotor development in 50 children - Snezhanka Loungova

·        A program to increase motivation in minority children (7-10) treated at the clinic to attend school by training them in basic learning and school life adaptation skills - Desislava Dicheva

·        A program for parents and children to decrease the rates of acute respiratory infections in children aged 3-7 - Maria Paneva

·        Organizing musical therapy classes for children and youths with disabilities - Alexy Alexiev

·        Training basic oral hygiene skills in creche children - Milena Tacheva

·        A health educational program on the harmful effects of smoking for children aged 13-14 - Elka Pomakova

·        A health education program for parents to shorten the period of adaptation to crèche regimen in newly admitted children - Elena Todorova

·        An information program for single mothers under 20 year to prevent child abandonment - Svetlin Simeonov

·        A program to improve the level of knowledge on protection of reproductive health for girls aged 15-16 – Mrs. Roumyana Koleva

·        A health educational program for 20 overweight children and their parents - Dr. Tzenka Nikolova

·        A program to improve oral hygiene skills and reduce caries incidence in first and second grade primary school children - Vassilka Rouseva

·        A health educational program for teenage school children on the harmful effects of drug use - Anyuta Makaveeva

·        A health educational program for mothers on proper dietary regimen to prevent complications in children with diarrhoea   - Ventzislava Stoyanova

·        A rehabilitation program for children with cochlear implants - Ivanka Radeva

On June 2-4^th  2006, a PSBHN workshop on hospital hygiene was held on June 2-4 with nurses from the St. Georgi University Hospital in Plovdiv. The workshop was organized by Dreyfus Health Foundation, the Bulgarian-Swiss Hospital Hygiene project, Medical University – Pleven, and the Association for Better Health – Pleven, in collaboration with the management of the hospital.

Problems of hospital hygiene were presented to the participants by Dr. Assen Pachedjiev, coordinator of the Bulgarian-Swiss Hospital Hygiene program, and the PSBH approach to solving problems for better health was presented by Dame Sheila Quinn, consultant for international nursing programs of Dreyfus Health Foundation. During the workshop, Mrs. Yanka Tzvetanova presented the programs of Dreyfus Health Foundation in Bulgaria, run in collaboration with the Association for Better Health in Pleven.

The participants prepared their plans of action, assisted by a team of facilitators – Dame Sheila Quinn and Ms Shelagh Murphy, international nursing program consultants for Dreyfus Health Foundation, and the local facilitators - Assoc. Prof. Angelika Velkova, Mrs. Yanka Tzvetanova, Mrs. Evgeniya Dimitrova and Dr. Emilia Kanyouvska (Medical University – Pleven), Mrs. Polya Zhivkova (Alexandrovska Hospital – Sofia) and Mrs. Slava Rouseva (Stara Zagora University Hospital).

Left: Group picture

Right: Dr. Assen Pachedjiev, coordinator of Hospital Hygiene Project

The plans of action present a wide range of problems concerning hospital hygiene in the St. Georgi University Hospital Clinics, as well as hygiene-related problems:

·        A program to improve the qualification of nurses to raise the quality of intubation nursing care - Angelina Maneva, ICU

·        A program to prevent suppuration and decubital ulcers in overweight women operated on for herniated disk - Anna Petrova, Neurology Clinic

·        A program to reduce the risk of infections in cases of placement of an indwelling urinary catheter after discharge from hospital - Antonia Lapatareva, Urology Clinic

·        A program to reduce infection rates in patients on artificial ventilation - Blagovesta Stoyanova, ICU

·        A training program for medical staff program to improve level of knowledge and skills to ensure high standards of aseptic and antiseptic practices in cardiac catheterization - Daniela Popova, Cardiac Surgery Clinic”

·        A program to ensure proper disposal of dangerous hospital wastes - Dimitrina Simeonova, Radiation Therapy Clinic

·        A health-education program to reduce he incidence of suppurations in women undergoing episiorraphy and perineorrhaphy after delivery - Dora Mryanova, Clinic of Obstetrics and Gynaecology

·        A training program for nursing staff on proper technique of collecting blood sample for hemoculture - Elena Minkova, Cardiac Surgery Clinic

·        A program to increase the level of knowledge in persons accompanying patients with tracheostoma cannulas - Elena Kostova , ENT Clinic

·        A program to reduce the number of mistakes in collecting, storage and transportation of samples for microbiological analysis - Emilia Razpopova, Cardiac Surgery Clinic

·        A program to reduce the incidence of decubital ulcers in stroke patients after discharge from hospital- Galina Borovanska, Clinic of Vascular Diseases

·        A program to reduce incidence of infections in in-patients with an indwelling urinary catheter - Gergana Gacheva, Urology Clinic

·        A program to reduce the rate of infections associated with improper placement of intravenous catheters - Gergana Boeva, Hematology Clinic

·        A program for prevention and decubital ulcers in orthopedic patients - Ivanka Tzokovska, Clinic of Orthopedics and Traumatology

·        A program to reduce the rate of suppuration of surgical wounds - Juliana Dimbareva, Urology Clinic

·        A health education program for patients and accompanying persons of roma origin at the ward for hepatitis patients - Kamelia Penkova, Clinic of Infectious Diseases

·        A program to promote the use of individual protective gear to reduce the risk of infection with Hepatitis B and C among nursing staff - Katya Boshnakova, Nephrology Clinic

·        A training program on feeding children operated on for cleft lip and/or palate - Kostadinka Momneva, Clinic of Pediatric Surgery

·        An educational program for patients with lupus erythematosus on the problems of in-hospital infections - Lidia Zgurova, Rheumatology Clinic

·        Prevention of in-hospital infections through introducing better practices in using oxygen masks- Lidia Bukolska - Lung Disease Clinic

·        A program for optimizing the time needed for instrument pre-sterilization procedures - Margarita Papazova, Clinic of Neurosurgery

·        A program to improve protocols for prevention of infections in hospital staff when collecting skin biopsy samples- Maria Spasova, Clinic of Dermatology

·        A program to improve the program for prevention of decubital ulcers - Maria Zapryanova, Clinic of reconstructive surgery

·        A program to improve compliance with proper protocols of nursing practice in treatment of surgical wounds - Maria Panayotova, Vascular Surgery Clinic

·        Improve the organization of admission of new patients - Maria Radeva, Psychiatry Clinic

·        A health education program to prevent decubital ulcers in bed-ridden patients aged 70 plus - Mariana Dyulgerova - Clinic of Orthopedics and Traumatology

·        A program to reduce the rate of urinary infections in cases of catheterizing patients with severe stroke - Nedyalka Delcheva, Neurology Clinic

·        A program to help hygiene support staff to high standards of hospital hygiene - Nena Tancheva, Cardiac Surgery Clinic

·        A program to introduce preparation and use of individual sterile sets in everyday nursing practice - Nevena Angelova, Hospital Hygiene Nurse

·        A program to reduce infection rates among medical staff treating patients with infectious diseases - Nina Kodinova, Clinic of infectious Diseases

·        A health education program to reduce the incidence of E-coli infections among neurosurgical patients - Parvoleta Hadjieva, Neurosurgery Clinic

·        A program to introduce more strict hygiene rules in handling emergency admissions to the clinic - Pavlina Pavlova, Cardiology Clinic

·        A program to improve hygiene among the persons accompanying patients with spinal traumas - Penka Kassarska –Dacheva, Neurosurgery Clinic

·        A training program for nurses on proper hygiene protocols for placement of intravenous catheters - Penka Kosturkova, Toxicology Clinic

·        A training program for nurses to improve cleaning and disinfection of anesthesiology gear to reduce infection rates - Petya Velickova-Nenova, Anesthesilogy Ward of ICU

·        Reduction of inflammation rates in patients with intravenous catheters - Petya Chokova, Emergency Surgery Ward

·        A program for pre-sterilization processing of instruments - Petya Zapryanova, Conservative Gynaecology Clinic

·        A program for proper disinfection of operating room - Savina Chausheva, Surgery Clinic II

·        A program to improve the skills and knowledge of hygiene support workers to improve disinfection in intensive care wards in Haskovo Regional Hospital - Slaveya Slavova, Haskovo Regional Hospital

·        A program to regulate the flow of visitors to the clinic - Snezhanka Urumova, Eye Disease Clinic

·        A program to optimize nursing care for colostomy patients - Stoyanka Tetimova, Surgery Clinic I

·        A training program for hygiene support staff on the proper disinfection - Teah Tzirovska, Central Clinical Laboratory

·        A training program for hygiene support staff on disinfection - Valya Petrova, Cardiac Surgery Clinic

·        A program to increase usage of individual protective gear by staff - Viara Shoumanska, Clinic of facial-mandibular surgery

·        A program to reduce the rate of suppurations in patients operated on at the clinic - Yana Tzankova, Surgery Clinic III

·        A training program for nurses and hygiene support staff to reduce suppuration rates in emergency patients - Yanka Gechkova, Clinic of Thoracic and Abdominal Surgery

·        A program to reduce the rate of postoperative infections in a surgery ward - Yovka Karadjova, Surgery Clinic I

SITE VISITS AND MEETINGS

On March 27^th, 2006 Dr. Daniel Levine – director of Children’s Help Net Foundation and PSBH facilitator, Mrs. Anelia Dimitrova - chief nurse of Univesrsity Hospital –Pleven, Dr. Emilia Kanyovska - epidemiologist of the University Hospital, PSBH facilitator, and Mrs. Yanka Tzvetanova – country coordinator visited projects from the 2005 PSBH workshop on nosocomial infections.

Four projects were completed and continued  at the Pediatric Clinic of the University Hospital in Pleven:

·        Health education for low-educated parents to reduce the rates of reinfections in children with pneumonia (Mrs. Katya Angelova)

·        A health education program on proper hygiene and diet for mothers accompanying infants during the hospital stay ( Mrs. Maria Milanova – Zlatanova)

·        A health education program on the hygiene of breast feeding roma mothers accompanying their babies in hospital (Mrs. Stefka Kancheva)

·        Introduction of transparent fixing pads for children with permanent infusion peripheral venous pathways (Mrs. Vanya Dobreva)

Left: Mrs. Vanya Dobreva with one of her patients at the clinic; right: from left to right - chief nurse of the University Hospital, Mrs. Anelia Dimitrova, senior nurse Malinka Ivanova, Assoc. Prof. Vanya Nedkova, Head of the Department of Pediatric Diseases, and Mrs. Katya Angelova.

Projects addressing of hospital hygiene were implemented at the Clinic of Obstetrics and Gynaecology and the Neonatology Clinic after the workshop on 2005 in Pleven:

·         A training program to introduce standard protocols for proper hand washing and disinfection for health personnel of the risk pregnancy clinic (Mrs. Vanya Zacharieva)

·        Reduction of rate of complications due to nosocomial infections by introducing individual protective gear for health personnel working in a risk pregnancy clinic (Dr. Antoaneta Lyubomirova)

·         A training program to improve compliance with proper hand disinfection protocol (Dr. Ghinka Ivanova)

·        Health education for pregnant women to reduce rates of conjunctivitis, pyodermia and dermatitis in new-born babies (Dr. Yonka Marcheva)

·         Introduction of check-list for disinfection control (Mrs. Tyulai Moustafova)

Dr. Yonka Marcheva, Clinic of Neopnatology, Uiniversity Hospital – Pleven

·         A health education program for pregnant women to reduce the rates of infections of the newborn (Mrs. Miglena Petrova)

·         A health education for couples expecting babies to prevent birth-related infections due to low level of knowledge of hygiene of pregnancy (Mrs. Natasha Andreeva)

Dr. Daniel Levine also visited the day care centre for disabled children in Pleven. In 2005, the Children’s Help Net Foundation provided two laptops for activities at the center. Several PSBH projects were started at the center after the workshop in March  2006 (photo on the right).

On March 27^th, the Rector of Medical University – Pleven , Prof. Grigor Gorchev, had a meeting with Dr. Daniel Levine, and Mrs. Yanka Tzvetanova, Assoc. Prof. Maria Alexandrova and Assoc. Prof. Angelika Velkova. Collaboration between the Medical University, Dreyfus Health Foundation, Children’s Help Net Foundation (CHNF) and the Association for Better Health (ABH) was discussed, including a program for donation of clinical laboratory reagents from Randox Ltd, UK which is coordinated by CHNF and ABH and the beneficiaries are hospitals where Problem Solving for Better Health programs are active. So far, these hospitals being the University Hospitals in Pleven, Stara Zagora and Varna, and the Regional Hospital in Gabrovo.

At the Regional Hospital “Dr. Tota Venkova” in Gabrovo, Dr. Daniel Levine had a meeting with the Director – Executive Director Dr. Bozhidar Paralchev, the Deputy Director - Dr. Antoaneta Stoykova and the chief nurse - Mrs. Nelly Todorova.  A press release was made on the importance of the Randox reagent donation program. Several project sites at the hospital in Gabrovo were visited.

Randox reagents have helped professionals at both the clinical (left) and microbiology (right) laboratories be more efficient in their everyday work.

For other details on this visit, please see Connections (January-April, 2006).

 Note! You can visit www.livebg.net/psbh-digest, where you can see some pictures from workshops and projects, as well as all previous issues of the digest.

 In this issue, information on hepatitis A, B, C from the internet in Bulgarian is included. 

Please send your suggestions and materials which you find useful for improving health, or send materials with experience you would like to share with the recipients of the Digest - workshop participants, medical schools and nursing colleges, to abh-psbh-bg@el-soft.com

The board of the Association for Better Health will appreciate your comments, recommendations and consideration for future collaboration.