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Nurse as Risk Manager in the 21st Century Hospitals
LAŠTOVKOVÁ, Marie
The main intention of this thesis was to monitor the activities of nurses as risk managers in selected healthcare facilities. The first objective was to map the current state of accreditation procedures in the Czech Republic, the number of accredited facilities and the types of accreditation. Another objective was to find out in which healthcare facilities there is a nurse as a risk manager or who has the responsibility of a risk manager in healthcare facilities. The third objective was to explore the activities of nurses - risk managers. To achieve these objectives, the following research questions were set: 1st What is the current state of accreditation procedures in the Czech Republic? 2nd In which accredited facilities there is a nurse - a risk manager? 3rd research question: What are the activities and roles of a nurse - a risk manager? (What activities nurses carry out in the performance of their duties; whether nurses feel a change in the provision of nursing care; which risks and incidents nurses encounter in their facilities and what are their solutions; what is the level of communication between the parties in the risk management process in a given facility; which benefits are seen in risk management). The research was conducted with respondents from those healthcare facilities that were willing to cooperate. The research conducted is a qualitative one. The respondents underwent interviews according to the structure of categorized questions. Subsequently, transcripts of the interviews were made as well as the analysis and categorization of the data was carried out and presented in tables under the framework analysis according to Ritchie and Spencer. The research revealed the answers to the research questions. In no of the facilities that have responded to the questions there is a nurse with the function of a risk manager. Activities within the risk management are taken over by staff at other positions, mostly quality managers, head nurses or auditors. Detailed proportion of these functions is clearly presented in the accompanying graphs. Research question 3 yielded a great number of responses. For example, nurses who have competence in risk management play mainly the roles of communicators, defenders, authors, auditors and mentors. In exercising their functions, they have observed changes, as compared with the past, in the responsibilities of nurses, patient activity, greater transparency, the quality and safety of the care provided. They describe in detail the risks and incidents which they have met at their workplaces, and how they have been solved. The respondents see the advantages of risk management in the fact that it is a good tool for defending not only patients but also nurses themselves; that it is a tool to increase responsibilities and activities of patients and to improve the quality and safety of the care provided. All the responses are clearly presented in tables and confronted with the knowledge derived from professional literature and our own experience. The results of the thesis can be provided to the healthcare facilities where the research has been carried out; it could be provided to competent institutions and also, in the form of an informative brochure, to nurses and other healthcare personnel. We would suggest a higher level of education about risk management potential. Our suggestions also include changes to legislation - powers, the establishment of clear procedures and rules, and the regulation of education in risk management so that implementation of this tool is unified and becomes accessible to all facilities.
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Risk factors at public health work: differences among professions in non-medical fields
LAŠTOVKOVÁ, Marie
The paper focuses on health risk factors for non-medical healthcare workers, namely general nurses and radiology assistants. Factors which may have negative impacts on healthcare workers{\crq} health affect both physical and mental health. Factors such as toxic substances, biological radiation, infectious diseases and spine and joints overloading caused by the incorrect manipulation with patients can have negative impact on physical health. Both physical and mental health is affected by stress, as well as by workers{\crq} lifestyle and education. Healthcare workers who take care of patients must be in a good physical and mental shape in order to provide quality care. Therefore, the goal of healthcare workers themselves, as well as of their employer, should be obtaining sufficient information on work safety and hygienic measures and being able to use the information in practice - they should actively participate in prevention of health damage related to the performance of their profession. The first hypothesis {--} non-medical healthcare workers are informed about risk factors associated with the performance of their profession - was confirmed. The second hypothesis - there are differences in the presence of risk factors among non-medical healthcare workers - was also confirmed; differences in the occurrence of some risk factors are clearly visible. Different healthcare professions should therefore be approached in a targeted way, with respect to the type of workplace and job description of healthcare workers. The third hypothesis {--} non-medical healthcare workers comply with preventive measures preventing health damage - was not confirmed. One of the reasons why hypotheses 1 and 2 were confirmed may be the fact that increased attention has been paid to this topic recently - standards have been made, and consequently also targeted audits. These measures have usually a positive impact - healthcare workers have gradually realized that safety measures are not useless, and by obeying them, healthcare workers protect not only patient and their surrounding, but especially themselves.
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