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The Management of Patients in the Vegetative State
Nettlová, Marie ; Bartůněk, Petr (advisor) ; Drábková, Jarmila (referee)
The goal of this thesis is in picturing the problems of care about the patients in the Vegetative State in intensive care units at Prague and Region of Central Bohemia. The thesis shall reveal fundamental informations about the number of patients in the Vegetative State, to take of basal stimulation in nursing care, cooperating with the family and assess the consciousness of these patients. The theoretical part is devoted to description of the Vegetative State, basal stimulation, reaction of family, needs of family members, basic examination of consciousness. The research part is heading towards the goal of this thesis a survey based verification of the lied out hypothesis. Research was realized from December 2008 till February 2009. The list of questions was intended for sister wards at intensive care units. The outcomes are summarized in the discussion and the final part of the thesis. The average rate of occurrence these patients is higher then in published foreign studies. The result of this thesis is not acceptable for representative and applicable exoteric health care institutions.
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Long-term and difficult weaning - discontinuation of ventilator- dependent adult patient
Hájková, Lenka ; Drábková, Jarmila (advisor) ; Srpová, Daniela (referee)
The main reason for choosing the topic of study, is an increasing number of long-term ventilator-dependent patients undergoing weaning proces from artificial pulmonary ventilation at intensive care units. The content of the chapters include anatomy and physiology of the respiratory system, pathophysiology and some diseases associated with the ventilator-dependence. Also, the development and charakteristics of the OCHRIP - NIP and DIOP, the weaning procedure and the role of the nurses in the weaning proces. This study presents goals and hypothesis of investigation, as well as a variety of methodologies used. The study presents two aims of the research. Firstly, to map the experience and knowledge of nurses when disconnecting patients from artificial lung ventilation. Secondly, to find out how nurses perceive the care of these patients, including their view on the possibilities for further development of weaning process care. The research was carried out at ARO, ICU, NIP and DIOP bed units at five hospitals and two faculties of Intensive Care. It involved an anonymous questionnaire of 147 respondents (nurses) and students. The main finding of the research is that nurses have sufficient knowledge and experience in weaning from mechanical ventilation, notwithstanding they underestimate their own...
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Impact of therapeutic mild hypothermia on selected pathophysiological and clinical processes after cardiac arrest
Škulec, Roman ; Dostál, Pavel (advisor) ; Drábková, Jarmila (referee) ; Michálek, Pavel (referee)
Introduction: Induction of therapeutic hypothermia to target body temperature of 32 - 34 řC for 12 - 24 hours may reduce post-cardiac arrest brain injury in patients resuscitated from out- of-hospital cardiac arrest (OHCA). It has been recommended that the target therapeutic temperature should be reached as soon as possible. Thus, prehospital initiation of cooling appears to be a method of choice. Aim of the study: We performed three studies to assess a feasibility and clinical effectivness of prehospital therapeutic hypothermia in the setting of emergency medical service in the Czech republic and to optimize cooling procedure. The selected cooling method was rapid intravenous administration of 4 řC cold normal saline. Materials and methods: Forty consecutive cardiac arrest patients were treated by prehospital administration of 4řC cold normal saline with the target dose of 15 - 20 ml/kg in a prospective multicenter study PRE-COOL (Pre-Hospital Cooling in Cardiac Arrest Patients). The results were compared with 40 retrospective control group patients who did not undergo any cooling attempt in the field. Twelve different application regimens of cold normal saline were investigated for infusion temperature changes during administration in a PRE-COOL 3 experimental "ex vivo" study to find the regimen...
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The Change in the System of Work of the Anaesthetic Team
Pytel, Mario ; Vrzáček, Petr (advisor) ; Drábková, Jarmila (referee)
The diploma thesis deals with a concept of a new system of anesthetic administration in the Czech Republic. The attitude of anesthesiological nurses was inquired in a form of quantitative research questionnaire. It suggests higher/wilder competence for non - medical staff during carring out an anesthesia. In the particular chapters of the theoretical part are described different contexts of the topic (history of anethesia, change implementation theory, description of a current situation in anestesiology, comparison with other countries, legislative) and their mutual connection. Research results dealing with anesthesiological nurses opinions on suggested model of changes in carring out an anesthesia are described in an Empirical section. In a section Results of quantitative research I describe many facts, give explanations, confirmations or disproves of hypothesis arising from the research. According to the results, there exists sufficient support among anesthesilogical nurses for carring out a new system of work into an anesthesiological department. Based on facts and information from the first part of the thesis and data research I described a plan of change implementation supervision. Key expressions competence, anesthesiology, non - medical staff, change supervision, system of work
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Comparison of need for cooperation in a medical team at a unit of intensive care and standard department
Polívková, Lenka ; Marsová, Jana (advisor) ; Drábková, Jarmila (referee)
Téma: Porovnání potřeby sounáležitosti ve zdravotnickém týmu na jednotkách intenzivní péče a standardních odděleních. Cílem diplomové práce je zjistit míru uspokojení potřeby sounáležitosti ve zdravotnickém týmu na jednotkách intenzivní péče a standardních odděleních. Ve své teoretické části se zabývám podrobným rozborem potřeby sounáležitosti. Charakterizuji problematiku lidských potřeb a jejich důležitost při působení v pracovním kolektivu na jednotkách intenzivní péče a standardních odděleních. Poukazuji na příčiny a projevy frustrace této potřeby. Zabývám se fluktuací zdravotnických pracovníků a pohlížím na narušení potřeby sounáležitosti, jako na jeden z důvodu proč sestry mění pracovní místa. Praktická část práce je zpracována formou kvantitativního výzkumu. Metodou dotazníkového šetření jsem získala data od 142 respondentů (všeobecných sester, sanitářů, fyzioterapeutů ve fakultních a krajských nemocnicích). V dotazníku jsem sledovala tyto oblasti: základní faktografické údaje, frustraci potřeby sounáležitosti a její projevy, důvody fluktuace, motivaci v pracovním kolektivu. Zpracováním dat jsem došla k závěru, že sestry znají význam výrazu potřeba sounáležitosti. Subjektivně více vnímají frustraci sounáležitosti zdravotničtí pracovníci ze standardních oddělení než zdravotníci z jednotek...
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Physiotherapy at the department of chronic resuscitation and intensive care
Sobotka, Daniel ; Drábková, Jarmila (advisor) ; Smolíková, Libuše (referee)
The principal aim of the thesis titled "Physiotherapy at Chronic Intensive Care Unit" (CICU) is to describe and analyze the not much known area of physiotherapy at the CICU and the various methods of its utilization. The thesis is structured in order to deal with the system at CICU, the typology of patients, physiotherapeutic methods and the ventilator modes. The patient should be taken care of by the multidisciplinary team which should cooperate in order to achieve a common goal - consecutive weaning followed by the liberating from the ventilator's support. The chapters about ergotherapy and psychological effects complete the overview of the topic. Practical part of the thesis consists of the survey file which represent the patient-family-doctor-physiotherapist point of view. Powered by TCPDF (www.tcpdf.org)
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The Management of Patients in the Vegetative State
Nettlová, Marie ; Bartůněk, Petr (advisor) ; Drábková, Jarmila (referee)
The goal of this thesis is in picturing the problems of care about the patients in the Vegetative State in intensive care units at Prague and Region of Central Bohemia. The thesis shall reveal fundamental informations about the number of patients in the Vegetative State, to take of basal stimulation in nursing care, cooperating with the family and assess the consciousness of these patients. The theoretical part is devoted to description of the Vegetative State, basal stimulation, reaction of family, needs of family members, basic examination of consciousness. The research part is heading towards the goal of this thesis a survey based verification of the lied out hypothesis. Research was realized from December 2008 till February 2009. The list of questions was intended for sister wards at intensive care units. The outcomes are summarized in the discussion and the final part of the thesis. The average rate of occurrence these patients is higher then in published foreign studies. The result of this thesis is not acceptable for representative and applicable exoteric health care institutions.
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