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Safety when handling and positioning of the patient
HŘEBEJKOVÁ, Blanka
This thesis focuses mainly on threats to the safety of nursing personnel. These include a high risk of injury when positioning and the risk of developing musculoskeletal disorders,which can lead to a long-term sickness of the member of the medical staff. The theoretical part is divided into four parts. The first part describes in particular the need for safety and security, as well as factors that have an influence on this human need.Attention is focused also on ensuring safety while providing nursing care, especially when positioning patients. In connection with safety during this activity, a section in this thesis is devoted to the kinaesthetic mobilization, which offers a slightly different view of the positioning and patient handling. In the last chapter of the theoretical part, findings concerning the prevention of damage to health nurses in providing nursing care are summarized. The thesis has three objectives that were formulated as follows. Objective 1: Determine whether nurses use kinaesthetic principles during a patient handling. Objective 2: Determine whether nurses, in their opinion, have enough equipment to ensure safety during patient handling and positioning. Objective 3: Map the causes of the use of inconsiderate patient positioning techniques. Based on these objectives, the research question and three hypotheses were set. Research question: What are the possibilities for improving patient handling and positioning within the nursing process? Hypothesis 1: The use of kinaesthetic depends on the type of department. Hypothesis 2: Nurses use bad positioning techniques despite their knowledge that they can harm their health and also patient's. Hypothesis 3: Lack of time is the most common cause of the use of the inconsiderate method of positioning. In order to fulfil the objectives, a quantitative research, for which we choose the questionnaire method of data collection, was conducted. The questionnaires were designed for nurses working in the department of surgery, internal medicine and the department of aftercare. The survey was carried out in 7 hospitals of South Bohemia. In total, 340 questionnaires were distributed into these hospitals.The final research sample, therefore, consisted of 209 completed questionnaires. The rate of return was 61%. The obtained data were processed and analysed using Microsoft Excel 2013, then analysed statistically using the chi-square test. The results were processed into graphs. Based on the results, we can conclude that the hypothesis 1 is confirmed. We found that kinaesthetic is used most in aftercare departments. On the contrary, surgery departments use it the least. This is probably due to a different composition of patients on these wards.Hypothesis 2 was, for testing purposes, divided into two working hypotheses. H2a: 60 % nurses know that classical principles of positioning can damage their health. This hypothesis has been disproved. A corollary is HA: Knowledge of nurses about the risk of an injury is not 60%. The research has also revealed that almost three quarters (74 %) of the nurses know that positioning can damage their health. The second part of the hypothesis 2, i.e. H2b: 60 % nurses know that the classical principles of positioning can damage the health of the patient, has also been refuted, and thus applies HA: Knowledge of nurses about the risk of an injury to the patient is not 60%. The results of the survey showed that only 24 % nurses consider the classic method of positioning a risk to patient's health. Hypothesis 3 was, through our research survey, refuted. Sisters see the most frequent reason for using the inconsiderate positioning procedure in the lack of staff.We managed to answer the research question by analysing literature in the theoretical part and performing the survey in the practical part of this thesis.An output of this thesis will be an expert article published in a professional journal and a presentation at a professional conference
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The Specifics of Nurse´s work on a Psychiatric Ward
HŘEBEJKOVÁ, Blanka
Theoretical background Psychiatry belongs to fundamental branches of medicine. Its task consists of diagnostics, treatment and prevention of mental diseases. Psychiatry includes adult psychiatry, child psychiatry and adolescent psychiatry, gerontopsychiatry, psychiatric addictology, psychiatric sexulogy with psychiatric rehabilitation. Nowadays, importance of the psychiatric branch is increasing; according to epidemiologists, we can see a slightly upward trend in the number of psychiatric patients. Work of a nurse in the department of psychiatry differs considerably from work in other standard departments. Such work is demanding both physically and mentally. In the department of psychiatry, it is extremely necessary that the nurse builds up a close relationship with the patient and acquires their confidence. Goals of the thesis The goal of the thesis was to map differences relating to work of a nurse working in the department of psychiatry, to find out what communication skills a nurse working in the department of psychiatry must have and in addition, to find out what the possibilities of further education within the framework of life-long education for nurses working in the branch of psychiatry are available. Methodology The qualitative methodology was applied to the research. The data were obtained by the interview method. Prior to execution of the research as such, the staff nurse was asked for permission and she agreed with execution of the research concerned. In cooperation with the charge nurse and the head nurse of the department of psychiatry, seven interviews with the nurses were made. The interview consisted of twelve questions and was absolutely anonymous. The written records of the interviews were analysed and the results were divided into categories and sub-categories subsequently. Results Based on the research, it was discovered that work of nurses in the department of psychiatry is much different from work thereof in other departments. The nurse working here should be interested in the field and should have good knowledge of the psychiatry-related issues. The nurse working in the department of psychiatry should be competent, resourceful and should be well informed of the patients to be able to perceive early possible changes in their behaviour. In the psychiatric nursing care it is important in particular to communicate correctly with various types of patients. Therefore, it is vital for the nurse to be well versed in mental diseases and symptoms thereof. Behaviour, perception and communication of the psychiatric patient are often affected by the disease as such. There are various communication barriers which the nurse has to cope with. Therefore, the nurse should be able to use all components of verbal as well as non-verbal communication correctly. Preparation for incidents consists of in particular regular training in the area of occupational safety and protection of health at work, fire protection and study of methodological guidelines and standards of the department of psychiatry. Certain preparation for incidents is included as well. There are sufficient possibilities of further education in psychiatric nursing care available. As it followed from the research, the nurses show active interest in education and search therefor independently. The nurses are sufficiently supported by their superiors in the search for suitable educational projects. Conclusion Considering the overall view of the thesis results, it is possible to say that the research questions were answered and the set goals of this thesis were achieved. The results of this bachelor's thesis may serve as supporting source material for lectures on nursing care in departments of psychiatry. In addition, the thesis may serve students as study and source material for their own studies and work.
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