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Care of pressure ulcers in retretirement home as a nursing problem
ČERNÁ, Eliška
This paper describes the implementation of care for a client with decubitus in a nursing home, how the nursing team works together, and what barriers the nursing team experiences throughout the process. The theoretical part focuses on the issue of decubitus and its classification, examines different methods of treatment depending on the degree of disability and also deals with the prevention of decubitus. Furthermore, this part of the thesis deals with homes for the elderly and focuses on the roles of the staff in these facilities and analyses in detail the nursing care provided. The aim of the bachelor thesis was to map the specifics of nursing care for clients with decubitus. Another aim was to find out the collaboration between the nursing team and the last aim was to find out what barriers in the care of clients with decubitus were perceived by the members of the nursing team. In order to achieve the objectives, answers to the research questions were obtained using qualitative research using interview technique. The research sample consisted of nurses working in a home for the elderly who care for a client with decubitus. The results of the research showed that the nurses carry out care for the client with decubitus by other means. The research showed a varied frequency of decubitus dressings. It was also found that collaboration between members should be more consistent in informing other members of the nursing team. The research investigation further revealed barriers in the lack of medication, positioning aids and nutrition
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In-Bed Posture Classification
Husák, Michal
The growing trend of the population age contributes to the accumulation of patients insocial facilities and in-home care, which leads to growing chronic diseases. Modern systems try toimprove the effectiveness of health care interventions. Our work aims to create a widely applicableplatform that combines the measurement of in-bed position with another’s negative states. All thesephysical influences are mainly the cause of chronic tissue damage (pressure ulcers). Processing ofthe pressure distribution on the bed is a more dimension problem. The mentioned data are multimodal.Therefore, we used the machine learning (ML) method to obtain the properties.
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The role of nurse in an interdisciplinary team in the care of patient with decubitus
HUBKOVÁ, Šárka
Introduction: Pressure ulcers are one of the most monitored indicators of nursing care. Thanks to a well-functioning interdisciplinary team, pressure ulcers can be effectively prevented. Main aims of the thesis: The aim of this work is to map the role of nurse in an interdisciplinary team, to describe how the interdisciplinary teams currently work and what the effectiveness of their work is in relation to the prevention of pressure ulcers and their healing. Methodology: A qualitative research survey was used to collect the data in the form of semi-structured interviews wtih nurses. The selection criterion was the fact that they encounter patients suffering from pressure sores. The informants were getting method Snow ball. The resulting set of informants consisted of 15 persons. The results of the interviews were processed using the open-coding technique of pencil and paper and then divided into six categories. Results of the thesis: Research shows that the nurse plays a key role in the interdisciplinary team in the care of a patient with pressure ulcers. Her role is to work with other team members, direct patient care, preventive work and family contact. The results show that the nurse is a full member of the team. The overall care effect of the interdisciplinary team is ineffective in some departments, because, as it happens that individual workers do not work together. In our research, we mainly come across the absence of a nutritional therapist. Also, nurses would welcome more cooperation from lower medical staff. Furthermore, nurses perceive the use of scales as a certain obligation, and in some cases report their incorrect evaluation. Last but not least, we are confronted with ignorance and non-compliance with the standards of pressure ulcers treatment. Conclusion: We would like to convey the results achieved by the necessity of cooperation of all workers who care for a patient with pressure ulcers. The provision of complex care is essential in this area, because pressure ulcers are multifactorial. The use of interdisciplinary teams in the care of a patient with pressure ulcers brings the possibility to use people with different expertise, knowledge and experience. Together, they effectively work towards the early recovery of the patient, shortening the hospitalization period and saving the cost of hospitalization.
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Nutritional prevention and the treatment of decubitus of seniors
DĚKANOVÁ, Klára
This bachelor thesis called Nutrition prevention and treatment of decubitus on seniors is about condition of client's diet in Máj České Budějovice Seniors' House and following nutrition intervention on critical clients. Decubitus is a disease, which greatly affects not only sick client or care staff, but also the economic aspect of the medical and social facilities. Because there was no knowledge about, how decubitus originate, the prevention nor treatment in the past, it was considered as very serious illness. Doctors were convinced, that decubitus origins spontaneously and it's a sign of inevitable death. Since the end of the 19th century, more attention has been paid to decubitus, and thus industrial production of phenol-impregnated bandages has been developed to improve the healing of decubitus, together with passive patient activation and surgical wound healing. There are currently many companies on the market that produce a wide range of products and tools to reduce the risk of decubitus or their effective treatment. For example, passive and active anti-decubital mattresses are used for keeping the wet environment in the wound and, last but not least, enteral and parenteral nutritional preparations to help wound healing. The goal of this thesis was to find out whether there are clients with a risk of developing decubitus in the Máj Česke Budejovice Seniors' House and then to process the nutritional intervention of these clients. The theoretical part of the work summarizes the previous knowledge in the field of prevention and treatment of decubitus. As first, the term "decubitus" has been characterized, and the distribution of the individual steps and assessment scales used for the risk assessment or the defects already occurred has been described. There are also mentioned factors influencing the occurrence of decubitus, prevention and nutrition prevention and treatment of decubitus. One chapter of the work was devoted to the NutritionDay project, which was used to collect data for the practical part of the research. A combination of quantitative and qualitative research methods was used to develop the practical part. In the first phase of the research, screening was carried out within the NutritionDay project in the Máj České Budějovice Seniors' Home. The screening revealed how many clients are at risk of malnutrition, how many of them are already malnutritive and how many of them are experiencing decubitus. In the second phase, the work has been done only with clients experiencing decubitus. For each of the clients with decubitus, an adequate daily intake of energy and essential nutrients was calculated. Nutritional support was then set and their diet evaluated in the Nutriservis Profesional program to determine whether it meets the recommended nutritional values. The results of this bachelor thesis can be used by other nutritional therapists for the purposes of teaching or further research.
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Comparison of chosen nursing in prevention of immobility syndrome in a senior nursing home in Germany and the Czech Republic for lying immobile patients.
ČERNÁ, Lucie
As the population is getting older there is increased number of geriatric patients. However there is also increased number of immobile seniors, who are not able to take care of themselves. Comprehensive health and social security is being provided in homes for elderly, which fulfil the role of long-term institutional care. Nurses must be trained for this highly professional and knowledgeable nursing care aimed at geriatric problems. For geriatric clients of home for elderly it´s important realization of prevention, treatment and social measures in the form of an individual approach. That these measures can be implemented it is necessary to evaluate the health status of seniors, their physical performance, self-sufficiency and mental functions in connection with the social situation and to formulate a nursing diagnosis. As a result of long-term bed rest can lead to health complications affecting all body systems, so-called immobilization syndrome. How to prevent secondary damage that threatens the patients White Theo arge already ill is focused rehabilitation nursing. Among rehabilitation resources in the prevention of immobilization syndrome in nursing practice arge included: positioning, verticalization, mobilization. Inseparable part of prevention measures is preventing health complications in case of immobile clients homes for the elderly arge suitably selected positioning aids, mobilizing resources, well-equipped bed with antidekubitus system. In the thesis there were two objectives. To Compare keeping preventive measures which prevent the formation of pressure ulcers and muscle contractures in nursing care for immobile patients in the Czech and German retirement homes. To map out the possibilities of aids in the prevention of complications in immobile clients in the Czech and German retirement homes. Bachelor thesis has been made by using qualitative research. For collection of data was used a method in-depth interviews with four Czech and four German nurses. This method involved non-standardized interviews through open-ended questions that were recorded by dictaphone and transcribed verbatim. The data analysis was carried out by hand coding or using a pencil and paper. By analyzing the data four categories were created, each divided into the home for the elderly in the Czech Republic and the home for the elderly in Germany: 1.Nurses knowledge ,2.Implementation of preventive measures , 3.Equipment for immobile clients, 4.General knowledge related to immobile clients. Research survey found out that there is not a big difference in adherence to preventive measures to prevent the formation of decubitus and muscle contractures in nursing care for immobile patients in Czech and German homes for the elderly and comparable are also the possibilities of using tools to prevent complications in case of immobile clients. The biggest gap in nursing care for clients is bad knowledge of contractures in both homes for the elderly. Also keeping documentation and records relevant to the implementation of preventive measures in the Czech home for the elderly is not satisfactory. Mobilization record is missing and positioning record should be more detailed. We therefore propose the creation of positioning and mobilization recording modeled according to the German retirement home and handing it to the leadership of retirement home in the Czech.
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Antidecubital Care as a Nursing Problem
KŘÍŽOVÁ, Monika
This thesis deals with the issue of providing antidecubital care and observes the fulfilment of nursing interventions in the care about non-self sufficient patients. During performing her duties, every nurse encounters the issue of decubitus ulcers formation and with this related antidecubital care. Thus, it can be stated that the occurrence of decubitous ulcers serves also as the indicator of the quality of provided nursing care. A lot of people think that the problem develops particularly in elders, but young people who are bedridden after injuries and accidents are also affected and this complication degrades the quality of their life. The thesis is divided into theoretical and empirical parts. The theoretical part describes the anatomy of skin and its function, decubitus and classification of decubitus ulcers are defined, their localization with characteristics of predilection sites are specified, outlining complications in decubitus ulcers. The theoretical part pursues antidecubital care with the division into subheads on positioning, antidecubital aids, nursing interventions, and the mission of the European Pressure Ulcer Advisory Panel is described. The separate chapter includes the risk assessment of decubitus ulcers formations, as is e.g. Norton scale, etc. The last chapter embraces the specification of conservative and surgical treatment of pressure sores. The aim of the research examination was to determine whether the nurses perceived antidecubital care as a nursing problem and to map the opinions of the nurses relating to antidecubital care. Three research questions were set to achieve the objectives: first, what the pitfalls of nursing care were on the part of the nurses, secondly, what areas within antidecubital care were neglected and finally, how antidecubital care at selected inpatient wards was provided. The research was implemented at the chosen inpatient wards in České Budějovice Hospital, PLC, from the period of February to April 2014. The research file consisted of the general nurses and the medical assistants. A hidden participant observation was conducted and then questionnaires with 15 questions that were closed or semi-closed were distributed to the nurses. 45 questionnaires were handed out, 31 handed back and all 31 questionnaires could be processed. Thus, the total return of the questionnaires was 69%. Questions in the questionnaire were based on the observation criteria. The hidden participant observation was processed and plotted on the observation sheet and then classified according to the given criteria. After delivery, the returned questionnaires were checked and evaluated graphically. All results were processed using Misrocoft Office Excel program, were plotted in graphs with keys and descriptions. By processing and comparing the results, we ascertained that in some fields the opinion of the nurses was different from the practice that was really performed. It could be also caused by the fact that antidecubital care is very time-consuming, demanding and comprises a lot of nursing interventions. Sufficient number of aids with which the ward is equipped is relevant as well, be it preventive aids or medical ones. And last but not least the organization of the care. At present, the time spent on completing documentation is increasing and the time that can be used by nurses for contacting a patient and satisfy his/her needs is decreasing. Nevertheless, the patient´s state and his/her contentment reflect and demonstrate our care. After previous arrangement, the results of our research examination will be communicated to the ward sisters at the selected inpatient wards where the research examination was performed.
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Prevention and treatment of pressure ulcers in nursing Home for elderly Milevsko
HRYCHOVÁ, Šárka
Background methods: Appearance of decubitus is a main indicator of therapeutic and nursing care quality and is monitored carefully. However, they supervence in despite of high-quality and professional care of nursing staff, because there are factors, which we cannot influence while decubitus emergence. The main purpose of research was to map the preventative and nursing care of clients with the risk of decubitus and with it, find out if the care is in high-quality and possibly debunk absences and deduce a treatment for work experience.Methodics: The research was done by quantitative method, by technique of secondary analysis of data. Analytic studies check if there is a relation among the watched features. The data was received from verified and enclosed nursing documentation of Home for senior citizens in Milevsko from years 2010 and 2011. Procured data was afterwards elaborated by descriptive statistics by Microsoft Excel and SPSS program. Validity of hypotheses was tested via Chí quadrate test. Research aggregate created nursing documentation of Home for senior citizens in Milevsko. This establishment has 36 beds and during the year 2010 and 2011, 85 clients were accomodated here. Consistent with the first research purpose "To map the high-risk factors, which increases the probability of decubitus emergence." was evaluated nursing documentation of 85 clients. Consistent with the second research purpose "To find out, the precautionary measures belittling the risk of decubitus emergence of vulnerability client group." was evaluated by nursing documentation of 54 clients. Consistent with the third research purpose "To map the nursing intervention of clients with decubitus." was evaluated by nursing documentation of 10 clients.Results: From the research, results arose that there was the risk of decubitus emergence at every client of Home for senior citizens in Milevsko according to directory evaluative Norton scale. The final results demonstrated a high percentage 63,4 % clients who were endangered by the decubitus emergence. After one month, a checking evaluation of the risk of decubitus emergence was made according to directory evaluative Norton scale. The results demonstrated the strong depression of the number of clients with the risk of decubitus emergence or at least the depression of risk. The last part of research was focused on watching the nursing intervention of the client group with decubitus and finding the fruitfulness of the decubitus treatment. The result demonstrated that the treatment was in most cases succesfull and that 80% of clients were healed in four month.Conclusion: The important finding for the nursing staff was the assertion that the provided nursing care in Home for senior citizens in Milevsko has a good standard. Simultaneously, some absences were found like deficient resource of nutritive accessoires, damp healing of wounds, and utilities against decubitus in standard goings. The solving of these absences is to increase accessibility and awareness of professional doctors for resource of the necessary amount of nutritive accessoires, damp healing of wounds, and not to let clients with deficient financial resources to be entirely dependent on out of date medical advancement. Also, not to corrupt treatment and precautionary measures. The next important step is to motivate family members and imply them to take care of their relatives. The research was shortened and offered to censored journal for medical and hospital branch Profese on-line to be published.
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Obesity at immobile patients - the factor affecting the quality of nursing care
NAGYOVÁ, Věra
The prevalence of obesity is increasing in an alarming rate not only in developed countries, but in developing countries in the last time, too. The high prevalence of obesity in some of the developing countries is connected with the economic development which currently reached the acceptance of western lifestyle including eating habits and automobilization. Obesity has nowadays became a serious problem in countries, where had hardly occurred before that time. In the beginning of the theoretical part of this work are medical pieces of knowledge about obesity, their complications, treatment and prevention. There are introduced different ways of treatment as the dietary treatment of obesity is, cognitively behavioural treatment of obesity, locomotive activity in a therapy of obesity of the immobile patient, pharmacotherapeutical treatment of obesity and surgical treatment of obesity. The influence has there a suitable education to a healthy way of living. In the second theoretical part of this work the role of nurse in the care about obese immobile patient is included, syndrome of immobile and psychosocial and spiritual needs of the immobile patient. Indeed, there should not be omitted the importance of rehabilitation of immobile patient in this chapter. To the quantitative research I used the questionnaire method on the base of the specific choice, which was created by questions and focused on nurses, who are taking care of immobile patients which are hospitalised in hospitals on the after-treatment care and medical institution for the long - term lying in the Czech Budweis and at the internal and surgical ward in Prachatice. The aim of this work was to find out how obesity influences the quality of provided nursing care in the area of hygiene and prevention of decubitus by immobile patients hospitalised in at the after-treatment care in the Czech Budweis hospital. From the given hypothesis it was confirmed the first one. In the hospital in the Czech Budweis at the after-treatment care are hospitalised immobile patients with BMI 30 and higher. The hypothesis number two was not confirmed. Obesity by immobile patients hospitalised at the after-treatment care did not influence the quality of provided nursing care negatively. The results show that the nursing staff provides quality comparable nursing care by immobile patients as well as immobile patients without overweight.
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