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Impact of a hospital palliative care team on costs and quality of care of patients at the end of life.
Křemenová, Zuzana ; Rychlík, Ivan (advisor) ; Merta, Miroslav (referee) ; Bužgová, Radka (referee)
This dissertation thesis describes the end-of-life care in hospital setting and compare the dying phase with and without specialist palliative care support. The second part of the thesis focus on quality of care improvement by using patient reported outcome measures (PROMS). To increase the quality of symptom assessment in palliative care the routine use of PROMS is recommended. Aims The first study aimed to compare costs of terminal hospitalization and quality of care between the group of patients with and without support of a palliative care team. The second study aimed to provide translation, cultural adaptation and validation of IPOS- renal measure, which is patient reported outcome measure used for patients with advanced chronic renal disease. Methods The first study was a descriptive retrospective case-control study. We explored the difference in daily hospital costs between patients who died with and without the support of the hospital palliative care team. As secondary outcomes, we compared the groups over the duration of the terminal hospitalization, intensive care unit days, intravenous antibiotics, MR/CT scans, oncologic treatment, preferences and limitation of care and family support. In the second study the IPOS-renal was translated to Czech and culturally adapted using cognitive...
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The quality of nursing care in aseptic treatment of operative wounds
KARŠULÍNOVÁ, Pavla
The present diploma thesis deals with the quality of nursing care in aseptic treatment of surgical wounds. High quality nursing care is desired in order to satisfy patients' needs. Equally high level of quality is required from the healthcare organizations where patients are treated. The diploma thesis is divided into two sections: a theoretical section and an empirical section. The theoretical section focuses on surgical wound, its healing, aseptic care, complications of wound healing, nosocomial infections, quality of nursing care, nursing care indicators, and quality of health care from the patient's point of view. The empirical section's aim is to evaluate the quality of nursing care in selected surgical departments. The thesis aims to answer two research questions: 1) How do nurses employ the aseptic technique when changing a surgical wound's dressing? 2) Nurses must enhance their expertise in surgical wound care. How do head nurses at selected surgical wards secure the aforementioned training? A qualitative research survey was used to process the empirical part of the thesis. Semi-structured interviews with ward managers and head nurses were conducted for data collection. The nurses answered 20 questions each. During the interview, valuable answers were provided by 17 nurses. The results indicate high quality of nursing care in aseptic treatment of surgical wounds, as nurses employ modern trends and techniques in surgical wound care; the high quality of nursing care is reflected in the minimally occurring complications that affect surgical wounds. Aseptic approach is a priority for the nurses working in the wards where the research was conducted. Nurses follow standardized procedures for aseptic dressing of surgical wounds. The head nurses and ward managers consider education of nurses in the issue of aseptic treatment of surgical wounds to be of the utmost importance, and they supervise or arrange education in aseptic care of surgical wounds for nurses on a regular basis. The information obtained in the research can serve as a basis for seminars on aseptic treatment of surgical wounds.
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Internal audit and its role in nursing practice
JINDRLOVÁ, Lenka
Current state: According to Act No. 372/2011 Coll., On health services, it is the duty of every health service provider to implement an internal control system. The purpose of internal audits is to identify deviations from recommended procedures and arrange for their correction. The aim of this research was to find out the opinions of general nurses and internal auditors on the influence of internal audits on the quality of provided nursing care and to evaluate the completeness and complexity of keeping nursing documentation. Methodology: The design of empirical research consisted of quantitative-qualitative procedures, the technique of content analysis of selected internal regulations, semi-structured interviews and secondary analysis of medical documentation (internal audit). The qualitative part of the research involved five general nurses working at the Department of internal medicine of a selected hospital in the South Bohemian region and five internal auditors within the same hospital. A content analysis of three internal regulations was performed. In the quantitative part of the research, 285 closed nursing documentation files were audited. Results: The research confirmed that internal audits of nursing documentation statistically significantly increase the accuracy of nursing care records. Repeated audits of nursing documentation have improved documentation management in the areas of identification of patient ID forms, standard procedure for correcting records, assessment of the risk of pressure ulcers, record of education about invasive entry, proposal of preventive measures to minimize the risk of falls and record of non-administration of drugs. Nurses and auditors evaluate internal audit as a suitable tool for maintaining and improving the quality of nursing care. Conclusion: Based on the identified shortcomings in the management of nursing documentation, we recommend the hospital management to increase the frequency of internal audits, identify the root causes of errors in the documentation management and arrange for their correction. Last but not least, we recommend to organize professional seminars on the issue.
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Legal aspects and their application in the real work of nurses standardized nursing procedures
Jánská, Lucie ; Rožnovská, Ludmila (advisor) ; Vaňková, Dana (referee)
Author: Lucie Jánská Institution: Institute of social medicine Faculty of medicine in Hradec Title: Legal aspects and their fair application in the work of the sister with standardized nursing procedures Supervisor: JUDr. Ludmila Rožnovská Count of pages: 78 Count of attached pages: 1 Year of completion: 2016 Keywords: standardized nursing procedures, the quality of care, kompetence, legal responsibility The thesis is made up of two parts, theoretical and practical. In the theoretical part are clarified the knowledge regarding the quality of nursing care, evaluation of this quality and brings the analysis of standardization. It deals with the komplete of General nurses and thein legal responisibilities. The practical paet of the reports on the researcg, which took place in a large hospitál with participation of the 91 respondets. Reports on thein awareness, knowledge, competences and legal awareness. Discussion and conclusion of the summary ot the results obtained are served.
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Needs and Experience of Families with Child Suffering from Spinal Muscular Atrophy - Current Situation and Challenges for Social and Health Care System in Czech Republic
Schagererová, Iveta ; Štegmannová, Ingrid (advisor) ; Tichá, Růžena (referee)
Situation of families in which a child with spinal muscular atrophy was born, is the topic of this thesis. This rare genetic disease affects neuromuscular system of children and shortens their lives. In most severe cases the failure of respiratory functions comes in the first year of child's life. This thesis is focused on support that Czech system of social and medical services provides to families with this disease. Next, it looks into needs of these families and examine the extent to which the system is able to saturate them. Very important point in this research is also families' perception of quality of care. The research was implemented with use of qualitative methods, mostly by semi-structured interviews which followed families' journey through the system of social and medical services. Then there is a comparison of experience of families with theories, policy and other normative framework and suggestion of steps that should be taken to improve families' satisfaction with services they receive concerning the child's disease. Key words: spinal muscular atrophy, rare diseases, patient's autonomy, patient- centered care, patient journey, quality of care.
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The needs of vulnerable older people in home health care
Dostálová, Vladimíra ; Holmerová, Iva (advisor) ; Macková, Marie (referee) ; Auer, Stefanie (referee)
The present dissertation, which focuses on the needs of particularly vulnerable older people in home health care, was written within the framework of the PhD study in Longevity at the Faculty of Humanities, Charles University and was carried out as part of the project supported by the Charles University Grant Agency "Met and Unmet Needs of Particularly Vulnerable Older Patients in Home and Inpatient Care" (GA UK No. 760219). The overall aim of the three researcher project, where I was the research coordinator, was to clarify the needs of particularly vulnerable older patients in both home health care and inpatient care, including the needs of patients living with dementia. The aim of this dissertation was to identify the needs of vulnerable older patients in home health care. This dissertation consists of four papers. At the time of writing, two articles had been published in peer-reviewed journals and two articles were under review. The thesis has chapters in the introduction and conclusion that set the professional articles in context, creating a comprehensive view of the needs of particularly vulnerable older people in home health care. As three of the four peer-reviewed articles submitted have been published (1) or under review (2) in international journals, the entire dissertation is written...
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How to meet needs of seniors in hospital care.
Bláhová, Hana ; Holmerová, Iva (advisor) ; Macková, Marie (referee) ; Kisvetrová, Helena (referee)
The submitted dissertation of the PhD study programme Longevity Studies was prepared and financially supported by the project GAUK - Grant Agency of Charles University No. 760219 entitled "Met and Unmet Needs Of Particularly Vulnerable Older Patients in Home and Inpatient Care", of which I am a co-investigator. The mentioned research project is also in the intentions of the strategic plan and long-term activities of the research team CELLO (Center for the Study of Longevity and Long-Term Care), which is the scientific basis of the PhD study programme Longevity Studies. The main goal of the GAUK project is to provide a comprehensive overview of the needs of vulnerable older patients who are provided health care. The project is focused on three areas, which are: the needs of patients with dementia, the needs of geriatric patients at home and the needs of geriatric patients in hospital care. Partial goals are the exploration of current knowledge of the issue based on a review of Czech and foreign literature. The aim of the survey is to find out attitudes and opinions on satisfying needs from the perspective of patients and healthcare professionals. The practical goal is to create recommendations for good practice for the health care of these patients. The dissertation consists of a total of seven...
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Reform of mental healthcare in Czech Republic
Šilhanová, Andrea ; Válková, Monika (advisor) ; Mlejnková, Kristýna (referee)
In the thesis I examine current legislative anchoring of healthcare and social care of mental health. In the second chapter of theoretical part I write about classification of mental illnesses. Third chapter, which is very important from my point of view, describe transformation of healthcare and social care in the foreign countries. Practical part contains pilot survey for the Ministry of Health. The purpose was to find out the satisfaction of the clients with social and health services, which are part of the treatment of mental health. Satisfaction was detected by questionnaires, which patients had available with their ambulant psychiatrist. Those questionnaires were created at round tables by experts, patients and service providers in a hospital. Social care and healthcare do not connect. Experts do not communicate with each other. Tragical finding was that ambulant psychiatrist has in average thirteen minutes for examination of a client. Definitely Czech Republic need Centre for Mental Healthcare for complex care of the patient.
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