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Effectiveness of Fall Prevention Intervention Programmes in Nursing Practice
HOROVÁ, Jana
Patient falls and fall injuries have become one of the most common adverse events reported by health care providers due to all the circumstances associated with hospitalisation.Worldwide preventive actions in the field of patient falls focus on soft factors,predominantly on the education of healthcare professionals and patients,and organisational culture.Due to the dynamic development of information technologies and the increasing digital literacy of the professional and lay population,the e-learning field is an increasingly sought-after form of education.The empirical part's main objective was to determine the effectiveness of general nurses' education through information technology as an intervention programme to prevent patient falls. The main objective was divided into consecutive partial objectives.A mixed approach was used.The study uses a observational-interventional design. The first partial objective,an analysis of patient falls, was investigated using a quantitative research method.Patient falls concerning a major health care provider were analysed over five years.The ??2-test or Fisher's exact test was used to test statistical relations.The Kruskal-Wallis test was used to test nonparametric variables.Regression analysis was applied to evaluate the trend in the incidence of fall injuries with regard to high-risk patients.The second research phase was based on the previous phase results,whereby a qualitative methodological approach was selected.The aim was to detect areas of falls focused on the specifics of the clinical environment,which were suitable for being included in the educational programme.Data was collected through a semi-structured interview. The third partial objective was creating and implementing an e-learning educational programme for general nurses in a clinical environment.Within the pilot testing,the properties of knowledge tests,content validity,and reliability were verified using Spearman's rank correlation coefficient and Cronbach's alpha.The effectiveness of the established e-learning programme (fourth partial objective)was verified by comparing the incidence of patient falls before and after the established intervention.Bonferroni correction and test of equality of parameters of two alternative distributions were used to verify the homogeneity of the compared groups of patients. With regard to the possible influence of confounders and to verify the incidence of injuries caused by falls,the method of statistical matching (propensity score matching) was subsequently used.Valuation of the e-learning programme's effectiveness with regard to the participants' level of knowledge was performed by comparing the results of the input and output knowledge test,for which the Stuart-Maxwell test and Fisher's exact test were used.The analysis of partial objectives of individual research phases was carried out separately;the objectives logically followed,and fulfilling the previous objective conditioned their fulfilment.The test of equality of parameters of two alternative distributions allowed for comparing groups of patients that could be considered equal.There was a decrease in the incidence of patient injuries due to falls in both disciplines (all injuries in the surgical discipline; p ? 0.05 and severe injuries in the internal medicine discipline; p ? 0.01).The results proved the influence of the e-learning educational programme on specific clinical practice indicators.Statistical matching eliminated confounding factors and confirmed a statistically significant reduction in the incidence of falls in patients with internal medicine injuries (p? 0,05).There was also an improvement in the participants' knowledge in the output knowledge test (p ? 0,001). Education of medical personnel based on the principles of science and the needs of clinical practice is a possible effective preventive intervention in patients falls and efforts to minimise the occurrence their consequences.
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Falls in Geriatric Patients at the Follow-up Care Department
CARDOVÁ, Lenka
This diploma thesis is dedicated to falls in geriatric patients in the aftercare department. Thesis Objectives: To carry out a complex analysis of multifactorial causes in chosen cases of geriatric patients that occured during hospitalization in a chosen aftercare workplace from 2020 through 2021 in Nemocnice České Budějovice, a.s. To carry out SWOT analysis of a chosen aftercare workplace in Nemocnice České Budějovice, a.s. with the objective to evaluate interventions used in preventing falls of patients hospitalized in the given workplace. Suggestion of recommendation to improve current practice of the chosen aftercare workplace in Nemocnice České Budějovice, a.s. in preventing falls in hospitalized patients. Methodology and Research File: To reach the objectives, three research questions were chosen. What are multifactorial causes of chosen cases of falls in geriatric patients in the chosen aftercare workplace? What interventions are used to prevent falls in geriatric patients in the chosen aftercare workplace? What interventions might improve current practice in preventing falls in hospitalized geriatric patients in the chosen aftercare workplace? To implement a survey, a qualitative research strategy was chosen. For case study purposes, the following data collection techniques were used - medical documentation content analysis, reporting adverse events, controlled documentation etc., semi-structured interviews with doctors in specific fall cases. In the following part of the survey, where we were finding out about the intervention used and intervention meant for improving the current practice in fall prevention, semi-structured interviews were carried out with doctors and nurses. Interviews with the nurses were completed by participant observations. Based on the survey results, a SWOT analysis was processed. The research file consisted of 14 chosen falls that happened in hospitalized geriatric patients in the aftercare department from 2020 through 2021, of 12 nurses working in the aftercare department, of 9 doctors that were informed of a fall. A deliberate choice of both nurses and doctros was used, the criterium for being included in the research file was the minimum of a year-long practice in the aftercare deparment. The obtained data was processed using the pen-and-paper method, open coding, and data was subsequently categorized and noted down into tables and schemes. Results: Complex analysis of multifactorial causes of chosen fall cases proved that falls happened due to internal as well as external factors. The risk of a fall was increased by the pateints´ age, morbidity, polypharmacotherapy, cognitive deficit, sarcopenia, fragility syndrome, instability, bed siderails lifted, and human resource failure. Based on the results, we carried out SWOT analysis and we suggested a recommendation to improve the current practice in the chosen aftercare workplace. Practice Recommendations: Based on the survey, we would recommend for a repetitive evaluation of the risk of patients falling to be carrried out. Another recommendation would be educating the nursing staff in the area of fall prevention, in the area of communicating with geriatric patients and patients suffering from dementia. Further on, we would recommend ensuring the use of suitable positioning aids and securing a movement-detection system inside the bed. Last but not least, we would recommend increasing numbers of nursing staff.
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The possibilities of physiotherapy which improve the postural stability of seniors
NOVOTNÝ, Petr
These days, due to low natality and increasing life expectancy, we face the fact that the Czech population is getting older and older. Growing old is connected with risks of health difficulties, that have a huge impact on the quality of our lives. One of the most important health problems that elderly people have is instability causing e.g. falls. They are quite common with increasing age and they can cause lots of serious consequences. Seniors with provable symptoms should not underestimate their state of health and they should rather look up specialized care. One of the options for the prevention of impaired postural stability and subsequent falls may be physiotherapy that focuses on this issue. This diploma thesis aims to describe the possibilities of how physiotherapy can help improve postural stability with elderly people. The thesis also suggests exercises that seniors could do on their own and thanks to them elderly people could improve their postural stability. My diploma thesis consists of the theoretical and practical part. The first one contains gained pieces of knowledge of later life, growing old, postural stability, and application of physiotherapy. In the practical part, I mention six case interpretations with elderly people between 76 and 78 years. In these interpretations, which consisted of entrance and final tests, we can see the differences that appeared after stabilographic training and after following the method that I had created. I believe that this thesis could help spread awareness of impaired postural stability with elderly people. It could probably be used for the training of seniors and it could become a therapeutic methodology not just for nurses in the retirement homes but probably for the general public as well.
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Fear as a risk factor of seniors falling
JUŘENOVÁ, Renáta
Fear of falling, even without previous experience with falling, can put older people in higher risk due to their reduced activities. In this diploma thesis Fear as a risk factor of seniors falling there were two objectives to achieve. The first objective was to determine the fear of falling for people aged 65 and over, living on their own or in nursing homes. The second objective was to determine the fear of repeated falls on physical and social activities of people aged 65 and over. In order to determine the set objectives both quantitative and qualitative research methods were necessary to use. The quantitative research was carried out in a form of an own questionnaire and FES-I test with 122 responders. The qualitative part was performed by semi-open interview with five participants. The data obtained in qualitative research were subsequently analyzed by open coding, pencil and paper method. A total of five predetermined hypotheses were statistically processed after the end of data collection. After evaluating the hypotheses, it was found that the level of fear of falling depends on age, but not on gender. An interesting outcome was the fact that level of fear of falling is higher in elderly people living in nursing homes than in people living on their own. It is also important to note that previous experience with a fall affects the level of fear, but hospitalization for injuries caused by a fall does not affect the level of fear of a fall. The research question revealed that older people, after the experience of falling, think more about where their next steps will lead when walking. However, there was no reduction in social activity in the sample of elderly people who have a history of falls. This diploma thesis should draw attention to the issue of falls of older people over the age of 65. Older people are often afraid of falling and therefore limit their daily and physical activities, which on the contrary increases the risk of falling. The elderly people need to understand the risks of falling, both internal and external, and be able to determine the danger of the fall. This requires educating them not only by nurses but also by doctors and other health-care oriented staff.
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The semantics of the genitive case in English
PIEGLOVÁ, Monika
This bachelor thesis deals with the function of the genitive substantive, the semantics and use of the English genitive case. The thesis is divided into two parts, the theoretical part and the practical part. In the theoretical part, the work deals with theoretical sources concerning the genitive case in English. In the practical part, real data, which were obtained from a corpus, are analysed. The aim of this thesis is to classify the semantics and quantify the particular meaning of the genitive case in English, using the real sample from language corpora. The thesis also intends to demonstrate, whether there are any gaps in classification of semantic relations within the genitive phrases.
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Analysis of dynamic strength of friction knots used in military climbing
Telvák, Radek ; Michalička, Vladimír (advisor) ; Braum, Zdeněk (referee)
Title: Analysis of dynamic strength of friction knots used in military climbing Objectives: The aim of this work is to determine the resulting impact force generated by selected friction systems at different values of the fall factor. To calculate what maximum values of auxiliary Reep cord length and maximum load weight can be achieved without system failure. Determine the correlation between the magnitude of the impact force and the slip length. Methods: This thesis describes an experiment in which the resulting impact force acting on a friction system at different drop factors was determined. A 6mm Reep cord and an 11mm rope and friction knots used in military climbing techniques were selected for analysis. Testing was carried out in a polygon on a drop tower. Each of the friction knots was subjected to 5 tests at the same fall factor. The individual knots were statistically compared with each other in terms of impact force and slip. Using direct proportionality, the maximum possible values of the auxiliary Reep cord length and the weight of the load were determined. A correlation analysis was used to establish a correlation between impact force and slip. Results: It was found that at all measured values of the fall factor, the Twist prusik achieved the lowest values of the resulting impact force...
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Comparison of impact force values amongst improvised and traditional rope fixed instalations
Kučera, Václav ; Michalička, Vladimír (advisor) ; Gajdošík, Jan (referee)
Title: Comparison of impact force values amongst improvised and traditional rope fixed instalations. Objectives: The aim of this work is to measure the resultant impact forces acting on a climber during a fall from an improvised fixed installation, using an improvised ferrata set, by means of an experiment. Furthermore, to compare the measured impact force values with those already measured for traditional fixed installation using ferrata fall arresters. Methods: This paper describes an experiment in which the actual impact force acting on a climber during a fall from an improvised fixed installation using an improvised ferrata set was determined. The aim of the first experiment was to determine the values of the impact forces for a given length of fall. At the same time, to determine the maximum value of the impact force at which the reep cord forming the improvised ferrata set will not break. The second test aimed to determine the resultant values acting on the load when falling into the sag from the dynamic rope, which were then used to compare with the results of the first test. The purpose of the last test was to compare the resultant values of improvised and traditional fixed installations. Each fall length was tested for ten trials whereby after each fall the textile material was replaced...
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Reinforced concrete slab supported on columns
Hadamíková, Karolína ; Strnad, Jiří (referee) ; Požár, Michal (advisor)
The bachelor thesis is focused on design and assessment point-supported slab on the lowest level of fourth-level storage to ultimate and serviceability limit state. Design of slab was created in software SCIA Engineer and followed by checking if it is right by manual calculation. This thesis contains a static calculation and technical drawings of typical column, foundation pad. At the end of structural assessment was calculated prefabricated staircase. All structures were proceeded according to the valid standard ČSN EN 1992-1-1.
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Manufacturing of ignition cover pad
Dostál, Martin ; Peterková, Eva (referee) ; Podaný, Kamil (advisor)
The thesis solves the design of the technology of production of the ignition cover pad made of steel 11 321 with a thickness of 1 mm with zinc surface treatment. It serves as part of the motorcycle engine sealing system. The part is rotating in shape with a diameter of 35 mm and consists of a central extrusion and a hole. The size of the series is 25,000 pieces per year. Production by a progressive compound tool from a coil with dimensions of 1200 x 500 mm is chosen. 3 forming operations with eating between steps are selected, which are implemented by cutting and embossing technologies. The necessary forming work of 476 kJ and the force of 267 kN are determined, according to which the PRESSIX CNV4 eccentric press is chosen. The machine is introduced into the automated Shungdar SJD and SJK production line, which consists of a straightener, unwinder and feeder.
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Decline of the Czech teacher's elite 1945-1955
Císařová, Pavlína ; Hnilica, Jiří (advisor) ; Bílková, Jitka (referee)
This dissertation focuses on history of czech teachers, primarily high school teachers. The idea is to originate everything from the basics of history that is traditionally in rythm with political changes. This thesis is focused on deeper understanding of transformation of czech education, changes and developpement of one multilayered professional status or in the end a change of czech society in the first half of the 20th century. The time period between 1945 and 1955 is well known for its political, bussines and economic transitions. The main focus of this disertation is to show from the history of teachers which they are related to the teaching laws, the big modification that has happened at the time period. Concrete examples are presented in a detailed developpements which are different between inland and borderline gymnasiums and the way the teaching is conducted. This disertation offers complete picture of this topic, that is until now processed only in ideologically orientated publications. KEY WORDS decline, elite, high school teachers, school reforms, school laws, history of teachers
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