|
|
Invasive monitoring in intensive care
CUPER, Tomáš
Invasive monitoring is a repetitive, durative observation of physiological functions of a patient and functioning of apparatuses which serve as support of these functions. It is thus an active, repetitive and continuous process when both the patient and the medical apparatuses are regarded. The human factor is thus essential and vital. The reason for application of the invasive monitoring during an intensive hospital care is above all the ability to support physiological functions of a patient, at the same time, it serves to timely detect divergences in physiological values; it very often effectively helps in further decision-making of medical interventions, and clarifies the effectiveness of patient´s treatment. The theoretical part of this bachelor thesis deals with the issue of invasive monitoring in intensive hospital care. The beginning of the thesis provides an explanation what actually the invasive monitoring means, and clarifies and characterises intensive medicine and monitoring in general. The individual types of invasive monitoring are divided according to areas of basic living functions in cardiovascular, respiratory, and central nervous system. With every type of invasive monitoring comes an explanation and clarification of it, further, generally indicated and contraindicated statuses are provided, along with instruments and the way monitoring is applied. The theoretical part is concluded by a chapter that deals with general nursing care. The practical part focuses on mapping of the most often used types of invasive monitoring given critically ill patients in Anaesthesiology and Resuscitation wards, and Urgent Admittance wards in hospitals of the area of South Bohemia, and the region of Carlsbad, and mapping of knowledge of staff of Anaesthesiology and Resuscitation and Urgent Admittance in the particular regions given invasive monitoring. The research was implemented by a quantitative method using a printed standardised questionnaire. The amount of data was collected in March 2014. The target group of the research was a team of general nurses and paramedics, who work in Anaesthesiology and Resuscitation wards and Urgent Admittance wards. The anonymous questionnaire was handed out 100 exemplars for hospitals in South Bohemia, and 100 exemplars for hospitals in the region of Carlsbad. In South Bohemia, there were picked the hospitals in České Budějovice, Jindřichův Hradec, Písek, Prachatice, and Tábor, there. In the region of Carlsbad, there were picked the hospitals in Cheb, Carlsbad, and Sokolov, there, to fill in the questionnaire. There took part 141 respondents in the research. The total amount of responses out of 200 exemplars (100%) of the questionnaire thus reached 70, 5%. The questionnaire contained the total of 28 questions, out of which the opening 4 were stratification-like, question nr. 5 was closed, question nr. 6 were half-open and the remaining 22 questions were dealing with knowledge of respondents in the issue of invasive monitoring in intensive care. The results were progressed by the statistic programme SPSS into well arranged tables, and the set hypotheses were statistically evaluated with help of X2 square test. The goal of this bachelor thesis was to map the most often used types of invasive monitoring with critically ill patients in Anaesthesiology and Resuscitation wards, and Urgent Admittance wards in hospitals of South Bohemia, and in region of Carlsbad. This goal was fulfilled. The next goal was to map knowledge of invasive monitoring given staff of Anaesthesiology and Resuscitation wards, and Urgent Admittance wards in hospitals of South Bohemia, and in region of Carlsbad. This goal was fulfilled too. Statistically evaluated questionnaire proved that the workers have the knowledge in the area of treatment, hemodynamic values, as well as techniques in taking care of critically ill patients in Intensive Care wards.
|
|
|
Basal stimulation in pediatric intensive care units
SOUKUPOVÁ, Alena
This diploma thesis deals with basic stimulation, specifically in intensive care units. Basic stimulation is a holistic method that approaches the patient as a whole. It views patients as individual beings with specific needs that make them different from others. We use basic simulation to enable people with physical or mental disabilities an easier integration in life. When taking care of patients within the framework of basic stimulation, we take their habits, manners of communication as well as experience into consideration. We make use of everything that an individual perceives as pleasant and is used to. When using the elements of basic stimulation we stimulate the individual whom we thus enable to perceive his or her bodily boundaries and surroundings, we facilitate his or her communication with the surrounding world and his or her return to becoming aware of his or her own ?I? ? of who I am actually. The objective of our thesis was to find out whether nurses working at paediatric intensive care units apply methods of basic stimulation in their profession and what attitude they adopt to it. Further, we investigated whether the parents of hospitalised children have information about basic stimulation, and again, we were interested in the attitude parents adopt to this method. To achieve our objectives, we chose both the quantitative method, by means of an anonymous questionnaire that we handed out to nurses at paediatric intensive care units, and the qualitative method, by which we obtained information from the parents of hospitalised children by means of a semi-structured interview. Our respondents were the above nurses from paediatric intensive care units and the parents of hospitalised children. We have found out from our results that despite the fact that basic stimulation is not applied by all nurses we interviewed, it is a widely used method in the care of patients and it brings quality results in care. The nurses adopt, in most cases, a very positive attitude to this method. They find improvement and calming in their patients. Although basic stimulation is a frequently applied method, some parents of hospitalised children have not heard of it. The parents got involved in the care of their children with pleasure, also when elements of basic stimulation was applied. The nurses were very often willing to teach the parents these elements. The parents regarded basic stimulation in nursing as very beneficial and observed its positive effect on their children.
|
|
|
The profession in intensive care and its impact on the lifestyle of nurses
ŠVECOVÁ, Radka
The diploma thesis has been focused on the issue of nurses working within intensive care and on the impact of performing a job in this branch on their lifestyles. The jobs of nurses working within the intensive branches clearly belong among the demanding ones. A nurse often becomes a witness of dying patients while there is hardly any chance of curability and stabilization of their conditions. All of that and many other factors affect her personal and professional life, as well as her current lifestyle. To perform her job at as high level as possible, a nurse must be motivated and directed by management of the health centre, she must be educated enough in her branch and the job should be a hobby for her, where she must feel certain and safe and the job should satisfy her. This diploma thesis has defined three following intentions. The first one highlighted mapping of a lifestyle of nurses working within intensive care. The second one was determination of psychical load of nurses working within intensive care. The third one included comparison of lifestyle of nurses working within intensive care and lifestyle of nurses working at standard wards. There were 4 hypotheses defined for the investigation survey. The first one analyzed if a job within intensive care affects diet of the nurses. This hypothesis proved true. The second one, if nurses working within intensive care consume more alcoholic drinks than the sisters working at standard wards do. This hypothesis did not prove true. The third one examined whether nurses working within intensive care smoke tobacco products more than the sisters working at standard wards do. This hypothesis proved true. And the fourth and the last hypothesis analyzed if a job within intensive care is psychically demanding for the nurses. This hypothesis proved true.
|
|
|
Attitude between paramedic and nurse in the prehospital urgent care and hospital urgent care
GRÜNN, Jan
The title of the bachelor?s thesis at hand is the Relationship between paramedics and general nurses during pre-hospital emergency care and hospital emergency care. The objective of the thesis was to find out how the general nurses and paramedics perceive the process of getting further education needed for work in the pre-hospital emergency care and hospital emergency care. The theoretical part deals with the current state of the Emergency Medical Service (EMS), its organisation, funding, and division. Next, the thesis provides characteristics of the professions of paramedic and general nurse, especially with regard to their educational background, how they get their qualifications, their competences, and with regard to legal relations these professions enter into. The practical part employed the method of quantitative research. Anonymous questionnaire was used as the method for collecting data. The target research group comprised of paramedics and general nurses that work at EMS Dispatch Centres of the Region of South Bohemia or at the Departments of Anaesthesiology and Resuscitation in the hospitals based in the Region of South Bohemia. This bachelor?s thesis introduces two hypotheses. The first one reads: ?University-educated paramedic needs more work experience for work at a Department of Anaesthesiology and Resuscitation than a general nurse with ARIC (Anaesthesiology, Resuscitation and Intensive Care) education.? The second one is as follows: ?General nurse education is more suitable for work in pre-hospital emergency care than that of paramedic.? At the beginning of writing this thesis, the competences of paramedics and general nurses were completely different. Due to the changes in laws and amendments to the law which defines these competences that came into effect in the meantime, the possibilities of getting further education have seen changes, too.
|
|
|
Integration of parents into the care of critically ill child from the perspective of nurse
MULAČOVÁ, Romana
Nowadays the parental presence in the pediatric intensive care units (PICU) is quite common. Building a fellowship between parents and health care staff and high quality parents' integration into the care is a very demanding process. First of all, the success of this process largely depends upon the nurse. It is the very nurse who leads, educates, supports and also professionally integrates parents into their child's care. In addition, critically ill child's care in cooperation with parents is complicated by a high parental stress level, child's serious condition and high professional and technical requirements posed to the nurse. The graduation thesis concentrates on the parents' integration into the care of a critically ill child from the nurse's point of view. The goal of this thesis was to describe the general conditions of parents' integration into the critically ill child's care and to map the actual state of the cooperation within the nurse ? parent ? critically ill child relation from the nurse's point of view. Other goals included the analysis of nurse's feeling of readiness for work with parents of critically ill children, and elaboration of a booklet concerning the initial introduction of an intensive care and resuscitation unit for infants and older children for better parents' awareness. In the research part of the thesis a qualitative research was used. The data collection technique was a semi-standardized interview. A research sample was represented by seven nurses working in the sphere of the critically ill children care in four selected hospitals in the Czech Republic. The study took place in the period starting May 2011 till July 2011. The research results revealed that the parental integration conditions are not quite optimal. First of all, in this sphere the nurses pointed to a limited accommodation capacity for parents, lack of supporting services and unsatisfactory site layout of the intensive care units. The nurses expressed their readiness to the closer cooperation with critically ill children's parents in the basic nursing sphere, mostly, thereafter, in the sphere of hygiene care. The parental cooperation in the special-care sphere was accepted rather negatively by the respondents. As the research results show, most of the nurses consider the work with parents psychologically very demanding and during their school education they had never been prepared for it by anybody. Findings flowing from the research results gave birth to the information booklet that is a basic informational and educational material for parents of children admitted to the intensive and resuscitation care unit for older children and infants in Hradec Králové University Teaching Hospital. It also represents a detailed instruction for a similar material for other facilities of this type and, last but not least, it facilitates the whole process of initial parents' education for nurses. This graduation thesis can also assist in the education of children's nurses, help students and nurses working with critically ill children's parents understand the "Family-centered care" principles and their practical introduction.
|
|
|
Nursing care of patients with bleeding to the GIT.
HOLZÄPFELOVÁ, Soňa
Gastrointestinal bleeding is a symptom of numerous diseases that might be serious. Acute GI bleeding is the most frequent abdominal incident and has been occurring more and more often recently. Acute bleeding in the upper GI tract is a very urgent state affecting circulation stability. The bleeding may have adverse consequences. This is why a quick intervention and immediate bleeding stoppage are very important here. The aim of the thesis was to determine the principles of nursing care for patients with GI bleeding and what may be provided to a patient with acute GI bleeding within nursing care. Two research questions were set: 1 - What are the principles of nursing care for patients with GI bleeding? 2 - What may be provided to a patient with acute GI bleeding within nursing care? The thesis was elaborated by means of qualitative research. The technique of interview was used for data collection. Non-standardized interview was applied to patients. Individual case studies of the patients were elaborated from the information obtained. Semi-standardized interview was chosen for nurses, from which individual case studies were elaborated. We had the opportunity to use an analysis of nursing documentation of the Gastroenterological Department of the České Budějovice Hospital. The research has shown that nurses mostly have sufficient information on the principles of nursing care for patients with upper digestive system bleeding. From the patient answers we found that awareness of their needs was essential. This is why an informational brochure compiled upon request of the patients is an output of my thesis. A presentation for nurses describing insertion of an esophageal probe is the second output.
|
|
|
The role of nurses in the care of patients with acute pain in intensive care departments.
LINHARTOVÁ, Lucie
Diploma thesis entitled focuses on acute pain in general, as well as on post-operation pain, which is one of the types of acute pain. The first part of the thesis deals with acute pain as such and its characteristics. The second part deals with intensive care units (ICU). The third part contains description of post-surgery pain, treatment thereof, and the nurse?s role in taking care of clients suffering post-surgery pain. Three goals have been outlined. Goal 1: Identification of the techniques that nurses use at ICUs to sooth clients? pain. Goal 2: Map the monitoring the pain of clients hospitalized at ICUs. Goal 3: Find out whether the techniques for reducing pain of clients hospitalized at ICUs are effective. A quality-oriented research was applied for evaluation of the results, using a method of non-standardized interview with nurses and clients.The results can be used as a comparative overview of the most common pain-reducing techniques and proof of their effectiveness for clients.
|
|
|
Support for Nurses in Death Cases at Resuscitation Units and Intensive Care Units
LAYEROVÁ, Helena
At Resuscitation Units and Intensive Care Units nurses face the issue of dying and death every day. Very often they are in contact with the dying and their immediate family and they are expected to have professional approach and provide comprehensive care. Stress that the nurses experience in these situations results into mental, emotional and physical exhaustion, and can be manifested by psychosomatic problems. Preparation of nurses to these situations and support of their management is therefore a key factor for the management of this demanding profession. The theoretical part of the thesis contains a description of the current state of the issue, characterizes resuscitation and intensive care, and deals with the issue of death and dying in Resuscitation Units nad Intensive Care Units, managing situations associated with death and the support of nurses in these situations. The work has four goals. The first objective is to determine what method of preparation of nurses is in practice ensured in Resuscitation Units and Intensive Care Units for the performance of high-quality nursing care for dying patients. Another objective is to determine whether and how the nurses are prepared and trained in the field of management of situations connected with the death of a patient in Resuscitation Units and Intensive Care Units. The third objective is, whether there is and what is the form of assistance to nurses in RU and ICU provided by the team and the management of the Department in case of deaths of patients, and the fourth objective is to determine what form and manner of support nurses expect and require. Research part of the thesis was carried out by quantitative investigation using an anonymous questionnaire. Respondents were answering 38 questions, 13 questions were closed, 21 half open and 4 were open. The support is most frequently understood as a psychological support, good teamwork, communication, supervision and representation where necessary. Management is expected primarily to provide support through education, ensuring supervision, corresponding financial support and professional psychological assistance where necessary. On the basis of this work?s results a proposal for the course for paramedical professions working in RS and ICU called ?Course of the Strategy of Difficult Situations Management in the Care for the Dying and Their Close Family in Intensive and Urgent Care?, was made.
|
|
|
Sepsis in intensive care, precautionary measures on the part of nursing personnel and department management
JANOUŠKOVÁ, Ludmila
Sepsis represents a serious medical, but also social problem. Hundreds of thousands of patients die from serious sepsis and septic shock every year. Patients with serious sepsis are treated at intensive care units and their treatment is long, costly and low efficient. These are the reasons why prevention of sepsis focused on prevention and effective treatment of nosocomial infections or timely solution of another problem, e.g. a shock is so much stressed. Nosocomial infections affect about 30 per cent of patients at intensive care units and may cause serious diseases, sepsis or even death. This thesis deals with the possibilities nurses have to influence sepsis, particularly by adherence to aseptic procedures and prevention of nosocomial infection, which might consequently develop in nosocomial sepsis. Combination of quantitative and qualitative methods was used for the research. There were two goals set for the quantitative research. 1. To find whether obstacles occur in adherence to proper aseptic procedures in nursing work as prevention of nosocomial infection occurrence and subsequent septic conditions in patients hospitalized at intensive medicine workplaces. 2. To map the weak points in adherence to proper aseptic procedures in nursing work in intensive care. The goals led to hypotheses H1 Obstacles obstructing thorough adherence to proper aseptic procedures in nursing work exist in intensive care. H2 Non-adherence to aseptic procedures occurs in nursing work at intensive medicine workplaces as a consequence of lack of time for particular interventions. The research sample consisted of nurses from the intensive care workplaces ARD and ICU from 8 hospitals. Questioning method through the questionnaire technique was used for data collection. 342 questionnaires were distributed in total. Hypothesis 1 was refuted, hypothesis 2 was refuted. We found that no obstacles obstructing adherence to proper aseptic methods occur, we mapped the weak points in adherence to proper aseptic procedures in nursing work in intensive care. There were two goals set for the qualitative research. GOAL 3 To find what measures preventing occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces are taken by department managements. GOAL 4 To find out how department management deals with possible occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces. The following research questions were set. 1. What are the measures preventing occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces taken by department managements? 2. How does department management solve possible occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces? The research sample consisted of 5 departmental nurses and 5 head nurses from intensive care workplaces from the same hospitals where the quantitative research took place. The research was performed by semi-standardized interview. The research questions were answered. A manual for nurses called ?Recommendation for nurses in prevention of nosocomial infection and nosocomial sepsis not only at intensive care units? was elaborated upon study of these issues and the performed research. A thought map for department management illustrating prevention and solution of nosocomial infection and nosocomial sepsis was also elaborated. Both the document and the research results will be provided particularly to the managements of the hospitals that took part in our research. The thesis may also be helpful to nurses, students and other interested people to gain overall insight into the issue.
|
|
|
The Challenges of Providing Nursing Care to Delirant Clients in Intensive Care Units
VONDRÁKOVÁ, Radka
The theme of this undergraduate thesis is The Challenges of Providing Nursing Care to Delirant Clients/Patients in Intensive Care Units. The thesis pursues three objectives and elaborates three hypotheses. The first objectives was to assess the challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital, from the nurses{\crq} perspective. The second objective was to examine the nurses{\crq} knowledge of the specific challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital. The third objective was to ascertain whether nurses were acquainted with the principles of using inhibition as a means of controlling situation, according to the nursing standards of the České Budějovice Hospital. The first hypothesis was based on the presumption that nurses taking care of delirant patients feel exhausted. The second hypothesis was based on the presumption that nurses use inhibition as a standard means of controlling situations involving delirant patients. The third hypothesis was based on the presumption that university-educated nurses have a better knowledge of patients{\crq} delirant condition than nurses with lower education. For the purposes of my research, which I conducted in January and February 2009, I applied a quantitative method using a questionnaire. The questionnaire was distributed among the nurses working at the ICU of the České Budějovice Hospital. The resulting data were recorded in the form of diagrams. The validity of all the hypotheses has been confirmed and the outlined objectives have been reached. In the closing part of my thesis, I recommend that a seminar be organized for all the nursing staff of the České Budějovice Hospital, where nurses would be presented with the complexity of delirium problems, as well as mental hygiene and relaxation techniques. Furthermore, it was suggested to perform an audit of the nursing care standard no. 37 at the České Budějovice Hospital. The hardest recommendation to meet was to ensure adequate staffing of the ICU. However, solutions for this particular problem lie beyond the limits of my undergraduate thesis, as shortage of nursing staff is a nationwide problem. My last recommendation calls for improving the theoretical preparation of non-medical students by including specific practical care of delirant patients.
|
guest ::
