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Safe Nursing Care
HAVELKOVÁ, Hana
Patients{\crq} safety is a global problem and we are increasingly thinking about the possibilities of improving the quality of care provided. This is a priority for all health care providers, including nurses. We must not forget the patients and their close family because they are our partners and the nurses should seek to ensure that the patients themselves are actively involved in the care of their health and play an important role in preventing some unwanted errors. The theoretical part of the thesis is devoted to a detailed analysis of the concept of safety and safe care and the associated negatives. The goal of the thesis was to determine which resources are used to maintain the level of safe nursing care by nurses with specialized training. Six hypotheses were determined. The quantitative survey technique was used to achieve the objectives of this thesis and to verify the hypotheses. The group consisted of nurses from all over the Czech Republic in the month of February 2010 studying on a specialized training course of the NCO/ NZO (National Center of Nursing/ Non- medical health disciplines) in Brno. The results imply that the nurses interviewed do not use enough resources to help reduce the risk of errors leading to an increase in the level of safe nursing care. The proposed measures are intended to increase the use of resources for maintaining the level of safe nursing care which is a clearly dependent on the awareness of their existence. This also strongly urges management to make more use of various resources and inform all medical staff not only nurses about new procedures and analyses carried out on a regular basis. Managers should conduct a regular and detailed analysis of past errors or incidents to establish the risk of error and take steps to minimize such unwanted events. The results of the survey will be provided to the professional public, published in professional journals and can serve as a basis for comparing other survey research.
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Factors of discontent among nurses and their impact on care quality at a cardiac surgery department.
ERETOVÁ, Zuzana
Occupation of a general nurse belongs to demanding jobs in terms of professional preparation and performance. A nurse is expected to cope with professional activity, working with modern technology, administrative work, to bear the physical and mental load of her profession, to be able to influence and direct patients? feelings and behaviour and finally to be able to cope with professional as well as family problems she is faced to. All this is often dealt with in continuous operation on shift basis at various specialized workplaces. Questions how nurses working at a cardiac surgery department are satisfied or dissatisfied at their jobs, how the work experience length affects their satisfaction, whether possible discontent among nurses may affect quality of the nursing services provided by them and how the hospital management reduces the factors of discontent, became the subject of my thesis. The research was performed at the IKEM in Prague. Quantitative as well as qualitative research methods were used for data collection when mapping the problems in question. The quantitative part involved a questionnaire both, for general nurses working at the cardiac surgery department, aimed at investigation into the discontent factors involved in their occupation, and for the patients undertaking treatment at the cardiac surgery department, to examine their satisfaction with the nursing care. Analysis of the collected data was then performed. An interview with representatives of the hospital line, middle and top managements was the instrument of the qualitative research. It was focused on the question how they proceed in elimination or reduction the discontent factors. The following facts were found out by the quantitative research. Increased physical and mental load, non-cooperating patients and care about more patients at the same time, extensive administration related to patient care, insufficient remuneration, lack of communication from doctors and superiors, lack of auxiliary staff, projection of occupation to private life or the problem of sleeping after a night shift are the most frequent discontent factors. Despite the above negative factors nurses are satisfied with their jobs regardless the length of experience. The indentified factors of discontent do not affect quality of the care provided by the nurses. The qualitative research results show that personal talks, active interviews and direct communication from the staff are the most frequent methods the management uses to map staff satisfaction. The management representative is able to work herself on elimination or reduction of the discovered factors of discontent within her competences, which happens most often. She may also cooperate with the chief nurses or ward sisters. Unless she is able to solve a problem, it is passed to the authorized persons competent to deal with it (health care manager, social-legal department, HR department). The hospital director is also informed on the most serious cases. The management hardly ever cooperates with physicians on elimination or reduction of the discontent factors. The most important aspect of solving the problem of discontent factors is its subject, which affects the solution method, whether it is to be dealt with by an individual or the whole team. They inform the head physicians or the ward chief consultant on serious problems. The course of the problem solution is communicated to the employees by the ward sisters or chief nurses personally, orally.The goals of the thesis have been met, the set hypotheses have been refuted, and the research questions have been answered.
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Nurse as Risk Manager in the 21st Century Hospitals
LAŠTOVKOVÁ, Marie
The main intention of this thesis was to monitor the activities of nurses as risk managers in selected healthcare facilities. The first objective was to map the current state of accreditation procedures in the Czech Republic, the number of accredited facilities and the types of accreditation. Another objective was to find out in which healthcare facilities there is a nurse as a risk manager or who has the responsibility of a risk manager in healthcare facilities. The third objective was to explore the activities of nurses - risk managers. To achieve these objectives, the following research questions were set: 1st What is the current state of accreditation procedures in the Czech Republic? 2nd In which accredited facilities there is a nurse - a risk manager? 3rd research question: What are the activities and roles of a nurse - a risk manager? (What activities nurses carry out in the performance of their duties; whether nurses feel a change in the provision of nursing care; which risks and incidents nurses encounter in their facilities and what are their solutions; what is the level of communication between the parties in the risk management process in a given facility; which benefits are seen in risk management). The research was conducted with respondents from those healthcare facilities that were willing to cooperate. The research conducted is a qualitative one. The respondents underwent interviews according to the structure of categorized questions. Subsequently, transcripts of the interviews were made as well as the analysis and categorization of the data was carried out and presented in tables under the framework analysis according to Ritchie and Spencer. The research revealed the answers to the research questions. In no of the facilities that have responded to the questions there is a nurse with the function of a risk manager. Activities within the risk management are taken over by staff at other positions, mostly quality managers, head nurses or auditors. Detailed proportion of these functions is clearly presented in the accompanying graphs. Research question 3 yielded a great number of responses. For example, nurses who have competence in risk management play mainly the roles of communicators, defenders, authors, auditors and mentors. In exercising their functions, they have observed changes, as compared with the past, in the responsibilities of nurses, patient activity, greater transparency, the quality and safety of the care provided. They describe in detail the risks and incidents which they have met at their workplaces, and how they have been solved. The respondents see the advantages of risk management in the fact that it is a good tool for defending not only patients but also nurses themselves; that it is a tool to increase responsibilities and activities of patients and to improve the quality and safety of the care provided. All the responses are clearly presented in tables and confronted with the knowledge derived from professional literature and our own experience. The results of the thesis can be provided to the healthcare facilities where the research has been carried out; it could be provided to competent institutions and also, in the form of an informative brochure, to nurses and other healthcare personnel. We would suggest a higher level of education about risk management potential. Our suggestions also include changes to legislation - powers, the establishment of clear procedures and rules, and the regulation of education in risk management so that implementation of this tool is unified and becomes accessible to all facilities.
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Need of a resuscitation standard in inpatient medical facilities
DLOUHÁ, Hana
The diploma paper presents a brief overview of the development of resuscitation in the world and current recommendations for resuscitation by the European Resuscitation Council. Also included is a description of basic diagnosis of a sudden cardiac arrest, providing vital functions, including the use of alternative materials and the problems of resuscitation in hospitals. Providing effective resuscitation is reflected in the quality of care provided, which is much emphasized nowadays, especially for the accreditation of medical facilities and the creation of standards for nursing care. The objective of this paper is to determine and compare the extent of knowledge of nurses in the inpatient departments of emergency cardiopulmonary resuscitation at two hospitals, one of which uses a standard resuscitation. Another objective is to create a resuscitation standard for nurses at inpatient departments, submit it to involved nurses for assessment and to determine to what extent the created resuscitation standard contributes to the work of nurses who have not used it yet. The first research question is: How do nurses view the newly created standard? The second research question is: Will nurses appreciate the contribution of the created standard? A given hypothesis implies a greater knowledge of nurses who use the resuscitation standard, than nurses who do not use it. The first phase used a quantitative survey using the questionnaire technique; skills and knowledge of nurses were mapped at two medical facilities, one of which uses a resuscitation standard valid for the entire facility. The questionnaire included 34 items, 21 questions dealt with the knowledge of nurses surveyed, and 13 questions mapped demographic data, work organization and the respondents{\crq} workplace experiences with resuscitation. Based on the results of the quantitative survey, the hypothesis has been confirmed. The results also unveil weaknesses in the training of medical personnel at both hospitals and the surveyed nurses{\crq} knowledge. In the second phase of the survey, nurses who did not have a resuscitation standard were presented with the resuscitation standard version for assessment. The assessment of the standard was carried out with qualitative survey using semi-standardized interviews with senior nurses at nursing stations. These nurses assessed the presented resuscitation standard positively; they welcome its presence and see its benefits in improving nursing care.
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Standard of non-pharmacological relieve and evaluation of pain by newborn and suckling children
PAVLÁSKOVÁ, Ilona
The importance of this thesis lies in finding about the current state of pain assessment and palliation at neonatal and infant wards of selected hospitals, in finding out about the extent of use of standardized rating scales for pain, in identifying the obstacles in pain assessment and non-pharmacological pain palliation, and particularly in the development of a standard for pain assessment and pain palliation for neonatal and infant hospital wards.
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Formation of Nursing Documentation and its Usage in the Home for Seniors Chýnov
CHAMROVÁ, Anna
Nursing documentation is becoming an important part of the medical documentation and it is an integral part of the nursing process in the homes for seniors too. The theoretical part of the Bachelor thesis ``Formation of Nursing Documentation and its Usage in the Home for Seniors Chýnov{\crqq} contains chapters concerning the nursing process and nursing documentation. Further this part deals with the characteristics of the Home for Seniors Chýnov and with the specific problems and needs of geriatric clients in particular the clients suffering from Alzheimer dementia. The target of the work is to make nursing documentation in the Home for Seniors Chýnov, to apply it in this establishment and to find out whether the availability of this documentation influences the holistic attitude of nurses to the client. The first stage of the research part involved formation of the new documentation and its application in the Home for Seniors. The respondents had an opportunity to work with the documentation in the months of January and February 2010. In the second part we tried to survey opinions of the respondents of the made documentation. Four research questions were preceding the research. Research question number 1: Shall the nurses working in the Home for Seniors Chýnov accept the newly made documentation as a part of the medical documentation? Research question number 2: Shall the nurses working in the Home for Seniors Chýnov refer to time consuming work with the documentation? Research question number 3: Has the new documentation influenced communication among the members of the nursing staff? Research question number 4: Shall the newly made documentation contribute to the change of the nurses´ opinion of the patients from the holistic philosophy point of view? To fulfil the set aims there was carried out the qualitative research using the method of questioning and semi-standardized interview. The research set consisted of 7 respondents (general nurses) working in this establishment. Considering the research results we suppose that the work target has been fulfilled. The research has proved that the newly made documentation has improved communication among the members of the nursing team and the nurses have accepted it as a part of the medical documentation. The aim of the work was making a quality nursing documentation which should be simple, not time consuming and which should be focused on specific needs of the clients of the Home for Seniors Chýnov. The thesis has practical contribution.
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History and the present of nurses´ education in the South Bohemia
HUBOVÁ, Vilma
Modern nursing has its roots in the past. It has undergone an enormous change moving from the original tending approach of sick-nursing to organized activities based on professional training of nurses. This study gives a historical account of the nursing development from 1945 to the present and describes the opportunities of nurse training. The aim was to describe the development of nurse education in the Region of South Bohemia in individual periods of time. It is a qualitative research using the secondary data analysis method and depth interviews with a number of nurses who graduated from nursing schools in the fifties and the sixties of the last century. The study shows the development of nurse education in the Region of South Bohemia until 1989 and continues with describing the innovation of educational programmes in nursing schools after 1989. It analyses syllabuses of nursing schools in the past and compares them to the present ones. The study shows how the nurse education has developed from the past to the present. It compares and presents opportunities of persons who are interested in nursing studies and also compares the contents of curricula. It is a historically comparative study.
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Risks concerning malnutrition and obesity in the nursing process
HORČIČKOVÁ, Marie
The care for nutrition of patients is given more attention these days than before. Patients with malnutrition and obesity represent a huge nursing problem in internal and surgical fields. In this thesis we focused on nursing process in clients with malnutrition and obesity. The research was quantitative, for the data collection the anonymous questionnaires addressed to nurses were used. It was carried out in internal and surgical departments and departments of follow-up care in hospitals in Písek and Tábor. 120 questionnaires were distributed, in each hospital 60, to particular departments 20. 95 (100 %) questionnaires were used for the research. In the thesis seven objectives were stated. The objectives were focused on carrying out the nursing process in clients with malnutrition and obesity, the most frequent nursing problems in these patients and the awareness of nursing staff in the problems of malnutrition and obesity. Seven hypotheses linked to the objectives were stated. The research showed that nurses meet the clients with malnutrition and obesity in all mentioned departments. Most nurses consider the care for these patients very demanding. It is pleasant that the part of nursing documentation is nutritional screening, which is carried out during an admission of each client. Further the research showed that for these clients no valid nursing standard, which would improve nursing process, has been carried out yet. In clients with malnutrition the most frequent nursing problems are decubital ulcers and in clients with obesity sore spots. Information on the problems of malnutrition and obesity is gained at professional seminars and conferences. Nursing process in patients with malnutrition or obesity is demanding and it is necessary to have a sensitive and considerate approach. The results of the thesis will be used to make nursing staff acquainted with these problems.
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Motivation for education of healthcare assistants with regard to their future practice
ŠMÍDOVÁ, Jaroslava
After accession to the European Union and adoption of Act No. 96/2004 Collection, on non-medical healthcare professions, changes occurred, which concern mainly nurses. These changes affect mainly administration and competences of the nurses. The act currently differentiates between and defines the procedures of secondary educated staff as procedures without special supervision and procedures with special supervision, and also defines the process for obtaining the certificate for the performance of a profession without special supervision based on the credit system. In practise this means that if the health care assistant does not achieve a higher or university level education, he/she cannot work independently without any special supervision. And it is the interpretation of the term without special supervision and with special supervision that is the subject of discussion. The nurses refuse to be responsible for the work of somebody else and present this attitude openly. The main goal of this bachelor thesis is to find out what motivates current healthcare assistants to work in healthcare and what their approach to education is, which should be an integral part of their life. There was also a discussion as to whether the information about the speciality, provided to basic school children, is appropriate for such a life-long decision as the selection of occupation. There were two hypotheses established during the investigation. H1: The pupils of the basic schools have no information about studying in Nursing Schools, H2: The students are motivated for further education and H3: The graduates of the Nursing Schools want to study in order to improve their qualification in the higher level schools. Based on a questionnaire, all established hypotheses were confirmed and the goal of the thesis was accomplished. The research was therefore successful. Obtained information may be used mainly for improving the approach while providing information to the pupils in the basic schools before their decision about the choice of profession, since the education advisers are interested in the results obtained. For teachers in the secondary schools, this knowledge will be useful to improve motivation of students for future professions
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