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Treatment of a pain from the perspective of nurse.
RŮŽIČKOVÁ NEUŽILOVÁ, Michaela
The theoretical section of a bachelor thesis deals with pain treatment, specifically of urgent post operational pain management treatment from the nurse's point of view. It is divided into several sections. First section is focused at pain in general, briefly characterizes the pain itself as well as its formation and division. This part also contains brief description of pain score and mostly used methods pain measurement. Then follows the part, where the urgent post operational pain as well as its specifics and cure possibilities are described. A post operational analgesia appearing by geriatric patients and kids is marginally mentioned here. In the conclusion of theoretical section there is mentioned the issue of urgent post operational treatment quality management. Thesis aim The main purpose of the bachelor thesis is to chart an evaluation of the level post-operative pain by general nurse in the post-operative unit. There are ways and technics, which are in general used on one side, on the other side opinion including practical experience. The second target is general information how to treat pain and to find shortage in management of quality treatment of postoperative pain. The third target is about to map the general nurse's practical skills in the care of patients with epidural catheter. Research methods A qualitative research was chosen for the empirical section of this bachelor thesis. A form of a half structured interview was used for data mining. The interviews with respondents were recorded in written way into in advance prepared form, consequently the qualitative data were analysed and organized according to their importance into categorization group with the coding technic pencil & paper. Results The research resulted, that nurses use VAS technic to chart the urgent post operational pain, which is also standardized pain record of particular medical institution. This technic is absolutely suitable for interviewed nurses, no other technics of pain score are used in daily routine. The nurses report clarity and intelligibility of the record of progression and pain treatment to be the main advantages in scoring pain according to VAS, which simplifies the communication with the other nursing team members participating on pain treatment of particular patient. Next result: Nurses working on post-operative units are not active enough to find symptoms of acute post-operative pain. Nurses wait for patients themselves to verbalize the pain. Nurses give a main cause of post operational pain postoperative wound, they don't accept other reasons. The next problem was discovered in organization of management of post operational acute pain. The main reason is bad accessibility or inaccessibility of attended physician. Also bad multiprofesional communication is guilty. Cooperation reaches on dead lock on bad communication, on confused records from preoperational and post operational period. Nurses have plenty of experience of treatment of urgent pain. Nobody from nurses has special education in algesiology. Care of patient with epidural catheter taken is provided in accordance with standard approach. Is an epidural analgesiology contributing for patients? Nurses answer positive. The main contribution is better cooperation in line patient staff and more effective care process. Conclusion The bachelor thesis is concerned on problematic and specify of care of patients with acute post-operative pain. Acute post-operative pain is good managed symptom, it is impossible to pass it. It could be negatively influenced postoperative recovering, it could be a reason of prolonged hospitalization, increasing costs of treatment. Untreated postoperative pain could lead to chronical problems with health in general.
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Nursing perioperative care on the gynekological section.
WOLFOVÁ, Petra
The bachelor thesis focuses on nursing care before, during and after a gynaecological surgery. Gynaecological surgeries are divided into small and big. Small gynaecological surgeries require only one surgeon and the hospitalization of the patient is shorter than 24 hours. Big surgeries require more surgeons, the patient is under anaesthesia for a longer time and the hospitalization is longer than 24 hours. In this bachelor thesis, we focused on perioperative care in women after a big gynaecological surgery. Care during the preoperative period is an integral part of the work of a birth assistant, as gynaecology is largely a surgical specialisation. With advancing technical progress and development of new surgical methods, various types of surgeries appear with specific requirements for nursing care. Effective perioperative care is important for trouble-free convalescence of women after surgeries. Perioperative care includes both nursing procedures and informing the patient about the hospitalization and care course. Perioperative care is very demanding for the woman herself and for the whole team participating in the care. Interaction of all the medical staff is necessary in perioperative care to provide specialised care according to the standards. The aim of this bachelor thesis was to determine the needs of patients that are affected in the highest extent during perioperative period. The research focused on the way women perceive perioperative period and the approach of health care professionals and the extent these items meet their expectation. The research was performed at a gynaecology-obstetrics department of a hospital, using qualitative assessment in deep interviews. The interviews included 13 open questions. The research group consisted of 8 women after a big gynaecological surgery. The participation in the interview was voluntary. The results of this research were carefully transcribed and analysed using the "pen-paper" method. These results were divided into four categories and further subcategories.
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Nursing care of the operation area before and after the operation
KRATOCHVÍLOVÁ, Michaela
Theoretical outcomes The preparation of the operating field is an important part of all preoperative preparation. Preoperative preparation, before surgical intervention, cannot be neglected. In most cases, the doctor will not perform an operation without proper preoperative preparation. The only exception is urgent surgical intervention for which only the most basic preoperative preparation is provided. Preoperative preparation can be categorized as long-term, short-term, or immediate. A thorough and proper preparation of the operating field reduces any development of postoperative wound complications. The aim of thorough preoperative preparation of the operating field is to reduce any risk of developing postoperative wound complications. Postoperative care prevents postoperative complications. It is aimed at controlling the state of a patient's current health after surgical intervention, but also the surgical wound and its dressing. Both nurses and doctors are obliged to perform these controls. In the early postoperative period, the client stays in the ward or in the postoperative room. In the case of arising complications during surgical intervention, the client is moved to the ICU/ARO. The Aims of the Thesis The aim of the thesis is to map the differences in preoperative preparation of the operating field among surgery departments, and to find the differences between preparation in the operating field before a scheduled and an urgent surgical intervention. Furthermore, the aim is to find out if nurses perform preoperative and postoperative care properly. The following questions were chosen: What are the differences in preoperative preparation of the operating field among surgery departments? How do nurses perform preoperative and postoperative care of the operating field? Implemented methods In order to gain the desired information, a qualitative form of research was chosen, namely an in-depth interview method, a method of questioning, and an observational method. Observation was implemented using the hidden observation method. The respondents in the research were the nurses from the urology and the surgery departments at a hospital in Vysočina. Data collection was conducted from February to March, 2014. The acquired data was then analyzed through an open coding method. Results The subsequently transcribed interviews and observations were carefully analyzed using the 'pencil & paper' method and open coding. Eventually, five categories were created: preoperative preparation before a scheduled surgical intervention, preoperative preparation before an acute or urgent surgical intervention, preparation of the operating field, postoperative wound care, medical documentation. Conclusion The research suggests that nurses are well aware of the complete preoperative and postoperative care. What is, however, surprising is how adherence to the principles of barrier care and the client's intimity vary in the course of providing this care.The conclusions in this thesis should aim at an improvement of preoperative and postoperative care of a client and to eliminate any discovered shortcomings in the provided nursing care. The practical outcome of this thesis will be an article in a professional magazine for nurses.
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The role of the nurse taking care of patients with breast cancer.
KRBCOVÁ, Julie
The actual issue regarding the female population consists in a high incidence of pathological breast findings that can be benign but even most frequently malign. For my bachelor thesis, I chose the theme "The Role of a Nurse in Providing Nursing Care for Women with Breast Tumors", because these issues remain still topical. Basic theoretical grounds of the thesis describe female breast anatomy and pathology. They inform us about problems regarding the causes of the tumor disease and the most common symptoms of the disease. The use of up-to-date diagnostic methods (primarily mammography) and their wide accessibility within a screening program take a significant part in a high percentage of early detected stages of the disease. Breast tumor surgery belongs to the operations demanding from both physical and psychic aspects. The role of a general nurse in providing preoperative and primarily postoperative care is important. A nurse provides a complex nursing care, observes nursing care principles to satisfy individual patient? needs. A nurse does not forget to give information, minds the education, sympathetic access and psychic support of a patient. This bachelor thesis was devoted to the issues of a nurse role in providing postoperative nursing care to patients with breast tumor. The first objective was to describe specific aspects of nursing care in patients after surgery for breast tumor. The second objective was to find out the role of a nurse within a postoperative period in patients with breast tumor. Two research questions were set to fulfill those objectives. The first research question: "Which specific nursing activities does a nurse perform within a postoperative period in patients after breast surgery?" The second research question: "What role does a nurse hold within a postoperative period in patients with breast tumor?" A qualitative research inquiry was used to process the research part of this bachelor thesis. A semi-structured interview was used as a data collection method. The research inquiry was performed in the Department of Surgery of the České Budějovice Hospital, Inc. The first research question surveyed specific nursing activities of nurses performed in patients after surgery for breast tumor. The answers showed that nurses were familiar with specific nursing activities which they performed within postoperative period in patients with breast tumor. Specific aspects described by both the nurses and patients are narrowly associated with the intervention they underwent and which is specific itself. The second research question found out the roles of a nurse within a postoperative period in patients with breast tumor. From the results of answers given by both nurses and patients is clear that the following roles of a nurse were fulfilled: a communicator, an educator and a bearer of changes. Some educational and illustrative tools (silicone breast phantom for the self-examination instruction) intended for nursing personnel are one of the possibilities how to achieve an effective application of nursing interventions in breast tumor prevention and how to help nurses to improve the relation of communication and education on these issues. The results of my bachelor thesis could be used as an information material that could serve to an improvement of the quality and effectiveness in nursing care for the experienced nurses as well as for beginning ones who meet such patients at their job. The results of my research inquiry could be used as basic material to elaborate some lecture for a professional seminary or conference intended for nurses.
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Nursing care for children with sculpture ears
MELNYKOVÁ, Milada
The name of the bachelor thesis is ?The Process of Nursing Children with Otoplasty?. Plastic surgery deals with operations of congenital and acquired defects and is concerned with post-operative and post-traumatic conditions. Plastic surgery includes aesthetic surgery, which still continues to grow in importance. The timing of a visit to a plastic surgeon depends on the defect type. Congenital cosmetic defects appear in the period of adolescence. Operations of prominent ears are the most common cosmetic operations. The operation can be carried out disregarding the age. Most often, schoolaged children and middle-aged people are interested. The costs of operation on children up to the 10 years of age are covered by the insurance company. The theoretical part deals with the description of plastic surgery, the history, the description of an operation, pre- and post-operative care and the child age development stage. It also concentrates on nursing care. The aim of the bachelor thesis was to identify the specifics of nursing care of children with otoplasty and the most common complications in relation to this operation. Three research questions were put forward. The research sample included children and their parents hospitalised in a child post-operative and post-traumatic ward. The research was based on semi-standardised interviews, observations and content analysis of documentation. All information was summarised in case studies, in accordance with Virginia Henderson model. In the second phase, the information was verified by means of a semi-standardised interview with a nurse based on interviews with children. The results have identified the most common complications relating to the operation of auricles. As far as postoperative care is concerned, nurses primarily monitor the pain and the patient?s general condition. Furthermore, it followed from the results that parents lacked comprehensive information on the operation. The specifics of care of children with otoplasty include wearing large compression bandage on the head and long-term application of an elastic headband. In consequence of the findings, a seminar for children wards will be held concerning the issues of nursing care of children with otoplasty, and a nursing plan has been worked out for such children.
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Nursing care of women after operative deliveries
KREJCAROVÁ, Jana
Nursing Care in Women after an Operative Delivery The bachelor thesis focuses on nursing care in women after an operative delivery terminating pregnancy. The theoretical part describes the individual surgical procedures (forceps delivery, vacuum extraction, cesarean section), nursing care and educational activity accompanying them. Further, it also includes a brief history of these methods. In the practical part, four basic goals and hypotheses were stated. The goal of the work was to identify differences in taking care of women after operative deliveries, to find out whether the care is conducted in the form of a nursing process, whether the care follows nursing and obstetrical standards in the selected delivery wards. With the view of these goals the following hypotheses were formulated: nursing care in women after operative deliveries differs in selected delivery wards and that midwives use a nursing process meeting the nursing and obstetrical standards in care of women. The research was conducted by a quantitative method. Data were collected through the use of anonymous questionnaires. These questionnaires were given to midwives in selected delivery wards (České Budějovice, Plzeň and Písek). The respondents were nurses working in delivery rooms, puerperium wards and gynecologic intensive care unit. The goals of the work were fulfilled. The hypothesis regarding the differences in care between individual delivery wards was confirmed. The second hypothesis that the care in women after operative deliveries is conducted in the form of a nursing process was proved in 72% cases. The third hypothesis confirms using of nursing standards in this care in 92% and the fourth hypothesis reveals that obstetrical standards are met in 75%. The results for the analyzed set of cases as a whole show certain definite tendencies, however the care differs among individual places and even among various wards within one institution. Therefore it would be useful to asses the organization of work, technical conditions and possible modifications that could improve the nursing care.
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Comparison of post-operation course in women after abdominal or vaginal hysterectomy and after laparoscopically assisted vaginal hysterectomy.
HUDÁ, Zuzana
The bachelor thesis is divided to two parts (theoretical and practical). In the theoretical section I engage with three kindes of hysterectomy, with its indications, complications and with the following treatment of the patient after the intervention. I further desribe the psyche of the patient and her life after the operation. Hypthesises and goals have been set in the practical section of this work. I tried to disprove or aprove these hypothesises on the basis of research. It follows from the outcome of the research that the postoperative condition after hysterectomy differes individualy from patient to patient.
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Women?s Awareness When Preparing for a Gynaecological Surgery
BICANOVÁ, Martina
When making decisions on future issues it is very important to be informed in all aspects. This applies to the health issues in particular. Being informed before every surgery on pre-operative procedure, the surgery in question and subsequent post-operative care is crucial for the patients? trust in us, medical staff. It is a communication between a health worker and a patient that is concluded with signing the informed consent. The theoretical part is focused on activities related to pre-operative care, activities related to post-operative care and communication between a health worker and a patient. The practical part is focused on the level of women?s awareness of pre- and post-operative care and activities related to them. A quantitative research method was selected in order to handle the issue and to ascertain the goals mentioned. The research was conducted using questionnaires that were anonymous. They had been designed for women undergoing a surgery at a gynaecological and obstetric department. Two goals and hypotheses related were stated. The goals of the thesis were to find out whether women are informed on pre- and post-operative care in case of a gynaecological surgery and to find out which sources women use to get the information on pre- and post-operative care. Both goals were met. Hypothesis 1 ?Most of information on pre-operative care was provided by a midwife? was not confirmed. The hypothesis 2 that most of information on post-operative care had been provided by a midwife was not confirmed, too. Hypothesis 3 ?Women search for the information on the Internet? was confirmed. This bachelor thesis can be used as a source of information and educational material for women who will undergo a planned surgery. An educational leaflet for women undergoing a gynaecological surgery is the result of the research.
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Knowledgeability of clients about postoperative care at orthopaedic department
LIŠKOVÁ, Jana
Clients suffering from musculoskeletal system problems are hospitalised at the orthopaedic department. Most clients must undergo a surgery here. Surgery is a stressful situation for many clients. They are in foreign environment and do not know what to expect, they are afraid. A nurse at an orthopaedic department has a very important function. She accompanies the client before, during and after the surgery. She aims to provide her clients with enough information to calm them and to make their stay in a medical facility pleasant. Quantitative research performed by means od anonymous questionnaires was used to collect data. We addressed nurses from traumatological wards in the following hospitals: Nemocnice Písek, a.s. and Ústřední vojenská nemocnice Prague. We also contacted clients hospitalized in orthopedic and traumatological ward in the two identified hospitals. We collected identification data and information about the general awareness of postoperative care and postoperative complications. Three objectives were determined in the bachelor essay. Determination of the level of clients´ awareness, the means used by nurses to provide information about postoperative care and about postoperative complications. And whether nurses provide information through the nursing process. Results of the research were fulfilled. Three hypothese were determined. The first and the second hypothese were to confirm that clients are sufficiently informed about the postoperative care and postoperative copmlications and that nurses provide clients with the nursing care through the nursing process. These hypotheses were confirmed. Nurses inform clients about the postoperative care and they provide nursing care through the nursing process. The third hypothesis was supposed to confirm that nurses utilize all means to inform clients about the postoperative care. This hypothesis was not confirmed; nurses inform clients only orally. The research showed that clients address thein inquiries to both nurses and doctors. Clients´ awareness of postoperative care was sufficient and there is no need to increase it, however, the awareness of postoperative complications is weaker and clients would like to obtain more information from doctors. In spite of that, most of them say that postoperative complications cannot be prevented by better awareness anyway. Postoperative care is a part of the recovery period after a surgery {--} knee ligament athroplasty. Sufficient awareness of clients and timely rehabilitation is an integral part of that. Therefore, it is necessary to provide clients with sufficient amount of information. The results of the bachelor assay will be submitted to nurses in orthopedic wards in the two identified hospitals, i.e. Nemocnice Písek, a.s. and Ústřední Vojenská Nemocnice Prague, where the research was performed; the results could also be used as a source of information in workshops not only for nurses working in orthopedic wards, but for everyne who is interested in this topic. The results could also enhance the postoperative care within the nursing prosess.
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Providing the patient´s privacy after total hip replacement operation
RŮŽIČKOVÁ, Michaela
Abstract In our company the emphasis in the field of nursing care has increasingly been focused on preservation of a patient`s dignity and intimacy. In daily activities in a pacient the privacy and intimacy the patient may be affected which causes different reactions of such a patient. One might say that even after the routine procedure such as total hip replacement it is very important that the patient has enough privacy. The aims of this study were to assess how the intimacy in the postoperative care is ensured in patients undergoing total hip replacement at the intensive care units and to find out the level of knowledge of the nurses as for adherence to intimacy after total hip replacement. The research group consisted of patients who were hospitalized at the intensive care and standard units in the Hospital České Budějovice, a.s. (PLC), Faculty Hospital Olomouc and Military Hospital Olomouc. The second research group consisted of the nurses who worked at the intensive care and standard units in the Hospital České Budějovice, a.s. (PLC), the Hospital Šumperk, a.s., Faculty Hospital Olomouc and Military Hospital Olomouc. The research investigation was performed by the method using two ananymous questionnaires. The first defined hypothesis was confirmed. The patients at the intensive care units are more satisfield as for their intimacy compared to the patients at the standard units. The second hypothesis was also confirmed. The nurses have not enough time to ensure intimacy of the patient after total hip replacement. The third hypothesis was confirmed. The nurses have enough information of how to take care of the intimacy in the postoperative period. The fourth hypothesis was not confirmed. The nurses at the intensive care unit do not care about the intimacy with a higher interest compared to the nurses at the standard unit. The findings of this investigation show that the patients after total hip replacement at the intensive care unit are more satisfield with the provision of intimacy in the postoperative care compared to patients at the standard unit. Although the nurses do not have enough equipment to ensure the intimacy of a patient in the postoperative care, they know how to take care of intimacy in the postoperative care.
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