|
|
Surveillance of bacterial strains producing broad-spectrum beta-lactamase.
VLASOVÁ, Martina
In the first part of my thesis I focus on mapping problems associated with antibiotic therapy and subsequent development of antibiotic resistance. Tracking resistance is based primarily on data collection and evaluation of the results set sensitivity from around the world. Antibiotic resistance is a natural phenomenon that can be observed in the evolution of microbes as one of the mechanisms of adaptation to new conditions in the environment. For this work I have chosen the following research questions. Do the incidence of ESBL strains in the České Budějovice Hospital a.s. increase over time? Are these values comparable to those achieved in another region, namely in Moravian hospitals the University Hospital of Olomouc, Ostrava University Hospital and Regional University Hospital of T. Bata in Zlin? The data collection I made in collaboration with the laboratory technicians and doctors at Hospital?s Bacteriology Laboratory in České Budějovice. Bacteries tested for the detection of ESBL production originated from biological materials, witch came from patients of hospital in České Budějovice. The first objective was to compare the results achieved in the České Budějovice Hospital in the period of 2007 to 2012. If we look at the total number of ESBL strains that have been isolated since 2007, values have upward trend. While in 2007 there were only 64 strains a year later, the number more than doubled. In 2010, the value soared to 281 tribes and in the year 2012, the number was 321 tribes. The incidence of ESBL strains in 2007 increased about five times. In the long term we can say the numbers have increasing tendency and the range of each species in the production of ESBL has significantly changed. In 2007, it was K. pneumoniae strains that dominated the statistics, but over time the strains of E. coli came forefront. Values of 2012 suggest that the presence of ESBL strains of K. pneumoniae is again almost equal to the number of E. coli strains. The second objective was to compare the results of the 2012 with study of the Prevalence of ESBL-positive Enterobacteriaceae in large Moravian hospitals. In the general overview of ESBL producers values in Hospital České Budějovice (5.23%) are comparable to those in Ostrava (4.9%) and in Zlín (4.3%). Number of strains in the Hospital in Olomouc (11.8%) is about twice as high as the numbers in České Budějovice. In this comparison the České Budějovice Hospital is one of the hospitals with a lower incidence of ESBL producers. The České Budějovice Hospital is below the national average, which originate from an elaborate system of care for patients with colonization or infection with ESBL strains, and from therapy control system using antibiotic center. These results may serve to the Hospital in České Budějovice for statistical purposes, and also for proposals for improving patient care. In the discussion, I pointed out the danger of the spread of resistant strains of bacteria in the community and also the associated risks that mentioned bacteria mean for patients injured in mass accidents or disasters. In these cases, number of infections including ESBL producers can penetrate through open wounds into the affected body. Unlike conventional sensitive bacteria those strains are resistant to commonly used antibiotics and thereby endanger the lives of people affected by the accident.
|
|
|
Nursing care for patient with polytrauma
SKLÁŘOVÁ, Lucie
Multiple traumas mean a present injury of at least two body systems. The patient with the multiple traumas is, because of the threatening failure of one or more organs, alternatively systems, placed on the intensive care unit. The nursing of the patient is therefore systematic, continual and its part is the monitoring of the conditions and saturation of basic needs. The nursing care on the intensive care unit is dependent on their health conditions and it permanently changes. A nurse usually takes over the whole care of the patient and they are dependent on her. Therefore the nurse must know all the patient´s needs and provide them regard to their self-sufficiency. Self-sufficiency is the level of independence during the daily routine. To its evaluation we use Barthel test of basic daily activities. In literature the word self-care is used as an identical term. The empiric part of the bachelor thesis is focused on self-sufficiency, self-care of a patient and activation of the nurses. The goal of the research is to find out the difference in the amount of care for a patient with multiple traumas on the Intensive care unit and a standard ward in connection with the level of self-care. To fulfil the goals three research questions were set. The research questions are: How do the nurses judge the self-sufficiency of a patient with multiple traumas on the intensive care unit and a standard ward? How do they provide the nursing care at a patient with multiple traumas in a standard ward? How do they provide the nursing care at a patient with multiple traumas on the intensive care unit? The qualitative research with the help of semi-structured interview was used to answer the questions and fulfil the goals. The research was taken on the traumatologic intensive care unit and in the standard ward. 5 respondents and one patient were from the intensive care unit and other 5 respondents and two patients were from the standard ward. The answers for the first research question were identical at all respondents. The evaluation of the patient´s self-sufficiency is according to Barthel test. The answers of most respondents point at the fact that the test in not practical and suitable. The results of the second and third research question can be comprehended in one conclusion. Regarding the fact, that the nurses from the intensive care unit and the standard ward made comments in the same way. The nursing care is always provided regarding the self-sufficiency of a patient. They support a patient mentally to make him more self-independent. They use different accessible tools for practice. With the help of the research questions we reached the goals. We found out that the difference in the extent of provided care is in the amount of activities which are done by nurses for the patient on the intensive care unit and in the standard ward. The nurses provide a patient with more activities logically on the intensive care unit. It is due to the conditions of a patient which are acute at the beginning. Even though, the nurses try to activate a patient as much as possible. By contrast, the nurses in a standard ward have the chance to increase patient´s self-sufficiency in more activities. They endeavour patients to be self-sufficient in hygiene, catering, walking and excretion. In these activities patients should be helped by physiotherapists. As it is agreed by the nurses from the intensive care unit as well as the nurses from the standard ward, this approach does not really work and so the only ones who activate a patient are the nurses and hospital attendants. The work should serve the nurses to clarify the importance of multiple traumas and deepen their knowledge of discussed problems.
|
|
|
Analysis of healthy social effects for the life of patiens with polytrauma
PLACER, Jiří
Polytrauma is a severe multiple injury posing an imminent threat to human life. Such trauma will then significantly affect the quality of client's life and, consequently, also the constituent parts of his or her personality. The research has shown that, the therapy succes, which is realised in the system of comprehensive rehabilitation, depends on an effective medical care delivered by a multidisciplinary team of specialists and also on an active involvement in the treatment by the clients themselves.The quality of clients' life that the polytraumas entaile is influenced by their age, sex, education, profession, classification of multiple injury and also by harmonious family relationships and support offered by the clients' partners.
|
|
| |
|
| |
|
| |
|
| |
|
| |
|
| |
|
| |
guest ::
