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Prevention of catheter - related bloodstream infections
SVOBODOVÁ, Jitka
The infection of the blood flow represents a serious problem even at the beginning of the 21st century, and has been discussed over and over again. Such infectious complications affect in average 10 to 15 percent of patients. The theoretical part of this work describes various kinds of vascular catheters, local hospital contagions, barrier treating methods and a prevention of catheter infections of the blood flow. The empirical part contains the results of the audit and the questionnaire, focused on the problems of intravascular catheters, which were assessed in the form of diagrams and charts. The target of my bachelor diploma work was to find out, whether the nurses are acquainted with preventive measures of the catheter infections of the blood flow, and whether they observe the correct techniques when introducing the periphery venous cannulas. At the beginning of our research we set up two hypotheses. Hypothesis 1: The nurses are acquainted with the preventive measure of the catheter infections of the blood flow. Hypothesis 2: The nurses observe the correct technique of introducing the periphery venous cannulas. The carried out investigation has been a quantitative research. We used the method of questioning and observation for the data collection. The research in the form of an audit was carried out with 31 nurses (100 percent) and it concentrated on the introduction and the care of the periphery venous catheter. The nurses had a standard procedure ``Care of the periphery venous catheter{\crqq} at their disposal and the standard in the DySSSy form. The questionnaire of 31 nurses (100 percent) concerned the central venous catheters. The nurses of the hospital wards in the hospital in Trebic participated in the research. The results of the audit show that the nurses are acquainted with the principles of the catheter infection prevention and observe them in practical work when introducing the venous cannulas. All the nurses in the audit exceeded the minimum limit of success (84.10 percent). Within the questionnaire investigation 13 indexes of the nursing care concerning the care of the central venous catheter were followed. In 11 criteria the nurses achieved or even exceeded 80 percent of the correct answers and were able to prove their good knowledge of the central venous catheter care. Both hypotheses have been verified. The research results were offered to the management of the Trebic Hospital, as one of the indicators of the nursing care quality.
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Comprehensiveness and completeness of managing of nursing documentation in selected medical institution
ZÁMOSTNÁ, Barbora
This bachelor thesis deals with the topic ``Complexity and completeness of keeping nursing care documentation in a selected medical facility``. The thesis is drafted in the theoretical part and empirical part. The objective of the empirical part of the investigation was to survey the complexity and completeness of keeping nursing care documentation in a selected medical facility. In accordance with the objective, we set two hypotheses. H1: Nurses keep nursing care documentation in accordance with the applicable standard. A H2: Nurses in surgery units keep nursing care documentation more complexly than nurses in internal departments. To collect data we chose the quantitative method of research by means of nursing care audit. The research sample consisted of 60 pieces of nursing care documentation, 30 pieces of documentation in a surgery unit and 30 pieces of documentation in the internal department of the Tábor Hospital, a.s. The overall success rate in the audit ``Complexity of keeping nursing care documentation{\crqq} was 99.73 per cent in the internal department and 91.12 per cent in the surgery department. At the same time, no audit index results have dropped below 76 per cent in the entire set (60 pieces of documentation), and below 53 per cent in partial sets (30 pieces of documentation). H1 hypothesis: Nurses keep nursing care documentation in accordance with the applicable standard, has been, on the grounds of the results obtained, confirmed. The overall success rate of the audit of the nursing care documentation in the internal department was almost by 8.5 per cent higher than that in the surgery department. For that reason, it is possible to make the conclusion that the H2 hypothesis: Nurses in surgery units keep nursing care documentation more complexly than nurses in internal departments, has not been confirmed. In the final discussion, results from the conducted audit in the two departments were summed up and, subsequently compared with literature. Practical use was set in the final part. The results of the bachelor thesis were given at the disposal of the staff nurse of the Tábor Hospital, a.s., to conduct improvement in keeping documentation or to conduct subsequent audits. Last but not least, a local standard for keeping nursing care documentation as the basis for drawing up a new standard in individual departments of the team of nursing care, was drafted and subsequently submitted.
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Task of nurse in support of care about ill senior in a family
MRÁZOVÁ, Lucie
Old age is a natural part of our lives. Poetically, it is considered to be its autumn. Aging is a natural process and in nature it can be observed at every living creature. Everything is aging, and also we are becoming old. These days, longevity is an indicator of how much civilized each country is. As a result of quality health care and the development of society, people are living to higher age. These days, men are on average expected to live up to 79 years, women up to 74 years {--} figures that would have been considered unthinkable in the past. Taking into account these figures, several questions arise: Are we adequately prepared? Do we have, today, a system of care for the elderly to assure a respectable life for us and our parents in future? In the most ideal world, it would be the family or a close relative who would look after the old, ill or the person with limited self-sufficiency. However, this is a very demanding claim on family environment in these nervous and fast-pacing days. My bachelor thesis analyses the question of old age and all the problems it brings. I have attempted to look deeper into the role of a nurse in homecare. The practical part aims to map the role of a nurse in a home-based care and to determine her possibilities (on the basis of a questionnaire technique) in treating the elderly with health problems at home. Another partial goal of this thesis is to ascertain what needs do the ill elderly people have at home and in what ways can the nurse satisfy these needs, and to determine the physical and social strain it creates on the caregiver. After analyzing the results, my conclusion is as follows: The role of a non-professional caregiver is very significant. Family has and will always have an irreplaceable place in the care for its dependant members. There is no way any medical organization can replace the role of a family in the care for its ill family members. Care, especially long-term care, can be both mentally and physically demanding and puts an enormous strain on the caregiver. Caregivers are threatened by the deterioration of family ties, loss of friends, limited social contacts leading up to social isolation, they are prone to suffer from health problems and, in many cases, great exhaustion. The solution is to make use of a home-based care: professional nursing care provided by professional nurses. The purpose of a home-based care is to leave the patient in his/her home environment as long as possible and, at the same time, to provide professional nursing care. This care is complementary to family care; the nurse is helping the caregiver - family member. Based on my analysis, it's a very gratifying fact that nurses working in this line of work provide it gladly and with loving care. The care for the elderly is based on the principle of gratefulness, love, on the principle of sharing mutual feelings and the joys of small improvements. If we manage to increase the quality of life of caregivers with an adequate help, we will also enable the elderly or ill people to lead a contended and better quality life.
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Human dignity and nurse
HRŮZOVÁ, Marcela
The aim of the thesis is to find out the conception of human dignity at medical staff. At nurses, in addition, with a hidden observation to verify to what extent they meet their statements in practice, whether for nurses a patient does not become only an object of relevant therapeutic and nursing acts. The empirical part of this thesis was processed in form of a qualitative research. The data collection technique was a non-standardised interview with nurses at standard in-patient departments, students of the nursery Master study programme, students of a higher nursing school and patients at a standard department. At nurses it was verified, using the technique of hidden observation, to what extent their actual behaviour in practice corresponds to the information mentioned in interviews. Therefore in their interviews we differentiated the mentioned and non-mentioned elements. The interviews were anonymous. They were recorded in writing because only in one case the respondent agreed for us to use a dictaphone. Collection of empirical data proceeded from June to August 2008. Unlike our expectations the research showed that respondents have no conception of human honour and have no complex conception of its keeping in practice. We categorised the rather poor information into five basic categories that covered 92% (intimacy, communication, individuality, empathy and equality of approach). Statements that we did not manage to categorise here create other 5 categories (worthy dying, consider seriously, pain calming, lege artis process and faith). Most often the respondents mentioned the following categories: intimacy (80.4 %), communication (76.8 %), individuality (60.7 %), empathy (39.3 %) and equality of approach (33.9 %). The hidden observation showed that most nurses (13 out of 16, i.e. 81 %) adhered to their fundamentals of keeping human dignity when working with ill people in a satisfactory way. The other 3 nurses made mistakes in all categories except keeping intimacy; here only one of them did wrong. Results of the thesis should contribute to improvement of quality of care and help to better respect for human dignity.
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Vietnamese patient in the Czech health system
DOLÁK, František
Vietnamese minority has been living in the territory of the Czech Republic already for several decades. It is discrete, flexible and has its closed community. It is clear, however, that it is not easy for Vietnamese to incorporate in society of other country. The reasons are a different culture and language barrier. All this is also valid in the environment such as medical facility which can have a stress effect on an appropriate individual. Several tens thousand Vietnamese have currently been living in our territory. Therefore there is a high probability that a citizen of Vietnamese nationality can become a client in any of Czech medical facilities. The aim of this work was to elaborate specialities of nursing care which members of Vietnamese minority wish to respect. Before the beginning of the research we defined 4 research questions. Research question No. 1: Do members of Vietnamese minority use health care in the Czech Republic? Research question No. 2: What specifics do members of Vietnamese minority have in connection with hospitalisation? Research question No. 3: How do members of Vietnamese minority understand situation when a member of their family becomes sick? Research question No. 4: What do members of Vietnamese minority expect from a nurse? We answered these questions in the research part in the qualitative form of research using the method of an interview. The interview contains in total 138 questions and as the base material for its composition served the conceptual models of M. Gordonová, M. Leiningerová and the model of J. Gigerová and R. Davidhizerová. It also contained a model situation which led the respondents to the imagination of themselves being a patient/client at hospital. The interview was fully anonymous and in Czech language. On the basis of the data obtained there were created case reports from which categorisation tables and diagrams with the most important research data were made. It was found out from the results that members of Vietnamese minority expect almost the same like most patients/clients using Czech health service. However, there are areas such as family or catering in which they have their specifics. If nurses know these areas they are able to provide a multicultural/trans-cultural care.
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Specific Midwife´s Care of Jewish Woman
MAŘÍKOVÁ, Eva
The thesis deals with Jewish culture and its relation to nursing in the Czech Republic. In the introductory section the most important historical moments of Jewish culture are mentioned, the origin of Jewish culture, religious and philosophical ideas of Judaism and its branches are described. The most comprehensive chapter presents Jewish festivals and Jewish family life. These are the crucial indicators of lifestyle from the religious point of view. They show how religion influences adolescence, the man´s and woman´s role in the family as well as life itself. The theoretical part of the thesis is closed with the description of nursing care specifics. Topics such as basic nursing care, the care for a dying person, stepping of a Jew into life, i.e. circumcision, childbirth or abortion are covered. The exploratory question on specific needs of Jewish women while given nursing care by a midwife was asked. The aim of the thesis was to learn midwives´ awareness on specifics of nursing women of Jewish religion. The results of the research show that midwives´ awareness is not high, for example 50% of midwives are convinced that termination of pregnancy is absolutely forbidden in Jewish culture, the absolute majority of midwives could not give the definition of Sabbath. But on the other hand, this information cannot even be found in literature dealing with multicultural nursing care. The hypothesis that midwives do not have enough knowledge about specifics of the care for Jewish women was confirmed. However, it is also difficult to make Jewish women communicate openly and get relevant information. Therefore it is necessary to seek for specifics of nursing care actively to improve the quality of nursing care. But yet the research brought the insight into specifics of nursing care such as insistence on caregivers´ adequate expertise or demand of quietness and privacy. In the course of pregnancy women do not require more attention than usual, do not give up their professional careers, but they slow down the pace by relaxing more. The other hypothesis suggests that while providing them with nursing care it is possible for midwives to meet all the specific needs of Jewish women. The results of the research show that it is possible to meet specific needs in full if we do our best to seek for concrete specifics when communicating with a Jewish patient.
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The differences in meeting affiliation needs of clients at gerontology-psychiatric wards in the Czech Republic and the Netherlands
KOTRČOVÁ, Ivana
The number of seniors suffering from a mental disorder, which have to be placed in an institutional facility due to their declining health and mental condition, has been increasing. Both family and the staff in such facilities should realise that strengthening the feeling of fellowship and belonging to a certain group is an integral part of holistic care for individuals who are ceasing to take bearings in themselves as well as their surroundings. This B.A. dissertation deals with the issue of meeting the needs of love and belonging of seniors suffering from a mental disorder placed in a nursing-type institutional facility. The research results can help nurses and students understand the significance of the needs of love and belonging and make them do activities resulting in meeting these needs.
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A Chinese patient in the Czech health care service
SCHOLZ, Pavel
The name of this thesis is: "A Chinese patient in the Czech health care service". China with approximately 1.3 million inhabitants belongs to the largest countries in the world. Migration and tourism of inhabitants of the Folk Republic of China and Republic of China towards the Central European region, is higher year by year. Simultaneously, with increasing accumulation of the Chinese minority group members in the Czech Republic, even the number of provided health care for this minority group of inhabitants is rising. Different conception of health and disease markedly affects the approach and understanding of the patient/client from another culture both from professional point of view and from the view of patient/client. Medical personnel should be aware of main differences in behaviour of the members of minority group and their population, and not only in connection with provided health care. This research work is worked out by means of qualitative research methods. Working out of nursing care peculiarities which the members of Chinese minority want to respect was the research goal of this thesis. Collection of data was carried out by means of a half-structured interview in members of the Chinese minority group in the Czech Republic. The content of questions of the half-structured interview is based notably on conceptual, nursing models developed by Gordonová, M., Leiningerová, M., and a model developed by Gigerová, J. {--} Davidhizerová, R. The five research questions were specified for the goal accomplishment. The results of research were treated by means of casuistics and a slightly modified approach of general analysis by Ritchie and Spencer. Established nursing care peculiarities in the area of blood taking, and information of physician´s diagnosis, especially towards the family, and apprehension of medicament addiction, and even the pain and answer to it belong to leading results. Description of how the members of Chinese minority group understand the Czech nursing and a nurse as a provider of professional nursing care also belongs to other results. The hypotheses decided on further research use were suggested on the basis of results of this thesis. This thesis and its results are determined to the professional health care purposes and for direct provision of nursing care in health service facilities in the Czech Republic. One of the outcomes of this thesis is also a propsal of the nursing care standard in members of Chinese minority group living in the Czech Republic, and, hereafter, an information summary book for nurses concerning trans-cultural specificity of the Chinese patient/client in the Czech health services.
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Tradicional Chinese medicine and current nursing
ROLANTOVÁ, Lucie
Traditional Chinese medicine is one of the oldest curative methods in the world. It is focused particularly on the support of a body to recover balance and harmony that have become impaired. Owing to the growing number of the Chinese and the Vietnamese minorities in the Czech Republic, the medical staff providing healthcare may meet members of these minorities for whom this medicine may be of a large importance both when being ill and when being healthy. The new conception of the Czech nursing is outlined to provide every individual, regardless of the race, with the care which is able to satisfy their bio-psycho-social-religious needs. The nursing staff must possess a basic knowledge of the traditional Chinese medicine so that they are able to satisfy the needs of these patients/clients better. The objective of this diploma work is to ascertain what health problems are treated by members of the Chinese and the Vietnamese minorities through the traditional Chinese medicine, and what curative methods are used most frequently by them. The empirical part was processed in the form of a qualitative research. The data collection technique was a semi-structured interview of selected informants of the Chinese and the Vietnamese nationalities living in the Czech Republic. Based on the interviews of individual minorities, case studies were established and used as the research base for elaboration of categorization tables and charts presenting the most important results of the research. The main results of the research include the ascertained heath problems which are treated by means of the Chinese medicine by members of both minorities, and the ascertainment what curative methods are used most frequently, and whether the members of both minorities wish to make use of the medicine also during hospitalization. Based on the results of the research, the information material was elaborated that may be of use for the nursing staff in healthcare facilities and for other specialized public as a brief summary of methods of the Chinese medicine and of their application by the members of the Chinese and the Vietnamese minorities.
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Quality Indicator Mapping of Nursing Care in Hospital České Budějovice
PAPOUŠKOVÁ, Petra
Quality nursing care is today the essential goal of contemporary nursing. Therefore it is necessary to introduce in sanitary facilities a quality improvement program, whose part is tracking quality indicators of care provided. Within the practical part we set three goals. The first of them is to define tracked quality indicators of nursing care in Hospital České Budějovice, a.s. The second goal is to evaluate the selected quality indicators of nursing care in Hospital České Budějovice. The third goal is to inform nurses on quality indicators of nursing care in Hospital České Budějovice. Based on these goals we introduced six hypotheses. The first hypothesis says: Hospital České Budějovice, a.s. tracks at least 15 quality indicators of nursing care within the tracked period. The second hypothesis says: Hospital České Budějovice, a. s. realized at least four nursing care audits per year. The third hypothesis says: nurses of Hospital České Budějovice are satisfied with working conditions. The fourth hypothesis says: clients of Hospital České Budějovice, a.s. are satisfied with the provided nursing care. The fifth hypothesis says: Nurses of Hospital České Budějovice know at least four quality indicators of nursing care in Hospital České Budějovice being tracked in their wards. The sixth hypothesis says: Prevalence rate of decubitus in Hospital České Budějovice decreases. The research ran over under collaboration with staff nurse of Hospital České Budějovice, a.s.; one of forms of the research was also a nursing audit; further data collection method by means of questionnaires was used. The research file involved nurses and clients of Hospital České Budějovice, a.s. In the course of the research we fulfilled the set goals; the first, fourths and the fifth hypotheses were confirmed and the second, third, and the sixth hypotheses were not confirmed. The research results have been offered to the hospital top management as a data source concerning the nursing care quality. The work should also provide nurses with information on that monitoring and evaluating nursing care quality through specific indicators is at present a necessity and indispensable fact and that its goal is not individual disciplinary decisions of individual nurses, but it concerns finding out system errors, their assertion and resolution.
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