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Patient safety in the operating theatre
Fejglová, Pavla ; Holečková, Zuzana (advisor) ; Milfaitová, Vlasta (referee)
Author: Pavla Fejglová Institution: Department of Social Medicine, Charles University, Faculty of Medicine in Hradec Králové, Department of Nursing Care Title of the thesis: Patient safety in the operating theatre Supervisor: Ing. Zuzana Holečková Number of pages: 133 Number of attachments : 8 Year of defence: 2014 Key words: perioperative care, safety, quality of care, adverse events This bachelor thesis deals with one of the crucial roles of the medical staff in the operating theater - the issue of ensuring patient safety and quality of nursing care during the perioperative period on central operating theaters of the University Hospital in Hradec Králové and Liberec Regional Hospital from the perioperative nurses point of view. The core of the empirical part consists of quantitative research in the area of compliance with the measures to ensure the safety of patients during their stay in the operating room. Research data were obtained thanks to the understanding of perioperative nurses from operating theatres of the above mentioned hospitals. Based on the data, analysis was conducted with interpretation of results and several measures aimed mainly to improve the safety of patients during the perioperative period and the prevention of adverse events are proposed.
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Education problems of children given to keep their grandparents
Pokorná, Daniela ; Vítečková, Michaela (advisor) ; Krykorková, Hana (referee)
This thesis deals with issues of upbringing children by their grandparents. It focuses on the fact, how the grandparents handle the upbringining of underage children. The theoretical part is divided into six main chapters. This part includes topics such as family, upbringing and the issue of foster care. The practical part deals with the research itself, as the main research method was chosen to interview and documents analysis. The interview was made with ten grandparents, who have underage child in their custody. The interview was focused on the financial security of families, cooperation with school, the possible educational problems of children at school or at home. Finally, there was made the evaluation based on available data.
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Outdoor preschools
Kapuciánová, Magdaléna ; Jančaříková, Kateřina (advisor) ; Uhlířová, Jana (referee)
My diploma work is concerned with the themes of outdoor preschools and pre-school education. It searches for and is stemming from the similar subjects in foreign countries and within the Czech Republic. It shows what the benefits of children being outside are. It also searches and points out liabilities which are necessery to be taken into account. The work presents the used resources, which can lead to the foundation of the other outdoor preschools and their maintanence. The empirical study is managed as an action research. The first part of the practical section shows experiences of the outdoor preschools in general and it presents interviews with their pedagogues. The second part of the practical section deals with the opinion of experts and the non-professional community. Moving on, one then investigates the ideal level of achievement in separate competences in an ordinary preschool, and outdoor preschools. Further more, the next section is targeted at the expert's expectations and apprehensions about children staying at an outdoor preschool, taking into account their views in relation to outdoor preschools. Focus groups are being used to question the experts. The important part of the work is to analyse the legal enactments in relation to outdoor preschools motherly school.
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The Use of the Allowance for Care by the Elderly in 2010-2011
VÍTOVÁ, Jaroslava
This thesis deals with the issue of assessing seniors' needs in relation to the urgency of their admission into a residential care facility. Act No. 108/2006 on social services has significantly changed the way people can obtain necessary assistance. Now it is possible to purchase social services thanks to a social welfare benefit in form of an attendance allowance. There was an assumption that if there is a development in field social work, seniors will remain in their natural environment and therefore the interest in residential care facilities for older people will lower. However, this assumption was not met. The number of senior citizens interested in retirement homes greatly exceeds the capacity of individual facilities. When we assess the needs of seniors related to admission to a residential facility, such need is perceived as an insufficiency. If we get rid of this need or provide support to satisfy it, we achieve safety and security. The extent of such support can vary. The level of help people need determines the amount they receive as an attendance allowance, but it is not the only criterion for preferential admission into a retirement home. Seniors' difficult life situation does not have to be directly related to the level of help they need. If seniors get a lot of points during assessment of their degree of autonomy, self-sufficiency and objective conditions, it does not necessarily imply that they need to be urgently admitted into a residential care facility. This assessment is carried out according to methodological documents devised by the retirement home. The thesis uses a qualitative research strategy; that is, content analysis, case study and qualitative evaluation. Residential care facilities came up with requirements for objective assessment and selection of seniors to be admitted in order to reduce the number of applicants - from several hundred to a group that needs to be admitted urgently. These requirements led to a preparation of methodological materials that describe the whole standard procedure of interaction with people interested in the residential social service. Next, a method of point score system to select the candidates was also established. One of the aims of this thesis was to carry out a qualitative evaluation of methodological documents of a specific residential care facility for older people. Next goal was to assess the seniors' needs before they are admitted to residential care. A content analysis of social investigation records was also conducted. The results showed that the most important needs of seniors are safety and security. Older people submit applications for retirement homes, although they actually do not want to use this service. It is a manifestation of their fear of the future and it has a significant impact on the number of registered applications. On one hand, it is important to regard people as fully-fledged, independent, free and responsible beings at any age. But on the other hand, it is also vital to be aware of various limits and restrictions arising from natural ageing. We usually encounter two extreme opposites when we communicate with older people. Seniors usually overestimate or significantly underestimate themselves in the area of autonomy and self-sufficiency. If these areas were only self-evaluated and objective reality (or senior's surroundings) was not taken into account, the assessment result would be significantly distorted. Quality of needs' assessment and level of social investigation directly depend on the knowledge, skills and abilities of social workers; one of their most important skills is the ability to reflect.
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Securing the patient in postoperative care.
JORDÁNOVÁ, Hana
Current status: Safe process treatment should be provided to every patient in every hospital. Nurses should work to avoid security violation, especially in the surgical field, associated with irreversible changes in the treatment process. Perfect mastery of these measures assures patient safety. Risk prevention, safety of the patient and the medical personnel require the involvement of all members of the multidisciplinary team (Pokojová, 2011; Škrla and Škrlová, 2003). Objective of the research: to map the attributes of postoperative care in the safe treatment of patients. To determine whether nurses master preventive measures in safe patient care and whether they ensure compliance with the principles of safe care in practice. Methods: the research analysis was chosen to be based on qualitative research method. Data acquisition was performed in semi-structured interview with nurses, supplemented with hidden observation. The participation in the interviews was voluntary and anonymous. Audio data was recorded from the interviews and transcribed verbatim. The observation aimed to determine whether nurses respect the principles of safe care for patients in the postoperative care. Research cohort: consisted of general nurses who worked at the surgical wards and recovery room. The research was conducted in one of the hospitals of South Bohemia. Twelve nurses were interviewed. The interview and hidden observation were focused on patient safety in the postoperative period. The interviews were performed at nurse day-time rooms of individual surgical wards, some of them outside the hospital. All nurses met the criterion to be a provider of nursing care for post-operative patients at surgical wards and recovery rooms. The interviews were finished when reaching the theoretical saturation, when the answers and hidden observation of the respondents started to repeat the already acquired data, i.e. after twelve interviews and observations. Results: The nurses working in surgical wards and recovery rooms are exposed to a considerable mental and physical strain. This profession is very demanding and requires not only theoretical knowledge, but also manual dexterity in practice. Nurses are involved in the care process in a considerable extent. Therefore, it is important that the care was good and safe. In the treatment process, the nurses sometimes do not comply with relevant standards and the requirements for safe treatment. It is essential to follow the identification bracelets to avoid patient mismatch, thus endangering patients' health. Some nurses checked the identification bracelets thoroughly, but there were also nurses who ignored these rules too much and gamble with the patients' health. Medication errors are the most common cause of patient injury. The risk of medication errors increases also due to improper storage of hazardous drugs. In our investigation, the medication was repeatedly stored at a different place (not returned back to the original area), poorly stored or left freely available to anyone. If the physician records are illegible, the nurses solve the issue rather by guessing or asking an assistance from colleagues in the department. This area also includes replacement of medication by nurses if the prescribed product is not available at the ward, without consulting a physician first. The negligence in the use of protective equipment during dressing changes is alarming. Possible transmission of nosocomial infections. Poor or little use of disinfectants. Conclusions: Treatment of patients in the early and late postoperative care is one of the high risk parts of the hospitalization of patients at healthcare facilities. In this period, patient monitoring and risk prevention are essential. It includes pain control, the care for surgical wounds, safe patient identification, prevention of adverse events in both medication administration and patient falls, the compliance with hand hygiene ...
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I Live Tarot
Oplatková, Hana ; Vondřejcová, Silvie (referee) ; Klímová, Barbora (advisor)
Private deck of cards created during six-month survey and documentation of daily experiences. The package contains 49 cards and it is inspired by a set of 78 tarot cards. Text content - reverse side of the card was created using diary notes. Face side of the card was chosen as a representation of processes taking place usually in days when the card was read.
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Camouflage
Ošlejšková, Petra ; Vaněk, Tomáš (referee) ; Klímová, Barbora (advisor)
Masters thesis works with concepts such as home intimacy, safety, system, etc. During the period from 16.1.2012 to 12.3.2012 author secretly penetrated into the apartment their parents and disrupted by subtle interventions to break the routine like their home. Secretly watched the behavior and rules which operate on her parents (with their parents she dont live). The intervention provoked to a specific form of interaction between author and her family.
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Safety when handling and positioning of the patient
HŘEBEJKOVÁ, Blanka
This thesis focuses mainly on threats to the safety of nursing personnel. These include a high risk of injury when positioning and the risk of developing musculoskeletal disorders,which can lead to a long-term sickness of the member of the medical staff. The theoretical part is divided into four parts. The first part describes in particular the need for safety and security, as well as factors that have an influence on this human need.Attention is focused also on ensuring safety while providing nursing care, especially when positioning patients. In connection with safety during this activity, a section in this thesis is devoted to the kinaesthetic mobilization, which offers a slightly different view of the positioning and patient handling. In the last chapter of the theoretical part, findings concerning the prevention of damage to health nurses in providing nursing care are summarized. The thesis has three objectives that were formulated as follows. Objective 1: Determine whether nurses use kinaesthetic principles during a patient handling. Objective 2: Determine whether nurses, in their opinion, have enough equipment to ensure safety during patient handling and positioning. Objective 3: Map the causes of the use of inconsiderate patient positioning techniques. Based on these objectives, the research question and three hypotheses were set. Research question: What are the possibilities for improving patient handling and positioning within the nursing process? Hypothesis 1: The use of kinaesthetic depends on the type of department. Hypothesis 2: Nurses use bad positioning techniques despite their knowledge that they can harm their health and also patient's. Hypothesis 3: Lack of time is the most common cause of the use of the inconsiderate method of positioning. In order to fulfil the objectives, a quantitative research, for which we choose the questionnaire method of data collection, was conducted. The questionnaires were designed for nurses working in the department of surgery, internal medicine and the department of aftercare. The survey was carried out in 7 hospitals of South Bohemia. In total, 340 questionnaires were distributed into these hospitals.The final research sample, therefore, consisted of 209 completed questionnaires. The rate of return was 61%. The obtained data were processed and analysed using Microsoft Excel 2013, then analysed statistically using the chi-square test. The results were processed into graphs. Based on the results, we can conclude that the hypothesis 1 is confirmed. We found that kinaesthetic is used most in aftercare departments. On the contrary, surgery departments use it the least. This is probably due to a different composition of patients on these wards.Hypothesis 2 was, for testing purposes, divided into two working hypotheses. H2a: 60 % nurses know that classical principles of positioning can damage their health. This hypothesis has been disproved. A corollary is HA: Knowledge of nurses about the risk of an injury is not 60%. The research has also revealed that almost three quarters (74 %) of the nurses know that positioning can damage their health. The second part of the hypothesis 2, i.e. H2b: 60 % nurses know that the classical principles of positioning can damage the health of the patient, has also been refuted, and thus applies HA: Knowledge of nurses about the risk of an injury to the patient is not 60%. The results of the survey showed that only 24 % nurses consider the classic method of positioning a risk to patient's health. Hypothesis 3 was, through our research survey, refuted. Sisters see the most frequent reason for using the inconsiderate positioning procedure in the lack of staff.We managed to answer the research question by analysing literature in the theoretical part and performing the survey in the practical part of this thesis.An output of this thesis will be an expert article published in a professional journal and a presentation at a professional conference
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Safety as an important factor for tourism development in Czech Republic
Šteflová, Lucie ; Valentová, Jana (advisor) ; Mikula, Mojmír (referee)
The main objective of this diploma thesis is to analyse the tourism safety situation and the CzechTourism hypothesis: "Czech Republic is a safe destination" for a visit. It is focused on tourism safety and security questions and its main forms, various international safety analysis and reports with emphasis on the situation in Czech Republic. The study of CzechTourism is analysed by means of a direct survey among foreigners and its results lead to the potential development of tourism safety situation in Czech Republic. Finally, the evolution of a situation in Czech Republic is observed according to the different tourism and peace indicators and the direct dependence "safe country / number of arrivals" is investigated.
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