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Specifics of feed nutrition to patients in acute and septic state
HOLOUBKOVÁ, Martina
This bachelor thesis describes specifics of nutrition for patients in acute and septic state. It is aimed at improvement of awareness and information of nurses that care about these patients, on the problems of malnutrition and possibilities of specific nutrition. The theoretical part describes malnutrition - imbalanced diet, as a risk factor that complicates the course of disease, extends the hospitalization time and increases mortality. There is also an outline of cooperation with nutrition specialists, diet recommendations and methods of feeding patients in acute disease stage. Enteral end parenteral feeding is analyzed here. The conclusion of the theoretical part deals with the organism inflammatory response syndrome, sepsis, multiorganic dysfunction, like complications threatening a patient in acute state. There are also diet recommendations for patients in septic state. The practical part of this thesis contains results of quantitative research based on data collection by means of an anonymous questionnaire designed for nurses or healthcare rescuers of anaesthetic-resuscitation departments and intensive care units. A nursing care standard focused on assistance in introduction of central venous catheter and consequent patient care was elaborated as the output of the work upon study of the issues of nutrition for patients in acute and septic state, specific possibilities of its administration and evaluation of the research results. The bachelor thesis may also be used as study material for education of healthcare staff caring about patients in acute or septic state.
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Investigation of blood cultures
ŠINDELÁŘOVÁ, Radka
Bloodstream infections are among the most serious pathologies with often severe or even fatal course, and therefore the microbiological testing blood cultures is very important. Bloodstream infections caused by various microorganisms - bacteria, viruses, parasites and fungal agents. Each of them in the organism induces a different response and clinical course. The aim of this work was to ascertain the possibility of investigating bloodstream infections, appropriate the technique of treatment of blood cultures in the laboratory of bacteriology in České Budějovice Hospital, Inc. and based on the results determine the percentage of positivity for the months of September and October 2012 and which agents and with what frequency was from the positive blood cultures catched. The theoretical part deals with the explanation of basic concepts that are associated with bloodstream infections and their complications. I also explore the possibilities of investigation in other laboratory branches - biochemistry and hematology which are also very important for the diagnostics of this infections and their importance is especially in speed of obtaining results. The main examination is the clinical microbiology one where culturing agents that cause these diseases, the rapid identification and determination of susceptibility to antimicrobial agents leads to accelerated and targeted therapy. The last section of the theoretical part I dedicated to individual agents that can cause bloodstream infections. The practical part describes the procedure by which blood cultures were processed. At first, I describe the pre-analytical sample testing, which is very important. Here is included the sampling and sample transport to the laboratory. Medical personnel, which take the sampling, should be duly lessoned how to act during the sampling to avoid contamination of the sample, so the patient was not been needlessly prescribed antibiotics. The actual analysis of the examination were performed in blood cultures system the Bact/ALERT 3D bioMerieux, whose principle is based on the colorimetric detection of CO2, arising from the growth of bacteria. If the unit is assessed positively, blood cultures bottle was further processed - inoculated on solid media and microscopic specimen was taken. The research results are displayed using simple statistics in graphs and a chart. From the assignment of the percentage of positivity, that are depicted in the graphs, the result for the months of September and October of 2012 is 17%. Another objective was to determine the isolated agent. These results are in a chart where I put the number of their representation and their relative frequency. The most common were isolated: Escherichia coli, Staphylococcus epidermidis, Staphylococcus hominis, and Staphylococcus aureus. The results, which I reached in this work, are similar to the results in the international literature. The occurrence of Escherichia coli and coagulase-negative staphylococci is presented in the frequency of incidence of agents isolated from the blood cultures in the first place. During the isolation of coagulase-negative staphylococci should be considered their incidence as a possible contamination of the skin flora in case of the taking of blood cultures. During the practical part of the thesis I was closer acquaint with the operation of bacteriological laboratories and methods of its work including techniques of blood cultures processing. These activities are the necessary part of diagnostics of infectious diseases and treatment of the patient.
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