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Birth Injuries in Neonatology.
ŠKVOROVÁ, Adéla
Current status: Mechanical damage to the newborn during childbirth can cause traumatic injuries. These may be visible immediately after delivery or within hours or days thereafter (Dort et al., 2013). Several risk factors or improperly managed childbirth can contribute to birth injuries, the most common at present including fractures of the collarbone and bleeding under the periosteum or paresis (Huml et al., 2013). Many injuries do not have permanent consequences, however, in such cases, multidisciplinary expert care is required. Objectives: The aim of the study was to determine the frequency and types of birth injuries in full-term newborns in a selected maternity hospital, to map their risk factors and consequences, to evaluate the frequency of increased bilirubin in the body in full-term newborns with cephalhematomas, and last but not least, to describe the nursing process in full-term newborns with a selected birth injury. Methodology: In the empirical part of this work, a mixed design combining quantitative and qualitative research was used. Selection of the research set was intentional, where in the quantitative part of the study 1733 full-term newborns delivered in a selected Prague maternity hospital in the period 1 January 2019 to 1 July 2019 were included. The research sample for the qualitative part of the study consisted of 10 nurses working in a selected maternity ward. The size of the research sample was given by theoretical saturation of the data. Results: Out of the total number of 1733 newborns, 280 newborns with birth injuries were delivered (16.2%). The most common injuries included obstetric tumors (12.2%), cephalhematoma (2.9%) and clavicle fractures (0.6%). Statistically significant risk factors increasing the likelihood of birth injuries involved prolonged labour (p < 0.001), shoulder dystocia (p = 0.045), irregular fetal position (p < 0.001), use of forceps (p= 0.005), and vacuum extraction (p < 0.001). Conclusion and use for practice: Based on the results, educational material was created for parents of newborns with birth injuries - a collarbone fracture.
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Health literacy of mothers with premature infant
Vencová, Barbora ; Ivanová, Kateřina (advisor) ; Valešová Malecová, Barbara (referee)
Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health, according to WHO. Common health literacy level may be sufficient in the case of smooth pregnancy and natural childbirth. However, if there are some health problems, it is necessary to support an increase in health literacy level of mothers. Main objective of this thesis is to describe the objective health literacy level of mothers with premature baby and to identify areas that are for these mothers most problematic. The theoretical part deals with demographic data related to premature births, the basic definition of prematurity, an essential characteristic of neonatology and organization of care, premature baby, the most common medical complications and prognosis. Defines and operationalizes health literacy of mothers with premature baby. Research used a qualitative methodology. Data were collected using semi-structured interviews. Respondents for interview were physicians who care for preterm infants. The selection of respondents was conducted using the snowball sampling to facilitate data analysis, were interviews transcribed and then analyzed using the cluster analysis. Results were...
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Development of communication abilities in premature infants
Svobodová, Barbora ; Klenková, Jiřina (advisor) ; Mlčková, Marie (referee)
The presented thesis deals with the topic of development of communication abilities in preterm infants from the perspective of special education. The thesis is for clarity divided into several parts. In the first part of the text the issue of incidence of premature births in the Czech Republic is discussed, following subsections are devoted to the definition and distribution of characteristics bonding with immaturity of child and approach selected health problems associated with postpartum adaptation and subsequent psychomotor development of child. The following chapter which analyzes the system of care for premature newborns in the Czech Republic focuses on two forms of care, acute care and followed-up. Next part has been devoted to issue of premature infants from logopedical perspective and describes the physiological process of development of communication abilities of child and based on current knowledge, especially foreign research, analyzes the peculiarities of speech development of preterm infants. The last and key part of the work, based on case studies, analyzes the specifics of development of communication abilities of four originally extremely and very preterm children of multiple pregnancies in the background of the their overall psychomotor development. KEYWORDS premature infant,...
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.Impaired Communication Ability in Premature Infants
Mikulášková, Eva ; Klenková, Jiřina (advisor) ; Korandová, Zuzana (referee)
This Master's thesis deals with the topic of impaired communication skills in premature infants. The thesis is divided into theoretical and practical parts. The theoretical part consists of three main chapters devoted to the development of children's speech, premature babies and care for premature babies. The first chapter describes speech and language, the ontogenetic development of speech, language levels in the ontogenesis of speech and impairment of communication skills in childhood. The second chapter defines a premature baby and discusses the most common postpartum complications. The third chapter is devoted to the care of premature babies in the Czech Republic, describes the logopaedic care regarding such children and their prognosis. The practical part is based on the methods of qualitative research. A triangulation of research methods was chosen - document analysis, observation and interview. The main goal was to describe how impaired communication skills are manifested in premature infants. The partial goal was to find out what postpartum complications occur in premature infants. To achieve the goals of the research, five research questions were formulated. Five respondents were included in the survey, namely four boys and one girl. Based on the obtained data, case studies of individual...
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Creation Of Prematurely Born Infant Airways Model Based On X-Ray Ct And Mri Scans
Lázňovský, Jakub
Proposed contribution deals with the creation of infants’ airway model, based on available clinical MRI and CT scans of newborns. For this purpose, an algorithm which extracts the airway geometry was developed. Resulting geometry is consequently transformed to the airway model in stereolithography format, suitable for further analysis. The algorithm was tested on the data which correspond to an infant born in 30 weeks of gestation and scanned 14 days after birth. Thus, the model corresponds to the 32 weeks old infant.
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A satisfaction of expectant mothers with care in the perinatology center
Klejová, Nikola ; Čábela, Radek (advisor) ; Přáda, Jan (referee)
This thesis is split into two parts, theory, where I primarily define terminology of perinatology, medical staff, perinatology itself in Czech republic, neonatology, which the Apolinář centre is very well known for. And also research theory. Second part is so called practical part of the bachelor thesis, which concerns the area of research into satisfaction of mothers in care in the perinatology centre of Apolinář in Prague. It is primarily focused on satisfaction of mothers with intimacy, privacy, care, staff behaviour, quality of food, cleanliness of the facility and the impression of the environment, in which the woman experiences the most important moments of her life. Research has been conducted by surveying mothers in care of the facility, as the simplest most effective, anonymous and least time consuming method. This research has pointed out the strong ant he weak points of perinatology centre. The weak points are also addressed in more detail in chapter ,,Recommendation and prevention", where I try to present viable solutions for those issues. The aim of this work was to determine the level of care in the maternity hospital at Apolinář and based on the results to recommend appropriate improving measures not only for the care of mothers and newborns. Keywords: perinatology, mother, maternity...
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Awareness of mothers about the care of premature baby
Budková, Eliška ; Tomová, Šárka (advisor) ; Nikodemová, Hana (referee)
The bachelor's thesis "Mothers' awareness of premature newborn's care" is focused on evaluating the effectiveness of informing new mothers by medical staff. The essay consists of a theoretical and a practical part. In the theoretical part I first describe the classification of newborns, the differences between a term and preterm newborn. Afterwards the focus is shifted to the description of individual procedures in the care for the preterm infant which includes the delivery room, the ward, physical therapy, hygienic care and nutrition. Information about sudden infant death syndrome is also included In the empirical part, an analysis of a questionnaire survey of 90 respondents from maternity wards was conducted. I was mainly interested in maternal awareness of preterm infants' care. Research shows that mothers are well informed about care. Nurses need to teach mothers more about the risk of developing SIDS.
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Airway analysis of prematurely born babies based on X-ray CT and MRI scans
Lázňovský, Jakub ; Harabiš, Vratislav (referee) ; Chmelík, Jiří (advisor)
Předkládaná Diplomová práce se zabývá analýzou a tvorbou modelů dýchacích cest předčasně narozených dětí. Nejprve je položen teoretický základ v oblasti vývoje dýchacího ústrojí a tvorby modelů dýchacích cest. Poté jsou představeny využité zobrazovací modality a popsány metody pro práci s obrazovými daty. Praktická část práce se zabývá vytvořením modelů dýchacích cest tří novorozenců. Všechny tyto modely jsou vytvořeny na základě klinických CT a MRI dat novorozenců narozených ve 30. týdnu gestačního věku. U těchto vytvořených modelů jsou dále analyzovány vybrané parametry související s anatomickou strukturou dýchacích cest. Na základě analýzy těchto parametrů byl následně navrhnut reprezentativní model, odpovídající dýchacím cestám novorozence daného gestačního věku.
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Supportive Care for Premature Newborns with psychological and ethical Aspects
TOMANOVÁ, Věra Veronika
The thesis, or more precisely its theoretical part, introduces the field of Neonatology, namely the specification of premature newborns concerning supportive care for them. In the thesis, the basic concepts of Neonatology are presented as well as the system of neonatological care, including the needs of premature newborns, which are part of everyday nursing care. Following the above chapters, the thesis describes not only the nursing care as such but also the possibilities of psychosocial care in Neonatology. For a more comprehensive presentation of the issue of premature newborns, the thesis also includes findings concerning ethical issues in Neonatology and it introduces some organizations in the Czech Republic, which are an integral part of the supportive care. The character of the thesis should correspond with the program of nursing care, namely nursing in selected clinical disciplines - the module of paediatrics. In the empirical part of the thesis, qualitative research by interviewing has been used. Despite this scientific approach is more time-consuming, the author considered this method more meaningful and natural concerning the chosen topic because it concerns the support of the lives of these children and their families. Premature newborns are unique, affecting and enriching human being as such. The target of the thesis was firstly to find out how supportive care in premature newborns is perceived by its providers, secondly to disclose the considerations of the care providers regarding premature newborns in České Budějovice. The research was effectuated in connection with the above objectives, which have importance and a significant value for the author. Conclusions of the Thesis: The informants assumed that society didn't have enough information about the provided services. Almost all the informants collaborated on some research or project. As service providers, the respondents acknowledged the comments from the clients. The informants were interested in improving or enhancing the services. The addressed people have specified many factors and difficulties that make their work difficult. The informants concretized foreign experience. The respondents felt considerate enough. The informants expressed sincerely that there was a lot of space for improvement in their profession. The respondents mostly took a partner and gentle stand to the premature newborns and their families. The service providers gave due reasons for a specific approach in their statements. The informants expressed their respect for premature newborns and their families, giving a specific justification. They mostly expressed respect for the needs of the families, for the biorhythms of the baby, for the naturalness, the intuition and the personal pace of the baby. The thesis can be seen as a source of information for both the general and professional public, which could improve current practice. Based on the presentation of the issue through the thesis, the author has published a guide on premature newborns.
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Nursig care about newborn within the perioperation care.
BENEŠOVÁ, Nikola
The topic of the thesis Nursing Care of Newborns in the Process of Perioperative Care deals with specific and distinct features of such care from the viewpoint of nursing. The main objective was to specify all tasks of nurses in the process of perioperative care and the procedures they use. Last but not least, we focused on how the nursing care differs with regard to the age of newborns. The selected research method was qualitative research using semi-structured interviews with nurses from perinatology centers. The research covered 10 respondents with various levels of education and lengths of practical experience. Nurses most frequently understand the term of perioperative care as the care provided before, during and after a surgery. Most of them actually perform preparation of the child before the surgery and then they provide postoperative care. Only 2 out of the 10 respondents are directly involved in the surgery procedure and thus accompany the newborns throughout the entire process of perioperative care. The care provided before the surgery most often includes identification of the child, checking of its vital functions, involvement in blood collection, including intravenous cannulation, administration of prescribed medication, preparation of the surgical site and communication with the parents. Children are most frequently accompanied by their mothers and nurses need to communicate with them. Nurses transport the child to the operating room, hand the child over and subsequently take it back after the surgery. They also record all those activities in the medical files and in some cases they check signed informed consents. Intraoperative care consists mainly of monitoring of the newborn, assisting to the physician in airway management - intubation and during the entire surgery procedure. The most common surgical procedures performed in children are hernia, bowel and heart surgeries. The nurses also generally mentioned surgeries of developmental disorders. After the surgery nurses usually move the child to the neonatology intensive care unit which is equipped with a ventilator, incubator and all types of medication. They regularly check and record child´s vital functions, monitor the surgical wound and its proximity, intake and excretion, they provide nutrition etc. Nurses also assess the pain, most frequently using the NIPS scale, and they educate the parents. Post-surgery complications occur only sporadically and they include infections, bleeding or abstinence syndrome after administration of opiates. The collected data have shown only one difference relating to the age of newborns who underwent a surgery. Specifically, certain surgeries, e.g. of necrotic enterocolitis, are performed more frequently on less mature newborns. In general, most of the surgeries are performed on prematurely born neonates and extremely immature neonates. When asked what they would like to change or improve in the perioperative care from the nursing point of view the nurses primarily mentioned more contacts between the mother and child and consistent compliance with aseptic procedures. The responding nurses were mostly content, they praised the highly specialized care and the good cooperation between the nursing team and the medical team which consists of pediatricians and specialists. Results of those teams thus contribute to continually decreasing mortality rate of high-risk and pathological newborns and to better quality of life of those children after the surgery.
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