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Attitude between paramedic and nurse in the prehospital urgent care and hospital urgent care
GRÜNN, Jan
The title of the bachelor?s thesis at hand is the Relationship between paramedics and general nurses during pre-hospital emergency care and hospital emergency care. The objective of the thesis was to find out how the general nurses and paramedics perceive the process of getting further education needed for work in the pre-hospital emergency care and hospital emergency care. The theoretical part deals with the current state of the Emergency Medical Service (EMS), its organisation, funding, and division. Next, the thesis provides characteristics of the professions of paramedic and general nurse, especially with regard to their educational background, how they get their qualifications, their competences, and with regard to legal relations these professions enter into. The practical part employed the method of quantitative research. Anonymous questionnaire was used as the method for collecting data. The target research group comprised of paramedics and general nurses that work at EMS Dispatch Centres of the Region of South Bohemia or at the Departments of Anaesthesiology and Resuscitation in the hospitals based in the Region of South Bohemia. This bachelor?s thesis introduces two hypotheses. The first one reads: ?University-educated paramedic needs more work experience for work at a Department of Anaesthesiology and Resuscitation than a general nurse with ARIC (Anaesthesiology, Resuscitation and Intensive Care) education.? The second one is as follows: ?General nurse education is more suitable for work in pre-hospital emergency care than that of paramedic.? At the beginning of writing this thesis, the competences of paramedics and general nurses were completely different. Due to the changes in laws and amendments to the law which defines these competences that came into effect in the meantime, the possibilities of getting further education have seen changes, too.
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Nursing care of physiological newborns nowadays ane future trends
LÍZALOVÁ, Karolína
This bachelor thesis has two parts: the theoretical and practical ones. The theoretical part describes the care of physiological newborn infants from the moment of their birth until discharge from hospital. It also includes the physiology of newborn infants and a summing up the history of this subject. In the practical part, investigations focused on the opinions and the common practice of nurses taking care of physiological newborn infants were conducted. Investigation reveals that nurses working in departments of physiological newborn infants mostly work according to present-day trends of care of physiological newborn infants.
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A healthcare assistant as a member of the nursing team
DUŠKOVÁ, Jitka
The Bachelor thesis deals with the profession of a healthcare assistant and acceptance of a relatively new healthcare staff category to a nursing team. The field of study of healthcare assistant has substituted the previous field of General Nurse at secondary medical schools within the changes of the nurse education conception. This change has shifted the field of general nurse to the tertiary level. The profession of a healthcare assistant should not be a marginalized part of a nursing team. The multilevel system of nursing care provision belongs to new trends in nursing and requires a nursing team consisting of staff of various qualification levels. Competences of a healthcare assistant are subordinated to nurses; assistants provide nursing care under supervision of a physician or a general nurse. They are entitled to performing a narrower range of activities mostly aimed at the basic nursing care. This new healthcare profession is becoming an important element and it is necessary to accept a healthcare assistant as a full-valued nursing team member. The theoretical part of the Bachelor Thesis deals with development of nursing and nursing education. It also contains information related to the healthcare assistant profession. The aim of the practical part was to find out whether general nurses are interested in including a healthcare assistant into their nursing teams and whether they know the competences of healthcare assistants. A quantitative research method in the form of a questionnaire was used to obtain results of the research. The questionnaires were designed for general nurses and distributed in the Central Military Hospital in Prague at the departments where healthcare assistants worked. The research results were presented in graphic form and evaluated in final discussion. The Thesis may be used for wider information on and closer insight into the issue, both for students and general nurses as well as nurse managers.
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Continuing Professional Education of Nurses Working in Outpatient Facilities
ADAMOVÁ, Kateřina
This bachelor thesis focuses on the lifelong education of nurses employed at outpatient physician offices. We tried to ascertain whether nurses employed in the outpatient segment feel the need for lifelong learning, whether they are supported by their physicians-employers within the lifelong education process, and what forms of lifelong learning they prefer. The results of the questionnaire research imply that the nurses feel the need for lifelong learning and most of them would educate themselves even without being obligated to do so by law. As regards different education activities, the nurses prefer participating at seminars. A majority of the physicians-employers support their nurses in the lifelong education process.
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Patient's perception of nursing practice provided by students of nursing.
ČÍŽKOVÁ, Marie
The topic of the thesis is "Patient's perception of nursing practice provided by students of nursing?. Nursing practice during the study is an important factor helping make a good nurse from a student. It is the combination of theory and practice in general nursing students which is essential for the educational process improvement. In nursing practice, it is important to interact with patients. Everything happens through interaction and communication, which is significant in terms of the professional conduct every medical staff member should learn during the study. This ability leads to the establishment and development of contacts with the patient and greatly affects the way the patient perceives the nurse. The aim of thesis is "To find out how the patient perceives the students performing nursing practice in hospital.? Therefore, the following hypotheses were stated: Hypothesis 1: "I assume the patients respect the students in nursing practice," which was confirmed, Hypothesis 2: "I assume that patients are scared of some nursing procedures provided by students,? cannot be confirmed, and Hypothesis 3: "I assume that younger patients are more critical to practicing students than older patients," cannot be confirmed. The second aim of the thesis is ?To find out how the patient perceives the students practicing in hospital?. This relates to Hypothesis 4: "I assume that patients are satisfied with the nursing students´ practice," which was confirmed. Another part of the thesis was answering the stated research questions. 1st research question was "What leads the patients to refuse a nursing procedure provided by students?" These were mainly the lack of the students´ experience, the patients´ distrust of the students and the patients´ pain and shame. 2nd research question was "Are the patients informed that there are students performing nursing practice in this ward?" 2 of 4 patients were informed about this fact. To obtain the necessary data both the qualitative and quantitative research were used. The qualitative research was carried out through non-standardized interviews. The quantitative research method was a questionnaire survey. The questionnaires were designed for patients at the departments where the general nursing students´ practice takes place. The questionnaire survey and non-standardized interviews were conducted in České Budějovice Hospital, plc.
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Role of healthcare assistants and nurses in the nursing process.
VODIČKOVÁ, Petra
This thesis treats the issues regarding the role of healthcare assistants in the nursing process and their mutual cooperation with general nurses. Four goals were set. The first goal was to ascertain in which way the general nurses allow the healthcare assistants to engage in the nursing process. The second goal was to ascertain what are the healthcare assistants? opportunities to participate in the nursing process. The third goal was to determine what problems are seen by managers regarding the integration of the healthcare assistants in the nursing care system. The last, fourth goal, tried to ascertain whether the system of integration of general nurses and healthcare assistants in the nursing team contributes to improvement of the patient?s care. The thesis is divided into two parts: theoretical and practical one. The theoretical part deals with the nursing process as a method of work of a nurse, qualification training of general nurses and healthcare assistants and possibilities of finding vacancies in the nursing practice. The practical part consists of quantitative-qualitative research survey. For the qualitative research a method of individually conducted, pre-prepared interviews with representatives of the above mentioned professions. Four research questions were determined, i.e.: 1. To what extent are the healthcare assistants, general nurses and managers in positions of ward sisters aware of the nursing process? 2. Have the healthcare assistants a possibility to use their knowledge of the nursing process pursuant to Act No. 96/2004 Coll.? 3. Is the cooperation of healthcare assistants and general nurses perceived as a positive element for improvement of nursing care? 4. What experience have managers in the position of ward sisters in integration of healthcare assistants into the nursing team? The surveyed group consisted of six healthcare assistants, six general nurses and eight ward sisters-managers from minor inpatient facilities in the Pilsen region and Cental Bohemian region. Qualitative research was realized through a survey by questionnaire. Students of the last grade of the study field ?Healthcare assistant? and the study programme ?General nurse? were addressed. For the qualitative part of the research survey the following hypotheses were set: 1. Students of the study field ?Healthcare assistant? are oriented in the competences of healthcare assistants and general nurses in accordance with At No. 96/2004 Coll. 2. Students of the study programme ?General nurse? are oriented in the competences of healthcare assistants and general nurses in accordance with At No. 96/2004 Coll. 3. Students of the study field ?Healthcare assistant? perceive the determined competences for individual fields as a tool for quality professional care. 4. Students of the study programme ?General nurse? perceive the determined competences for individual fields as a tool for quality professional care. In total, 200 questionnaires were distributed, and subsequently, 142 of correctly completed questionnaires were evaluated. The output of this thesis is the verification of the present status of the issue in question. The results will be provided to nursing care managers in the researched healthcare facilities where they could help to improve the management of healthcare activities. The results may be also used to prepare informational and educational sessions clarifying the rules of cooperation of healthcare assistants and general nurses. Furthermore, the results could be offered to the Ministry of Health of the Czech Republic, namely to the Working Committee for transformation of non-medical healthcare professions in the Czech Republic the main work objective of which is the amendment of Act No. 96/2004 Coll.
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Safe Nursing Care
HAVELKOVÁ, Hana
Patients{\crq} safety is a global problem and we are increasingly thinking about the possibilities of improving the quality of care provided. This is a priority for all health care providers, including nurses. We must not forget the patients and their close family because they are our partners and the nurses should seek to ensure that the patients themselves are actively involved in the care of their health and play an important role in preventing some unwanted errors. The theoretical part of the thesis is devoted to a detailed analysis of the concept of safety and safe care and the associated negatives. The goal of the thesis was to determine which resources are used to maintain the level of safe nursing care by nurses with specialized training. Six hypotheses were determined. The quantitative survey technique was used to achieve the objectives of this thesis and to verify the hypotheses. The group consisted of nurses from all over the Czech Republic in the month of February 2010 studying on a specialized training course of the NCO/ NZO (National Center of Nursing/ Non- medical health disciplines) in Brno. The results imply that the nurses interviewed do not use enough resources to help reduce the risk of errors leading to an increase in the level of safe nursing care. The proposed measures are intended to increase the use of resources for maintaining the level of safe nursing care which is a clearly dependent on the awareness of their existence. This also strongly urges management to make more use of various resources and inform all medical staff not only nurses about new procedures and analyses carried out on a regular basis. Managers should conduct a regular and detailed analysis of past errors or incidents to establish the risk of error and take steps to minimize such unwanted events. The results of the survey will be provided to the professional public, published in professional journals and can serve as a basis for comparing other survey research.
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Factors of discontent among nurses and their impact on care quality at a cardiac surgery department.
ERETOVÁ, Zuzana
Occupation of a general nurse belongs to demanding jobs in terms of professional preparation and performance. A nurse is expected to cope with professional activity, working with modern technology, administrative work, to bear the physical and mental load of her profession, to be able to influence and direct patients? feelings and behaviour and finally to be able to cope with professional as well as family problems she is faced to. All this is often dealt with in continuous operation on shift basis at various specialized workplaces. Questions how nurses working at a cardiac surgery department are satisfied or dissatisfied at their jobs, how the work experience length affects their satisfaction, whether possible discontent among nurses may affect quality of the nursing services provided by them and how the hospital management reduces the factors of discontent, became the subject of my thesis. The research was performed at the IKEM in Prague. Quantitative as well as qualitative research methods were used for data collection when mapping the problems in question. The quantitative part involved a questionnaire both, for general nurses working at the cardiac surgery department, aimed at investigation into the discontent factors involved in their occupation, and for the patients undertaking treatment at the cardiac surgery department, to examine their satisfaction with the nursing care. Analysis of the collected data was then performed. An interview with representatives of the hospital line, middle and top managements was the instrument of the qualitative research. It was focused on the question how they proceed in elimination or reduction the discontent factors. The following facts were found out by the quantitative research. Increased physical and mental load, non-cooperating patients and care about more patients at the same time, extensive administration related to patient care, insufficient remuneration, lack of communication from doctors and superiors, lack of auxiliary staff, projection of occupation to private life or the problem of sleeping after a night shift are the most frequent discontent factors. Despite the above negative factors nurses are satisfied with their jobs regardless the length of experience. The indentified factors of discontent do not affect quality of the care provided by the nurses. The qualitative research results show that personal talks, active interviews and direct communication from the staff are the most frequent methods the management uses to map staff satisfaction. The management representative is able to work herself on elimination or reduction of the discovered factors of discontent within her competences, which happens most often. She may also cooperate with the chief nurses or ward sisters. Unless she is able to solve a problem, it is passed to the authorized persons competent to deal with it (health care manager, social-legal department, HR department). The hospital director is also informed on the most serious cases. The management hardly ever cooperates with physicians on elimination or reduction of the discontent factors. The most important aspect of solving the problem of discontent factors is its subject, which affects the solution method, whether it is to be dealt with by an individual or the whole team. They inform the head physicians or the ward chief consultant on serious problems. The course of the problem solution is communicated to the employees by the ward sisters or chief nurses personally, orally.The goals of the thesis have been met, the set hypotheses have been refuted, and the research questions have been answered.
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Nurse as Risk Manager in the 21st Century Hospitals
LAŠTOVKOVÁ, Marie
The main intention of this thesis was to monitor the activities of nurses as risk managers in selected healthcare facilities. The first objective was to map the current state of accreditation procedures in the Czech Republic, the number of accredited facilities and the types of accreditation. Another objective was to find out in which healthcare facilities there is a nurse as a risk manager or who has the responsibility of a risk manager in healthcare facilities. The third objective was to explore the activities of nurses - risk managers. To achieve these objectives, the following research questions were set: 1st What is the current state of accreditation procedures in the Czech Republic? 2nd In which accredited facilities there is a nurse - a risk manager? 3rd research question: What are the activities and roles of a nurse - a risk manager? (What activities nurses carry out in the performance of their duties; whether nurses feel a change in the provision of nursing care; which risks and incidents nurses encounter in their facilities and what are their solutions; what is the level of communication between the parties in the risk management process in a given facility; which benefits are seen in risk management). The research was conducted with respondents from those healthcare facilities that were willing to cooperate. The research conducted is a qualitative one. The respondents underwent interviews according to the structure of categorized questions. Subsequently, transcripts of the interviews were made as well as the analysis and categorization of the data was carried out and presented in tables under the framework analysis according to Ritchie and Spencer. The research revealed the answers to the research questions. In no of the facilities that have responded to the questions there is a nurse with the function of a risk manager. Activities within the risk management are taken over by staff at other positions, mostly quality managers, head nurses or auditors. Detailed proportion of these functions is clearly presented in the accompanying graphs. Research question 3 yielded a great number of responses. For example, nurses who have competence in risk management play mainly the roles of communicators, defenders, authors, auditors and mentors. In exercising their functions, they have observed changes, as compared with the past, in the responsibilities of nurses, patient activity, greater transparency, the quality and safety of the care provided. They describe in detail the risks and incidents which they have met at their workplaces, and how they have been solved. The respondents see the advantages of risk management in the fact that it is a good tool for defending not only patients but also nurses themselves; that it is a tool to increase responsibilities and activities of patients and to improve the quality and safety of the care provided. All the responses are clearly presented in tables and confronted with the knowledge derived from professional literature and our own experience. The results of the thesis can be provided to the healthcare facilities where the research has been carried out; it could be provided to competent institutions and also, in the form of an informative brochure, to nurses and other healthcare personnel. We would suggest a higher level of education about risk management potential. Our suggestions also include changes to legislation - powers, the establishment of clear procedures and rules, and the regulation of education in risk management so that implementation of this tool is unified and becomes accessible to all facilities.
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Formation of Nursing Documentation and its Usage in the Home for Seniors Chýnov
CHAMROVÁ, Anna
Nursing documentation is becoming an important part of the medical documentation and it is an integral part of the nursing process in the homes for seniors too. The theoretical part of the Bachelor thesis ``Formation of Nursing Documentation and its Usage in the Home for Seniors Chýnov{\crqq} contains chapters concerning the nursing process and nursing documentation. Further this part deals with the characteristics of the Home for Seniors Chýnov and with the specific problems and needs of geriatric clients in particular the clients suffering from Alzheimer dementia. The target of the work is to make nursing documentation in the Home for Seniors Chýnov, to apply it in this establishment and to find out whether the availability of this documentation influences the holistic attitude of nurses to the client. The first stage of the research part involved formation of the new documentation and its application in the Home for Seniors. The respondents had an opportunity to work with the documentation in the months of January and February 2010. In the second part we tried to survey opinions of the respondents of the made documentation. Four research questions were preceding the research. Research question number 1: Shall the nurses working in the Home for Seniors Chýnov accept the newly made documentation as a part of the medical documentation? Research question number 2: Shall the nurses working in the Home for Seniors Chýnov refer to time consuming work with the documentation? Research question number 3: Has the new documentation influenced communication among the members of the nursing staff? Research question number 4: Shall the newly made documentation contribute to the change of the nurses´ opinion of the patients from the holistic philosophy point of view? To fulfil the set aims there was carried out the qualitative research using the method of questioning and semi-standardized interview. The research set consisted of 7 respondents (general nurses) working in this establishment. Considering the research results we suppose that the work target has been fulfilled. The research has proved that the newly made documentation has improved communication among the members of the nursing team and the nurses have accepted it as a part of the medical documentation. The aim of the work was making a quality nursing documentation which should be simple, not time consuming and which should be focused on specific needs of the clients of the Home for Seniors Chýnov. The thesis has practical contribution.
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