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Cooperation of nursing staff with the ostomy nurse
HÁLOVÁ, Kateřina
The bachelor thesis is focused on cooperation between stoma nurses and general nurses, their procedures in the education of stoma patients, and nursing problems related to stomas. The bachelor thesis is divided into two parts - theoretical part and research part. The theoretical part contains characteristics of a stoma nurse, stoma, stoma indications, complications and appropriate stoma care. It also defines cooperation among healthcare staff, and education of ostomates. The research part is focused on cooperation between stoma nurses and general nurses, education of ostomates, and the most common nursing problems related to stomas. Two objectives were set for the research part, namely: To explore cooperation between nursing staff and stoma nurses. To identify the most common nursing problems encountered by stoma nurses in the education of nurses. This part had the form of a qualitative research survey using semi-structured interviews. Interviews were taken with two research sets. The first set consisted of three stoma nurses and the other one of four general nurses. After theoretical saturation was reached, the information was processed in the form of open coding and was subsequently categorized into seven categories. The results show that cooperation between stoma nurses and general nurses in taking care of ostomates is very common. In most cases such cooperation involves professional help in dealing with complications, provision of stoma care supplies, or patient education. Concerning the second objective, it has been found out that the most common problem in the education of nurses is poorly cut holes in ostomy bags and subsequent occurrence of complications. It has also been found out that stoma nurses try to educate staff in accordance with their nursing procedures so that the education of patients is of the highest quality possible. The findings were used to create an information material for nurses and students of nursing professions.
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The impact of colostomy on the patient's life
JELÍNKOVÁ, Adéla
This bachelor thesis is focused on the problems of colostomy patients, especially on changes in life from previous life without the colostomy. The aim of this work was to find out what changes occur in life of patients with colostomy. To achieve the goal, we used a high-quality research survey that was conducted through semi-structured interviews with colostomy patients and stomist nurses. In the research, we found many facts about the changes in the lives of these patients. There have been changes mainly in their social life, eating habits, defecation; fewer changes have occurred in the social sphere, including jobs, sporting activities, hobbies and even travel. From interviews with patients, we have also confirmed the complications that appears after establishment of colostomy. These were particularly early complications, especially of the skin nature (redness, soreness, skin maceration, rash). Another, very fundamental change in life of these patients has been the treatment of colostomy. With this change, patients are helped by a stomist nurse who helps them with choosing stomic aids and teaches them how to take care of colostomy on their own. From interviews with stomic nurses, we learned about changes in the psyche. Patients experience depression, embarassement, inferiority complex and social isolation. The help of patient's family is very important while helping with these issues. The elaboration of this work created a clear material for seminars of health workers, especially nurses.
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Cooperation of a stoma nurse with multidisciplinary team
VOTRUBOVÁ, Veronika
A stoma is an opening of a hollow organ on the surface of the body. The care for a stoma aims at returning a patient to ordinary life and it is exactly in this process that a stoma nurse should help the patient. The stoma nurse guides the patient through the pre-operative preparation, the post-operative preparation and also through the outpatient preparation in which the patient visits the stoma nurse in a stoma clinic. Cooperation of the stoma nurse with other members of the multidisciplinary team is important because it makes it possible for the stoma nurse to meet all the needs of the patient. The theoretical part deals with the anatomy and physiology, definitions stoma stoma and also the history of its development in nursing. The next chapter deals with the indications, types of stoma and possible complications. The chapters on preoperative and postoperative care, nutritional advice and clubs for stoma patients. Other chapters are devoted to stoma nurses. The primary intention of the thesis is to meet one objective which is to find out how a stoma nurse cooperates within the framework of a multidisciplinary team in various departments of a healthcare facility. The following hypothesis was set for this objective: "The integration of a stoma nurse in a multidisciplinary team is different in every department." The research question was: "How is a stoma nurse integrated in a multidisciplinary team?" The research was carried out by means of a quantitatively qualitative investigation. A method of questioning using the technique of questionnaires was used for collecting data in the quantitative research of the bachelor's thesis. The questionnaires were addressed to nurses in the internal medicine and surgical wards. The collected data were evaluated by means of processed graphs. The qualitative research was carried out with stoma nurses in the surgical ward by means of interviews. The quantitative survey implies that the shift nurses in a surgical ward cooperate much better with the stoma nurse than nurses in an internal medicine ward. In the surgical ward the cooperation is better in terms of communication with shift nurses because they exchange information about patients with stomas, the occurrence of complications and the nursing procedure. On the other hand, in the internal medicine ward this communication in many cases does not work. In most cases the nurses at the internal medicine ward do not feel a need to communicate and discuss the care for a patient with the stoma nurse. The stated objective was achieved using the research question and the confirmation of the hypothesis. From a qualitative investigation implies that stoma nurses are integrated in the education of patients before and after operations. The pre-operative preparation includes also the drawing of a suitable place for a stoma on the body of a future stoma patient. In most cases they discuss a suitable procedure of caring for a stoma patient with shift nurses and inform each other about the occurrence of complications. If they are interested, the stoma nurse informs the nurses of new appliances and findings from seminars. She has got also her own specific documentation where she writes down details about patients. Two stoma nurses also point to the option of cooperating with a nutritional therapist as a part of the nutritional consultation of a patient with a stoma. When cooperating with a physical therapist the stoma nurse informs him of the patient's overall condition and the physical therapist provides total rehabilitation. The results of the findings established by this bachelor's thesis will be provided to the management of hospitals where this research took place.
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The importance of the ostomy nurse for the surgical department
ZRONKOVÁ BROŽOVSKÁ, Alena
Surgical procedures of gastrointestinal diseases often lead to the creation of an ostomy. The number of clients with an ostomy is increasing as the Czech Republic ranks among the countries with the largest incidence of malignant colon disease. Health care professionals in any field can often encounter the client with a stoma. Therefore, it is essential for them to understand and manage this issue well. Nursing care of such individuals is very extensive and specialized. Nursing team usually focuses only on physical care but other problems associated with stomas are pushed aside. The only highly knowledgeable and qualified expert in this area is a stoma nurse specialist (an ostomy nurse). This thesis deals with the importance of the role of the stoma nurse specialist in the postoperative phase from the perspective of nurses from surgical departments as well as from the perspective of patients with a colostomy. The thesis is divided into theoretical and empirical part. The theoretical part is further divided into four chapters: colostomy, care about stoma patients, life with a colostomy, an ostomy nurse. Two objectives were determined for processing of the empirical part. We used a combination of quantitative and qualitative research to achieve our goals. The first objective was to determine whether general nurses have the knowledge to care for a client with colostomy in the postoperative phase. To obtain data for the quantitative part of the survey the method of anonymous interviews using a questionnaire, in which the research group was formed by general nurses, was selected. The survey results revealed that nurses have sufficient knowledge to treat and educate clients with a stoma. Although not all general nurses encounter colostomy patients, they widely believe the knowledge of this issue is important for the occupation of a nurse. For the quantitative part three hypotheses were selected and tested statistically. Hypothesis 1: General nurses have the knowledge to treat the client with a colostomy. It was confirmed. Hypothesis 2: General nurses have enough knowledge to educate the client with a colostomy. It was confirmed. Hypothesis 3: General nurses positively evaluate the benefits of an ostomy nurse in care for stoma patients in the postoperative phase in the surgical department. It was confirmed. The second objective was to determine the significance of the stoma nurse for clients with a colostomy. For the qualitative part of the survey the method of direct questioning by means of a semi-structured interview with open questions was chosen. The study group consisted of patients with a colostomy. For this part of the survey a research questions was specified: What is the importance of an ostomy nurse for the stoma patient in the postoperative period? We concluded that the ostomy nurse is viewed as an educator, counselor and psychological support. The ostomy nurse is the only one who can provide stoma clients with coherent and comprehensive information they need to live with a colostomy. Both groups of respondents agree that the stoma nurse is the irreplaceable specialist. Shift nurses fail to provide comprehensive care stoma patients need. An ostomy nurse needs to be a part of nursing care not only in the postoperative phase, but also in the preoperative period. There is need for closer cooperation between general nurses and the ostomy nurse. Nurses indicate their willingness to be educated in this area, while preferring seminars, lectures and conferences. The results also led us to create information material Care of the client with colostomy, as the nurses indicated that they would welcome a brief, clear, visual information material.
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Meet the psychosocial needs of stoma patiens
GREGOROVÁ, Jana
For a person stoma means change both in the health as well as psychosocial area. It is necessary to perceive the person as a bio-psycho-socially-spiritual being requiring satisfaction of all his/her needs. Shortage of satisfaction of psychosocial needs can have very serious impacts on the overall health condition of the client. Stoma nurses and stoma clubs significantly contribute to satisfaction of needs. Stoma nurses deal not only with a preoperative, postoperative care for stoma suffering people, their education but they also help them to solve problems, which occurred in connection with stoma, answer their questions and are their consultants and support. Stoma nurses are a great benefit for stoma suffering people and their families. Stoma clubs are voluntary associations where people suffering stoma meet. Their task is to defend the interests and rights of stoma suffering people, organise meetings, special seminars, cultural events and stays. Versatile activity of the clubs is involved in client?s stoma adaptation, improvement of his/her life and making satisfaction of psychosocial needs easier. The target of the Diploma Thesis was to find out the most frequent psychosocial problems of stoma patients and whether stoma stresses more ileostoma patients than colostomy ones. Targets of the thesis were met. There were defined five hypotheses for the targets. First hypothesis dealt with the question, whether stoma patients suffer lack of satisfaction of psychosocial needs. Second hypothesis analysed, whether stoma disturbed partner life of the stoma patient. Third hypothesis analysed, whether stoma nurses bring benefit to a stoma patient and the fourth one, whether stoma clubs are beneficial for a stoma patient. These hypotheses were proved. The fifth hypothesis analysed, whether stoma stresses more ileostoma than colostomy patients. This hypothesis was not proved. To collect data I used the form of quantitative research using non-standardised questionnaire for people suffering ileostoma and colostomy. This Diploma Thesis shall point out the necessity of satisfaction of psychosocial needs of stoma patients in practice.
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The problems of nursing care in children with stomia of small and large intestines
BARTYZALOVÁ, Martina
The bachelor thesis is aimed at the problematics of the children patiens with stomia. Stomia is the taking out of the small or large intestine out of the body. The most often indications with insomia is to remove the large intestine, inborn development defect and the necrotising enterocolitidis (NEC). The most often reasons for the by-passing with the colostomy are also the development defects and the Hirschsprung desease. Children with the stomia are few in the Czech Republic. They are mainly newly-borns or suckling infants, with whom stomia is tempoval. Children with this desease are usually taken care of by the parents in the home invironment. The parents are dependant on the assistance of a stomia nurse, which educates them and informs about everything connected with the illness. The goal of the bathelor thesis is to map the needs of the children with stomia of the small and large intestine and specify the needs of the nursing care. The work was also aimed at the task of the stomia nurses caring for the children with stomia. A qualitative research with the method of questioning was applied together with the discussion method with the parents of the sick children and the stomia nurses, who have already had experience with caring for the children with the stomia disease. All in all ten parents have been contacted, six of which have participated in the interview. Fourteen stomia nurses have been contacted, but due to little experience with treating the stomia children just three of them have been interviewed. The respondents came from various parts of the Czech Republic. As for the specifics of the nursing care we were interested in three aspects of the nursing care. The first sphere was skin care, where it was found out that the parents of the children with ileostomy should pay special care to the skin in the place around stomia. It is caused by the fact that ileostomy takes out watery and agressive substance, which causes skin damage in the place of stomia. Another important fact was that the patents use common children cosmetics, which is considered to be absolutely unsuitable for the children with stomia. It is also important to mention that due to a wide choise of stomia amendments the nursing care is on a much higher level than before. As for catering it was found out that newly-borns and suckling infants should be breast feaded and with the ileostomics the stool should be was thickened by adding rice puding without milk. The third sphere was evacuation. Childer with stomia evacuate in a specific way with the help of bags and systems. It was found out that the most suitable system for children with stomia was the simple one. The other goal was to map the needs of stomia children. From the research it was found out that stomia has a negative effect on the quality of life of both the children and their parents. Stomia affects the life socially but mainly mentally. As for the mental aspects it was found out that the services of psychiatrists are not used. It is also supported by the fact that just one parent out of six uses consultations with the stomia nurse regularly, who should be their main support. It was also found out that every child cried while stomia was treated. From the social side it was found out that children with stomia can be isolated from other children at kindergartens and schools. Stomia also restricts children when doing sport and other activities. As for the fysiological needs, they have already been mentioned in the specifics of the nursing care. The last goal was to find out what role in treating children stomia the stomia nurse plays. It was found out that the education of the stomia nurse is very important for the parents of the children with stomia but their opinions do not coincide. Some nurses say that they educate the parents before and after the operation, but we have found out that it was not true. Very few parents were educated before and after the operation.
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Reality of cooperation of a stoma nurse with shift nurses.
KRATOCHVÍLOVÁ, Markéta
Abstract Reality of cooperation of a stoma nurse with shift nurses Pernicious diseases of intestines and rectum often lead to creation of a temporary or permanent intestinal outlet alias stoma. Having been diagnosed, the patient is confided to the care of healthcare workers, in particular nurses, who endeavour to provide the patient with the highest possible quality care in the most intensive manner. At present, almost every hospital has a specially trained stoma nurse who should play the role of an advisor or coordinator in the nursing team. Regrettably, non-cooperation between shift nurses and the stoma nurse harm in particular the patient. Five hypotheses were raised. The first hypothesis was to confirm whether the shift nurses on surgical wards cooperate with the stoma nurse more efficiently than the shift nurses in other than surgical wards. This hypothesis was confirmed. The second hypothesis was to confirm whether the stoma nurse provides the shift nurses with regular information on developments in the concerned area. This hypothesis was not confirmed. The third hypothesis was to confirm whether the shift nurses cooperate with the stoma nurse as early as in the period before the operation; this hypothesis was aimed at surgical nurses and was not confirmed. The fourth hypothesis was to verify whether the shift nurses have sufficient information from the stoma nurse so that they could substitute her adequately when she is absent. This hypothesis was not confirmed. The fifth hypothesis verified whether the shift nurses ask the stoma nurse to provide them with information concerning correct handling of the stomal equipment. This hypothesis was not confirmed. The data were collected in the quantitative research supplemented with an interview with the stoma nurse. The shift nurses in surgical and non-operational wards obtained anonymous questionnaires. The research was conducted in seven hospitals in the Region of South Bohemia. The objectives were fulfilled. The information will be provided to deputy managers for the nursing care and stoma nurses. We believe that our results may contribute to higher efficiency of the cooperation between nurses, which will have a positive impact on provision of comprehensive care of patients with a stoma.
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Informedness of stomia patients before the surgery
SOUKUPOVÁ, Alena
In this bachelor thesis, we discuss the awareness of ostomates prior to an operation. The awareness and education is considered an integral part of quality and professional care for the patient. If the patient receives sufficient and comprehensible information, they become part of treatment, diagnostics and overall health care process, thus assuming a proactive role in their health care. The objective of our thesis was to find out how ostomic patients are informed prior to an operation and map the education process and compare information for a planned and acute operation. A quantitative method was selected to achieve the objective, using an anonymous question form. We approached ostomic patients as respondents. The results show that even though awareness has quite improved since the past years, deficiencies are still seen in many cases. Some information is not understood or sufficient for the pacient. As we expected, patients coming for a planned operation are better informed than patients arriving in acute cases. But in spite of an acute operation, the patient should be briefed and educated. The education process prior to a resection operation is again Better quality for planned operations. Unfortunately, pacients coming for an acute operation are deprived of such education. The education process can make the patient less afraid and their vision of future life is clearer.
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Specific eating habits of a stoma clients
OSADČÍ, Jana
This work focuses on eating habits of patiens with colostomy and ileostomy and their personal experience with observing the given nourishing rules. The number of such patients has been growing in the Czech Republic in the last time. Introduction of colostomy or ileostomy is a very difficult situation for every patient. When adapting to the new situation the patient needs all possible professional care. Many changes enter his life and one of them is the change in eating habits. There is no universal diet at present that could go for all such patients. In spite of the fact that correct nourishment and drinking regime are the most important for them. That is why we were interested in the patients experience in the area of nourishment. This work had two targets. The first one concentrated on the specific eating habits of the patients after colostomy and the other one the specific eating habits of the patients after ileostomy. There were two hypotheses connected with the targets. The first hypothesis tried to find out, whether the patients with colostomy have their specific eating habits. The other hypothesis tried the same for the patients with ileostomy. To be able to achieve the targets a quantitative research has been applied, implemented by means of an anonymous questionnaire. The questionnaire contained 27 questions. The data were collected in March 2009. 100 questionnaires were distributed, 80 percent of them were returned. This work has confirmed the fact that there is no universal diet that could be applied for all the patients. The nourishment must adapt to the individual requirements, because different people react in a different way to individual food and they must try out, what suits them. In this way they themselves find out the best eating habits with the course of time, they will not feel restricted and they will stop being afraid of the negative effects of food.
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