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Prevention of catheter infections in patients in the need of critical care
SVOBODOVÁ, Alžběta
Current status: The term sepsis refers to a systemic inflammatory response to the presence of an infection. The highest mortality rate associated with bloodstream infection is linked to severe septic shock. The most commonly used invasive bloodstream inputs include peripheral and central venous catheter, arterial catheter also included are PICC and Midline catheter an alternative method of securing the venous system in intraosseous entry. The aim of this study was to describe the spectrum of nursing practices that minimize the risk of catheter infections related catheter infections and to evaluate the skills of nurses in the area of vascular access care. Methodics: Qualitative research methods using semi-structured interviews and participant observation were employed for data collection. The research was conducted in selected hospitals of the Vysočina Region and the South Bohemia Region. It was a deliberate selection. Nurses working in intensive care units (i.e. anesthesiology and resuscitation departmen and unit critical care) were approached. Covert observation was conducted to ascertain compliance with nursing standards and uncover errors in the care of invasive vascular access. The size of the research sample was determined by theoretical data saturation. Results: The survey shows that the interviewed general nurses have sufficient knowledge in the field of catheter infections to reduce their incidence. Participant observation, specifically peripheral venous cannula insertion, revealed that nurses do not check the expiration of the necessary equipment for this procedure. Furthermore, there was a lack of hygiene and epidemiological precautions and disposal of the needle from the cannula in the sharps box. There was evidence of not using a sterile table but only sterile instruments, improper hand hygiene and use of personal protective equipment when treating a central venous catheter. Conclusion: The outcome of this diploma thesis is a set of recommendations for non medical healthcare personnel.
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Training of non-technical skills as a prevention of errors in intensive care
SVÁROVSKÁ, Tereza
The main goal of this work was to map the current state of training in non-technical skills. Training in non-technical skills can contribute to improving the safe care of critically ill patients in intensive care units, where situations are often demanding, stressful, and tense. Maximum concentration, precise commands, and teamwork are necessary in these work-places. The theoretical part establishes the foundations for understanding concepts such as intensive care, non-technical skills, or simulation-based education and their relevance. The research was conducted with students in the Advanced Nursing Specialization in Intensive Care, who, thanks to simulation-based education, are aware of acquiring non-technical skills and practice them in specific simulated scenarios. The second research sample consisted of nursing staff working in intensive care units, who are exposed to stressful situations daily, and therefore should know and use the basics of non-technical skills to per-form their duties in order to prevent as many errors as possible, which can have fatal consequences. The objectives of the work focused on mapping the current situation in the training of non-technical skills in intensive care units and in student education. Another goal focused on the experiences and subjective feelings of healthcare professionals and students with training in non-technical skills in crisis situations within intensive care and during simulation-based education. The final goal aimed to identify methods and techniques of training in non-technical skills that are most effective for healthcare workers and students in intensive care, considering their specific needs and obstacles. The research was conducted using qualitative inquiry method, employing semi-structured interviews with nursing staff and students undergoing simulation-based education, along with non-participant overt observation during the mentioned simulation-based education.
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Pre-hospital and intensive care for patients after a stroke
KULHAVÝ, Jakub
The thesis is divided into two main parts (theoretical and empirical) and deals with prehospital and intensive care for patients with stroke. The thesis has a total of three objectives. The first objective was to map selected aspects of the process of providing prehospital emergency care to patients suspected of having an acute stroke. The second objective was to describe the course of intensive nursing care for patients after a stroke, and the third objective was to determine the differences in nursing care between patients with ischemic stroke and hemorrhagic stroke. The empirical part focused on studying medical and, primarily, nursing documentation. The obtained data were processed using a quantitative research method based on retrospective data analysis, which was then interpreted. The data was recorded in record sheets created specifically to adhere to the predetermined objectives and hypotheses. The contribution of the thesis is primarily its unusual approach to the issue, addressing at the same time both prehospital and intensive care for patients after both ischemic and hemorrhagic strokes. The results indicate that crucial aspects of prehospital care include correct and rapid diagnosis, assessment of vital functions, consultation of the condition of a patient with a stroke physician and rapid transportation to the nearest appropriate medical facility. The course of intensive care focuses primarily on continuous monitoring of vital functions and their potential stabilization combined with comprehensive nursing care, which depends on the level of self-sufficiency of a patient and includes all care for basic human needs, primarily aimed at restoring the patient's ability to manage basic daily activities. In summary, it could be said that patients with hemorrhagic stroke required more demanding and comprehensive nursing care compared to patients with ischemic stroke.
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Acute postoperative complications in surgical intensive care units
HLOBILKOVÁ, Magda
The master's thesis addresses the issue of acute postoperative complications in the conditions of surgical intensive care units from the perspective of a nurse. The thesis consists of theoretical and empirical sections. The theoretical section focuses on the issues of surgery, intensive care units, and acute postoperative complications. The empirical section includes the research's objectives, methodology, and results. Three objectives were set to elaborate on the master's thesis. First objective: To determine the relationship between the length of practice, the highest level of education attained, and nurses'orientation on the issue of acute postoperative complications. Second objective: To determine nurses' interest in education regarding acute postoperative complications. Third objective : To map the most common acute postoperative complications in surgical intensive care units. The research part of the master's thesis is addressed through a combined research approach involving nurses from surgical intensive care units with different lengths of practice and the highest levels of education attained. The research was conducted in four South Moravian and Zlín hospitals. The quantitative part of the research was carried out through non-standardized questionnaire surveys. The research sample consisted of 138 respondents. The qualitative part was conducted through semi-structured interviews with 10 nurses. Several conclusions can be drawn from the research that was conducted. A statistically significant relationship was observed between nurses' orientation on the issue of acute postoperative complications, length of practice, and the highest level of education attained. With increasing length of practice, nurses' orientation also increases, as does the level of highest education attained. Participating nurses show interest in education on the issue, which the employer does not sufficiently compensate. The most common acute postoperative complications in surgical intensive care units, from the nurses' perspective, are pain and acute bleeding. The output of the diploma thesis is a proposal for the content of a seminar to increase nurses'orientation in specific acute postoperative complications.
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History and development of intensive care
KADLECOVÁ, Eva
The thesis deals with the history and development of intensive care with emphasis on the Czech lands. Its aim is to describe the historical development of intensive care and nursing in the Czech lands with an emphasis on aspects (such as new techniques, devices, etc.) that have determined this process. The core of the thesis consists of three main chapters. The first one establishes the basic premises of the work, focusing on the definition of intensive care, the history of medicine, and nursing. The second main chapter analyzes the beginnings of intensive care in an international context, emphasizing the influence of Florence Nightingale on the emergence of intensive care and the reflection of her work in the Czech lands. The third chapter describes the history and development of intensive care and nursing in the Czech lands, with this exposition being divided into chronologically arranged subchapters. The thesis is primarily based on historical sources (primarily contemporary publications and journal articles reflecting the discourse of the time) and professional literature. The communist Czechoslovakia period is reflected as an important period when contact between Czechoslovak medicine and Western knowledge was significantly limited, and intensive care as well as nursing were heavily ideologically conditioned, leading to lagging behind the West in many aspects.
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Monitoring in neurointensive care
BAXA, Radim
Monitoring in neurointensive care is one of the important parts of caring for a patient in critical condition. Monitoring enables tracking of values and parameters continuously or intermittently over time. It evaluates the patient's current condition and draws attention to possible changes that may occur as a result of the development of a primary disability, and warns in time of the development of a secondary disability. Neuromonitoring is divided into invasive and non-invasive monitoring. The main goals of the presented work were to detect the knowledge of nurses and paramedics from the environment of the anesthesiology-resuscitation department in the field of neuromonitoring. To discover whether nurses and paramedics in the anesthesia-resuscitation department are familiar with neuromonitoring procedures. And the final goal was to find out whether the recommended procedures are followed in the framework of neuromonitoring in intensive care. The empirical part of the analysis was carried out through quantitative research using a non-standardized questionnaire. The research was conducted among nurses and paramedics who have experience with neuromonitoring in the anesthesia-resuscitation department. To the analysis were subjected 158 complete questionnaires. Based on the statistical analysis of the results, a connection was established between the respondents' highest level of education and the level of knowledge. A connection was also found between the respondents' length of experience and level of knowledge. On the contrary, the connection was not shown in the relationship between the age of the respondents and the level of knowledge.
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Analysis of nurses' knowledge in newborn resuscitation
Žáková, Jana ; Průšová, Kateřina (advisor) ; Hromádková, Jaroslava (referee)
The present Bachelor thesis ,,The analysis of nurses' knowledge in resuscitation of newborn", focuses on the evaluation of the level of knowledge of nurses working in neonatal wards and delivery rooms. The thesis is divided into two parts, theoretical and empirical. The theoretical part of the thesis provides a comprehensive overview of information on the classification of the newborn, conditions requiring resuscitation, postpartum adaptation and the first treatment of the newborn. The theoretical part of the thesis deals in detail with the procedure of neonatal resuscitation and post-resuscitation care according to the latest recommendations of the European and Czech Resuscitation Council. The aim of the empirical part of the thesis is to compare the obtained analysis of the knowledge of nurses of selected specialist departments, namely Thomayer Hospital and Bulovka Hospital. The method for obtaining data was a quantitative research using a questionnaire of own construction, which had 26 closed questions. Of these, 20 were aimed at verifying the knowledge of nurses in neonatal wards and delivery rooms. 120 questionnaires were distributed and the return rate was 81.66%, thus 98 questionnaires were analyzed. The results of the research showed statistically significant difference only according to...
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Procedural pain in children in intensive care
Duchoň, Jan ; Javůrková, Alena (advisor) ; Sedlářová, Petra (referee)
Diploma thesis Proecdural pain in children in intensive care 11 ABSTRACT Background: This diploma thesis deals with the effect of the pharmacological approach of the topical anesthetic EMLA and the non-pharmacological approach of visual distract- ion on self-reported procedural pain and fear during the insertion of a peripheral venous catheter (appr. PVC) in children aged up 2 to 8 years in the intensive care environment. Objectives: The aim of the theoretical part of this thesis was to provide a systematic review of relevant studies that dealt with the effects of pharmacological and non-pharma- cological interventions used in the procedural pain and fear management in children aged up 6 to 18 years during the PVC insertion. The objective of the empirical part of the thesis was to determine whether the use of the topical anesthetic EMLA in children aged up 8 to 18 years undergoing PVC insertion is more effective in reducing procedural pain and fear than visual distraction and whether the level of procedural pain in these children with regard on the provided therapy is influenced by sociodemographic and clinical variables. Methods: A systematic search was conducted in five relevant databases on PRISMA parameters. N = 16 randomized trials were included in the systematic review. In the pros- pective,...
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Nurse's specific role in communicating with family members in intensive care - supporting loved ones and relatives
Kolníková, Daniela ; Trnková, Ivana (advisor) ; Sekorová, Jitka (referee)
The purpose of the thesis was to map the conditions and barriers of nurses in communicating with relatives and survivors of patients hospitalized in intensive care units and intensive care units with the aim of creating a manual on the principles of proper communication between nurses and patient relatives, which will be of practical use in the daily practice of nurses. It will be applicable in all types of hospital wards. However, we anticipate that it will be of greatest benefit to nurses in intensive care units. For the purpose of the work, we have chosen the method of quantitative research conducted in the form of a non-standardized electronic questionnaire of our own design. We identified the communication situations that nurses subjectively perceived as the most stressful. These are mainly situations closely related to the patient's irreversible condition or death. This finding led us to give increased attention in the handbook to the experience of grieving relatives and the approach to them. We also concluded that the level of concern nurses have about communicating with a patient's relatives decreases in direct proportion to the increasing age of nurses and the associated length of experience in the field. In view of these findings, we recommend that the handbook be designed primarily for...
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Influence of early antibiotic treatment on lower airway microbial colonisation in patients receiving mechanical ventilation
Kroupová, Alžběta ; Duška, František (advisor) ; Kukol, Václav (referee)
AJ Introduction: Ventilator-associated pneumonia (VAP) is a significant source of morbidity and mortality among patients undergoing mechanical ventilation. Its development is preceded by colonization of the lower respiratory tract with pathogenic bacteria. The purpose of this study was to investigate how antibiotic therapy administered for non-pulmonary infections affects the colonization of the lower respiratory tract compared to patients not receiving antibiotics. The hypothesis is that antibiotic treatment reduces colonization of the lower respiratory tract but increases the occurrence of multidrug-resistant bacteria. Methods: This was a retrospective observational cohort study conducted on critically ill patients hospitalized at the Department of Anesthesiology and Resuscitation, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady. This study is part of an ongoing project aimed at improving the quality of care and preventing VAP in intensive care unit patients. Patients had to meet certain criteria: they had to be on mechanical ventilation for more than 48 hours, have no pre-existing pulmonary diseases upon hospital admission, and not be immunocompromised. The primary outcome was the difference in the proportion of patients with positive microbiological...
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