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Competencies of pediatric nurses in clinical practice
PEŠLOVÁ, Klára
The bachelor's thesis aims to map the perspective of paediatric nurses on their competencies in clinical practice. The theoretical part of the thesis introduces the concepts of competency and competency in nursing, the characteristics of the personality and education of the paediatric's nurse, the professional nursing activities of the paediatric's nurses based on their competencies and the application of the paediatric's nurses in clinical practice. The practical part is prepared by qualitative research method and analyses data obtained from 10 semi-structured interviews with selected paediatric nurses working in paediatric, neonatal and neonatology wards.
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Care for children with autism spectrum disorders in the home environment
FLORIÁNOVÁ, Eliška
The bachelor thesis deals with the care for children with autism spectrum disorders (ASD) in the home environment. The thesis is divided into a theoretical and a practical part. The historical development, classification, characteristics, etiology, clinical picture, diagnosis and therapy of autism spectrum disorders are discussed in the theoretical part. The most important chapter of this theoretical part is family and care in the home environment. It describes a family and a child with ASD, as well as homesharing, needs, the role of the paediatric nurse in care and specifics in the area of self-care. The practical part and the objectives are focused on the specifics of care in the home environment, the needs of children with autism spectrum disorders and also how the paediatric nurse participates in the care. A qualitative research method was used to conduct the research using semi-structured interviews with eight mothers and two paediatric nurses. The interviews were recorded anonymously on a dictaphone and then transcribed into written form. The survey results were coded using the "pencil and paper" method, and nine categories and several subcategories were subsequently created. Specifically, the following categories were created: Diagnosis, Information Resources about Care, Care in the Home Environment, Homesharing, Reactions to Change and Strangers, Communication, Needs, Specifics of Care in the Home Environment and Paediatric Nurse and Care for a Child with ASD. The results are divided into well-arranged charts and diagrams The research showed that the care of children with ASD in the home environment is individual and often demanding. Mothers also reported that they were not satisfied with the information about home care because no one talked to them about this issue. The most common problem is self-care because most children with ASD need help with everything, whether it is dressing, eating, going to the toilet or hygiene. Another specificity in the care is hypersensitivity, for example to various colours, shapes or materials. Communication with these children is also very hard, as they communicate especially in a non-verbal or visual way through the use of special objects. Also the observance of rituals before sleeping or eating is very specific for children with ASD. The children with ASD have biological, social and psychological needs. In many cases, however, these children with ASD do not feel the biological needs, so their parents have to look after them. The paediatric nurses participate in the care by educating the parents and trying to support them in whatever is needed. If a child with ASD visits a General practitioner's surgery for children and adolescents or a dentist's surgery, the nurse should always try to respect the child's rituals.
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Children's wards nurses knowledge of taking care of intermediate-term vascular access devices
Müllerová, Julie ; Hromádková, Jaroslava (advisor) ; Průšová, Kateřina (referee)
The bachelor's thesis is focused on mapping and researching the nurses knowledge of taking care of intermediate-term vascular access devices inserted to pediatric patients. The aim of the work was to find out, based on a questionnaire, the level of nurses knowledge of individual types of intermediate-term catheters and nursing procedures related to catheters. The theoretical part of the bachelor's thesis includes pediatric anatomical specifics, general characteristics of vascular access devices, specifically described types of intermediate-term vascular access devices and nursing care of these catheters. The empirical part presents classified data in the form of overviews of tables and sectional charts, which are then compared with hypotheses based on age, length of practice, type of workplace and specialized competence of the respondent in the field of intensive care. The research methodology consisted in distributing a self-designed structured questionnaire in the form of a didactic test to nurses working in the children's wards of The University Hospital in Motol Faculty Hospital. The examined sample consisted of 76 respondents. Based on the questionnaire survey statistically significant difference was found in three particular items depending on the type of workplace of respondents in favor of...
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Scale assessment in nursing process for children
BENEDIKTOVÁ, Anna
Introduction The nursing process is an integral part of quality nursing care in paediatrics. This process contains many individual components that can work together to create a whole that not only assists nurses, but also makes patients' hospital stays more enjoyable. One of the components is assessment and measurement scales. These can be focused on pain, consciousness, nutrition or fall risk. Objectives of the work The aim was to become familiar with assessment and measurement scales in paediatrics and to find out their application in the nursing process in selected paediatric wards. First, we investigated which assessment scales can be applied in the nursing process in children. This was followed by interviews in which we focused on the assessment scales used in the selected wards and how nurses view the use of assessment scales. Methodology The research was conducted in two phases. In the first phase, we searched the literature for assessment and measurement scales in paediatrics. In the second phase, we conducted closely interviews, which were conducted with nurses working in standard wards or in the ICU. The research investigation was developed by searching information from the literature and also using closely interviews with nurses in our selected wards. Data collection was conducted from January to June 2023. All interviews were recorded on a dictaphone and then transcribed into MS Word. The "pencil paper" method was used to analyse and code the data. Subsequently, the data was broken down into units, which were assigned appropriate codes and these were grouped into categories. These categories and subcategories were then worked into clear diagrams and described in detail. Results From the research we found that there are many scales for assessing pain, and not all can be applied to the same age. In addition, for each of the scales the correct tally or technique needs to be found and each is rated differently in the result. Nurses are familiar with the assessment scales they use on the wards and know what they are used for, but do not know their exact names, but rather a general one for the assessment issue. Most nurses spoke in general terms such as 'pain assessment', 'fall risk assessment', 'consciousness assessment'. Not all units use the same assessment techniques, nor do they all use the same assessment domains. Conclusion The results show that rating scales are an essential part of nursing documentation. So many assessment scales have been used that most wards are able to choose one that suits their particular issue and the department we selected did so. However, it is important to choose the right one with respect to the age and psychomotor development of the child. This bachelor's thesis can be used in the theoretical and practical part of teaching in Paediatric Nursing. The assessment techniques can be used in professional practice in the respective departments or we can offer a pain assessment scale that we have devised. It could assist nurses in diagnosing and determining the degree of pain in all ages.
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The role of paediatric nurse in prevention of the CAN syndrome
KROUŽKOVÁ, Aneta
Abstract Current state: CAN (Child Abuse and Neglect) syndrome can be characterized as physical and psychological abuse, sexual abuse and neglect of a child. The most common perpetrators of such treatment are parents or family members. Domestic violence and bullying are also part of CAN syndrome. The aim of the thesis was to evaluate trends in the number of reported cases of violence against children in the Czech Republic within the observed period of 2012-2021, to describe parents' knowledge of the abused and neglected child syndrome, to describe parents' knowledge of the Shaken Baby Syndrome, to describe the role of paediatric nurses in the prevention of the abused and neglected child syndrome and to describe the role of paediatric nurses in the prevention of the Shaken Baby Syndrome. Methodology: A combination of a qualitative-quantitative research strategy was chosen for the empirical part of the thesis. For the quantitative data collection, the method chosen was secondary analysis of documents from the Ministry of Labour and Social Affairs from the period 2012-2021. For the second part of the quantitative research, a questionnaire survey method was used using a non-standardized structured questionnaire. The data collection was partly carried out in the practitioners' offices for children and adolescents, and partly collected on the internet through forums for parents. A total of 212 questionnaires were collected. The method of semi-structured interviews was chosen for qualitative data collection. The research file consisted of six nurses working at practitioners' offices for children and adolescents. Results: In the period of 2012-2021, a total of 84 897 cases of abused and neglected children were reported to the register of the Ministry of Labour and Social Affairs (100%). Neglect was the most frequent form of CAN syndrome (72%). 11.2% children suffering from CAN syndrome were mentally abused, 10.2% were sexually abused including children in prostitution and children used for pornography, 7.6% were physically abused. The representation of girls and boys was almost equal, with 51.5% of girls and 48.5 % of boys. The most abused and neglected age group of children were children aged 6-15 (55%). Statistical testing did not confirm the hypothesis that the number of reported cases of violence against children increased significantly in the period of 2015-2021 (p<0.830). A total of 212 parents participated in the survey and 43.9% of the respondents had experienced some form of CAN syndrome. According to the parents surveyed, the most at-risk groups of people who are at higher risk of child abuse, neglect or exploitation include: alcohol addicts; substance abusers; or sexual deviants. According to the respondents, the most frequent perpetrators of sexual abuse were stepfathers (87.7%) or uncles (66.0%). According to the respondents, symptoms of physical abuse include: bruises of different ages, change in the child's behaviour , burns, fractures or stab wounds. According to respondents, symptoms of child sexual abuse include: anal injuries, genital bleeding, behavioural changes, increased anxiety or aggression. Parents were most likely to agree with the statement that shaking their infant resulted in brain injury (4.4 ? 0.9), brain haemorrhage, death of the infant, or retinal haemorrhage. Parents' knowledge of Abused, Abused and Neglected Child Syndrome and Shaken Baby Syndrome did not vary significantly with their education (p<277) or age (p<406). Based on the interviews with primary care nurses, it can be concluded that the role of nurses in the prevention of CAN syndrome is to seek out children at risk for CAN syndrome and educate parents about Shaken Baby Syndrome. On the basis of the theoretical and empirical part, an informative material was designed CAN "syndrome" for parents and nurses in general practitioners' offices for children and adolescents.
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Procedural Pain Relief in Premature Neonates
DUDARCOVÁ, Terezie
This Bachelor's thesis deals with the topic of procedural pain management in preterm newborns. Procedural pain is caused during medical procedures. Long-term exposure to pain has a variety of consequences, which is why it is very important to pay attention to the procedural pain prevention management. The first aim of the thesis was to explore the possibilities of assessing procedural pain in premature neonates. The second aim was to map the available methods of procedural pain management, followed by the final goal to identify the possibilities of involving mothers of premature neonates in the procedural pain prevention management. The research part of the paper was based on a qualitative investigation by means of questioning and observation. Data collection was carried out using in-depth interviews with paediatric nurses and mothers of premature neonates. Next part of the research involved observation of paediatric nurses during painful procedures. The information obtained was logged in observation sheets. Research has shown that there is currently a great effort to reduce the number of painful procedures that preterm newborns have to undergo. It was found that when evaluating procedural pain, all circumstances must be taken into account and not evaluated only according to a given scale. According to the research, the most effective of the non-pharmacological methods of pain relief is direct contact between mother and child. Pharmacological methods of pain relief are used in rare cases. It was also confirmed that there is currently a great effort to involve parents in the care of preterm newborns, but this needs to be further intensified and fathers need to be engaged more, for example. The results obtained from the research can be used in the education of paediatric nurses. An educational leaflet for mothers has also been developed.
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Educational needs of mothers with newborn twins
ŠIMEČKOVÁ, Tereza
Introduction: Despite the declining trend of multiple pregnancies, twins are encountered quite frequently. Caring for two children at once can be very challenging, and for this reason support from both partner and family, as well as from health care professionals, is important. Nurses responsibilities include educating mothers about newborn care, with safety and breastfeeding playing a major role with newborn twins. Objectives of the work: The first goal was to determine the specifics of nursing care in newborn twins. The second goal was to discover the educational needs of mothers of newborn twins. The third goal was to reveal the most important areas in which the mother needs to be educated and the fourth goal was to find out if there is a difference in educational needs from the perspective of mothers and nurses working in the newborn unit. Methodology: The research part of this work was done in the form of qualitative analysis and semi- structured interview with nurses of neonatology unit and mothers of newborn twins was used for data collection. The interviews were conducted from December 2022 to March 2023. All interviews were recorded on a recording device after consent and then transcribed into Microsoft Word. The analytical software ATLAS.ti was used to analyse, code and generate individual charts. Subsequently, the data were broken down into units, which were assigned appropriate codes, which were further grouped into categories that captured contexts with a direct link to the research questions. Subsequently, the categories and subcategories were processed into clear diagrams. Results: The research showed that the specifics of nursing care for newborn twins clearly include breastfeeding, which has countless benefits for both the newborn and the mother. The areas in which the mother needs to be educated include the aforementioned breastfeeding, but most importantly safety. Among the educational needs of mothers, we can again include breastfeeding and a supportive, empathetic approach from nurses. Differences in educational needs from the perspective of the nurses include practical education with practice and subsequent observation of the mother to see if she is doing the activity well and subsequent re-education. Mothers, on the other hand, would appreciate if another family member participated in the education. Conclusion: The results show that mothers of newborn twins are educated in the same way as mothers with a single newborn. The emphasis is mainly on safety, so that the mother does not leave the children unattended or leave one unattended while she takes care of the other. Breastfeeding is also an important area, with mothers of twins preferring tandem breastfeeding, which means that the mother breastfeeds both babies at the same time. This bachelor thesis can be used in improving the care of mothers with newborn twins and in the teaching of future paediatric nurses.
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Nursing care for paediatric patient after orthopaedical surgeries
WEISSOVÁ, Eva
Abstract Current situation Current range of orthopaedics is not only surgery of musculoskeletal system, but it also deals with diagnostics of congenital defects, injuries, illnesses, metabolism disorders and their after-effects on musculoskeletal system. A paediatric nurse plays a key role in taking care of a paediatric patient after an orthopaedical surgery. She helps children to overcome an unpleasant situation and tries to minimize physical and psychological complications. Cooperation with child's family is essential. Child's pain, suffering and fear can be moderated by proper nursing care. Aim of the work We determined three aims in this diploma thesis. The first aim was to map children awareness before orthopaedical surgeries and during hospitalization. The second aim was to analyse satisfaction of parents during hospitalization. The third aim was to assess the importance of psychological pre-surgery preparation of children and hospitalization of parents in overall perception of child's hospitalization. Methodology A quantitative research by means of a paper and electronical survey was used for the empirical part. The research group was made up of 104 respondents, it means 52 parents and 52 children. Those were parents and children from two selected hospitals and from general public. The surveys were processed statistically afterwards. A descriptive analysis of all the questions was used and four determined hypotheses were tested. Results It was found out that most of the children felt sufficiently informed before and during the hospitalization. It could be claimed that better awareness of a nurse means better feeling of child's sufficient awareness. Furthermore, we found out from the results that most of the parents were sufficiently informed by the nurse and that their overall satisfaction depends on children awareness provided by the nurse. Based on results, nurse education in the area of children care and manipulation with children during hospitalization is very important and leads to satisfaction of both children and parents. Based on other results, a child's hospitalization with a parent is very important because 97% of children said that they were calmer because of the presence of a parent. We can claim this about parents as well, because the presence of a parent is perceived by parents themselves as a very important factor improving the perception of a stay at a hospital. Hospitalization of a parent with a child depends on the age of the child, in which case a child at the age of 5 and less was always hospitalized with a parent. Moreover, it was found that compared to the presence of a parent, parents claim the psychological preparation (talking in form of play or with the help of a therapist) has slightly more important point. That was confirmed by the children as well. We can obviously see from the response that they stand the hospitalization better if they are prepared for the surgery. Conclusion The research has shown that most of the children felt informed enough during the hospitalization and before the surgery. I find the psychological preparation of children for a surgery very important. That was also confirmed both by the children and parents, who consider the psychological preparation to be one of the most important factors. The hospitalization of a parent with a child depends on the age of the children. We trust that this work could serve as a study material for paediatric nurses working at corresponding postoperative departments, besides other things as a study material for students of medical subjects. This diploma thesis can describe given illness or the care of a child after an orthopaedic surgery to both parents and children.
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Multidimensional view on the work of children's nurse in the emergency room of children's ward
PŘÍPLATOVÁ, Iveta
The work of nurses in the outpatient department belongs between discussed topics. The interplay and cooperation of all members of the medical team are especially important. Correct communication between all team members and communication with children and their accompaniment are also a matter of course. The aim of this diploma thesis is to map the work of a nurse in a comprehensive view in the outpatient area of the children's ward, the satisfaction of children and parents in the outpatient area of the children's ward and to suggest possible improvements for the outpatient sphere of the children's ward of České Budějovice a.s. The diploma thesis is processed by qualitatively quantitative investigation using semi-structured interviews, questionnaires and observations. The research group consisted of nurses, doctors, paediatric patients and their accompaniment at the children's ward, paramedics and the general public as well. The interviews were categorized and processed by the method of pencil and paper. Questionnaires were processed statistically. The hidden participating observation was focused on the collaboration and communication of nurses from outpatient department with other nurses, doctors, paramedics, children and their accompaniment; and it was also focused on the satisfaction of the children or their accompaniment at the outpatient department. The results of the work showed that the view of the work of the paediatric nurse is distorted both from the health care professionals and the general public, which means that the nurse is seen mainly as a nursing care provider. The results also showed the necessity of proper communication and knowledge of foreign languages. At the same time, the thesis was used to identify shortcomings or suggestions for changes in the paediatric outpatient department of the České Budějovice Hospital, including the satisfaction of patients and their accompaniment during visiting the department that depends on the time spent in the waiting room. Suggestions for improvement were drawn up, drafted and handed over to the children's ward management.
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The roles of nurse in nursing care for a child with congenital cataracts
MEDVECOVÁ, Vladimíra
Current state: Congenital cataract is an ophthalmic disorder where the clouding of the lens causes defect in its transparency and light dispersion. The child experiences a visual impairment that can be examinated depending on the age and mental state of the child. The treatment is removal of the clouded lens, subsequent correction of dioptric defects and subsequent training and monitoring of amblyopia. Purpose: of this study was to describe the roles of paediatric nurse in nursing care of children with congenital cataract and the specifics in nursing care in this condition, based on reviewed material. The following research problems were explored: What are the roles of paediatric nurse in nursing care of children with congenital cataract? What are the specifics in nursing care of children with congenital cataract? Methods: In order to reach the goal set by this study we used qualitative data and study analysis. This study implements data sources from National Medical Library in Prague, the Academic Library of University of South Bohemia in České Budějovice, the library of 2. LF UK and FN Motol in Prague and the library of National center of nursing and non-medical health providers in Brno. Moreover the study reviewed the material from bibliographic databases (Cochrane Library, Ebscohost, Medscape, ProQuest, PubMed, ScienceDirect, Scopus) and online databases of medical associations of ophthalmology (The American Academy of Ophthalmology, The Royal College of Ophthalmologists). Results: The goal of this study is to provide a comprehensive view on nursing care of children with congenital cataract. Conclusion: Even though the role of paediatric nurse in nursing care of children with congenital cataract is rather neglected in current literature, it is crucial in all forms of healthcare. In conclusion we define the role of paediatric nurse in nursing care of children with congenital cataract and description of the specifics of this care.
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