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The care of the patiens with tracheostomy from the nursing staff perspective
Kritznerová, Tereza ; Hocková, Jana (advisor) ; Nejdlová, Tereza (referee)
The thesis is focused on nursing care of patient with tracheostomy cannula from the perspective of nurses at the Department of the intensive care or Intensive Care Units. It consists of theoretical and empirical part. Essential terminology, anatomy and physiology of the airways, historical aspects of surgical procedures and types of tracheostomy tubes are described in the theoretical part. Moreover, there are discussed modern surgical techniques, indication and possible complication. The next theoretical chapter is focused on the nursing care. The last chapter deals with the different alternatives of communication of the patient with tracheostomy tubes. The research part uses questionnaires as a quantitative research method. The aim of the thesis is to investigate the theoretical knowledge of the nurses in their care of the patient with tracheotomy tubes and knowledge how to communicate with this patient. The statistically significant results are also listed and discussed. The last part concludes with the recommendations of the best practice in the care of the patient with the tracheostomy tubes. keywords tracheostomy, airway, tracheostomy tube, nursing care
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The incidence of postoperative infectious complications in neurosurgical ICU
Brindová, Jana ; Mrákava, Vlastimil (advisor) ; Hocková, Jana (referee)
This thesis examines in detail the nature of postoperative infectious complications in patients who underwent brain tumor surgery. It deals with the incidence of these complications and their severity, depending on various factors and suggests the most appropriate nursing procedures used in the care of a patient in whom these complications occurred. For the structure of the work is divided into two parts - theoretical and empirical. The theoretical part deals with the issues examined in terms of the medical field Neurosurgery (closer diagnoses, conditions, operations and other procedures, and complications to occur after these operations or expected performance), analyzes a nursing practice and patient care on neurosurgical ICU, and finally closely examines infections and nosocomial diseases, including a description of the most common types, their agents, diagnosis and treatment. The second, empirical part focuses on the problems from a practical point of view. With the help of set of case studies it closer which specific complications are most commonly found on the neurosurgical ICU in patients after surgery of brain tumors, what are the most common methods of treatment and nursing procedures which are most used in the care of patients with these complications. In conclusion summarizes the...
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Long-term vascular access for home parenteral nutrition and their complications
Králová, Petra ; Novák, František (advisor) ; Hocková, Jana (referee)
Home parenteral nutrition is a treatment enabling the patients with intestinal failure to live their lifes in their home environment. The possibility to commence and practise home parenteral nutrition requires not only a medical and pharmaceutical team, but also paramedical staff, which plays a signifiant part mainly in education of the patient and his close relatives. The study's aim was to characterize the patients involved in the home parenteral nutrition programme (HPN) and catheters used for this purpose and as well to analyze complication rate of the long term catheters related to their use and subsequent care. Into the retrospective quantitative study were included patiens treated with home parenteral nutrition since january 2009 to september 2015 within one nutrition care center. Data collection was realized by research in medical documentation. Altogether 135 patients were included in the study (93 female and 42 male), who have hade 227 catheters inserted in total (114 portcatheters, 73 Broviac catheters and 40 PICC) with 86 187 catheter days. The most frequent basic disease was cancer (36%) and the most prevalent indication to HPN was a short bowel syndrome (50%). Overall complication rate was 2,12/1000 catheter days (1,62 catheter sepsis, identically local infections and thrombotic...
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Intensive care of patient with metformin intoxication
Zajícová, Alena ; Povolná, Pavla (advisor) ; Hocková, Jana (referee)
Metformin is the first-line oral antidiabetic drug for patients with type 2 diabetes mellitus. As the rate of new diagnosed cases of diabetes increases year-on-year, the number of patients who are prescribed metformin rises as well. In the Czech Republic only, 858,010 patients were treated for diabetes in 2015. 786,586 of them were treated for the type 2 diabetes mellitus. Metformin intoxication, called also MALA (metformin- associated lactic acidosis) after its main symptom, is a rare complication (≤ 10 cases per 100,000 patients per year) in the metformin treatment, but the mortality is high (up to 50%). Metformin-induced lactic acidosis develops when the contraindications of metformin therapy are not respected or in the event of an acute disease linked with dehydration and hypoxia. Patients with MALA are hospitalized at the int ernal medicine intensive care unit or the department of anesthesiology and critical care with multiple organ failure. This thesis aims at determining whether procedural nursing care standards, implemented in the form of a nursing process, are actively used in practice on intensive care beds. Methodology: The empirical part is compiled in the form of a qualitative research, as a case study of a female patient suffering from metformin intoxication, caused by a suicide...
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Issues of communication between nurses and patients with secured airways at Resuscitation Department
Cvrkalová, Lenka ; Hocková, Jana (advisor) ; Podaná, Jana (referee)
Purpose: Interpersonal communication is one of the most important abilities and skills in everyday life. But when patient's communication ability is limited due to endotracheal or tracheostomy tube insertion, the patient, who had communicated verbally, is not able to convey their feelings, needs and wishes anymore. The purpose of this thesis is to help improve communication skills of nurses in the area of communication with conscious, unconscious and analgosedated patients whose airways are intubated. Methods: The survey has form of quantitative research, the questionnaire method was used. Research data was obtained from a total of 144 nurses working at resuscitation departments at four hospitals in Prague. Results: By studying this issue, it has been found nurses have trouble communicating with intubated patients. The most difficult communication is with conscious patients, who are intubated by endotracheal tube. Communicating with patients with impaired consciousness is also very problematic. Conclusion: Despite the fact, that communication with intubated patients is inherently difficult, more than half of the respondents have never been educated about how to communicate with these patients. Not only but also to address this issue, the outcome of this thesis is information brochure with...
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The patient's transition to home mechanical ventilation
Vacek, Jakub ; Rambousková, Kateřina (advisor) ; Hocková, Jana (referee)
The presented quantitative diploma thesis deals with the issue of the home mechanical ventilation (HMV) in the Czech Republic. It outlines its history, describes the most common diagnoses of clients using the HMV, and gives an overview of departments of long-term and follow-up intensive care. The thesis summarizes the course of transition from the hospital to homecare and comprehensively describes government allowance available to the families. Finally, institutions which were most commonly named by the queried departments of follow-up intensive care as intermediaries of the HMV are briefly identified. In the empirical part, the thesis aims to find out, using a questionnaire survey, how the aforementioned issues play out in practice, how the transition to domestic environment takes place, who helps the families, or whether the caregivers use all the financial assistance available to them. The thesis proposes five hypotheses, out of which two met the pre-established criteria. The first confirmed hypothesis stated that there are organisations which help the patients with the transition to the HMV and that the families are satisfied with the speed and the gradually increasing difficulty of the transition. The second confirmed hypothesis stated that the patients are appropriately educated in basic...
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The Origin and Development of Interventional Cardiology and the Role of Nurses in the Field
Hašková, Martina ; Hocková, Jana (advisor) ; Kulhavá, Miluše (referee)
The diploma thesis addresses the historical development of interventional cardiology, an important field of medicine, which improves the prognosis and quality of life of patients with cardiovascular diseases. The goal of the work is to describe the evolution of interventional cardiology from humble beginnings to present day and to point out important events and historical moments which led to breakthroughs in cardiology and to demonstrate the role of nurses, important members of catheterization laboratory teams. Several sources were analyzed in this theoretical work, mainly articles from scientific journals and textbooks, the gathered information was complemented by interviews with medical professionals witnessing the origins of interventional cardiology in Czech Republic. The result of the thesis is an overview of the development of interventional cardiology since the demanding first steps, through the performance of the first coronary angioplasty to the wide array of diagnostic and therapeutic procedures replacing some of the cardiac surgery procedures of the present day. keywords: interventional cardiology, heart catheterization, percutaneous coronary intervention, intensive care
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The needs of the ICU patient after myocardial infarction requiring V-A ECMO support
Procházková, Tereza ; Konopásková, Marie (advisor) ; Jankovcová, Kateřina (referee) ; Hocková, Jana (referee)
The incidence of acute myocardial infarction is still high. One of the methods of reperfusion therapy is the cardiac surgery by coronary artery bypass graft, which may be postoperatively complicated by the development of postcardiotomy cardiogenic shock with the urgency of the venoarterial extracorporeal membrane oxygenation (V-A ECMO). The quality of very specialized and complex care for these long-term hospitalized patients depends on understanding their needs and ways of saturation. The aim of this study is to present these needs from the perspective of the patient and their family. Research questions ain to identify the main aspect of recovery, the factors negatively affecting the mental state of patients, the ways to help them by healthcare professionals and family, how can healthcare professionals help the family and how this experience has affected both the family and the patient. The research is carried out using a qualitative method of semistructured interview with six respondents with this type of anamnesis, who were hospitalized between 2015 and 2021 in the ICU of cardiac surgery department, and three of their relatives. According to the study's findings the main aspect of recovery is the patient's mental well-being. The dependence on help of others, muscle weakness and loss of intimacy...
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Pre-hospital phase of acute myocardial infarction from the patient's perspective
Pokorná, Petra ; Hocková, Jana (advisor) ; Jankovcová, Kateřina (referee)
Acute myocardial infarction (AMI) represents severe complication of atherosclerotic vascular disease. Despite therapeutic advances and better risk factor control, acute myocardial infarction remains the leading cause of death worldwide. Goal of this thesis was to interview a group of patients hospitalized for acute myocardial infarction and evaluate their knowledge of disease course, perception of disease representing a sudden change of health status, awareness of disease symptoms and motivation for future lifestyle changes. Quantitative research with inductive approach was chosen for our research. Data was collected using individualized non-standardized semi-structured interview. Seven selected patients hospitalized for acute myocardial infarction with ST elevation were entered into our analysis. All the patients were informed in advance about our research methods and ethical aspects. All the participants had insufficient awareness of AMI symptoms. However, intensity of disease symptoms was severe, so they contacted health system early. Majority of them called emergency service. Level of education had significant impact on patient behavior. Patients with university degree had the best awareness of disease symptoms and shortest times from symptom onset to medical system contact. They were...
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Complications of central venous catheters applications 2011 CDC guedelines
Šťastná, Monika ; Michálek, Pavel (advisor) ; Hocková, Jana (referee)
In the presented diploma thesis I deal with the issue of proper insertion of short-term central venous catheters, adherence to procedures by medical and non-medical staff according to CDC guidelines 2011 during insertion and subsequent treatment in intensive care in a faculty-type medical facility. The aim of the diploma thesis is to determine the occurrence of complications, especially infectious, the level of adherence to recommended procedures in practice according to 2011 CDC guidelines, central venous catheter manipulation, comparison of real activities with recommendations and mapping the level of knowledge of non-medical staff about short-term central venous catheters. The theoretical part deals with the importance of clinical guidelines, central venous catheter in general, complications associated with the central venous catheter and prevention of infectious complications of invasive inputs. For the empirical part of the diploma thesis, a prospective non- randomized observational study of cannulation and possible complications associated with a short- term central venous catheter according to CDC 2011 guidelines was chosen to determine real procedures for insertion, treatment and removal of a short-term central venous catheter. This was supplemented by an exploratory questionnaire survey of...
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