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Nursing care measures in the prevention of ventilator-associated pneumonia
Kukol, Václav ; Heczková, Jana (advisor) ; Feixová, Dagmar (referee)
The thesis is focused on ventilator-associated pneumonia and its possible preventive measures during nursing care. In the theoretical part of the work we have included chapters on nosocomial infections emphasizing on the etiology and epidemiology of ventilator-associated pneumonia and its clinical manifestations. We have analyzed the issues of artificial airway management with a detailed focus on the peculiarities of nursing care of the ventilated patients. There, we focus primarily on the care of the patients oral cavity, respiratory tract and the ventilation circuit. A big chapter is dedicated to preventive measures and to the possibilities of prevention in the nursing practice. The empirical part includes research on preventive measures that are implemented in practice and comparative analysis of the measures between different facilities as well as their compliance to the guidelines. We have also determined the level of VAP awareness and its prevention among the nurses. KEYWORDS nosocomials infections, nursing care, prevention, ventilator-associated pneumonia
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Pitfalls of the surgical treatment of obesity from the patient's point of view
Hakenová, Renata ; Heczková, Jana (advisor) ; Stoklasová, Radka (referee)
This thesis examines the surgical treatment of obesity from the perspective of the patient. The theoretical portion deals with etiopathogenesis, diagnosis, complications, related illnesses, conservative and surgical treatments (definitions, overview and types, principles of basic bariatric approaches, as well as effects and indications, side effects, and results of treatment. It also includes the specifics of the pre-operative preparation, immediate and long- term post-operative care, psychological preparation and post-bariatric-surgery nutrition. The empirical portion consists of quantitative research in the form of a survey instrument with closed-end questions with the possibility of individual responses. The respondents were patients who had been diagnosed as morbidly obese or third-degree obesity and who had also been through surgery within the past three years. One hundred and fifty surveys were distributed, 125 were returned, and 10 of those were not used for incompleteness, and another 6 were not used because the respondents did not meet the criteria. One of the primary goals of the research was to ascertain the information that patients were missing before bariatric surgery and whether this information had a significant effect on the result of the bariatric approach. Another primary goal of...
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Options preventing catheter-related sepsis during hospitalization
Slavkovská, Jana ; Heczková, Jana (advisor) ; Mrákava, Vlastimil (referee)
The thesis is focused on the assessment of nurse's knowledge in the prevention of catheter sepsis. The aim of the study was to expertise knowledge in the prevention of catheter sepsis among nurses working in intensive care units. Map out the latest theoretical and practical possibilities of nurses working in intensive care units in the prevention of catheter-related sepsis of hospitalized patients. The work is divided into theoretical and practical part. The theoretical part consists of three chapters. In the first chapter, we focused on a theoretical overview of nosocomial and bloodstream infections. The second chapter is focused on an overview of invasive inputs. The third chapter focuses on prevention of catheter sepsis. Practical part was divided into two chapters. In the first section of the empirical part of the diploma thesis, which is the fourth chapter, we characterized the survey sample, the evaluation of the survey data that have been collected through the questionnaire. Practical part was divided into two chapters. The fifth chapter consists of discussion and suggestions. Key words: sepsis, prevention, nursing, catheter, nurse, hospitalization.
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Effect of sporting activity on the risk of burnout in nurses working in intensive care
Fialová, Zdeňka ; Heczková, Jana (advisor) ; Strnadová, Alice (referee)
Master thesis is dealing with the influence of sport activity at burnout among nurses working in intensive care and resuscitation. The thesis is divided into the theoretical and the empirical part. In the theoretical part we deal with burnout, its risk factors, symptoms and preventive measures. Other chapters are devoted to sports, primarily focused on the influence of sports activities on psychological stress and burnout. We also describe the possibilities of introducing sport activities to the workplaces. The main goal of our work is to determine whether there exists a relationship between sport activity and the risk of burnout. The research was carried out with the use of a quantitative questionnaire survey, which consisted of two parts. The first part contained questions related to burnout and was conducted using a validated MBI (Maslach Burnout Inventory) questionnaire. The second part contained questions related to the leisure sports activities of nurses. Within Všeobecná fakultní nemocnice in Prague, Malvazinky rehabilitation clinic, hospital Mělník, Tanvald, Sedlčany and Neratovice were distributed 298 questionnaires to the nurses working on the resuscitation or intensive care departments. The final testing sample consisted of 233 questionnaires (78% of surveyed nurses). It was found out...
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Motivation and attitudes of students to study at the master's program of Intensive Care
Valachová, Ľubica ; Heczková, Jana (advisor) ; Eckelová, Ivana (referee)
The thesis deals with the perception of the education's quality of the master's degree program of Intensive Care (NMgr. IC) at the 1st Medical Faculty of Charles University (1st LF UK) of current and former students towards their motivation and attitudes. It is processed in two parts within the specified topic of the thesis motivation and attitudes of students to study in NMgr. IC at the 1st LF UK. Introduction to the topic is focused on motivation and attitudes to study, qualification, specialization, continuous and higher education, to the list of educational opportunities in the field of intensive care, the competencies and their comparison with nurses and nurses in intensive care. The research is devoted to explore the perception of the education's quality for students and graduates of NMgr. IC at the 1st LF UK in conjunction with other aspects. It contains the empirical quantitative research, which was carried out by an anonymous online questionnaire distributed via e-mail. The obtained data were analyzed by mathematical statistics and are presented in graphs or tables. In the study participated 22 of the 44 students in the 1st and 2nd year and 26 of the 87 surveyed graduates of NMgr. IC at the 1st LF UK. Total research sample consisted of 48 respondents. The research clearly shows that...
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Efficacy of education regarding child patients with congenital deformations of pectoral wall in University Hospital Motol
Popková, Zuzana ; Heczková, Jana (advisor) ; Eckelová, Ivana (referee)
The aim of this paper was, at first, to evaluate the effectiveness of education of child patients with inborn deformation of pectoral wall in the University Hospital Motol in the MIRPE (Minimally Invasive Pectus Excavatum) operation correcting the inborn deformation of pectoral wall by using of a metal bar and for its surgery extraction after three years. At second, to map the effectiveness of education of child patients done by the hospital personnel during their hospitalization in the University Hospital Motol. This paper also presents its own opinions of both groups of respondents on the current system of education done in the clinical practice. According to the available sources there was not in the Czech Republic any similar study about this problem realized up to now. There were 116 respondents involved in the research who went through the MIRPE surgery and the extraction of their bar in the University Hospital Motol. The data that were received by the method of own constructive form was further statistically processed. From the analysis of the results came up a need to improve the education in the pre-surgery time, and to better develop the system of education during the hospitalization of child patients. There was an interest confirmed from the researched respondents about printed...
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Current possibilities and resources of enteral nutrition
Hrnčířová, Naďa ; Heczková, Jana (advisor) ; Meisnerová, Eva (referee)
0BABSTRACT This thesis is focused on enteral nutrition. This issue is an integral part of intensive and resuscitation care, but it is also a part of standard and follow-up care. There are more and more new resources and the products for enteral nutrition are improving. The theoretical part deals with malnutrition, discusses the different components of nutrition. Much of the thesis forms ways of application of nutrition. The issue is a nasogastric tube, a nasojejunal tube, percutaneous endoscopic gastrostomy, percutaneous endoscopic jejunostomy, feeding button or sipping. There are further expanded the introductions, nursing care, indications and contraindications of these options. The following chapters analyse the modes of enteral feeding, advantages and disadvantages of enteral nutrition compared to parenteral. The practical part is focused on research using anonymous questionnaires in the area of enteral nutrition. The survey was conducted in four departments of three teaching hospitals in Prague. It was focused on nurses and paramedics in medical intensive metabolic care units. The survey had 73 respondents. The aim was to identify the mode of feeding that nurses prefer and how they apply it, analyze the extent to which the nurses actively involve themselves in this, how they are oriented in...
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Glycemic level check performed by a nurse in critically sick people in intensive care
Vaňková, Daniela ; Heczková, Jana (advisor) ; Lišková, Iveta (referee)
This thesis deals with the control of blood glucose levels of critically ill patients in intensive care, focusing on hyperglycemia of the critically ill and possible therapy within the competences of nursing and medical staff. The theoretical part of the thesis deals with the issue of hyperglycemia of critically ill patients from the medical and nursing perspective as well as the issues concerning instrumentation. The first chapter describes briefly the history of insulin, relating to its discovery and introduction into practice. The following chapter describes the concepts of critically ill, intensive medicine, intensive care as well as specific nursing care. Short information about etiology, diagnosis, treatment and complications of diabetes mellitus is described in the third chapter. The following are the chapters, which are more specifically devoted to the issue of hyperglycemia of the critically ill, including chapters on glucose homeostasis of the critically ill, the evolution of blood glucose levels, instrument technique, insulin protocols, insulin therapy, details of insulin therapy in intensive care and on the principles of correct blood collection for the determination of blood glucose levels in the conditions of intensive care. The empirical part of this work contains research on the...
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Caring for patients colonized with resistant microbial strains
Poláková, Stanislava ; Heczková, Jana (advisor) ; Novotná, Jindra (referee)
This thesis is focused on the complex nursing care of patients colonized with the resistant microbial strains. In the theoretical section I describe the major events of the history, the current issue of the antibiotic treatment and the species of occurring resistant strains of microbes. It also deals with recommended procedures in the care for these patients, such as patient isolation, use of the protective equipment, handling of the biological material , individualization of the aids, handling of the linen and the principles of health care. It also includes preventing the spread of disease resistant strains of the microorganisms and patient recolonization. The empirical part consists of the quantitative research conducted at the University Hospital in Pilsen with the help of a questionnaire survey. The questionnaires will be distributed to the nurses in intensive care units without the single - patient box system. The aim of the research is to determine nurses' knowledge of the disease resistant microbial strains and the ways they create patient isolation. Evaluation questionnaires will provide the pieces of information to compare the individual practices and knowledge of nurses in intensive care units. Results of this work can be used as a source of information or the study material. The benefit...
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ECMO in University hospital Pilsen
Zlochová, Lada ; Heczková, Jana (advisor) ; Jankovcová, Kateřina (referee)
The presented dissertation concerns of extracorporeal membrane oxygenation (ECMO) in adults within the University hospital in Pilsen. The ECMO has been used in Pilsen from 2011. The first part (theoretical one) illustrates in general the ECMO, a life saving method for a treatment of failured lungs or heart. The sites of cannulation, the management and monitoring of ECMO patient are then described. Possible complications as a result of ECMO application and its settlement are mentioned. The second part consists of a retrospective insight, which shows data of 43 ECMO patients for a period of three years 2011- 2013 in the University Hospital Pilsen and a questionary survey. The survey involves 83 non- medical healthcare workers, who are in charge of the ECMO patients, at three intensive care and resuscitation units where the ECMO is used. It finds out what do the medics know about the method. The outcome of this dissertation is a guideline of nursing care of an adult patient on ECMO and most common difficult situations and solutions, that could be faced in the course of nursing an ECMO patient. KEY WORDS ECMO support, heart failure, pulmonary failure, complication, knowledge
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