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Epidural catheter for orthopedic wards - the benefits for patients and nurses?
MAŠÁTOVÁ, Milada
Epidural analgesia causes a temporary cessation of nerve conduction via administration of low concentration of local anaesthesia, or opioid, into epidural space. The resulting temporary discontinuation of nerve conduction is called central neuroaxial anaesthesia and it facilitates the process of surgical intervention. An epidural catheter is usually inserted during epidural desensitisation. It helps to control the amount of administered anaesthesia and hence to respond to surgery progress, but it also enables to keep the catheter within the epidural space for the following postoperative analgesia, which will promote timely postoperative rehabilitation and pain management.The research project was conducted on basis of quantitative and qualitative investigation. The quantitative research was performed via questionnaires directed at the nursing staff, and the qualitative research took form of semi-structured interviews with patients. The quantitative investigation was conducted in fourteen health care facilities in the Czech Republic. Respondents of the quantitative research were nurses working in orthopaedic departments, multidisciplinary ICU or ARO (Anaesthesiology Resuscitation Dept.), who provided care to patients after TKR or THR with an epidural catheter insitu. Qualitative research respondents were patients hospitalised in orthopaedic departments for TKR or THR, with epidural catheter insitu and who agreed to participate at the interview. Quantitative research data were processed in Excel 2010 and presented in graphs, frequency and contingency tables, whereas the qualitative research data were processed using charts of the Smart Art program. After the agreement with the management of health care facilities, this dissertation will promote education and aid situation improvement. The Standard of Nursing Care Assisting a Patient with Epidural Catheter during Insertion and Care will be an outcome of this project. Moreover, we will design a patient information booklet and a quality of care indicator that will focus on monitoring of complications occurrence such as infections in patients with epidural catheter. The findings may help to design a training course specialised in nursing care provision to those patients and also to provide basis for further research.
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Assessment of physical distress of staff nurses in intensive care units
MAŠÁTOVÁ, Milada
In this thesis, we focused on physical load evaluation of nurses working at intensive care units. Physical load is an integral part of nurses' everyday work. The work of the nurses in these wards is a very physically demanding one, as there is a risk or actual single or multiple organ systems failure in the hospitalized patients. This thesis describes the basic negative results of physical load, its aim was to determine the physical load at individual intensive care units. The theoretic part focuses on overall characteristics of ICU, movement system anatomy, ergonomics, working environment risks and excessive physical load consequences. Practical part includes quantitative research using a questionnaire to confirm the presumed hypotheses. Hypothesis 1: The nurses working at ICU are subject to higher physical load than nurses in standard care unit Hypothesis 2: The most common manifestation of nurses? physical load is back-pain Hypothesis 3: In ICU, there are tools helping with immobile patient manipulation Altogether, we distributed 200 questionnaires to the nurses at ICU in 3 hospitals in southern part of the Czech Republic - České Budějovice, Český Krumlov a Prachatice. We recovered 183 questionnaires (91, 5 %). After the processing, we analyzed 171 completely filled questionnaires (85, 5 %). The questionnaire research results have been interpreted and charted into graphs and tables. All the 3 hypotheses were confirmed. Further, we found out that nurses do not care about prevention of illnesses possibly resulting from high physical load. The theses results should help in increasing the nurses? awareness, I suggest its integration into human back school program.
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