|
|
Scoring system for sputum evaluation assessing specificity and sensitivity
Fidra, Dominika ; Trnková, Ivana (advisor) ; Maláska, Jan (referee)
The aim of this diploma thesis is to create a scoring system in sputum evaluation for general nurses in the intensive care unit. It is conceived as a diagnostic study that assesses the ability of the scoring system to accurately determine the ongoing condition - an infectious inflammatory disease. The collected biological material was compared with the gold standard - microbiology, by two independent persons. The result of the diagnostic study is a verified scoring system, where the color, consistency, admixtures and odor of the biological material of sputum are described for individual point evaluations. The main parameters of the diagnostic test - sensitivity, specificity and predictive value (positive and negative) - were used to verify the scoring system. For normal and pathological values, cut-off values were determined, according to which the value of sensitivity and specificity changed. By plotting the values on a graph and creating a ROC curve, it was found that with a cut off value of 1 and 2 for the first evaluator, the resulting area under the curve (AUC)=0.75. The result represents the scoring system according to the first evaluator as a good and effective test. The research was carried out at the anesthesiology and resuscitation clinic at the University Hospital of Kralovske Vinohrady...
|
|
|
Delirium in intensive care unit
Hájková, Nela ; Pekara, Jaroslav (advisor) ; Maláska, Jan (referee)
The Abstract The diploma thesis is a review study in the form of scoping review which deals with non- pharmacological interventions to prevent and manage delirium. The diploma thesis is divided into two parts: theoretical and practical. The theoretical part approaches the issue of delirium and provides an overview of the latest findings on this issue. A search of professional literature was made within the practical part or also known as methodology, according to the recommendations of the Prisma methodological procedure. The included studies also dealt with non-pharmacological interventions to prevent and manage delirium. The search strategy for professional publications was limited to a range of 10 years (2012-2022) and also to Czech, Slovak and English languages and was searched using specific keywords. This definition led to the finding of 8776 professional publications which were then reduced to a final number of 40 studies that met the inclusive criteria. The included articles were analyzed in detail and gathered using codes into individual topics like patient reorientation, sleep care, environmental adjustment, early mobilization, family involvement, analgesia and sedation or package implementation and multifactorial approach and education. The effect of individual interventions against delirium was...
|
|
|
Terminal extubation - perception of the family
Salomonová, Kateřina ; Le Roy, Anne (advisor) ; Maláska, Jan (referee)
This study focuses on withdrawal of life-sustaining therapy in patients with end-stage disease, and more specifically ventilatory therapy. Our goal was to find out how relatives of patients perceive this process, and in particular, whether they perceive a difference between they are intubated or not. We also investigated whether the nurses caring for the patients are able to correctly assess the feelings of the family, and we looked at who were the people involved in the decision process of withdrawal of treatment. Terminal extubation allows for a more natural dying process, and the patient does not have to endure the discomfort linked to endotracheal intubation. Nevertheless, in many units, there attitudes towards terminal extubation are still reserved, in part because it is not entirely clear how it is perceived by the patient's relatives. In our sample, there were 10 respondents from the ranks of related patients and 9 from the ranks of nurses. As part of our study, we conducted a review of czech and foreign literature and obtained data from the relatives of deceased patients who were present in the unit during the last hours of the patient's life. We also interviewed the nurses who cared for these patients during this visit. We were interested in how they evaluated the situation and compared...
|
|
|
Terminal extubation within DCD and its perception by ICU's health workers
Brendlová, Aneta ; Línková, Šárka (advisor) ; Maláska, Jan (referee)
Despite the fact that hundreds of transplants take place in the Czech Republic every year, hundreds of other patients will remain on the waiting list and not all them will undergo transplant that would save their lives. Absence of routine clinical practice of DCD may also play a role in this. If it will start to be a part of routine local transplant practice as well as DBD, the number of available organs for transplantation will go to increase. The aim of my work has been description of the DCD problematics in the Czech Republic and to find out how medical staff perceive the procedure of terminal extubation, which is part of the DCD process. My work has a theoretical and practical part. In the theoretical part I summarize the available information about DCD, including the course of the DCD process. Furthermore, the work deals with the process of terminal extubation, including perception of the terminal mechanical ventilation by medical staff. I carried out the research part of the work by using a quantitative method and it took place in two phases. The tool of the research method was a non-standardized questionnaire in both phases. Given that DCD is closely related to palliative care and termination of organ support for terminally ill patients, the first phase was to determine whether palliative...
|
|
| |
|
| |
guest ::
