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Nursing care for patients with craniocerebral trauma
PILNÁČKOVÁ, Jitka
The topic of this thesis is ?Nursing care for patients with craniocerebral trauma?. Three goals were set. We tried to find what the specifics of nursing care for patients with craniocerebral trauma are. We also examined whether nurses were aware of the specifics of nursing care for patients with craniocerebral trauma. The last goal was to find out whether nurses used basal stimulation in these patients. The research was based on a non-standardized interview. The interviews were performed with twelve nurses caring about these patients in the České Budějovice Hospital and the Faculty Hospital Královské Vinohrady. Three research questions were set. 1: What are the specifics of nursing care for patients with craniocerebral trauma? The research has shown that elevated head position, monitoring of GCS, pupil state and response, administering of bolus analgosedation doses in some nursing activities, ensuring detention administration and list of valuables are the specifics. We have also included CT examination, pre-operation preparation, care of invasive inputs, drains, operation wounds, careful handling with patients, constipation problems, care of a disturbed or aggressive patient and special approach to communication with these patients. 2: Are nurses aware of the specifics of nursing care for patients with craniocerebral trauma? We found that respondents knew the above mentioned specifics. However we found two drawbacks. The first one was in the unawareness of the possibility to increase ICP during defecation among the respondents, the other one was in communication with disturbed or aggressive patients. 3: Do nurses use basal stimulation in patients with craniocerebral trauma? The research has shown that the respondents do apply the concept of basal stimulation, but they only use some of the stimulation elements. This thesis may serve as study material for new nurses starting at the department, where they will care about these patients. The research results and the Standard nursing procedure of Basal stimulation elaborated by us will be offered to managers of both the hospitals where the interviews with nurses were performed.
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The Standardisation of Procedures in Pain and Nursing Care Assessment in Patients with Pain in Hospitals
PILNÁČKOVÁ, Jitka
The topic of this Bachelor Thesis is called ``The Standardisation of Procedures in Pain and Nursing Care Assessment in Patients with Pain in Hospitals``. Its objective was to find out whether nurses observe the Nursing Care Standard of patients with pain. The research survey was realised by means of a questionnaire and an audit survey at the České Budějovice Hospital, a.s. The questionnaire was given to nurses of all surgery branches, between the 26th January to the 6th February 2009. The audit was carried out in the accident and plastic surgery department on the 23rd February 2009, and in the orthopaedic department on the 2nd March 2009. The audit survey was assessed according to Control criteria concerning the audit of the Nursing Care Standard No. 041 ``Pain``. We laid down 4 hypotheses. Hypothesis 1: Nurses of surgery branches do not use the visual analogue scale for patients with pain, was refuted. Hypothesis 2: Nurses do not record the effect of medicaments in the documentation after administering a medicament influencing pain, was confirmed. Hypothesis 3: Nurses of surgery branches use the application of heat and coldness to alleviate pain, was also confirmed. Hypothesis 4: Nurses do not know the pain treatment strategy according to WHO, was refuted. In connection with these facts we proposed correction measures. To improve this situation, special lectures on pain assessment, informing nurses and physicians about the importance of pain assessment and using this information, could help. More frequently conducted audits of Nursing Care Standard No. 041 ``Pain`` could improve the quality of requirements laid down by this Standard. With regard to the latest information about creating standards and about the questions concerning care of persons suffering from pain, we drew up the Standard Care Procedure Nursing Care of patients with pain. This standard will be offered, along with the results of the survey, Control criteria concerning the audit of the Nursing Care of patients with pain and the DySSSy standard method (Dynamic Standard Setting System) to the deputy in charge of nursing care Mgr. Jiřina Otásková, MBA.
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