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The application of insulin in nursing practice.
PIVOŇKOVÁ, Lenka
Abstract The diploma thesis is focused on the application of insulin in nursing practice. In 2013, there were 678,935 patients with diabetes mellitus in the Czech Republic. Of this, 17.5 % of patients were treated with insulin. When applying insulin, we must observe certain principles and procedures to avoid complications. The diploma thesis consists of the theoretical and research part. The theoretical part describes the characteristics of diabetes mellitus, describes insulin and its history, regimens, types and storage of insulin. It is also focused on the insulin application process and the education of patients. In relation to the topic, two objectives were set. The first objective was to find out how to apply insulin in nursing practice based on evidence. The second objective was to find out how the nursing process is provided by a nurse when applying insulin in nursing practice. Following these objectives, two research questions have been identified. First research question: How is insulin applied in nursing practice? The second research question: How is the nursing process filled with the insulin application? The practical part was elaborated using a qualitative research survey. The research was carried out using two variants of a semi-structured interview. The first variation of the interview was for insulin-like patients. The second variant was intended for general nurses from standard departments of selected hospitals and for nurses working in diabetological outpatient clinics. The first set consisted of ten respondents, of which 5 were women and 5 men. The second group consisted of 9 respondents, of whom all were women. The conversations were recorded and then literally overwritten. Interviews were overwritten using the pencil-paper method and further analyzed by Open Encoding. Based on data analysis, 5 categories were created with several subcategories for patients and 6 categories with several subcategories for nurses. Based on the analysis of the data, it can be said that patients or nurses do not apply insulin completely correctly. I perceive the basic problem in the distribution of insulin by species and its correct application, which varies for each species. I see another problem in incorrect application according to the length of the needle, such as the angle of the needle and the formation of the skin kelp. The output of the diploma thesis will be the standard of nursing care based on EBP, in order to highlight the shortcomings we found in the research investigation and to prevent their prevention. This standard aims to refine and improve the care provided.
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Specifics of nursing care for the blind patients to standard wards
PIVOŇKOVÁ, Lenka
Bachelor thesis is focused on the specifics of nursing care for the blind patients on standard bed wards. This topic is actual because in the Czech Republic live from 7 000 to 12 000 thousands of blind people. The most frequent reason of blindness is cataract. If these reasons begin to heal in time, blindness can in many cases completely preventable. Blindness is the hardest stage of visual impairment. Blind person suffers from a lack of visual cues that compensates for increased tactile and auditory perception. During a blind person's hospitalization is therefore necessary to respect the specific frequent related to the implementation of individual interventions. For treating blind people is also important that the nursing staff is familiar with when the blind lost his sight. His care must be subordinated to it. It should be realized that the organ of sight is the most important sensor for active and quality life, therefore his protection is important and people must regularly visit an ophthalmologist. The thesis consists of two parts, from the theoretical and research part. The theoretical part includes anatomy and physiology of the visual system, visual defects and their causes, diagnosis and classification of visual impairment. It also focuses on the specifics of nursing care of blind patients in the reception area of the department, the moving inside the hospital, examination, self-care, communication with blind patients, aids for blind patients and organizations for the visually impaired. In relation to the topic were two objectives. The first objective was focused on the specifics of nursing care for the blind on standard bed wards. The second objective was focused on the experiences of blind admissions to the standard bed wards. Based on those targets two research questions have been established. The first research question was focused on finding out the specifics of nursing care of blind patients. The second research question was aimed at finding the experience of blind patients requiring hospitalization. The practical part was processed using qualitative research. The survey was carried out at the Eye Department of the Hospital České Budějovice and the charitable society Tyflo Vysočina Jihlava. The research sample included blind clients who have previously or currently hospitalized in inpatient department. A qualitative survey was conducted through semi-structured interview. Interview contained 20 question divided into four groups. The research sample consisted of nine respondents (R1-R9), four women and five men aged from 27 to 75 years. The data were collected during the months of March and April 2015. Interviews were tape-recorded and then transcribed verbatim. Interviews were transcribed using paper and pencil method and analyzed by open coding. Based on analysis of the data was created 5 categories with several subcategories. Based on analysis of the gathered data can be said that the specifics of nursing care for the blind include patience, cooperation and communication with a blind patient. In this area are health works increased demand especially in the appropriate client familiarization with the hospital environment, providing enough information about various examinations and procedures. According to the respondents the nursing staff communicated correctly in most cases. The blind must be communicated about everything that is done and what will be done. It was also found that the majority of blind respondents have a standard admission to the inpatient department quite a good experience. But they experienced some uncomfortable moments. These moments were associated with theft, defamatory salutation, misperception that if a person can not see, still he can hear. One of the respondents also said the fact that the staff spoke when communicating with accompaniment and not with him. Bachelor thesis will be used for improve in nursing care and will be proposed draft standard for nursing.
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