|
|
Tools for identification and analyze risks in nursing practice.
PUCHNAROVÁ, Jana
Current state: Using tools to identify and analyse risks is presently very important in nursing to minimise the risk of harm to patients that can be prevented. The FMEA (Failure Mode and Effect Analysis) is a very efficient tool to address the failure issue. It is an important preventive method determining possible failures and proposing preventive measures to minimise the risk of errors. The RCA (Root Cause Analysis) is another important tool to handle failures. Objectives of the work: The objective of the research was to determine processes with the highest risks in nursing and to find out the most common risks associated with the nurse profession. Another objective is to describe the undesirable events reporting methods and to find out the utilisation of all risk analysis methods by nurses. And the final objective was to describe the intervention fall prevention programmes.Methodology: A qualitative research method was used to prepare the empirical part of the thesis. Data were collected using in-depth interviews. Qualitative data were coded using the pencil and paper technique; data were then categorised and respective subcategories were determined and shown in the SmartArt application. Research participants: Interviews were conducted with the head nurse, quality manager, senior nursing officer and departmental sister from the department of internal medicine, department of neurology and aftercare department. The first research was conducted in Nemocnice Jindřichův Hradec, a.s., the second in Nemocnice Tábor, a.s. and the final one in Nemocnice Písek, a.s. Results: It was found out from the results of the qualitative research that the most risky processes included medication in form of pills when, for example, generics drugs are given incorrectly or drugs of wrong strength are administered. The second risk process is the preparation of drugs from concentrated solutions of kalium, heparin or insulin. Administering intravenous drugs and infusion solutions is the third risky process. Too many activities of a nurse at one time is often the cause. Non-cooperation, poor communication of the patient and his/her family also lead to risky situations.Another serious group of risky processes includes patient transfer, moving the patient from a stretcher to a bed or going to the toilet. Further, it was found out that the most common risks are nosocomial infections, falls and decubital ulcers. Too much workload of nurses and new staff undergoing training are also mentioned as a risk. They include in particular medical assistants. Prescribing drugs through a computer system where the doctor relies on the nurse that she will alert when wrong drugs are prescribed although it is not her obligation to do so is also considered a common risk. Closing the infectious department in a hospital is the next risk. Patients who have a suspicion for certain diseases are then examined in a department. Nurses working there are afraid of getting infected from the ill person. And quite often, a disease is really found in the patients. Respondents gave different answers to the procedure of reporting undesirable events. The answers were different from one hospital to another. Nevertheless, all the reporting go to the hospital management that evaluates it. Nurses in the inquired hospitals do not use any risk analysis method. Not even nurses in management positions do not work with the methods and do not know the FMEA method. A direct analysis is addressed by the quality manager who most often uses the RCA analysis. Its results are discussed at meetings of nurses in the department, meetings of senior nursing officers or meetings of chief physicians. As for preventive programmes reducing the risk of falls it was found out that in all hospitals the screening of the risk of falls is standardly performed in all patients upon admission, except hospitalisations shorter than 3 days.
|
|
|
The importance of nutritional support in the treatment of wounds.
PUCHNAROVÁ, Jana
This bachelor thesis is devoted to the importance of nutrition support for therapy of wounds. Today the importance of nutrition support is generally known in all branches of medicine. Due to malnutrition bad healing of wounds occurs. From this reason each nurse should be aware of the importance of proper and balanced nutrition together with proper care of healed wounds. Proper nutrition protects people against infections, facilitates the process of healing and improves therapeutic results. The theoretical part is engaged in the importance of nutrition support, malnutrition, nutrition team, peroral support, and enteral and parenteral nutrition. It further deals with acute and chronic wounds, phases of healing, factors influencing healing, and nursing care of wounds. Two targets were set within the research. The first target was to monitor the knowledge of the importance of nutrition support for healing of wounds nurses have. The other target was to find out whether nurses have active attitude towards the questions of nutrition support when healing wounds. The empirical part uses the method of quantitative research survey together with the method of data collection using a non-standardised questionnaire. The research group consisted of nurses working on shifts and charge nurses working in internal medicine wards, surgical wards and after-care wards in the Jindřichův Hradec Hospital a.s and the České Budějovice Hospital a.s. The questionnaire consisting of 31 questions was filled in by 126 nurses. Processing of the survey was carried out using Microsoft Office Excel 2007. The questionnaire is stated in Annex No.2. Three hypotheses were assessed on the basis of the targets. H1: Nurses are aware of the importance of nutrition support for healing wounds. H2: Nutrition support is provided to patients on the basis of nutrition screening. H3: Nutrition support records are made by charge nurses.
|
guest ::
