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Comprehensive nursing care for a patient after a neurosurgical operation in selected diseases
VEJVODOVÁ, Hana
Theoretical approaches: Neurosurgery is a wide and sophisticated field and given the variety of neurological issues, this thesis focuses on the brain (vascular issues and tumors). Goals: This thesis has two goals. 1. To single out the specifics of caring for patients after brain surgery (of selected conditions). 2. To find out, whether the nurses know the specifics of caring for a patient after brain surgery. Hypotheses and research questions: H1: Nurses with tertiary education have greater theoretical knowledge of caring for patients after brain surgery than the nurses without tertiary education. H2: Nurses after getting the job of caring for patients after brain surgery didn't have an instructor.H3: Nurses after getting the job of caring for patients after brain surgery, most commonly struggle with an external ventricular drainage system. H4: Nurses most commonly gain the required knowledge to care for patients after brain surgery from literature. Research question 1: What is the level of knowledge of novice nurses about the specifics of caring for a patient with a brain condition? Methodology: The research was split in two parts. For the quantitative part of the research, the questionnaire method was selected. The questionnaire had 22 questions, 17 of them closed, 4 of them semi-open, 1 was an open question. The researchers handed out 300 questionnaires and received 246 (82%) of them back. 49 questionnaires had to be discarded as invalid. The final research sample consisted of 197 (100%) filled-out questionnaires. For the qualitative part of the research, the method of semi-structured interviews with open questions was selected. There were a total of 8 interviews conducted. Results: The goal of quantitative part of the research was to confirm or disprove the 4 hypotheses. H1: Nurses with tertiary education have greater theoretical knowledge of caring for patients after brain surgery than the nurses without tertiary education. Based on the data, we can see that the knowledge of nurses with tertiary education is not different from the knowledge of nurses without tertiary education. H1 was disproved. H2: Nurses after getting the job of caring for patients after brain surgery didn't have an instructor. Based on the questionnaire data, nurses did have an instructor. H2 was disproved. H3: Nurses after getting the job of caring for patients after brain surgery, most commonly struggle with an external ventricular drainage system. Based on the research data, an external ventricular drainage system is indeed the most commonly quoted problematic procedure when caring for a patient after brain surgery. H3 was confirmed. H4: Nurses most commonly gain the required knowledge to care for patients after brain surgery from literature. The research shows that this is not the case. Nurses most commonly learn the specifics of caring for patients after brain surgery from their instructors. H4 was disproved. For the qualitative part of the research, the method of semi-structured interviews with open questions was selected. The research question was: What is the level of knowledge of novice nurses about the specifics of caring for a patient with a brain condition? The interviews have shown that the knowledge of novice nurses about the specifics of caring for patients with a brain condition is on an appropriate level they know the specifics of caring for patients after brain surgery. Conclusion:The conducted original research as well as secondary literature has led us to several questions and recommendations: Is the nurse who has just started at the neurosurgery division properly being instructed about the specifics of her new job and is the adaptation process being conducted in the proper fashion? The results of this thesis suggest that a "Caring for patients in neurosurgery" manuscript could be written for general care nurses just starting at neurosurgery. This option was mentioned by some of the respondents in the questionnaire research
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Nurse´s possibilities to affect disturbing outside influences in intensive care unit
VEJVODOVÁ, Hana
Abstract Noise, light, restless or aggressive patients may constitute disturbing effects for a patient who is hospitalized in an intensive care ward. These disturbing factors form an integral part of modern medicine. Invasive methods, monitoring technologies and other devices securing vital functions of a patient in an intensive care ward mean a greater chance for the patient to survice and recover but also a greater chance of discomfort during hospitalization in an intensive care ward. The objective of the thesis was to find out how nurses in intensive care wards influence negative disturbing factors affecting the patients in connection with the regime of the intensive care ward, and how the patients react to negative disturbing factors in intensive care wards. Five hypotheses were raised. The first hypothesis was to confirm whether nurses are aware of negative factors affecting patients hospitalized in an intensive care ward. The second hypothesis was confirm whether nurses eliminate these disturbing factors as much as possible with respect to maintenance of the intensive care ward operation. The third hypothesis was to verify whether patients regard these disturbing factors as negative. These three hypotheses have been confirmed. The fourth hypothesis was to confirm that noise is regarded by the patients as the worst disturbing effect. This hypothesis has been confirmed. The fifth hypothesis was to confirm whether disturbing effects are more easily endured by men than women. This hypothesis has not been confirmed. Data were collected by means of a quantitative research. Patients and nurses obtained anonymous questionnaires. The research was conducted in the intensive care wards in hospital Nemocnice České Budějovice, a.s. The research revealed the following facts. The objectives have been fulfilled. Four of five hypotheses have been confirmed. Both patiens and nurses are conscious of the disturbing effects. Nurses in the intensive care wards have opportunites to influence negative disturbing factors without affecting the operation of the intensive care ward. Negative disturbing effects are frequent in intensive care wards and form an integral part of their regime. This thesis may lead the nurses worging in intensive care wards to considerations how to reduce negative effects that are disturbing for the patients.
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