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Nursing care of patients with nephrostomy
ZIKOVÁ, Jana
The subject of the Bachelor thesis is Nursing care of patient with nephrostomy. Despite the fact that creation of nephrostomy is not as common as for example colostomy, patients with nephrostomies are on the increase. Nursing care is based not only on complex nursing of patient but also on careful raising his awareness and education contributing to complete self-sufficiency in the area of the care of nephrostomy. Nurse has to approach patients with nephrostomy individually with consideration to their current needs. The Bachelor thesis is divided into a theoretical and an empirical part. In the theoretical part there is a description of nephrostomy intervention itself, its indication, complications, advantages and disadvantages. In the next chapter notion of nursing and of nursing process is defined. It is followed by a description of nursing care in the preoperative period. In the postoperative period there is described the work of nurse which is monitoring physiological functions of the patient. Next, the thesis focuses on patient´s life after the creation of nephrostomy and on its skills in the area of care of nephrostomy. In the empirical part it is detected if nurses of chosen departments of the České Budějovice Hospital (Department of Internal Medicine, Department of Surgery and Aftercare Department) have not only theoretical knowledge in the area of the care of nephrostomy, but also the fact if they know particularities of the care and if they are able to care of patient with nephrostomy. Research inquiry was realised also at patients with an inserted nephrostomy. Three aims of the bachelor thesis were set. First aim detect if nurses are able to care of patient with nephrostomy. Second aim detect if patient is limited in relation to inserted nephrostomy and third aim detect if patient is able to care of nephrostomy. In the thesis three hypotheses were set. The first hypothesis nurses are not able to care of patient with nephrostomy. The second hypothesis patients in the home milieu are able to care of nephrostomy and the third hypothesis nephrostomy limits patients in everyday life. To verify hypotheses questionnaire method of data collection was used. Research inquiry was realised in the period from December 2013 to March 2014 at the Department of Internal Medicine, at the Department of Surgery, at the Aftercare Department and at Urology Ambulatory Surgery. First questionnaire was designated for nurses. Definitely 105 questionnaires were processed, 31 from the Aftercare Department, 36 from the Department of Surgery and 38 from the Department of Internal Medicine. Second non-standardized anonymous questionnaire was designated for patients with nephrostomy who are regularly dispensarized at the Urology Ambulatory Surgery or hospitalized at other departments of the České Budějovice Hospital. Because of relatively low occurrence of patients with nephrostomy 70 questionnaires were distributed altogether. From it 10 questionnaires did not return and it was not possible to use 5 questionnaires because of data incompleteness. Results of questionnaires were then processed by means of computer programme Microsoft Excel 2010 and transferred into charts. From the research inquiry it results that nurses are able to care of patients with nephrostomy, that is why the first hypothesis was not confirmed. The inquiry confirmed the second hypothesis that patients in the home milieu are able to care of nephrostomy. The third hypothesis was also confirmed, patients feel limited in everyday life. The thesis should serve to familiarization with nursing care for nephrostomy and to a possible elimination of mistakes which could arise at general sisters in relation to care to these patients. Results of the thesis will be used in practice in the form of an information booklet. This booklet could be used not only by sisters but also by patients to acquire knowledge and skills related to this issue.
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