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Design of Bed for Anesthesiology and Resuscitation Hospital Department
Andrášová, Lenka ; Buganská, Tamara (referee) ; Rubínová, Dana (advisor)
The thesis focuses on analysis and design of a special hospital bed designed for the department of anesthesiology and resuscitation. The design was based on the rules set by the ČSN EN 60601-2-52 norm. The bed is adjusted for the use at the department of anesthesiology and resuscitation not only with its look but also with its functions. The design emphasizes the ergonomics of the bed, safety and the needs of the patient as well as of the staff and also an easy maintenance of the bed. Some of the main innovative elements are: basal stimulation system placed directly in the bed, used colors, more infusion-rack holders or a headboard fixed to the construction of the bed if not needed. The bed was designed especially to provide more comfort to the patient.
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Mental and physical stress for nurses in anesthesiology and resuscitation department
MALÍSKÁ, Veronika
The subject matter of this bachelor´s thesis is a mental and a physical strain on nurses working at anaesthesiology-resuscitation ward (ARO). Nurses' work is generally regarded as extremely demanding both physically and mentally. Nurses at intensive care are exposed to very high demands that are for them mentally and physically strenuous. Daily encounter with human pain, suffering, dying and death. At the same time, the nurse is exposed to a high physical workload, especially in nursing care, which is associated with the constant handling of immobile patients or patients with very limited movement and unconscious people. A substantial part is also caused by an underpowered staffing, from which it follows overwork-overtime. The aim of this paper is to refresh awareness about these loads that are placed on nurses and also to point out the possibilities which are and options that can help nurses to prevent the consequences of mental and physical overload and reduce the burden to the lowest possible level. To meet the intent of the thesis, there were three goals set up. Goal n. 1: To determine, whether nurses working at ARO are using procedures to reduce physical stress. Goal n. 2: To determine, whether nurses working at ARO use the opportunity to protect health from mental stress. Goal n. 3: To determine, whether the level of psychological stress of nurses working at ARO is greater than the rate of physical activity. There were three research questions defined. Research question n. 1: Are nurses working at ARO using aids to reduce physical exertion? Research question n. 2: Are nurses working at ARO using available options to protect health against increased mental strain? Research question n. 3: Is the level of psychological stress for nurses working at ARO greater than the rate of physical activity? The research sample consisted of nurses working in Anesthesiology and Resuscitation (ARO) in hospitals in Písek, Český Krumlov, Tábor, Jindřichův Hradec and České Budějovice. A quantitative research has been used in order to achieve a practical result of the work . The method of quantitative data collection, using non-standardized anonymous questionnaire, has been used in order to obtain the information. The research showed that although the sisters´ work at ARO is very challenging so mentally so physically, which was proved by a high percentage of both types of drains, the rate of mental stress reached higher level in the research study, and so the research question of the degree of mental and physical stress of nurses at ARO has been answered. Another part of the research was about the possibilities of health protection against mental stress, both in terms of personal options of sisters and possibilities that nurses´ organization offers. This part showed that nurses use their personal possibilities of the mental hygiene methods and also options available for mental health offered by the organization. So the research question, whether nurses working at ARO are using available options to protect their health from increased psychological burden, has been answered. The last part of the survey dealt with tools and techniques which helps to reduce physical exertion for nurses working at ARO. The investigation revealed that nurses consider the material-technical equipment for workplaces as sufficient and that they use it. So the result is that the research question of whether nurses working at ARO use aids to reduce physical stress, has been answered. The outcome of the thesis, will be providing hospitals, where the research was conducted, the research results, mainly in order to increase the quality of work of the nursing team, to improve prevention of the health protection against excessive mental and physical stress in the workplace.
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The motivation of nurses to the working performance
KREBSOVÁ, Lenka
Abstract The motivation of nurses to the working performance Motivation shall be understood as coordinating, maintaining and energizing the individual{\crq}s behaviour. Result expectations of the activity are an important aspect of motivation and work motivation, too. If the given task is to be fulfilled, what remuneration will be gained and what costs will be connected with it? Income, social business environment and work satisfaction are usually given as the work motivation factors. The aim of the bachelor thesis on ``Nurses{\crq} Motivation for Work Performance{\crqq} is to map out and compare the nurses{\crq} motivation for work performance at the standard care unit, and anaesthesiology and resuscitation care unit, intensive care unit, further to determine factors that reduce nurses{\crq} motivation to perform their work. The nurses working at the anaesthesiology resuscitation care unit, intensive care units and standard care units of Hospital České Budějovice a.s. were the research subjects. A questionnaire has been chosen as a research method. Hypothesis No. 1 was whether the nurses working at the anaesthesiology and resuscitation care unit and at intensive care units are motivated for their work more than the nurses working at the standard care units. Whether the nurses are or are not motivated, each of them is motivated by different aspects. I did not manage to prove that the nurses working at the anaesthesiology and resuscitation care unit and at intensive care units are motivated more or less. The given results suggest that the first hypothesis was not proved. Hypothesis No. 2 whether the low monetary remuneration is the most common aspect of the low work motivation. The results of the research suggest that the low monetary remuneration is not the most common aspect of the low work motivation; rather underestimation of nurses{\crq} work and lack of staff are the reasons for low work motivation. The second hypothesis was not confirmed either. Even though the monetary remuneration of nurses is one of the biggest motivation factors, it is not that important. If nurses and their work are appreciated by both doctors and nursing management, they will perform their work with enthusiasm and for lower income. I would like to present the results of my research at seminars and inform my colleagues about them. The nursing management should be interested in the motivation factors that have a certain kind of influence on behaviour and acts. If the nurses{\crq} motivation is not supported, the nurses will leave their positions and the lack of nursing staff will be increasing. Any low motivation should not become evident provided proper targets, whose achievement provides satisfaction, are set.
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Specifies of nursing care for patiens with non-invazive ventilation.
TICHÁ, Věra
The use of the non-invasive ventilation of the lungs is connected with the positive pressure ventilation. When the endotracheal tube was developed, this method was put aside. Recently, its use has gone up again. It is indicated for the patients with acute respiratory insufficiency, cardiogenic pulmonary oedema. The non-invasive ventilation of the lungs does not require any sedation. In addition, there is no risk of intubation of the airways. The contraindication includes acute ischemic myocardium, a non-cooperating patient and inability to ensure the face seal. The research used qualitative and quantitative data collection methods. The qualitative research was done in the form of interviews and content analyses of data. The research sample composed of six patients from the intensive care units in the hospital Nemocnice Tábor, a.s. The research sample of the quantitative data collection was made up of nurses from four hospitals in the Czech Republic, who work at the intensive care units and at the anaesthesiology and resuscitation unit. In total, 100 questionnaires were distributed and 84 properly filled in questionnaires were returned. The questionnaire included 40 closed questions. Objective 1 was to find out whether the nurses know and use the standard of the nursing care for the patient with non-invasive ventilation of the lungs. Objective 2 was to map actual conditions of the nursing care for the patients with non-invasive ventilation of the lungs. Objective 3 was to map which problems the patients with non-invasive ventilation of the lungs have. The objectives of the work were fulfilled. This work has got one research question. Which problems do the patients with non-invasive ventilation of the lungs have? The research found out that the patients most often have problems with rubbing and soreness to their face, dry mouth and throat and problems with sleeping. Hypothesis 1 (the nurses know standards of the nursing care for patients with non-invasive ventilation of the lungs) was disproved. The standard is not established in any hospitals. Hypothesis 2 (the nurses use the standards of the nursing care for the patients with non-invasive ventilation of the lungs) was disproved. The output is the development of the standard called "The nurse assistance of the patients with non-invasive ventilation of the lungs". Hypothesis 3 (the way of the nursing care for the patients with non-invasive ventilation of the lungs is different in the selected hospitals) was disproved. The nursing care in the selected hospitals is provided at the same level. The nursing care for these patients is a very demanding task for a nurse. An important element of successful treatment is a good psychological preparation of the patient and almost continuous presence of the nurse at the patient´s bedside. We hope that some of the results of this research will draw attention to the problems of the nursing care for the patients with non-invasive ventilation of the lungs and will help to solve them. The developed standard could also become a part of the nursing care procedures in medical facilities. .
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The awareness of nurses working in anestesiology-resuscitation wards and intensive care units about competences determined in regulation No. 424/2004 Coll.
MARTÍNKOVÁ, Petra
This paper investigates the competences of nurses on staff of the anesthesiology & resuscitation departments and the intensive care units as such competences are defined in Decree 424/2004 Coll. The paper has been split into two sections: theoretical and practical. The theoretical section looks into the roles and competencies assigned to the non-specialized nurses and to those who have completed a specialism course, specifically the "intensive-care general nurses", and describes the kinds of patients hospitalized at the mentioned departments. The paper aimed (1) to examine the extent to which the nurses were informed on their competencies following from Decree 424/2004 Coll. and (2) to find out how consistent the nurses were in adhering to what the Decree required. A questionnaire-based survey was conducted at the Brno Faculty Hospital, the Pilsen-Lochotín Faculty Hospital, and the St. Anne Faculty Hospital in Brno; moreover, the questionnaires were distributed among the nurses also using an internet social network. At the early stage of the work the authors formulated two hypotheses: (1) the nurses are not familiar with all their competencies; and (2) the nurses fail to observe the competencies following from the Decree specified above. With the questionnaires answered and the answers evaluated, both the hypotheses proved to be true. The nurses were found not familiar with all their competencies and not performing all that the Decree allowed. We believe the paper could be instrumental in enhancing the vocational education of nurses and, consequently, in could improve the quality of nursing care provided at the anesthesiology & resuscitation departments and the intensive care units.
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Evaluation of nutrition habits of nurses on ICU and ARW by NutriDan programme
EIGNEROVÁ, Anna
Nutrition and eating habits are one of the items of healthy lifestyle as well as mental and physical well-being. Eating should be performed on regular basis and all nutrition components have to be represented in proper proportion. The interrelation of sugars, fats (seba) and proteins is very important (55 - 60 % : 25 - 30 % : 10 - 15 %), sufficient protein ingestion (3-6 portions a day), fruit and vegetables (3 - 5 portions a day), dairy products (2 - 3 portions a day), meat and meat products (1 - 2 portions a day). Drinking liquids should be sufficient and should be kept within the range of about 30ml per 1 kg of our body weight, and of course the drinking liquids is important integral part of our nutrition. The aim of this work has been to evaluate and assess quality of eating habits of nurses working at Intensive Care Units (ICU) and Anaesthesiological Resuscitation Ward (ARW) according to NutriDan programme. In order to accomplish this aim the following four hypotheses have been postulated: H 1 The nurses working at ICU and ARW eat their meals on regular basis. H 2 The nurses working at ICU and ARW have their menus containing fruit and vegetables with ratio in accordance with recommended quantities for daily consumption (4 x 100 g). H 3 The consumption of liquids at work is lower than that out of work (at home). H 4 The interrelation of sugar, fat and proteins in nurse menus is in harmony with individual estimate of energy expenditure. Research has been outlined and drawn up as quantitative one and anonymous questionnaire (answer sheet) has been used containing 3 parts (general pat, special part and the menu mentioned above applied in time period of 24 hours). One hundred and four questionnaires (104) have been distributed in all while fifty-two (52) pieces of which have been given to nurses working at Anaesthesiological Resuscitation Ward and fifty-two (52) pieces of the questionnaire have been given to nurses working at Intensive Care Units.The aforementioned questionnaires have been distributed in three hospitals and seventy-three (73) have been received for our evaluation, of which forty-three (43) from nurses working at Anaesthesiological Resuscitation Ward and thirty (30) from nurses working at Intensive Care Units. For research data processing we have applied two programs: Microsoft Excel program and NutriDan program; the results obtained have been processed so as to be presented as graphs. The aim of the work has been fulfilled and the hypotheses 1, 2 and 4 se have been invalidated i.e. disconfirmed whereas the hypothesis 3 has been confirmed. The nurses working at Intensive Care Units and Anaesthesiological Resuscitation Ward do not eat their meals on regular basis, they often have lower energy taking, moreover they do not have correct interrelation of sugar, fat and proteins. The aforementioned nurses show lower and irregular consumption of fruit and vegetables, meat and dairy products and dietary fibre. Consumption of liquids is sufficient both at work and at home. The management of hospitals and wards as well will be made familiar with the results of this bachelor's degree diploma work i.e. those where the research has been carried out. This work can be used as a source material for lectures and enlightenment material in order to change the attitude of nurses of intensive care to eating habits of theirs.
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Utilization of aids for handling of non-self-sufficient patients at departments of intensive medicine.
JANTAČOVÁ, Dana
Departments of intensive medicine often hospitalize patients with self-sufficiency disorders in routine daily activities. Nurses working in those departments have to handle such patients on daily basis, as a part of providing quality nursing care. To make their work easier there are more or less available aids, however, they are not always fully used. The reasons include complexity of the use, unavailability of the aids in hospitals or saving time for other duties. This thesis is divided into two parts. The first part considers the theoretical side of the issue. We have focused on patients at departments of intensive medicine, who are dependent on assistance provided by nurses. Nurses function primarily as attendants. The theoretical part also describes the most common aids used for handling of non-self-sufficient patients. The second part of the thesis focuses on research. We have conducted surveys in selected hospitals in the Czech Republic at departments of intensive medicine. The survey used anonymous questionnaires for nurses working at intensive medicine departments. The objectives of the thesis were as follows: To find out whether nurses at departments of intensive medicine use all aids for handling of non-self-sufficient patients; to find out which aids are used most frequently by nurses at departments of intensive medicine for handling of non-self-sufficient patients and to find out whether nurses at departments of intensive medicine are able to use correctly the available aids for handling of non-self-sufficient patients. To achieve the objectives, three hypotheses were established H1: Nurses at departments of intensive medicine do not use all aids for handling of non-self-sufficient patients. H2: The aid most frequently used by nurses at departments of intensive medicine is a positioning mat. H3: Nurses at departments of intensive medicine are able to use correctly the available aids for handling of non-self-sufficient patients. The objectives of the work have been met and three hypotheses were confirmed in the survey. This thesis may serve as an information material for nurses interested in nursing in intensive medicine. Further, it may serve for manufacturers of aids for handling of non-self-sufficient patients; it presents opportunities for improvement of the most frequently used aids and for simplification of work with aids used by the nurses less frequently.
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The care of skin in Anaestheziology - resuscitation department and Intensive care unit
MUŽÍKOVÁ, Eva
My Bachelor Paper, focused as indicated in the title, relied on questionnaires distributed among nurses to find out whether they could access with sufficient readiness the anti-decubitus aids and hygiene agents needed for proper care of the patients. Moreover, through inconspicuous observation I tried to make sure the patients had the aids readily available. The first hypothesis, proved warranted, predicted that the nurses took proper care of the patients' skin in conformity to the relevant nursing standards. This hypothesis could be confirmed because I had a chance of reading standards used to regulate practices at the health-care facility being investigated. The nurses had available an adequate range of aids required to adjust the patients' positions, keep the patients clean and take care of their skin. The second hypothesis predicted that the ARW and ICU patients had available the anti-decubitus aids. Now, with the questionnaires reviewed and the observation completed, I can conclude that this hypothesis has been confirmed as well. I believe, the care is also dependent on sufficient supply of bedclothes available the wards and units; judging from my observation and the questionnaires returned by some selected nurses, the bedclothes are in no short supply. The occurrence of decubitus ulcers in these patients is not extremely widespread, and their injuries heal mostly per primam. The nurses try to improve their relevant qualifications by reading vocational periodicals and attending thus oriented seminars - obviously, they pay proper attention to these issues. The Paper endeavored to map the care of skin provided by nurses at the AR Ward and the IC Unit. In my opinion this objective has been met. To get a better idea of my research results, please see the related charts.
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Providing the patient´s privacy on regular wards and intensive care units
ŠVAGROVÁ, Soňa
Providing the patient´s privacy on regular wards and intensive care units Abstract At present, dignity and intimacy of a patient has been increasingly put in the shade. The issue of security of intimacy differs at each ward. The objective of the bachelor thesis on the topic ``Security of intimacy of a patient at a standard ward, an anaesthesiology-resuscitation ward and an intensity care ward{\crqq} is to map out the knowledge of nurses in the field of intimacy and its observance at various sorts of wards. Conducting a number of activities, a nurse enters the intimate zone of a patient and disturbs their intimacy. Therefore we intended to ascertain whether nurses have sufficient knowledge in this field. In a number of cases, patients are not able to defend themselves so their protection is to be secured by the health workers who should behave in the manner respecting the patients in any situation and state. They must do anything not to disturb their intimacy at all or only to a minimal extent. For this reason we raised the questions: Do nurses observe intimacy of patients sufficiently? Do the nurses working at an anaesthesiology-resuscitation ward (ARO) and an intensity care ward (JIP) observe the intimacy principles more than the nurses at standard wards? The research group consisted of the nurses working at ARO, JIP and standard wards of surgical sections in Nemocnice České Budějovice a.s. and Nemocnice Český Krumlov a.s. The research method I used was a questionnaire. Hypothesis No. 1 that nurses have a sufficient knowledge in the field of intimacy was confirmed on the basis of the knowledge test results. Regrettably, hypothesis No. 2 that nurses observe patient intimacy insufficiently was confirmed. Hypothesis No. 3 that the nurses working at ARO and JIP wards observe the principles of intimacy security more than the nurses working at a standard ward was not confirmed. It follows from the results of the research that while nursing the patients, nurses observe the principles of intimacy security insufficiently at all the types of wards. On the basis of the undertaken research, the hospitals that have not internal regulations (guidelines) on this issue elaborated should do so e.g. in the form of ``Ten Rules of Patient Privacy{\crqq} and should pay attention to observance of principles of patient intimacy protection. It is necessary that the nurses serve as defenders of the patients{\crq} rights in this field.
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