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Intensive care unit delirium from nurses perspective
Křížová, Jana ; Hocková, Jana (advisor) ; Maffei Svobodová, Ludmila (referee)
Intensive care unit delirium from nurse's perspective Introduction: Delirium is a disturbance of consciousness, one of the most frequent organ dysfunctions in the ICU. Delirium occurs in 60 - 80% patients who receive mechanical ventilation and is independently associated with increased mortality and development of post-ICU neurocognitive deficit in adult ICU patients. It is recommended to monitor delirium routinely with validated screening tools (CAM-ICU or ICDSC). Experienced and well educated nurse, armed with appropriate diagnostic tools, can actively participate in prevention, diagnosis and therapy od delirium. Objective: This Master diploma thesis objective was to get to know current knowledge of nursing staff working in Czech ICUs about delirium and their clinical praxis. Method: Quantitative research was conducted with a questionnaire filled by nursing staff of ICUs for adult patients in two university and one regional hospital in Czech Republic from August to September 2017. Results: Altogether, 110 questionnaires from 130 have returned (84% return). The outcomes showed that 63% of nurses are sufficiently informed on ICU delirium, 66% would appreciate more education on the subject. All in all, 51% of nurses don't prevent delirium in their patients and 35% don't even know what are the...
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Lifelong learning of nurses working in ICU
KÖHLEROVÁ, Andrea
In this thesis, we dealt with the lifelong learning of nurses working in the ICU. The aim was to find out the specifics of lifelong learning of nurses in ICU. The thesis is divided into two parts, theoretical and practical. In the theoretical part, we focused on the beginnings of nursing, but our primary focus was on nursing learning that nurses currently need for their work, and at the same time, we are focusing on further education opportunities, so that they can get the necessary specialization to work in ICU. For the empirical part we chose the methodology of quantitative survey, the technique of data collection was a questionnaire. For the research part we chose three basic hypotheses: nurses working in the ICU have a need for lifelong learning; nurses working in the ICU have a need for further learning; nurses working in the ICU have a motivation for further learning. Questionnaires were distributed to nurses working in the ICU in one hospital in the Hradec Králové and Pardubice regions. In total, 100 questionnaires were distributed, but only 66 completed questionnaires were returned. These questionnaires consisted of a research section. This research has shown that most nurses think lifelong learning is meaningful, nurses need to further educate themselves after the credit system is abolished, nurses have support from the employer, but nurses lack sufficient motivation for further education. Most nurses would be educated, for example, for better financial evaluation or career growth.
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Perception of hospitalization of polytraumatised ICU patients and its evolution in time
Haramijová, Eva ; Mareš, Jiří (advisor) ; Gigalová, Veronika (referee)
Author: Eva Haramijová Institution: Charles University in Prague Faculty of Medicine in Hradec Králové Department of Social Medicine Department of Nursing Title: Perception of hospitalization of polytraumatised ICU patients and its evolution in time Supervisor: Prof. PhDr. Jiří Mareš, CSc. Number of pages: 132 Number of attachments: 6 Year of defense: 2016 Keywords: polytrauma, pacient's perceptions, aspects of hospitalization, ICU Bachelor's thesis is a summary of basic knowledge in the field of general traumatology and specifics of polytraumatized patient's care. It describes the system of patient's care based on ATLS principles, care management, complications and psychosocial aspects. Empiric part concentrates on description of qualitative research performed in two phases by the method of half structured interviews with five patients to describe perception changes in time. Mainly, the goal was to clarify negatively percepted phenomenons of ICU hospitalization: restrictions, sleep and rest, staff behaviour and psychological dealing with the situation. Additional questions referred to the worst experience, positives of hospitalization and potential live changes due to injury. The research was performed in intensive care unit of surgical clinic of university hospital in Hradec Kralove. The result...
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The rate of stress load on standard nursing wards and intensiv care units.
Brzicová, Věra ; Kulhavá, Miluše (advisor) ; Ptáček, Radek (referee)
This thesis deals with the stress, strain and stress level of stress. It examines what more burdens on JIPu sisters and what the standard department, what are the specifics of their work. Compares the work load and nursing department and the standard JIPu. It looks at how the situation affects of stress nurses. It outlines the causes and manifestations of stress effects on the human organism. He is also the burnout that often occurs among workers in the helping professions. The thesis is focused on the shift operation (especially on night shift), relationships at work (sister-sister, sister-doctor), the aggressive behavior of patients, or the lack of sufficient time for patient care. Research method is a questionnaire distributed to the nurses and the internal standard surgical wards and ICU. The evaluation questions of the questionnaire confirms or overthrows the hypothesis that I set at the beginning of research. The hypotheses were confirmed hypotheses 2 and 5 of the hypothesis was not confirmed. It was confirmed that the exchange operation and overload nurses, patient aggression, care of confused patients and bad interpersonal relations a high burden on medical personnel and contributes significantly to the stress load of nurses. In conclusion, I mention that a large role in preventing and...
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Lifestyle changing of the nurses working at ICU
JENERÁLOVÁ, Andrea
In our work, we have been working on changing of the lifestyle of nurses working at ICU. The aim of the work was to find out whether the nursing class at the ICU had an impact on their lifestyle. The thesis is divided into two parts. In the theoretical part, we have focused on the lifestyle characteristics, which included healthy nutrition, drinking regime, physical activity, sleeping and stress factors. We also characterized the ICU, the competence of the nurses at the ICU and their education. The research part is realized in the form of a qualitative approach, by using a semi-structured interview. For the research section, we have chosen three following research questions. What kind of lifestyle do nurses working at ICU have? Did the nurses change their lifestyle after joining the ICU? In which aspects and how did nurses significantly change their lifestyle after entering the ICU? The research sample consists of eight probands who have previously worked at the standard department and are currently working on ICUs. Probands were selected for internal ICU, surgical ICU, urological ICU and traumatic ICU in one of the hospitals in the South Bohemian Region. During the interview, we have been comparing the nurses' lifestyle at the standard department and the ICU. The results of the research showed that nurses have a poor quality of life. They eat irregularly, have poor sleep, which is born on the basis of interchange, they also have a lack of physical activity, because they have no time for it and they are tired after their work. Furthermore, the results of the research showed that nurses´ conditions (after their arrival to ICU) have been improved by eating aspects and their regularity, less stress situations and a better workplace atmosphere. Other aspects mentioned in the theoretical part were not significantly altered.
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Specifics of nursing care for elderly pacients after orthopedic surgery at the ICU in the faculty hospital Na Bulovce
ŠVECOVÁ, Markéta
Seniors are the group of patients most frequently occurring at the workplace of the author of this thesis, the ICU department of the Orthopaedic Clinic of Bulovka Faculty Hospital. Nursing care of seniors has its specifics mostly resulting from higher demands of aging organism. Despite the intensive efforts to provide the largest group of patients with quality care made at the workplace there is always something to improve. The main goal of the thesis thus was to find an answer to the question what could be improved on the quality of nursing care of patients after an orthopaedic intervention. Qualitative research in the form of a non-standardized interview was applied to collection of the necessary information on the present state of the issue. The research was conducted at the Orthopaedic Clinic of Bulovka Faculty Hospital. The research sample consisted of nurses working at the department and senior patients hospitalized there after orthopaedic interventions. There are several conclusions resulting definitely from the research. The nurses are sufficiently informed on the issues of nursing care of seniors after orthopaedic interventions and have sufficient possibilities of providing quality care. The factors negatively affecting the care being provided particularly involve obsolete technical background of the ICU and unsatisfactory constructional arrangement of the theatre. The solution of the problems is however closely linked to the lack of funds. As for staffing there is a problem of a large number of insufficiently qualified nurses compared to those meeting the qualification requirements. The conclusion of the research has provided an answer to the question what the spheres of improvement of the quality of nursing care of patients after an orthopaedic intervention were. According to the conclusions of the interviews with nurses and patients these are particularly better information of patients and investment in gradual improvement of material and technical base of the ICU, which would provide the patients with sufficient privacy, and make their exacting stay at the ICU easier. The problems of patient information might be solved by distribution of informational brochures defining patient?s rights and obligations, including the basic data of the department regime and instructions where to find answers to frequent questions. Prohlášení
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Nursing barrier care in the ICU
DUŠKOVÁ, Ludmila
Barrier nursing care is one of the important methods falling under the area of prevention of nosocomial infections which should be known and adhered to by nurses during the execution of their work. The theoretical part of the thesis deals with nosocomial infections and the characteristics of intensive care and it explains the principles of barrier nursing care. The practical part of the thesis inquires into the nurses´ knowledge of the principles of barrier nursing care, the adherence to these principles and the aids needed for caretaking using the barrier nursing technique. The research inquiry was carried out using quantitative research method. Data collection was realised by a questionnaire. Three goals had been set. Goal 1: Finding out what knowledge the nurses working in intensive care departments have about the principles of barrier nursing care. Goal 2: Finding out what principles of barrier nursing care are adhered to by nurses working in intensive care departments. Goal 3: Finding out what problems nurses working in intensive care departments identify in terms of the adherence to the principles of barrier nursing care. To specify the goals, four hypotheses were laid out. Hypothesis 1 stating that nurses in intensive care departments know the principles of barrier nursing care wasn´t affirmed. As the nurses do not adhere to the principles of barrier care during the execution of their work, we suppose they do not know them. Hypothesis 2 stating that nurses in intensive care departments research information concerning the principles of barrier nursing care wasn´t affirmed. Only 58.5 % of nurses are interested in educational events dealing with the principles of barrier nursing care. The remaining nurses (41.5 %) would not attend training events. Hypothesis 3 stating that nurses in intensive care departments work in adherence to the principles of barrier care was not affirmed. Out of seven questions testing work habits of nurses during caretaking according to the principles of barrier care, only one was answered correctly by more than 70 % of the nurses. Hypothesis 4 stating that nurses in the departments of intensive care do not identify the problem with caretaking according to the principles of barrier nursing care in the lack of aids was affirmed. Most nurses (89.6 %) think they have enough aids for caretaking according to the principles of barrier nursing care at their disposal in their workplace. The result of the research inquiry also point to the principles the nurses adhere to. These include using aids necessary for caretaking by the barrier nursing technique and isolating the patient in a separate room or a closable box. The nurses state that acute states of health related to intensive care represent a problem which sometimes leads to breaking the principles of barrier care while taking care of the patient. The research revealed the need to motivate nurses to acquire more profound information in this area of problems and to adhere to the principles of barrier nursing care. Furthermore, it is necessary to monitor nurses more during the execution of their work and point out their malpractice to them in time. The result will be submitted to the management of the hospital where the research inquiry took place. Our recommendations, which should contribute to raising more interest in the area of problems of nosocomial infections and barrier nursing care on the part of the nurses, can be proposed to the management. The cause of the low level of awareness and low interest in acquiring more knowledge about barrier nursing care on the part of the nurses could be a further research issue.
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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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