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Principles of preparation and administration of selected Medicaments in the Intensive Care
ZÁRUBA, Petr
According to the European Union, medication errors are among the most common adverse events connected with the provision of healthcare services. The safety of nursing care is a basic indicator of the quality of health care providers. One of the basic activities of general nurses is the preparation and administration of medicines, during which, especially in intensive care, even the slightest non-compliance can harm the patient. When preparing and administering medicines it is therefore essential that general nurses consistently follow safety regulations, internal guidelines of health care providers, recommendations of the World Health Organization and national nursing standards, which can effectively prevent potential errors. In clinical practice general nurses may not adhere to these measures for a variety of reasons, so it is important to establish and analyse them. In the theoretical part, the legislative framework for the preparation and administration of medicines in the Czech Republic is defined. This part also describes general principles of handling medicines connected with the problem of medication errors in the context of the quality of health services and defines forms of medicines and their application methods. The practical part of the paper sets out to determine what knowledge nurses working in intensive care have, whether they apply this knowledge in their work process and whether they observe failings of their colleagues relating to the preparation and administration of medicines. With this in mind, four hypotheses and six research questions were established. A quantitative method, non-standardised questionnaire technique was used to collect data. After the quantitative method, the method of qualitative investigation by observation and the technique of an in-depth semi-structured interview were conducted. The research population comprised non-medical health care workers (general nurses and paramedics) working in anaesthesiology-resuscitation departments and intensive care units of district-type hospitals. The quantitative data was processed using descriptive statistics with tables and graphs, while the qualitative data was processed using charts and diagrams.
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Hyperbaric Oxygen Therapy in Intensive Care from the Perspective of Nurses
KRAJÍCOVÁ, Dominika
This diploma thesis deals with the work of nurses taking care of patients in intensive care during hyperbaric oxygen therapy. The theoretical part of this thesis summarizes current knowledge in the field of hyperbaric medicine. The practical part of the thesis applies to the particular experiences of nurses, which accompany the patients during therapy. The thesis studies how the nurses are trained, how they prepare the patient, and how they perceive the work in hyperbaric conditions. The nurses work in two different workplaces, which are compared.
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The importance of pronation position in the care of patients with Acute respiratory distress syndrome
ARNOŠTOVÁ, Kateřina
The bachelor thesis deals with the prone position, which is used as a method for treating patients with acute respiratory distress syndrome. The aim of this work is to show the importance of the prone position for patients with ARDS from the point of view of a non-medical healthcare worker and to determine the obstacles posed by applying this position. The theoretical part is based on studying the professional literature and professional journals, and dividing data into individual chapters. The individual chapters deal with the definition of the terms acute respiratory distress and the prone position. This followed by the causes of ARDS, which are described in individual chapters, ARDS treatment, which also includes the use of the prone and semi-prone position, and the particularities of nursing care. The practical part of the bachelor thesis is focused on evaluating the answers to the research questions which were asked using a qualitative research strategy. The data were obtained through interviews with non-medical health professionals from the anaesthesiology and resuscitation department at the hospital in České Budějovice who, during their training in this department, have experienced the use of the prone position in practice. The data obtained were analysed by open coding and subsequently categorized into individual categories. Finally, it was possible to evaluate the aim of the bachelor thesis and draw some conclusions. The results of the research show that the prone position became a widely used method of ARDS treatment during the Covid-19 pandemic. The prone position is used for patients with Covid-19 when all the therapeutic options have been exhausted and the use of the prone position is the last hope to save their lives.
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Mental health care for nurses working in the anesthesiology and resuscitation department
FORMÁNKOVÁ, Kateřina
The thesis focuses on mental health care among the Anaesthesiology and Resuscitation department nurses. Two goals were set. The first goal was to find out what means the nurses use to take care of their own mental health. The other goal was to map what elements the nurses find the most stressful. Five research questions were defined in order to accomplish these goals. The empirical part is in the form of a qualitative research survey using a semi-structured interview, which consisted of 12 questions. The focus group consisted of 10 nurses working at the inpatient section of the department of Anaesthesiology and Resuscitation. Acquired information was subsequently analysed and categorized. The nurses prevent the everyday stress by looking after their mental health and spending time with their family and close friends. The nurses' active relaxation consists of going for walks, trips or sport. Passive relaxation includes reading, watching movies, playing games, going shopping, sauna, good food, looking after themselves or going abroad. Some nurses are trying to pay attention to healthy lifestyle as they find it important. They most often experience mental workload when admitting a patient because of the burden of responsibility, time pressure and work overload. They also attribute the strenuousness of their occupation to them being constantly vigilant, ready to react quickly, decision making, improvisation and taking care of restless patients.What the nurses find particularly emotinally demanding is communication with the families of their patients and looking after young patients. They further prevent workload by using teamwork, being in a good mood and joking in the workplace. The interviewed nurses expressed their overall satisfaction with their work but at the same time they mentioned the need of hiring more staff and financial contribution for sports activities.
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Cultural competences of nurses in intensive nursing care
BALOUNOVÁ, Lucie
The goal of this thesis with the name "Cultural Competence of Nurses in Intensive Nursing Care" is to analyze the cultural competence of intensive nursing care. Based on this topic, two questions have been created: "What is the cultural competence of nurses in intensive nursing care" and "Which cultural challenges do nurses face in intensive nursing care?" The theoretical part of this thesis focuses on the characteristics of multicultural nursing care, defining basic concepts that are associated with this topic. It also describes various nursing care models about multicultural nursing care, along with communication and the challenges associated with specific minorities. There is also a chapter that focuses on the characteristics of intensive care and the specifics of communication with patients. The empirical part of this thesis was written in a qualitative form, comprising of interviews that gathered data based on thirty-two questions and a few sub-questions. The introduction had three questions collecting personal information of the interviewees, then another twenty-nine questions followed with thirteen sub-questions that focused on the nursing care of patients of minority groups, the specifics of transcultural nursing care, educating nurses about this topic and how much experience did they have with this topic. If necessary, further questions were asked. The whole interview was done so that it would be able to provide answers to our study questions that were made ahead of time and to also provide a picture of how nurses handle intensive care in patients of minority groups. We asked a total of ten general nurses who at the time of this study worked in intensive care, either at a department of anesthesiology and resuscitation, intensive care department or intermediate care. The interviews were then processed with open code and coloring text. In order to make the results of the study easier to understand, they have been divided and presented into four categories and ten subcategories. The categories clearly describe the experiences and thoughts of nurses. The results provide a holistic view on transcultural nursing care in intensive care. Based on this study, transcultural nursing care is becoming even more significant in today's society and it is important to not just focus on the education of nurses regarding this topic, but also to teach foreign languages, because language barriers are one of the most common obstacles nurses must face. This work may serve as educational material not just for students of healthcare professions, but also for nurses working in intensive care. The results alone point to shortcomings and problems associated with providing a culturally competent care and may contribute to improving this specific topic.
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Selected nursing services in the context of Evidence Based Nursing
KRATOCHVÍLOVÁ, Gabriela
The thesis deals with the issue of selected nursing processes in the context of Evidence Based Nursing. The process in question is the care of central venous entry and peripherally placed central entry in relation to the incidence and prevention of central line associated infections. One of the aims of this paper is to map and analyse information on central line entry care. Other objectives are to determine which central line entry care is most effective in relation to infection incidence and to provide an overview of the interventions provided in central line care that are absolutely necessary and essential. The thesis is divided into several chapters which are structured around Evidence Based Nursing. The chapter describing the current state of the art outlines Evidence Based Nursing, invasive admissions and catheter infection. Chapters dealing with the education of general nurses in relation to central line nursing competency are presented, the area of infection and its prevention, the site and method of central line insertion, the type and characteristics of the central line catheter, dressing and draping techniques, disinfection, and the issue of flushing and needleless entry are discussed. The last chapter reviews education, care training and training in the care of central venous accesses. The information sources were searched from all over the Word in scientific databases. Several recommendations for practice have been established based on the development of this thesis. The thesis can be used as educational material and be an inspiration in the issues of different practices and education in this field.
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The role of the nurse in the system of early search for critical ill patients
BOUŠOVÁ, Adéla
The diploma thesis is focused on the role of nurses in the system of early search for critically ill patients in intensive care units. The Czech healthcare system still does not place the emphasis on the system of early search for the critically ill as it should. Knowledge of the issue can improve the quality of health care and reduce the mortality of critically ill patients who suddenly enter a life-threatening condition, but with knowledge of the issue, a life-threatening condition could have been prevented. The theoretical part of the diploma thesis consists of five chapters and several subchapters. The first chapter focuses on the critically ill, the second chapter on the monitoring of the critically ill, the third chapter on technical equipment in intensive care, the fourth chapter on the role of nurses in intensive care and the last chapter deals with the system of early search for critically ill patients. Three goals were set for the diploma thesis, namely to map the roles of nurses, how nurses are involved and whether they are educated in the issue of early search for critically ill patients. The practical part was processed by a qualitative survey in the form of semi-structured interviews, which were analyzed in the form of "paper pencil" by the method of open coding. The practical part was divided into four categories and then into subcategories. For clarity and clarity, the categories and subcategories have been visualized in diagrams. Based on the set goals of the diploma thesis, three research questions were set. The first research question dealt with the roles represented by nurses in the system of early search for critically ill patients. The second research question was how nurses are involved in the system of early search for critically ill patients. The third research question deals with the way of lifelong education of nurses in the system of early search for critically ill patients. The set goals of the diploma thesis were met.
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Palliative care in intensive and resuscitation care units
ZIMOVÁ, Eva
The diploma thesis deals with the topic of palliative care in Intensive and Resuscitation Care units. Intensive care aims to save lives, while palliative care accompanies the patients and improves their last moments. Although it would appear that these two fields has not much in common, this is not the case. Both touch the death and work with people who balance between life and death. The theoretical part describes the various fields, including their history. The chapter is further dedicated to the connection of these two areas. The following chapters cover the ethical aspects of palliative care provided in Intensive and Resuscitation Care units. Following chapters deal with dying and death. The last chaptersof the theoretical part are focused on the relatives of dying and deceased patients. The aim of the thesis was to map the awareness of medical staff working in Intensive and Resuscitation Care, discover the approach of medical staff working in Intensive and Resuscitation Care to the provision of palliative care in Intensive Care units, to identify problems and shortcomings on the part of medical staff in providing palliative care to Intensive and Resuscitation Careunitsand to identify the factors which influence the medical staff in the provision of palliative care in Intensive and Resuscitation Care units. The research was carried out at the Department of Anaesthesiology and Intensive Care of one of the South Bohemian hospitals. Results are showing that the medical staff working at the Department of Anaesthesiology and Intensive Care staff have excellent theoretical knowledge in the field of palliative care. They try to provide the best possible care to patients and do their best for them. Despite all this, problems related to insufficient and inappropriate communication were found, which is underlined by the environment in which it takes place. Due to the great specificity of the ward, it is often very difficult to ensure the best possible conditions for the dying patient and his beloved ones. Another shortcoming was the absence of psychological support and care for medical professionals, who are constantly exposed to stress. There was also a complete absence of support and care for the bereaved which is part of and a prerequisite for providing quality palliative care. Based on the interviews, we can say that at Department of Anaesthesiology and Intensive Care is highly educated stuffandthey do their work with passion and want to provide it with the best possible quality. However, in this case, it would be appropriate to offer healthcare professionals sufficient training opportunities in palliative care and communication. The results of this work could help to minimize the problems identified and could serve as a basis for lectures and seminars for Department of Anaesthesiology and Intensive Care staff.
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Admission of polytraumatized patient to the hospital - preparation of simulated scenarios for paramedics and nurses
ŠEVČÍKOVÁ, Tereza
The most common cause of death of children and adolescents is trauma. The Czech Republic is dominating and ranks in leading positions in Europe. Children mostly occur in situations such as falls, traffic accidents, when the child is in the position of a passenger or is represented as a pedestrian or cyclist. Other causes include burns, drowning or suffocation. Treatment in the first 20 minutes is most important for the patient's further prognosis. Therefore, it is necessary to proceed quickly during treatment and provide emergency assistance first - which means securing the airways and circulation. A polytraumatized patient is considered as one in a very serious condition who needs acute assistance from rescue services. When admitting a polytraumatized patient to the hospital, it is important for the rescue team to organize the work and provide it to the patient with the fastest and highest quality care. The diploma thesis is elaborated in theoretical form and is divided into four parts. Scientific information was obtained when studying professional literature. It was Czech and foreign literature and both monographic works and scientific periodicals were used. The process of nursing care procedures for children with polytrauma and my personal experience as a nurse working at the resuscitation department for children greatly contributed to the extended data collection for the diploma thesis. The diploma thesis creates a summary of procedures for the admission of a polytraumatized patient and enables a better orientation in the provision of nursing care for children. It focuses on differences in the provision of emergency care for children and highlights priorities in the treatment of patients in pre-hospital and hospital care. It also points to the clash of non-medical staff with doctors and the ability to cooperate in the provision of care within the rescue team. The diploma thesis provides information on the topic of admission of a polytraumatized patient to the hospital and is intended primarily for non-medical healthcare professionals, but also for the professional and lay public.
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Interpersonal relationships and their projections into the quality of nursing care provision in intensive care units
FÜRST, Zdeněk
This thesis deals with interpersonal relationships and their projection into the quality of the provision of nursing care at intensive care units. 3 goals were set for this purpose and 8 hypotheses were subsequently defined and statistically analysed. The above-mentioned goals were achieved by the means of a quantitative research in which the technique of non-standardized questionnaires was applied (valid questionnaires returned: 56.5%). The research sample consisted of 173 intentionally selected respondents from among non-doctoral healthcare workers. The research has shown that positive interpersonal relationships prevail at intensive care units (61.3%). 87.3% of the respondents met their colleagues outside of working hours. Interpersonal troubles occurred among 44.5% of respondents, while interpersonal conflicts were noted among 59.5% of respondents. The occurrence of bullying was noted among 26.6% of respondents. Respondents mostly faced arguing and aggressiveness (22.1%) within the performance of their duties. They also faced offence and humiliation (18.2 %) and slandering (18.2%). The quality of nursing care was defined on the basis of the opinions of the respondents and their ability to cooperate. The proportion of the occurrence of good-quality and poor-quality nursing care does not differ (p = 0.323). The fact that the quality of the nursing care with positive and negative relationships differs (p < 0,001) was a significant finding; negative relationships reduce the quality of nursing care. We consider the issue this research deals with to be topical. The thesis presents an insight into the problems in question and can serve as a basis for further projects. The thesis also points out the importance of the regulation of interpersonal relationships at intensive care units on the basis of empiric data, and urges that interventions positively affecting these relationships be implemented as they can have a desirable impact on the quality of nursing care.
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