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Nursig care about newborn within the perioperation care.
BENEŠOVÁ, Nikola
The topic of the thesis Nursing Care of Newborns in the Process of Perioperative Care deals with specific and distinct features of such care from the viewpoint of nursing. The main objective was to specify all tasks of nurses in the process of perioperative care and the procedures they use. Last but not least, we focused on how the nursing care differs with regard to the age of newborns. The selected research method was qualitative research using semi-structured interviews with nurses from perinatology centers. The research covered 10 respondents with various levels of education and lengths of practical experience. Nurses most frequently understand the term of perioperative care as the care provided before, during and after a surgery. Most of them actually perform preparation of the child before the surgery and then they provide postoperative care. Only 2 out of the 10 respondents are directly involved in the surgery procedure and thus accompany the newborns throughout the entire process of perioperative care. The care provided before the surgery most often includes identification of the child, checking of its vital functions, involvement in blood collection, including intravenous cannulation, administration of prescribed medication, preparation of the surgical site and communication with the parents. Children are most frequently accompanied by their mothers and nurses need to communicate with them. Nurses transport the child to the operating room, hand the child over and subsequently take it back after the surgery. They also record all those activities in the medical files and in some cases they check signed informed consents. Intraoperative care consists mainly of monitoring of the newborn, assisting to the physician in airway management - intubation and during the entire surgery procedure. The most common surgical procedures performed in children are hernia, bowel and heart surgeries. The nurses also generally mentioned surgeries of developmental disorders. After the surgery nurses usually move the child to the neonatology intensive care unit which is equipped with a ventilator, incubator and all types of medication. They regularly check and record child´s vital functions, monitor the surgical wound and its proximity, intake and excretion, they provide nutrition etc. Nurses also assess the pain, most frequently using the NIPS scale, and they educate the parents. Post-surgery complications occur only sporadically and they include infections, bleeding or abstinence syndrome after administration of opiates. The collected data have shown only one difference relating to the age of newborns who underwent a surgery. Specifically, certain surgeries, e.g. of necrotic enterocolitis, are performed more frequently on less mature newborns. In general, most of the surgeries are performed on prematurely born neonates and extremely immature neonates. When asked what they would like to change or improve in the perioperative care from the nursing point of view the nurses primarily mentioned more contacts between the mother and child and consistent compliance with aseptic procedures. The responding nurses were mostly content, they praised the highly specialized care and the good cooperation between the nursing team and the medical team which consists of pediatricians and specialists. Results of those teams thus contribute to continually decreasing mortality rate of high-risk and pathological newborns and to better quality of life of those children after the surgery.
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Safety process in anesteziology care and perioperative care
Benáková, Miluše ; Heczková, Jana (advisor) ; Kordulová, Pavla (referee)
Patient safety is one of the top priorities of anesthesia and perioperative care in the operating room. The patient safety is greatly compromised due to administered medication and the actual operating performance in the perioperative care. The risks of anesthesia and the operational performance are many, starting with the fall of the patient, the possible wrong- site, wrong-procedure, wrong-patient errors, adverse reactions to administered medication, difficult airway management or an unexpected perioperative bleeding. Patient harm in hospital care leads not only to increased costs for additional treatment, prolongation of the hospitalization time, but also significantly affects the subsequent quality of life. Most adverse events are preventable, since most of them are caused by susceptible factors, such as incomplete or incorrect information or the lack of communication between the members of the operating team. Due to the increasing number of such adverse events around the world, including those of the most serious, The World Health Organization has created a program called The Save Surgery Saves Lives, whose aim was the identification of key risk areas in ensuring the safety of patients. On the basis of the identified risk areas the Surgical Safety Checklist was introduced in 2008. It is aimed...
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Perioperative nursing care for patients with colorectal cancer - robotic resection
Kalvachová, Lucie ; Kordulová, Pavla (advisor) ; Hakenová, Renata (referee)
Introduction: This Bachelor thesis expounds, from the perspective of a scrub nurse, the issues of nursing care with a patient undergoing a planned intestinal surgery with the help of a robotic system. In the theoretical part, it describes procedures of nursing care such as preparation of a patient before the surgery, nursing care in the operating room and after the surgery. It also points to principles of modern perioperative approach ERAS (Enhanced Recovery After Surgery). The sources that I have used for this Bachelor thesis come mostly from the National Medical Library (through Medline), from the Pub Med database, Web of Science, and also from nursing standards and Google search. In conducting the search, I followed the keywords: perioperative care, nursing, colorectal cancer and robotic system da Vinci. I have used literature written in Czech or English and published in the last five years (with the exception of the history of the robotic system). Methods: To lay out the thesis, I have chosen a case study of a patient with colorectal carcinoma operated by a mini-invasive robotic system da Vinci. On this particular example, I show standard nursing processes, potential risks of perioperative care and their prevention. Objective: Focus on nursing perioperative care of a patient and on the...
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The safety and quality of health services provided in the field of perioperative care
Panušková, Markéta ; Jirkovský, Daniel (advisor) ; Kolomazníková, Václava (referee)
Bachelor thesis "The safety and quality of health services in Perioperative Care" deals with quality control of nursing care in selected inpatient health care facilities as well as prevention and management of potential risks associated with the provision of nursing care. The empirical part of the thesis focuses on the awareness of perioperative nurses regarding the use of and adherence to standards, recommended work practices and quality control of nursing care in operating theaters. Custom survey was carried out at the University Hospital Motol in Prague 5 and simultaneously at the General University Hospital in Prague 2. The obtained data were evaluated using statistics CZ 12 and are presented in tables and figures. In the final discussion the information obtained were compared with the results of previously completed studies, and recommendations were set for improving the quality and safety of nursing care in operating theaters.
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Assesment of quality of postoperative analgesic care
Rákosová, Andrea ; Burišková, Klára (advisor) ; Hakenová, Renata (referee)
Introduction: The acute postoperative pain management is recently a concern of many expert committees and professional associations. The evidence of an increased interest in this issue is the Practice Guidelines for Acute Pain Management released by American Pain Society. According to these recommendations, the pain should be monitored as a fifth vital function. As a logical consequence of modern trends of pain management, Czech Society of Anaesthesiology and Intensive Care Medicine issued guidelines for acute pain management in postoperative setting. This paper is an attempt to describe and evaluate the quality of postoperative analgetic care after total knee and hip replacements in a selected institution's department.………………………………..…………………………………… Methods: The aim of our empirical survey was to assess the level of quality of postoperative care and analgesia in the selected department. We focused mainly on the question of pain trivializing from the nurses side, their approach towards patients suffering from acute pain and, finally, the level of patient's awareness of pain intensity assessment systems and treatment options. Using the quantitative research methods, we evaluated the differences in perceiving of postoperative pain treatment quality from patient's and nurse's point of view. The survey...
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The development of job descriptions theatre nurses across half a century
Kalašová, Veronika ; Prošková, Eva (advisor) ; Kordulová, Pavla (referee)
Bachelor thesis is focused on the history of the profession operating nurses, from 1953 to the present, primarily on the development and changes in workload of operating nurses at this time period and educational possibilities. The theoretical part explains the basic concepts of the theme, such as perioperative care, job descriptions of the staff in the operating theatre, operating theatre equipments et cetera. The thesis is focused on the differences development in the workload and competencies of the operating nurses throughout the entire period, and the increasing need to understand the technical equipment in the operating theatre and its operation. The aim of this thesis is to map the development in the education and legal regulation for the operating nurses. The second objective is to determine the differences in the character of the operating nurses' work nowadays and 50 years ago. Bachelor's thesis is theoretical and practical nature. To meet the goals and answer research questions was chosen the form of qualitative research, studying of archival documents and the period literature, which has been within the options complemented with structured interviews with witnesses (nurses, even. doctors, and other health care professionals). Keywords: perioperative care, operating rooms, theatre nurse,...
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Ethical problems in perioperative care and their impact on patient safety
Wichsová, Jana ; Holmerová, Iva (advisor) ; Munzarová, Marta (referee) ; Fontánová, Anna (referee)
The dissertation examines the ethics of staff in perioperative care. The aim was to analyze the errors that occur during surgery, to determine the participants in perioperative care who commit these mistakes, and to analyze the reasons why these errors occur. The theoretical part deals with the concept of security from different perspectives of patient safety in surgery, and the international guidelines that direct it. The situation in the Czech Republic in terms of care for patient safety in surgery is also described. One chapter deals with the autor's internship in operating rooms in Sweden. Using the results of observations, the empirical part of the dissertation analyzes the actual behaviour of staff in perioperative care during surgery against the binding documents that ensure safe perioperative care. It also sets out the reasons that lead to non-compliance of health and safety regulations in perioperative theatres. In conclusion, I suggest steps that would help to improve the situation. Key words Perioperative care, safety, security, pacient pafety, medical ethics, nursing ethics
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Hemodynamics in the early stages of the critical illness and in the perioperative setting
Beneš, Jan ; Kasal, Eduard (advisor) ; Málek, Jiří (referee) ; Kroužecký, Aleš (referee) ; Adamus, Milan (referee)
Beneš J.: HEMODYNAMIKA V ČASNÉ FÁZI KRITICKÝCH STAVŮ A PERIOPERAČNÍ MEDICÍNĚ - Využití méně invazivních monitorovacích prostředků k cílené hemodynamické péči ABSTRACT Hemodynamic instability occurs very often in critically ill patients and during the perioperative period. Insufficiency in the preload, contractility and afterload contribute in major part to this phenomenon. Hemodynamic monitoring allows clinicians to recognize and to intervene early the underlying cause. Due to new technologies development in recent years it is possible to provide continuous monitoring of hemodynamic parameters with diminished invasivity. Hemodynamic optimization and goal directed therapy show treatment benefit in some groups of critically ill patients and mainly during the perioperative period. Aim of hemodynamic optimizations is to attain the best obtainable hemodynamic conditions with use of fluid loading and inotropic support. In many studies in recent years goal-directed therapy was associated with morbidity and mortality reduction. According to the results of our clinical research hemodynamic optimization using stroke volume variation and minimally invasive device based on the pressure wave analysis is feasible and show the same results as other works with more invasive devices. Key words Hemodynamic monitoring,...
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The workload of nurses in perioperative care
POLÁKOVÁ, Ivana
The basic theoretical background: It is known that the profession of nurses is very physically and mentally challenging. Otherwise, it is not even for nurses in the operating room. The work of nurses in operating rooms is highly specialized and demanding profession that requires specific skills and knowledge primarily because the operating rooms is very specific and puts high demands on the technical and material equipment, flawless organization work and to perfect the principles of antisepsis and asepsis. It's about challenging, diverse activities, including the preparation of operating material, devices, apparatus, instruments and sterilization. The correct execution of all these activities, the profession ranks between occupation with time pressure, physical stress and irregular rhythm of life and professions, in which psychological and physical depletion of reserves means not only a danger to themselves, but also the health of the patient. The objectives of the work: To meet the main intent of the work were established two objectives. The first goal is to find out what type of workload for nurses in perioperative care predominates. The second goal is to compare the differences of the workload for novice and long - term working nurses in perioperative care. Hypothesis: Depending on the set objectives have been identified four hypotheses. H1: the incidence of psychological burden for nurses in perioperative care predominates over the occurrence of physical exertion. H2: for nurses working less than three years in perioperative care is the presence of psychic load higher than for senior sisters. H3: for nurses working for more than three years in perioperative care is the presence of physical load higher than the sisters with less length of practice. H4: the workload of nurses in perioperative care does not differ from the standard, based on the Meister´s method of assessing workload. Methodology: Research method of quantitative inquiry of research using the techniques of a standardised questionnaire, supplemented by their own questions. The questionnaire was completely anonymous and respondents ' participation in the research was voluntary. Were used two standardized questionnaires. The first questionnaire was elected from Maister, which assesses the impact of work on the psyche of the individual. The second questionnaire was used as a working activity from Baecky, which is used to measure physical activity. The target group were the nurses working in the perioperative care. In total, were interviewed across nine hospitals of the Czech Republic. All selected Hospital have agreed to perform the research investigation to this thesis. The results obtained were statistically processed. Conclusion: The work provides information about what type of workload predominate for nurses in perioperative care and about the differences of the workload for starting and working nurses in perioperative care. The results of the thesis can be used by medical facilities to identify the workload for nurses in perioperative care and by the perioperative nurses. From the above results, it is clear that the issue of mental and physical loads primarily nurses in the operating room is a very current topic, and it is important to deal with manifestations of this load. In addition to this thesis was created, information material on the prevention of the workload and the methods of its elimination.
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Peroperative nurse work demands
VELÁTOVÁ, Simona
My thesis has two parts. Part One explains the concept of "perioperative nurse" and her competences set forth in the Decree no.55/2011 Coll., on the activities of healthcare workers and other professional workers. The following chapters discuss the working environment of perioperative nurses, job principles of perioperative nurses, preparation of the operating room, treatment and preparation of instruments and technical equipment. Theory Part One is concluded by the chapter that explains the concept of perioperative care. Part Two is focused on education and training of perioperative nurses. It provides historical information, conditions and opportunities for specialized training of perioperative nurses. The last chapter deals with lifelong learning. Objectives of the Thesis The first objective was to map the range of activities performed by perioperative nursesduring selected types of surgery. The second objective was to identify differences in perioperative nurses' activities during standard and laparoscopic surgery. The last objective was to identifyopportunities for further training of perioperative nurses. The method of qualitative research was used. Research data were collected from non-standardized in-depth interviews. The research covered perioperative nursesof three operating rooms in the Hospital of České Budějovice a. s., namely surgery, urology and gynaecology. The research was carried out in collaboration with 3 perioperative nurses of each of the above mentioned operating rooms. Responses were recorded in writingand interviews with individual nurses were numbered followed then by verbatim transcriptionof interview data. The evaluation and analysis of interviews were categorized and categories were supplemented with subcategories. The results of research focused on duties of perioperative nurses show that perioperative nurses' workencompasses many duties they have to performandfollow. The duties of perioperative nurses include activities before, during and after surgery. They smoothly follow one after another and have a predefined sequence. The Scrub Nurse and CirculatingNursejointly perform most activities. Checking was identified as the most frequent activity of perioperative nurses. Checking on the patient, checking on instruments, checking on equipment / devices, but no surgery check-listsare used in the workplaces fornow. For laparoscopic surgery, no great differences in activities were mentioned by perioperative nurses. There would only be some additional activities related to deployment, checking and control of devices. The spatial arrangement must ensure safety of the patient as well as personnel. The operation and control of devices and equipment is very challenging for perioperative nurses in terms of their technical skills and competences. The research concerning opportunities for further training of perioperative nurseshas showed that perioperative nurses prefer specialized training. As another method to refresh their knowledge, participation in workshops was mentioned by perioperative nurses. No other activities are pursued. The purpose of my thesis was to describe activities (duties) performed by perioperative nurses in their daily routine work and establish how they learn and addnew information and knowledge. Perioperative nursesmanage theactivities / operation of operating rooms. They are required to be familiar with the technique and operating procedures and faultlesslyhandle various types of instruments. Professional knowledge supports a smooth course and good quality results of surgery. All of that requires continuous control, training and expanding their knowledge. This thesis points out the need for employer'sinvestments in training and more proactive approach of perioperative nurses to lifelong learning. The research results could provide the basis for preparation of a lecture for perioperative nurses.
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