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Nasojejunal tube placement techniques
Součková, Veronika ; Novák, František (advisor) ; Paul, Oldřich (referee)
Author's title and name: Bc. Veronika Součková Institute: Charles University, Prague 1. Faculty of medicine Kateřinská 32, 121 08, Prague 2 Study branch: follow-up Master's - intensive care Study programme: specialization in intensive care Title: Nasojejunal tube placement techniques Consultant: MUDr. František Novák, Ph.D. Number of pages: 81 Number of attachments: 3 Number of tables, grafs and pictures: 24 Year of presentation: 2013 Keywords: Nasojejunal tube, placement techniques, enteral nutrition, endoscopy, fluoroscopy, blind bedside technique This dissertation is dedicated to the issue and options in the field of nasojejunal tubes placement technique. Theoretical part aims at the description of methods and procedures of placing the nasojejunal tube and briefly mentions possible complications and principles of enteral nutrition, which is administrated by this method. Empirical part of the dissertation aims at the comparison of placement the nasojejunal tube using the blind bedside technique developed at intensive care unit in General University Hospital in Prague to, endoscopic and fluoroscopic methods. The research brings description and comparison of the most frequently used methods of placement the feeding tube into the small intestine.
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The role of nurses in endoscopic examinations
URBANOVÁ, Radka
Nowadays, endoscopy is considered one of the most widely used methods of examination. It enables not only the examination of bodily cavities, but also the extraction of tissue or other medical procedures. Endoscopic examinations are widely used. Thanks to preventive colonoscopies, diagnoses of the widely spread colorectal carcinoma occur in time. Another type of an endoscopy selected for the thesis is a gastroscopy. It allows the removal of foreign objects or the diagnosis of pathological changes in the upper part of the gastrointestinal tract. The last of the selected examinations is the Endoscopic Retrograde Cholangiopancreatogram (ERCP). It is considered the most reliable method for the diagnosis of pancreatic cancer, which occurs with increasing frequency. Additionally, it is the only one of the selected endoscopic examinations which combines endoscopy with X-ray imaging. It has, therefore, become unique due to the direct imaging of the pancreatic and biliary tracts. This disadvantage of endoscopic examination creates certain complications. These may occur during the procedure as well as in various intervals following the examination. It is, therefore, essential that patients are thoroughly prepared, examined by a doctor beforehand and that the execution of each examinations is sufficiently thought through. The work of nurses in endoscopic workplaces has certain specifics. These nurses must be able-bodies and must have technical and manual skills, since they need to operate costly endoscopic equipment. It is of utmost importance that the nurses have good communication skills, as they are the ones who come into contact with the patients most often. They should be able to alleviate the concerns of the patient, since this is the main purpose of their work. Last but not least, every endoscopic nurse should also have very good theoretical knowledge regarding the anatomy and physiology of the digestive tract, as well as expertise in the field of endoscopy.
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Problems of nursing care in endoscopic retrograde cholangiopancreatography.
RYVOLA, Lukáš
Theoretical groundwork Endoscopic Retrograde Cholangiopancreatography (ERCP from now on) is nowadays referred to as the golden standard in diagnostics and treatment of bile duct and pancreas diseases. At the same time it is regarded as the most reliable method of modern medicine in diagnostics of most common oncogenic diseases of pancreas. This examination combines endoscopic diagnostics with X-ray screening and it is unique thanks to the direct display of bile and pancreas ducts. Final picture is made by probing of Vater papillae filled by a contrastive liquid. Other merit consists of completing eventual therapy that follows the diagnostic ERCP. Disadvantages of this examination are complications that may arise already when probing or after a certain period of time. Therefore it is essential to consider each ERCP procedure carefully. Nursering ERCP at the endoscopy section as well as at the ward block of the gastrointestinal department bears its particularities. The priority at the endoscopic section is to employ manually and technically competent nurses skilled in ERCP so they can assist the gastrointestinalist properly. The nurses must be also able to establish contact with the patient to guide him through the examination, using professional skills. Exactly the nurses moderate possible concerns of the examined person. Communication at the ward block is crucial as well ? the nurses explain particularities of the treatment and instruct the patient in basic rules of hospitalisation. They also must be professionally skilled to care for patients after ERCP. Goals of the thesis The aim of this thesis is to monitor particularities of nursing ERCP at the endoscopic section of the gastrointestinal department and to learn how the general treatment of ERCP patients is carried out at the ward block.Qualitative methodology was used for the empirical part of the thesis. Data were collected by interviewing and hidden observations.Results The research survey indicated that ERCP examination nursing treatment bears its particularities that are well known and reflected by nurses at the endoscopy section. Patients confirm that the skills of nurses minimize their stress when undergoing the treatment. The survey indicated that an ERCP examination should be assisted by a nurse with not only technical and manual skills but also empathic and anticipating qualities in order to react appropriately without confusion. Nurses should be able to explain the treatment to the patient properly and to create a comfortable ambience. The survey also indicates that nurses actively seek for courses to keep their knowledge up to date. Particular complications are managed very well by the nurses, they are familiar with specific complications and are always prepared and able to provide the patients adequate nursing. Nursing at the ward block is also at high level in the field of knowledgeableness when informing patients or preparing arrangements and regimes. The patients themselves are satisfied with the overall care after the ERCP examination. The hidden observations show that the nursing after ERCP examination follows the literature properly. Pleasant surprise was that nurses at the ward block of the gastrointestinal department fully implement the five parts of nursing process ? from reviewing the health status of the patient in the beginning to their final evaluation, and that they concurrently create up-to-date nursing diagnoses.
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