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Childbirth in pre-hospital care
ZELINKOVÁ, Sára
This bachelor thesis deals with the topic of childbirth in pre-hospital care. The bachelor thesis is divided into a theoretical and a practical part. The theoretical part is dedicated to four main topics - individual periods of childbirth, evaluation of a newborn with APGAR score, selected complications during childbirth and its guidance. Under the umbrella term of childbirth in pre-hospital care belong making decisions about transport during imminent childbirth, guidance of the said condition in pre-hospital care and resuscitation of a newborn and a pregnant woman. Two goals were given for this bachelor thesis. The first goal was to find out how paramedics perceive the guidance of childbirth outside hospital facilities. The second goal was to research how paramedics are prepared for the guidance of the condition mentioned above. The empirical part of the bachelor thesis has been done by a qualitative research survey in the form of a semi-structured interview. The research file consisted of 12 paramedics from the South Bohemian Region and the Pilsen Region, who had already been present during a childbirth outside a hospital facility. The research was going on from January to March 2022 and the participation was completely voluntary. The acquired data was then analysed, coded and divided into categories and subcategories. In the research part two research questions were stated. The first question was supposed to find out how paramedics perceive the guidance of a childbirth in prehospital care. The research results showed that every questioned paramedic, except interviewed paramedics I5 and I6, is nervous when going to a prehospital childbirth. The nervosity is caused by the knowledge of possible complications. The second question was about the preparation of paramedics for childbirth guidance. The results of the research showed that there are big differences in the way, frequency and content of the medical training. Many paramedics would like to have a shorter interval between trainings and some would appreciate an opportunity to practice in the delivery rooms. From the research results it is clear that many paramedics do not agree with home deliveries because of many possible complications and risks. This bachelor thesis highlights the options of improvement of the education of paramedics and its realisation. The interviewed paramedics emphasised more frequent trainings of childbirth and participating in practices in delivery rooms. The results of this bachelor thesis could be presented in conferences and could be used to present the opinions of paramedics to their trainers and chief medical officers.
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The first treatment of a newborn after delivery in pre-hospital care
KOFROŇOVÁ, Erika
The bachelor's thesis discusses the treatment of a newborn after birth in pre-hospital care. In order to elaborate the bachelor's thesis, four objectives were defined. The first objective was to find out how paramedics prepare themselves for taking care of the newborn. The second objective was to record how they handle the situationS psychologically when it comes to the newborn care at fieldwork itself. Furthermore, the third objective ascertained the procedure of the newborn treatment by paramedics in pre-hospital care. Last but not least, the fourth objective was to explore the procedure of a premature newborn treatment. Four research questions were chosen for the research part of the thesis. The first research question dealt with how paramedics prepare themselves for taking care of newborns. The second research question carried out how stressful treating a newborn is for paramedics. The third research question examined the process of treating a newborn. The last research question discusses the treatment procedure in case of the premature newborn. This work highlights the importance of education and implementation of the defined procedure of the newborn treatment in pre-hospital care, as well as the implementation of the most essential interventions which leads to the correct adaptation of the newborn to the new environment. The bachelor's thesis is divided into a theoretical and a practical part. The theoretical part is divided into five main chapters. The first chapter deals with the legal definition of the emergency medical treatment services, pre-hospital emergency care and the profession of a paramedic itself. The competences of a paramedic as well as further educational possibilities are discussed here. In the second chapter, the issue of the childbirth is introduced alongside the labour process itself, its classification, and particular stages. It is complemented by the process of the childbirth and the treatment of the newborn in a health facility as well. The third chapter deals with the childbirth in pre-hospital care. The fourth chapter discusses the various complications that can arise during the birth. The last one describes the care of the pathological newborn and the process of a resuscitation. In the second part of the thesis a qualitative research was applied. The research sample consisted of 8 paramedics who had encountered a newborn after the birth at least once.
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The role of a midwife in supporting woman's partner during pregnancy, childbirth and the puerperium
ČEJKOVÁ, Tereza
This bachelor thesis dealt with the topic of the role of midwives in supporting a woman's partner during pregnancy, childbirth and the puerperium. The thesis consists of two parts, namely the theoretical part and the research part. In the theoretical part there is information about pregnancy, childbirth, puerperium and related issues. Education, involvement of the woman's partner and his cooperation with the midwife are issues that this bachelor thesis deals with. In the research part of the bachelor thesis, a quantitative method was used for data collection. The data was collected using a questionnaire consisting of 48 questions, of which 25 were closed, 9 semi-closed and 14 open questions. In the introduction, there were sorting questions. Next, the questions were divided into three basic areas: pregnancy, childbirth and the puerperium. The questionnaire was directed for men whose wife already gave birth. The questionnaire was distributed online, via the social network Facebook and via a direct link and sent to men of an unlimited age category whose wife already gave birth. A total of 120 men participated in the research. The questionnaire was processed using Microsoft Excel. Answers were processed using graphic representation accompanied by a verbal description. In this work, we set 1 goal: To find out what is the role of the midwife in supporting the woman's partner during pregnancy, childbirth and the puerperium. For the research part, 3 hypotheses were established. The first was to find out whether a partner who is educated by a midwife during pregnancy in a woman perceives this period more positively than a partner who is not educated about the period of pregnancy. Here, a dependence was not found between the partner's awareness of the course of pregnancy in a woman and a more positive perception of this period. The second hypothesis was to find out whether a partner who is educated by a midwife during the period of childbirth in a woman perceives this period more positively than a partner who is not educated about the period of childbirth. Hypothesis number two has been confirmed. The third hypothesis was to find out whether a partner who is educated by a midwife in the postpartum period in a woman perceives this period more positively than a partner who is not educated about the postpartum period. Hypothesis number three has also been confirmed.
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Community midwife in the care of women in postpartum period and newborn
LANDOVÁ, Lucie
The bachelor thesis focuses on the topic of community care provided by community midwives to women and newborns in the six-week period. The thesis consists of theoretical and practical part. In the theoretical part of the bachelor thesis, the reader is first introduced to community care. The subchapters dedicated to community care describe the history of community care, then describe the activities of community midwives in the Czech Republic and the last subchapter is dedicated to community midwifery care abroad. The theoretical part of this bachelor thesis also characterizes the six-week period. The chapter about the six-week period is divided into subchapters that describe anatomical and physiological changes in the six-week period, midwife care of the six-week period woman, breast care, lactation and breastfeeding, and last but not least midwife care of the newborn. For the practical part of the bachelor thesis one goal was set. The goal of the thesis was to map the care of community midwives in the South Bohemian Region. Two research questions were formulated for this goal. The first research question focuses on women's attitudes towards community-based care in the six-week period. The second research question investigates which care is provided by community midwives in the South Bohemian Region. The practical part of the bachelor thesis was done by a qualitative research investigation in the form of individual semi-structured interviews. The data collection for the research survey took place from January to March 2022. Two research sets were defined. The first research set was composed of six community midwives from the South Bohemian region, designated as KPA1 to KPA6 to protect anonymity. The second research set was composed of six women between 7 and 42 days after childbirth, they were designated as Š1 to Š6. The obtained data were analyzed by text coloring. The main categories and subcategories were established for data analysis and are described in the research section of this bachelor thesis. From the statements of the informants of the first research set, three main categories were obtained, which contained a total of eight subcategories. In the second research set, we analysed three main categories, that were divided into five subcategories.
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The specifics of care for a newborn baby of a drug-addicted mother
PEKÁRKOVÁ, Barbora
The neonatal abstinence syndrom occures in newborns of addicted mothers to any kind of drug. The drugs may be soft (legal) or hard (illegal). The manifestation of neonatal abstinence syndrom is mostly of neurological symptoms, such as seizures, restlessness and tremble. The neonatal abstinence syndrom can also be manifested by gastrointestinal, respiratory and termoregulation problems. Neonatal abstinence syndrom begins to manifest within 24 to 72 hours after birth and the most conclusive examination drug testing is from newborn's meconium. The newborns are assesed by the Finnegan score and if the result is higher than eight points, the neonatal abstinence syndrome can be diagnosed. The first goal was to reveal and describe the differences in care between a newborn of a drug-addicted mother and a physiological newborn, second goal was to specify nursing problems of a newborn of a drug-addicted mother and the third goal was to concretize the role of the nurse in a care of a newborn of a drug-addicted mother. The research part of this work was processed by the qualitative research method, using semi-structured interviews. The interviews took place in june 2022. Five interviews were recorded on a recording device and three interviews were written down on a paper due to dissapproval of said nurses to record the interviews. All interviews were transcribed into Microsoft Word programme. The ATLAS.ti programme was used to analyse, code and create schemes. The data was split into parts and codes were added to the said parts. The codes were put into categories related to the research questions. Afterwards, the schemes were made from said categories and subcategories. Based on data collected from the research we can say that the most common nursing problem in a newborn with neonatal abstinence syndrom is restlessness, crying, tremor, scream, sleep deprivation, instability of temperature, gulping and vomiting. Futhermore, the analysed data showed that the role of a nurse in taking care of a newborn with NAS are mainly "nurse as a provider of nursing care" and "nurse as a educator". The main differences in care between the newborn of a drug-addicted mother and a physiological newborn are in nutrition, contact with mother, when it also depends on her presence and the condition of the baby, in participation of other profesionals. There are hardly any differences in education, but it also depends on the condition of a baby and its needs. In conclusion, the most common nursing problems in a baby with neonatal abstinence syndrom are neurological problems, following the problems with sleep, temperature and nutrition. The nurse is mainly in a role of a nurse educator and provider of a nursing care. The differences in care between the baby with NAS and the physiological baby depend on the presence of its mother, the condition of the baby and its gestational age. The differences are mostly in nutrition and the participation of profesionals, for example the child protect services. The results of this research can be used in improving the quality of care for newborns with NAS, in an education of the future pediatric nurses in Pediatric nursing study programme and in further education of pediatric nurses in NAS in hospital through lectures.
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The importance of LATCH score in promoting effective breastfeeding
MATĚJKOVÁ, Radka
The LATCH score is a breastfeeding mapping system that supports effective breastfeeding, and it is used to predict the duration of exclusive breastfeeding at six weeks after delivery. Assessments, which begin in the delivery room and continue until the mother and newborn are discharged, are essential. The LATCH system serves as a systematic collection of information about breastfeeding. The rating scale assigns 0, 1 or 2 points to five key areas of breastfeeding. Every letter of the LATCH acronym indicates an area of assessment. With the LATCH scoring system the pediatric nurse can assess maternal and newborn variables, and can easily define areas for intervention and prioritize nursing care at maternity hospital. Our first goal was to reveal the importance of the LATCH score in promoting effective breastfeeding. The second goal was to reveal in which areas of breastfeeding techniques mothers most often make mistakes. The third aim was to describe in which areas of LATCH mothers need more education. And the last goal was to find out what are the specifics of nursing care for mothers and newborns with a low LATCH score.The practical part of the bachelor's thesis was processed using the method of qualitative research using direct observation and the method of questioning through a semi-structured interview. The research group consisted of ten mothers who, during the research period, were hospitalized after delivery in the department for physiological newborns. Mothers were directly observed during breastfeeding on the day after delivery and upon discharge from the hospital. LATCH scores were evaluated during observation. For mothers with a low LATCH score on the first day after delivery, the interventions provided to the mothers were further qualitatively evaluated and their effectiveness verified by the LATCH value at discharge. These mothers were contacted again in sixth week of the child's age, and through a short interview we verified, whether the mothers were still breastfeeding, what problems they had and what was the reason for stopping breastfeeding. The obtained data were qualitatively analyzed with the ATLAS.ti program. Based on the research investigation and the obtained analyzed data, it follows that the LATCH score is important in promoting effective breastfeeding. Nowadays, more and more women want to breastfeed as long as possible. During the analysis of the obtained data, we established three categories. The first category deals with the evaluation of the LATCH score at the first feeding after birth, here it is captured what affects breastfeeding in the first hours after birth by the mother, the newborn and the child's nurse. In the second category, we deal with the most common problems during breastfeeding and their solution by a pediatric nurse. The most common obstacle was the mutual position of the mother and the newborn and the correct latching and sucking of the newborn. The psychological and physical comfort of the mother is also closely related to breastfeeding. Nursing staff, i.e. children's nurses, educate the mother more in LATCH areas, where points are removed, and their goal is for the newborn to leave the maternity ward fully breastfed and for the mother to know everything about breastfeeding in the home environment. The last category is the progress of breastfeeding after six weeks after giving birth. We are interested in whether the mothers are still fully breastfeeding and whether they have had any complications.The results show that the LATCH score is a quick and simple tool for assessing breastfeeding after delivery, during hospitalization and before discharge. This breastfeeding assessment method serves pediatric nurses to effectively evaluate mother and newborn variables, define areas where intervention is needed and determine priorities in the provision of nursing care for the mother and newborn. The results of the research investigation can be used to improve the quality of nursing care...
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The use of leisure time to develop psychomotor development of children under three years
SMRČKOVÁ, Adéla
The Bachelor thesis deals with the research issue of the possibility of leveraging free time as a part of psychomotor development of children under the age of three. Within the theoretical part the notions of leisure time, such as the importance of the influence of the family environment on the formation of the relationship to free time in the smallest children are characterised. The question of whether and how younger children actually perceive and understand free time is the starting question that has to be asked in the introducing right now. The thesis also includes a description of age periods: newborn, infant and toddler. Bachelor thesis also characterizes their sensory and psychomotor development. At the same time, these three development periods form the target groups of the practical part. Furthermore the work deals with the definition of the game and its development at different stages of the child's life. In the practical part three draft activities suitable for the adequate psychomotor development of the child in free time are processed.
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Newborn Care Safety from Mothers' Perspective
HIPPMANNOVÁ, Sonja
Current Status: The need of safety and security is one of the basic needs of a newborn. The nurses' role is to assess the level of education need in a newborn baby care and educate the mother accordingly, using a suitable method. The aim of the research was to assess the level of knowledge of mothers in a newborn care safety in home environment. Methodology: The study used quantitative method of research, using the technique of non-standardized survey. The selection of the respondents was intentional. The focus group were mothers of physiological newborns (N=300), that gave birth in Hospital in Jablonec nad Nisou between 15.11. 2020 and 30.1.2021. Results: Approximately half of the respondents (52 %) claimed that the benefit of postpartum bonding between a mother and her newborn is promotion of creation of breast milk. Only 45 % of respondents claimed that they wash their hands longer than 30 seconds and less than 1/5 of all respondents follow all six steps of proper hand washing. Less than half of the respondents (45 %) consider sleeping position on stomach or side of a newborn as a risk factor of SIDS. More than half of the respondents (60 %) knew how to resuscitate a newborn. The share of mothers in age category between 18-25 who answered wrong questions asking about CPR of a newborn was statistically significantly greater (p = 0,035) than share of mothers in higher age category. Respondents whose postpartum hospitalization lasted more than 72 hours claimed greater satisfaction with education in breast care statistically significantly more often (p = 0,029) than mothers hospitalized for shorter time. Respondents with primary level of education answered wrong questions asking about manipulation with a baby on a changing table statistically significantly more often (p = 0,046) than mothers with higher levels of education. Mothers having a fourth baby answered correctly question if blisters are a symptom of omphalitis, statistically significantly more often than mothers with less children (p = 0,014). Conclusion and Utilisation in Practice: Based on results of the research was created educational material "At Home with a Newborn Baby. A Few Handy Tips".
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Birth Injuries in Neonatology.
ŠKVOROVÁ, Adéla
Current status: Mechanical damage to the newborn during childbirth can cause traumatic injuries. These may be visible immediately after delivery or within hours or days thereafter (Dort et al., 2013). Several risk factors or improperly managed childbirth can contribute to birth injuries, the most common at present including fractures of the collarbone and bleeding under the periosteum or paresis (Huml et al., 2013). Many injuries do not have permanent consequences, however, in such cases, multidisciplinary expert care is required. Objectives: The aim of the study was to determine the frequency and types of birth injuries in full-term newborns in a selected maternity hospital, to map their risk factors and consequences, to evaluate the frequency of increased bilirubin in the body in full-term newborns with cephalhematomas, and last but not least, to describe the nursing process in full-term newborns with a selected birth injury. Methodology: In the empirical part of this work, a mixed design combining quantitative and qualitative research was used. Selection of the research set was intentional, where in the quantitative part of the study 1733 full-term newborns delivered in a selected Prague maternity hospital in the period 1 January 2019 to 1 July 2019 were included. The research sample for the qualitative part of the study consisted of 10 nurses working in a selected maternity ward. The size of the research sample was given by theoretical saturation of the data. Results: Out of the total number of 1733 newborns, 280 newborns with birth injuries were delivered (16.2%). The most common injuries included obstetric tumors (12.2%), cephalhematoma (2.9%) and clavicle fractures (0.6%). Statistically significant risk factors increasing the likelihood of birth injuries involved prolonged labour (p < 0.001), shoulder dystocia (p = 0.045), irregular fetal position (p < 0.001), use of forceps (p= 0.005), and vacuum extraction (p < 0.001). Conclusion and use for practice: Based on the results, educational material was created for parents of newborns with birth injuries - a collarbone fracture.
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Current trends in the care of newborns.
MARKOVÁ, Anna
Neonatology is a branch of medicine that still evolves. Therefore, it is necessary to adjust some experienced, obsolete or even dangerous procedures so as to find current care options that will suit either current medicine or current society. The thesis aims both to verify the newborn care development in a period of the last twenty years and to primarily map the actual situation. The diploma thesis is divided into two parts, theoretical and practical. The theoretical part of the work deals with current obstetrics and clarifies individual areas of newborn care. The practical part presents the results obtained using a qualitative research survey, having two goals delineated. The first goal focuses on mapping changes occurring in the newborn care in the past twenty years. The second goal aims to realize possible benefits of alterations to mother and child. To obtain data, two sets of framework questions were set. One questionnaire was determined for nurses and midwives who had at least ten years' experience in taking care for the newborn and the other for mothers where it was at least a five-year- gap between the first and last delivery. The research survey shows that over the years there have been changes in all areas of newborn care that we monitor. In the first treatment of the newborn after birth, in the initiation of nutrition, bath, care of the umbilical stump, in the childbirth management and other necessary procedures where the needs of the child and the mother's wishes must merge. Personnel' knowledge and procedures in individual facilities also play an important role, which should correspond with current recommendations. Information obtained from the research survey could be used to think about possibilities how to make the work of nurses and midwives more efficient and it could be used to improve the quality of nursing care.
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