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Comparison of the Vascular Access Care in the Intensive Care Unit and Standart Departement
Vašková, Marcela ; Tomanová, Alena (advisor) ; Petrášková, Hana (referee)
Abstaract(thesis) In my thesis, I decided to take the issue of treatment of vascular input in surgical department and surgical intensive care units. This nursing problem can be found practically on every inpatient department and each nurse meets with vascular access dutiny her career. The work is divided into theoretical part and empirical part. The first theoretical part deals with the history of vascular input, a list of basic vascular entries and the educational process. Of the vascular inputs, the work focuses especially on central venous catheter and peripheral venous catheter. The second empirical part focuses on the evaluation of collected data and their statistical analysis. Before the research 4 hypotheses were provided. These hypothesis were confirmed by statistical evaluation of questionnaires. The questionnaires were filled in by sisters from the surgical department and intensive care units. At the end of the thesis is work evaluation. Keywords Vascular access, peripheral venous cannula, central venous cannula, nursing, dressing, asepsis, infections, nurse, patient
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Reactive Powder Concrete
Gabko, Miroslav ; Klečka,, Tomáš (referee) ; Hela, Rudolf (advisor)
Reactive powder composites (RPC) have been recently a subject of many researches of modern concrete technology. This type of concrete is very fine and its behaviour exceeds the other types of concrete, therefore there are new possibilities of its use. The design and production of RPC is complex technology process which needs to gain new results in RPC research to get the best features regarding its higher price. This thesis is focused on design of reactive powder concrete (RPC200), which compressive strength is between 200 – 300 MPa. Next goal is to prove the influence of curing regimes like high temperature or pressure, and also check the possibilities of production of low cement reactive powder composite (LCRPC).
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The effect of the stockperson on the behaviour of cattle
Janská, Jaroslava ; Chaloupková, Helena (advisor) ; Valníčková, Barbora (referee)
The thesis is focused on influence of keepers on cattle and it is pointing out the importance of cattles welfare that has also influence on economy of cattle breeding which is for keeper very important.
The concept of animals welfare is explained in the first part of thesis, because we can consider this concept to be the key concept and it occurs in every part of this thesis.
Following part is devoted to changes that cattle breeding have been facing recently. The changes are thanks to the shift in performance and thanks to modification of keepers, carers and customers ways of thinking. Doležal and Staněk (2015) point out so called breeding complex:
1. Breed (choice of breed, breeding itself)
2. Keeper (technological, nursing and veterinary care, working conditions and knowledge of employees)
3. Nutrition (quality production of top feed, compilation of rations)
4. Environment (quality requirements, ethology and welfare).
It is not possible to say that for the successful breeding we need only perfect race (genetics). It is impossible either to claim that the decisive factor is nutrition. Also the conviction that perfect stable and parlour makes the milk is mistaken. The perfect carers cannot create higher than average herd only by formidable care. The keeper has to see all of these aspects complexly and respect them.
At this point the thesis starts to focus on carers. It is obvious that quality of carers is rather neglected factor. This thesis describes analyses of carers nature and their approach towards their job in relation to behaviour dairy cows and their production pointers. In my thesis mentioned studies state that after designed and applied intervention of stereotyped behaviour of carers, that means treatment of dairy cows and approach to their work in farms - we can see increasing production of milk. The carers said that the dairy caws were calmer, it was easier to manipulate with them and that they are convinced that positive approach towards the animals has a huge positive effect.
The last part of the thesis shows how to apply found information into practice and how to proceed. Training of employees is one of the possibilities that start to be more and more important - not only abroad but in The Czech republic as well. Training is focused on
correct way of milking, taking care of cattle and hygiene in breeding, so that the health condition of dairy cows is good and the production is quality and harmless.
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The development of ultra-high strength (UHPC) and reactive powder (RPC) composites
Rundt, Lukáš ; Hela,, Vlastimil (referee) ; Hela, Rudolf (advisor)
Bachelor’s thesis studies ultra-high strength concrete and reactive powder composites. In theoretical part there are researched and described properties of raw materials used for their production, mainly additions. Design methodology, processing and types of curing are also studied. Psychical mechanic and durability properties of fresh and hardened concrete are described. In practical part 4 mixtures were designed and prepared and their rheological properties, strengths after 7 and 90 days in case of UHPC and strengths after 7, 28 and 60 days in case of RPC were tested.
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The issue of treating patient with polytrauma
DVOŘÁKOVÁ, Barbora
Polytrauma is an injury of one or more organic systems or body areas the mutual combination and extent of which may lead to direct death threat. Polytrauma stands on the first step of the mortality ladder particularly among those of 1 45 years of age. Not only timely emergency care, but also professional quality of the care play important role here. Treatment of a patient with polytrauma requires quality performance of physically and psychically demanding work The aim of the thesis was 1: To find out whether nurses at an ARD, an ICU and a standard department have knowledge of nursing care of a patient with polytrauma. 2: To find out the specifics of nursing care of a patient with polytrauma at an ARD, an ICU and a standard department. 3: To find out the differences in nursing care of a patient with polytrauma at an ARD, an ICU and a standard department. Research questions: 1. Where do ARD nurses see the biggest problems of nursing care of a patient with polytrauma? 2. Where do ICU nurses see the biggest problems of nursing care of a patient with polytrauma? 3. Where do nurses from a standard department see the biggest problems of nursing care of a patient with polytrauma? 4. How do ARD nurses care of a patient with polytrauma? 5: How do ICU nurses care of a patient with polytrauma? 6: How do nurses from a standard department care of a patient with polytrauma? 7: What opportunities for education in nursing care of a patient with polytrauma do ARD nurses have? 8: What opportunities for education in nursing care of a patient with polytrauma do ICU nurses have? 9: What opportunities for education in nursing care of a patient with polytrauma do nurses from a standard department have? Qualitative research was applied to preparation of the thesis. Non-structured interview and involved observation were the data collection methods. The research was performed at an anaesthesia and resuscitation department, at an intensive care unit and at a standard traumatology department. The research was anonymous. The research has shown that ARD and ICU nurses as well as those at the standard department are aware of treatment of patients with polytrauma. We observed that they cared about patients' needs and all activities they perform comply with nursing care standards. They are aware of complications that might occur in a polytraumatized patient. We have also found that mainly the difference in communication with a patient belongs to the specifics of the above mentioned departments. The results also show that the care provided at the ARD and the ICU is acute, while the standard department mostly provides subsequent care. We found that the biggest difference in treatment of patients with polytrauma at the above departments is in communication with a patient. Communication is at the minimum at ARD, where work with monitors prevails. Nurses of the ICU and the standard department cope with different problems. These are lack of space and electronic equipment at the ICU. The care of a patient with polytrauma who is not self-sufficient and requires permanent care and attention of a nurse is physically and psychically demanding at a standard department. It is not sufficient according to the nurses. The problem is in their opinion in high number of patients, lack of beds, extensive attention to some patients and last but not least the growing administration conducted by nurses. This brings the problems in nurse-patient communication at a standard department. The nurses are aware of the fact that effective communication has positive impact on patient recovery as it moderates pain and confusion and helps against anxiety and stress, helps relieve pain, reduce complications and accelerate convalescence. It would be interesting to prepare a seminar for the ARD, ICU and standard department healthcare staff to improve nursing care of a patient with polytrauma in relation to that.
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Treatment of a dependent geriatric pacient in domestic environment
ŠULISTOVÁ, Veronika
The issue of the treatment of geriatric patients in a home environment is due to the more current demographic trends. The treatment of these patients is not easy and brings a number of problematic situations. Therefore, it is necessary to think, what the quality of care is in a home environment and how the family of geriatric patients on changes in his health will adapt. It is also important the education and the support of the lay family caregivers in the theoretical and practical knowledge and skills necessary to provide high-quality care. In the theoretical part of the outlined the division of age, characteristics of the geriatric patient, problems that can affect the patients and the carings and the home care. For geriatric patients are mainly the geriatric syndromes and the geriatric frailty. The carings and health professionals talk often about burnout. The main objective of the Bachelor thesis was to map the treatment of the infirm geriatric patients in a home environment. The singular targets have been set as follows: The experience of the non professional caregivers care of geriatric patients infirm in the domestic environment. To find out the problem situation in connection with the care of geriatric patients infirm in the domestic environment. Find out ways to resolve problem situations in the care of geriatric patients infirm in the domestic environment. To find out the needs of non professional carers in care of geriatric infirm patients in a home environment. To find out, how is the cooperation between doctors, nurses and lay carers to ensure the care of geriatric patients in a home environment. Research file was consisted of the geriatric infirm patients older 65 years in home care of the non professional lay carers, their family members and the professional nurses of the home care agencies. For the Bachelor thesis was used qualitative research strategy. To obtain the requisite information has been used polling method, technique of data collection was a free interview. The obtained data was processed by the technique of open coding, method of pencil and paper. Subsequently, the reduction was carried out with the data organized into categories and subcategories. There were created seven categories and sixteen subcategories. Some caregivers suffer from economic, social, psychological and health problems. It was found that the caregivers were forced to do in their lives many fundamental changes. They all had to adjust the housing, in some cases they had to move or even leave their jobs. Furthermore, it was found that the family is not whole in all patients, and therefore in two cases, there is nobody who could who rotates in the care of the infirm member of the family. Many of the problems were turned out as well for example, that many patients suffer from the diaper rashes, problems with defecation, obesity, depression, and other. Lay caregivers do not have enough information about the care or compensatory utilities. Often they suffer from health problems, such as back pain, depression, burnout, insomnia and other. The work can be used as a source of information for students of nursing and professional nurses. Many of the shortcomings are evident after charting nursing home care. The most alarming is the lack of information. Therefore it is necessary to develop care and ensure that most patients could be treated at home. The economic and psychological support of the non professional caregivers and especially the prevention of burnout are highly important. Home care can lead to the better medical outcomes and the lower costs for care.
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Specifics of nursing care for the blind patients to standard wards
PIVOŇKOVÁ, Lenka
Bachelor thesis is focused on the specifics of nursing care for the blind patients on standard bed wards. This topic is actual because in the Czech Republic live from 7 000 to 12 000 thousands of blind people. The most frequent reason of blindness is cataract. If these reasons begin to heal in time, blindness can in many cases completely preventable. Blindness is the hardest stage of visual impairment. Blind person suffers from a lack of visual cues that compensates for increased tactile and auditory perception. During a blind person's hospitalization is therefore necessary to respect the specific frequent related to the implementation of individual interventions. For treating blind people is also important that the nursing staff is familiar with when the blind lost his sight. His care must be subordinated to it. It should be realized that the organ of sight is the most important sensor for active and quality life, therefore his protection is important and people must regularly visit an ophthalmologist. The thesis consists of two parts, from the theoretical and research part. The theoretical part includes anatomy and physiology of the visual system, visual defects and their causes, diagnosis and classification of visual impairment. It also focuses on the specifics of nursing care of blind patients in the reception area of the department, the moving inside the hospital, examination, self-care, communication with blind patients, aids for blind patients and organizations for the visually impaired. In relation to the topic were two objectives. The first objective was focused on the specifics of nursing care for the blind on standard bed wards. The second objective was focused on the experiences of blind admissions to the standard bed wards. Based on those targets two research questions have been established. The first research question was focused on finding out the specifics of nursing care of blind patients. The second research question was aimed at finding the experience of blind patients requiring hospitalization. The practical part was processed using qualitative research. The survey was carried out at the Eye Department of the Hospital České Budějovice and the charitable society Tyflo Vysočina Jihlava. The research sample included blind clients who have previously or currently hospitalized in inpatient department. A qualitative survey was conducted through semi-structured interview. Interview contained 20 question divided into four groups. The research sample consisted of nine respondents (R1-R9), four women and five men aged from 27 to 75 years. The data were collected during the months of March and April 2015. Interviews were tape-recorded and then transcribed verbatim. Interviews were transcribed using paper and pencil method and analyzed by open coding. Based on analysis of the data was created 5 categories with several subcategories. Based on analysis of the gathered data can be said that the specifics of nursing care for the blind include patience, cooperation and communication with a blind patient. In this area are health works increased demand especially in the appropriate client familiarization with the hospital environment, providing enough information about various examinations and procedures. According to the respondents the nursing staff communicated correctly in most cases. The blind must be communicated about everything that is done and what will be done. It was also found that the majority of blind respondents have a standard admission to the inpatient department quite a good experience. But they experienced some uncomfortable moments. These moments were associated with theft, defamatory salutation, misperception that if a person can not see, still he can hear. One of the respondents also said the fact that the staff spoke when communicating with accompaniment and not with him. Bachelor thesis will be used for improve in nursing care and will be proposed draft standard for nursing.
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Needs of Oncology Patients in Ambulatory Care
CHOVANOVÁ, Martina
The number of people diagnosed with cancer is constantly rising. According to the World Health Organization (WHO), this disease will affect four times more people within the next ten years. Therefore it is advantageous to invest time and energy to identification of oncology patients' needs. Systematic evaluation and planned fulfillment of needs are the key element of modern nursing. One of the biggest challenges of the 21st century is proper classification of cancer treatment. However, this challenge is a tough one, which is confirmed by the fact that patients need to undergo a complex procedure including a correct diagnosis, surgical treatment and curative care together with supportive and palliative care. What is more, patients meet a number of specialists during this process. The aim of this Bachelor's thesis was to: 1) Identify the needs of oncology patients in ambulatory care. 2) Determine the possibilities of need satisfaction among patients. This objective consists of four research questions. Question 1: What are the specific needs of cancer patients in ambulatory care? Question 2: How can we achieve maximum fulfillment of their needs? Question 3: What are the relationships of oncology patients with patients suffering from the same or similar disease? Question 4: Where do patients get all the necessary information about their disease? The research was conducted by means of a qualitative survey consisting of interviews with cancer patients. The interviews took place from January to March 2015. The obtained data were then processed using the pen and paper method. Next, these data were entered into individual schemes. The research group consisted of eight oncology patients. The results will be used as a support text for establishing a social day care services in Chrudim.
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The issue of Nursing Care for the Patients with fractured Humerus.
JORDÁNOVÁ, Hana
Primary theoretical basis: The fractures of humerus are mostly results of hit or fall (15). The cure of humerus fractures is developing not only because of material options, but also thanks to medical technology development. (20). Purpose of the work: Main purpose of this bachelor work was to find out through qualitative research, if nurses have theoretical knowledge in the nursing care of the patients with fractured humerus. To this goal was defined research question: Do nurses have knowledge about nursing care for patients with fracture of humerus? Related investigation was about patients, with humerus fracture, preference needs during the time of hospitalization, according to his self-care deficit. To this goals were defined research questions: How big is the deficit rate in self-care with humerus fracture? Which patient's needs are on the first place during humerus fracture? Quantitative research with patients revealed Research questions were defined subsequently: How high is appearance of humerus fracture according to age? How high is appearance of humerus fracture according to hobby? How high is appearance of humerus fracture according to unsports or other leisure activities? Methodics: Empirical part of bachelor work was written on mixed research basis. Quantitative research was realized using data collection from Traumacentrum České Budějovice, a.s. patient's documentation. Research included 152 patient respondents. Qualitative research was realized using half structured interviews, on which participated nurses from Traumacentrum Nemocnice České Budějovice, a.s. and patients with humerus fracture here hospitalized. The research group consisted of six patients and six nurses. Data collection took place since May 2013 to June 2014. Results: From nurse research results came out following categories: Preoperative patient care, Post-operative patient care, Rebandage specifics, Rehabilitation factors, Complications and symptoms. In preoperative patient care five of six nurses focus on pain, sensitiveness, and perfusion. In post-operative on the other hand all nurses observe coverage and pain. In complication category were mostly recorded infections, nervus radialis harm and compartment syndrome. By nervus radialis harm all nurses recorded posibility of limb functional changes. As rehabilitation factors in this category five nurses mentioned as effect of infection, pain and size of the wound. By patients came out following categories: Self-care activities: Dressing, Day routine, Motions on the bed, Hygiene, Toilet, Eating, Preferred needs. In category dressing four patients can't put on T-shirt. Regarding category of eating, here all patients recorded complications with holding the food tray. Preferred needs category reveals that all six patients values family relationships. In quantitative part of work thanks to data collection formed these graphs: Percentage: Participation of patients, Average age, Age categories, Participation of age categories, Influence of activity on injury formation. As percentage participation was found out that 68% of patients are women in average age of 58 years. These data by men are 32% and 54 years. The injury is mostly appeared considering age in women category in the age of 66-70, in 9,21%. In men category in the age of 61-65, in 4,61%. Hobby injury appeared more in men category 8,55%, in women category are more frequent leisure activity injuries, 64,47% . Conclusion: From research result we can say the nurses have great knowledge. However in all categories are knowledge gaps leaving space for knowledge supplement. Patients mostly fumble with self-care activities deficit in all spheres, this category and family relationships are most preferred categories. In qualitative research is obvious that women are twice more hospitalized with humerus fracture.
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Nursing care of patients with pressure ulcers
ŠERIOVÁ, Martina
This dissertation deals with nursing care issues relating to patients with pressure ulcers. The presented topic is quite actual these days, because the number of bedridden patients is constantly increasing, in which the potential risk of the formation of pressure ulcers arise. "Decubitus ulcer is a bedsore, which arises as a consequence of pathological pressure on the predilection place." (Pejznochová, 2010, p. 23). Mostly immobile patients suffer from this disease. Pressure ulcers can be prevented by regular adjust or with anti-decubitus aids. The treating of already existing pressure ulcer today is preferably with the use of modern therapy, the so-called "wet treatment". This dissertation is divided into a theoretical and an empirical part. The theoretical part outlines the formation issue and the assessment of pressure ulcers, the most common place of origin, the defect rating scale, the importance of prevention and subsequent treatment of pressure ulcers. And finally, it describes how the treatment of pressure ulcers is done in hospitals and home care agencies. Two goals were set for the practical part, to describe new methods in the treatment of pressure ulcers and to compare options in the treatment of pressure ulcers in hospitals and home care agencies. To achieve the set goals, a qualitative research was used, which was performed through interviews with nurses from inpatient ward of the hospital of Czech Budejovice, as well as with the nurses from the City Charity in Czech Budejovice and nurses of nursing home care and nursing services ALICE in Czech Budejovice. When interviews were making, two sets of questions were prepared. The research group was consisted of 11 respondents. The respondents came from the dermal ward, ward of internal medicine and aftercare ward. These respondents were identified as respondents under No. 1 to 4. The nurses of home nursing care agencies were signified as respondents from No. 5 to 11. This selection of respondents enables to compare the specific patient care on the wards and in home care agencies. The data were collected from February to March 2013. At the beginning of the research project, five research questions related to the. The first question was concerned of new ways in the treatment of pressure ulcers. The second focused on the nursing care of a patient with pressure ulcers in hospitals. The third question examined the area of nursing care for patients with pressure ulcers in home care agencies. The last two questions were focused on the use of surgical dressings for the treatment of pressure ulcers in hospitals and home care agencies. Based on the survey, it was found that in both institutions proper prevention is ensured, which means the client positioning, nutrition, hygiene and the use of anti-decubitus aids. The research showed the original relieving aids were often replaced by blankets and pillows, as these tools are the more available and fulfil its purpose. The use of surgical dressings on patient units and home care agencies, there is a predominant use of moist therapy and appropriate therapy materials for this purpose. In therapy, this method is considered to be better, because it accelerates the healing of the defect, less surgical dressings are needed and they are less painful for the client. The evaluation of nurses showed that the majority of nurses in home care agencies believe that the agencies are providing better care than in hospital. Certainly nurses from inpatient department think the opposite. Except one respondent, all of the others regularly attend professional seminars, where, within these seminars, new materials and methods of treatment are presented to them. The work will be used for improvements in nursing care of patients with pressure ulcers and will serve as a study material for students in medical fields.
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