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Monitoring quality indikators of anesthesilogy care
Šimonová, Petra ; Jeřábková, Lenka (advisor) ; Dynáková, Šárka (referee)
Safety and quality of care are considered to be one of the main priorities in anaesthesia and their management and monitoring should be continuous and systematic. Quality indicators in anaesthesia must be frequently evaluated. Their evidence and evaluation create not only safe environment for patients but also continuously improve quality of anaesthesiologic care. The main objective of this diploma thesis was to evaluate patient's satisfaction with provided anaesthesiologic care, one of the main quality indicators in anaesthesia. Other objectives were research of quality indicators recommended in the Czech Republic and quality indicators recommended by foreign medical societies. The last partial objective was to create quality indicators checklist tailored for specific department of anaesthesiology based on collected data. Quantitative method research was conducted, using unstandardised questionnaire for patients, hospitalized and anaesthetised. 140 questionnaires were distributed of which 117 questionnaires returned. Based on objective the author of diploma thesis found out that Czech society of anaesthesia, resuscitation and intensive care determines quality indicators monitored in the Czech Republic. Quality indicators in foreign countries are in form of criteria that are necessary to adhere to....
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Skin lesions prevention in perioperative care
POHLOVÁ, Lucie
Thesis objectives: The diploma thesis deals with the issue of prevention of skin lesions in perioperative care. In the theoretical part, the current state of knowledge is presented concerning the pressure ulcers identification due to the persisting real problems in differential diagnostics in clinical practice. Further, the thesis deals with the issue of wet and thermal lesions, which occur also during the perioperative care. In the empirical part of the diploma thesis, the first objective was to find the frequency of documented occurrence of decubital lesions in connection with the surgery in Jihlava Hospital for a period of one year. The second objective of the thesis was to find out whether, and what barriers exist when using specific preventive measures. The last aim of the diploma thesis was to compare the efficiency of preventive measures from the point of view of perioperative nurses and nurses from service units. Three hypotheses were formulated to meet the objectives of the thesis. Method for achieving the objectives: The set objectives were achieved through a retrospective analysis of the hospital information system data and a quantitative questionnaire survey. The study included nurses working in surgery, orthopaedics, traumatology, intensive care units and perioperative nurses in Jihlava Hospital. The total number of respondents was 140. Scientific benefits of the thesis: The research implies that the use of prophylactic aids in pre-operative preparation contributes significantly to reducing the risk of skin lesions. The addressed set of nurses did not indicate any serious barriers to their application and, on the contrary, considered it to be very effective. The results of the thesis can be used in practice, especially in a specific health facility for further care improvement. The findings and conclusions: On the research group we have verified that the declared use of preventive strategies in the area of prevention of lesions in perioperative care differs according to the type and focus of the workplace; (p = 0.000) the least frequent use was declared by the general nurse from orthopaedics, however, the methods used did not differ (p = 0,220). In addition, we found out that there was a statistically significant difference in the opinion on efficiency of prophylactic covering in lesion prevention (p = 0.001, the worst evaluation was by the respondents from orthopaedics) but only 2 respondents stated negative experience with their use.
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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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Patient safety in the operating theatre
Fejglová, Pavla ; Holečková, Zuzana (advisor) ; Milfaitová, Vlasta (referee)
Author: Pavla Fejglová Institution: Department of Social Medicine, Charles University, Faculty of Medicine in Hradec Králové, Department of Nursing Care Title of the thesis: Patient safety in the operating theatre Supervisor: Ing. Zuzana Holečková Number of pages: 133 Number of attachments : 8 Year of defence: 2014 Key words: perioperative care, safety, quality of care, adverse events This bachelor thesis deals with one of the crucial roles of the medical staff in the operating theater - the issue of ensuring patient safety and quality of nursing care during the perioperative period on central operating theaters of the University Hospital in Hradec Králové and Liberec Regional Hospital from the perioperative nurses point of view. The core of the empirical part consists of quantitative research in the area of compliance with the measures to ensure the safety of patients during their stay in the operating room. Research data were obtained thanks to the understanding of perioperative nurses from operating theatres of the above mentioned hospitals. Based on the data, analysis was conducted with interpretation of results and several measures aimed mainly to improve the safety of patients during the perioperative period and the prevention of adverse events are proposed.
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