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Selected risks in nursing practice
HLADÍKOVÁ, Šárka
Current state: High percentage of risk is associated with providing medical care and therefore it may harm both the patient and the nursing staff (Drahoš, 2007). Objectives: To assess the most frequent risks in nursing care that may harm patients during their hospitalization. Furthermore, the aim is to find out whether the occurrence of these risks changes depending on the type of care provided and also whether the nurses' understanding of the principles of administration of oral medication is affected by the length of their work experience. Methods: The empirical part of this thesis was based on the quantitative research study - data collection method via structured questionnaires. The study was then supplemented by observation of nurses using the audit technique. The research group-participants: The questionnaire was designed for general nurses working in selected wards of Ceske Budejovice Hospital, plc. During the Semester-in-Practice Externship, six nurses in 'The administration of oral medication'audit. Results: The result of the aritmetic mean, results in the nurses stating the risk of fall in patients as the highest risk (3,56), risk of medication error (3.01). According to the addressed nurses from the internal department, the following risks belong to the group of the most significant risks to the patients of the internal department- risk of injury to the patient during hospitalization, risk of nosocomial infection, risk of falls in patient and risk of immobilization syndrome. According to the questionnaire research results, some differences were shown in the knowledge of principles of safe administration of oral medication in connection with the length of work experience of the addressed nurses. Nurses with the longest practise (over 11years) most frequently chose the correct answer in the following parts: expired drug usage and checks, medical refrigeration temperature, preparation and disposal of left-over medication, how to care for tablet splitter, correct action taken when a patient refuses to take medication and filling in the daily medication report. On the other hand, nurses with practise of 5-10 years more often correctly answered questions regarding drug administration system, safe usage of medical trolley cart and optimum storage conditions in medicine fridge. Nurses with the shortest work experience (under 5 years) proved to have the weakest knowledge of administration of oral medication. A conclusion that can be drawn from the audit results is as follows: the most common errors committed by the nurses are usage of generic drugs, lack of hand disinfection, touching medication with bare hands, preparation of meds in corridors instead of at the patient's hospital bed and incorrect drug disposal when the left-over tablets were put back in the packet. Conclusion: From the statistically significant connection between the probability of the risk and the department (type of care), it came to light that risk of injury to patients during their hospitalization, risk of nosocomial infection, risk of falls in patient, risk of immobilization syndrome and risk of aggressive behaviour are more common risks in internal wards rather than in surgical wards. Nurses with work experience over 11 years proved to have the best knowledge of principles of safe administration of oral medication. The audit proved that despite their good knowledge of safe drug administration procedures, the nurses do not always follow these in the workplace. My thesis is a proposal for standard care procedure 'administration of oral medication'.
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Simulace a protiřetězce pro efektivní práci s konečnými automaty
Holík, Lukáš ; Černá, Ivana (referee) ; Jančar, Petr (referee) ; Vojnar, Tomáš (advisor)
Cílem této práce je vývoj technik umožňujících praktické využití nedeterministických konečných automatů, zejména nedeterministických stromových automatů. Jde zvláště o techniky pro redukci velikosti a testování jazykové inkluze, jež hrají zásadní roli v mnoha oblastech aplikace konečných automatů. V oblasti redukce velikosti vycházíme z dobře známých metod pro slovní automaty které jsou založeny na relacích simulace. Navrhli jsme efektivní algoritmy pro výpočet stromových variant simulačních relací a identifikovali jsme nový typ relace založený na kombinaci takzvaných horních a dolních simulací nad stromovými automaty. Tyto kombinované relace jsou zvláště vhodné pro redukci velikosti automatů slučováním stavů. Navržený princip kombinace relací simulace je relevantní i pro slovní automaty. Náš přínos v oblasti testování jazykové inkluze je dvojí. Nejprve jsme zobecnili na stromové automaty takzvané protiřetězcové algoritmy, které byly původně navrženy pro slovními automaty. Dále se nám podařilo použitím simulačních relací výrazně zefektivnit protiřetězcové algoritmy pro testování jazykové inkluze jak pro slovní, tak pro stromové automaty. Relevanci našich technik pro praxi jsme demonstrovali jejich nasazením v rámci regulárního stromového model checkingu, což je verifikační metoda založená na stromových automatech. Použití našich algoritmů zde vedlo k výraznému zrychlení a zvětšení škálovatelnosti celé metody. Základní myšlenky našich algoritmů pro redukci velikosti automatů a testování jazykové inkluze jsou aplikovatelné i na jiné typy automatů. Příkladem jsou naše redukční techniky pro alternující Büchiho automaty prezentované v poslední části práce.
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Methods of transfer pricing by multinational enterprises in terms of tax administration
BÖHMOVÁ, Dana
The aim of the thesis is the analysis and evaluation of the application of transfer (transfer) the prices used in transactions of multinational enterprises in terms of tax administration. Generally describe the basic principles of the United people, the principle of the arm, the methods of the determination of the transfer pricing and documentation for transfer prices in accordance with the international rules and standards laid down by the Organization for economic cooperation and development, in accordance with the laws and guidelines of the Czech Republic. Furthermore, this thesis seeks to clarify the specific case studies, which are based on the practice of financial management, and the case-law, the effects of the determination of the transfer pricing methods, comparison of their advantages and disadvantages in establishing transfer prices in the Czech Republic. At the conclusion of the thesis summed up the results and recommend the adoption of more appropriate legislation in each of the areas of transfer pricing in the Czech Republic.
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Property assessment
DOBEŠOVÁ, Johana
Aim subject of this bachelor theses is to characterize useful procedures and principles and their application in housing assessment, i.e. an apartment. This bachelor theses is divided into two parts. First, teoretical part deals with the legal regulation of housing assessment in Czech Republic, furthermore it brings determination and characterization of basic terms as well as it introduces various ways how to make the housing assessment. Practical part deals with the nature of the housing market. In practical part is also value the specific unit in Jindřichův Hradec. The valuation is made by the metod by marktet value and the method acording to the administrative price regulation. Finally the applied methods are compared.
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Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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Cystic fibrosis and Nutrition
PECHOVÁ, Jana
The name of bachelor's thesis is "Cystic fibrosis and nutrition". Cystic fibrosis is hereditary chronic disease. It is dysfunction ducts of chloride in a human organism. The manifestation of cystic fibrosis is large quantities of a mucus in the respiratory and digestive system of patient with this diagnostic. This disease we put in the group of very rare illnesses. The smaller percentage citizens in the Czech Republic have this disease. For the people with cystic fibrosis is priority follow recommended eating habits. Prognosis of this disease is getting better and patients can live full-value life. This thesis dealing with how observe the recommended eating habits and eating regimens. The thesis contains some objectives. First, there is finding out whether children who suffer from cystic fibrosis can all sorts of foodstuffs whether they have special requests for quality and preparation of foodstuffs. The second most important objective is appraisal of diets some sample of people with cystic fibrosis. For objectivity this thesis was chose four respondents in age bracket from three to eighteen years. On the basis of evaluation their week-long diet, questionnaires with their parents and with them and manoeuver a conversation will be to find out whether children observe all principle of recommended eating regimens. In the theoretic part of the thesis are use opinions of experts who are occupying with cystic fibrosis exhaustively. Their experience show how is important to choose right diet and observe correct eating principles and eating regimens. These opinions are use in the practical part. Conclusions from discussion can be used for practical work nutritive therapists who can meet with children with cystic fibrosis.
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Diets for food allergies
DOBRUSKÁ, Klára
I have chosen topic Diet with Food Allergy as a topic of my bachelor thesis. This illness is quite common these days. It affect infants mostly but allergy of cow´s milk protein of children under three years disappears itself mostly. There is increasing amount of causes when patient suffers more allergies. Number of people who have the most serious reaction the anaphylactic shock, icreeases. It can end with death. Doctors recommend to patients to strictly follow the elimination diet which is basic treatment of this illness. The most accurate diagnosis of illness (immunological or not) is another important factor for effective treatment. I have chosen three aims for this bachelor thesis. First to find out if patients are informed about their illness. Second to map eating habbits of people with food allergy. Third the evaluation of correctness of daily menus. I used approach of guality research. Research group consisted of six respondents with different food allergy. Those respondents wrote down their weeks menus. Menus were evaluated with program Nutriservis and it was assessed if it follows recommended dietary value. Suitable intake of energy and essential nutrients was calculated for every respondent. It was evaluated if respondents follows priciples of rational diet and if their diet contains sufficient amount of minerals and vitamins. Questionnaires were another key point of this research. Questionnaires were about illness know-how of patients and who has instructed them about it. It was found out the patients hasn´t got enough information about their illness and half of them has no idea which essential nutrients, minerals and vitamins could lack in their diet. It resulted from menus simultaneously that five of six respondents do not follow principles of rational diet and eat very monotonously. Only one respondent follows strictly elimination diet others violate diet exceptionally. Respondets would appreciate other research would focus on creation of special centres and training of doctors and nutritional therapist who would be focused on food allergies. Spreading the information about illness not only to patients but to public also is really important. Another important point is to increase amount of books about food allergies at the market.
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Poliomyelitis and contemporary issues of its eradication
PETRÁŇOVÁ, Monika
This diploma thesis deals with the issue of the eradication of infectious polio and its current problems. Polio is a highly infectious disease of viral origin. The most effective form of protection from the disease is vaccination. The main aim of this work was to determine the major issues in polio surveillance in the Pilsen region at present. Intermediate goals were determined in relation to the main aim: to ascertain the awareness of practicing paediatricians about the principles of poliomyelitis surveillance with an emphasis on diagnosing and reporting cases of acute palsy and further to ascertain the quality of the cooperation between the locally competent public health authority and practicing paediatricians in the field of poliomyelitis surveillance. The work is divided into two parts, theoretical and practical. The practical part was elaborated using a qualitative method based on semi-structured interviews with practicing paediatricians and with the locally competent public health authority. The research was participated in by 9 practicing paediatricians and one public health authority worker from the Pilsen region, with an average length of practice of 20 years. The resulting data was then evaluated by a coding method and divided into schemes according to Švaříček and Šeďová (2007). Three research questions were defined based on the set aims: RQ1: What do practising paediatricians see as the prime problems in polio surveillance? RQ2: How many cases of acute palsy do practising paediatricians record and subsequently report to the competent public health authority? RQ3: What is the quality of the cooperation between practising paediatricians and the locally competent public health authority? The research revealed that, according to the practising paediatricians, the problem in poliomyelitis surveillance is refusal of the vaccination and the associated decreasing immunisation coverage of the population. The next most commonly reported problem was population migration. Furthermore, it was found that not one practising paediatrician recorded or reported cases of acute palsy in their surgery. Only one respondent encountered acute palsy 10 years ago. The answer to the last research question is also apparent from the information obtained. More than half of the respondents agreed that so far there is no cooperation on this issue. Although four respondents stated that the cooperation is at a high level and is of very good quality.
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Redevelopment study for brownfield of Rukavičkářské závody in Dobříš
Kortusová, Daniela ; Novotný, Vojtěch (advisor) ; Peltan, Tomáš (referee)
The topic of this bachelor thesis is redevelopment study for brownfield of Rukavičkářské závody and near surroundings in Dobříš. The study is composed from the three parts. The theoretical part deals with problems of the brownfields, functions built-up areas and arrangement infrastructures.
The second part of this thesis deals with analyzes this territory, that are important for creation of the study. In the end of this chapter were determinated the problems and values of this territory.
On the base of the analytic results and theoretical principles is suggested resolution. The result of this study is master plan of the mixed living area with good interconnection the surrounding areas and town center.
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