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Nutritional care about immobile patient on standard department of internal type
AMBLEROVÁ, Michaela
Nutritional care for immobile clients at a standard department of internal type becomes still more important, because nutritional care is important for maintaining good health and supporting quality of life. Nutritional status of immobile clients is very important to diagnose as early as possible in order to avoid all risks of potential complications. Adequate nutrition is also very important to maintain good mental health. The central objective of this work was to explore the specifics of nursing care in the field of nutritional care for immobile client at a standard department of internal type. Following this goal, three research questions were set up: How is the nutritional status of patients at a standard department of internal type assessed? What are the possibilities of application of nutrition for immobile client at a standard department of internal type? What are the specifics of nursing care in the fields of nutrition of immobile client at a standard department of internal type? The empirical part of the thesis was processed using qualitative research, which was realized through semi-structured interview technique. The interview contained 3134 questions, which focused on nutrition care for immobile clients on standard unit of internal type. The research sample consisted of nurses working in the standard department of internal type in the České Budějovice Hospital, a.s. Overall, this study leads to two findings, both positive and negative. Within the positive findings we can say that nurses provide adequate care in the application of nutrition per os. Negative findings relates to the fact that the interviewed nurses provide only basic care in case of the introduction of enteral and parenteral nutrition. They do not know more detailed specifics of enteral and parenteral nutrition. Based on this finding, we think it would be useful to organize regular seminars and trainings for nurses to expand their knowledge about this type of care, or at least remind it. This thesis can serve as an informational material for nurses in practice or students of other health professions. This work can serve also as a basis for further research.
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Communication of medics with the parents of a child patient.
ŽÁKOVÁ, Nikola
The theoretical part is divided into eleven chapters. The first chapter deals with the definition of communication. The second chapter describes the kinds of communication, including verbal and nonverbal. The third chapter discusses the communication skills of nurses. In the fourth chapter we expanded on the communication of the nurse with a child patient. The fifth chapter describes the basics of communication between nurses and parents of child patients. The sixth chapter discusses a situation where the nurse communicates with parents of a disabled and dying child. The seventh chapter describes the communication of nurses at the pediatric department. The eighth chapter contains the specifics of the children's department. In the ninth chapter is divided into childage. The tenth chapter discusses communication as a part of nursing care. A final chapter describes the process of hospitalization of children and their parents. The thesis is divided into theoretical and empirical parts. Much of the theory is described above whereas the empirical section describes the results of the research. Objectives and research questions The first objective of this thesis was to investigate how the nurse communicates with the parents of a child patient. The second objective was to determine whether a parent understands the information given by the sister and the final objective was to determine any errors that the nurse makes when they communicate with parents of child patients. Research questions: 1. How the nurse communicates with the parent of a child patient? 2. How does the nurse inform parents of a child patient? 3. How a parent of a child patient assesses the clarity of the information provided by the nurse? 4. What mistakes nurse makes in communication with the parents of a child patient? Methodics For the research a survey was chosen to provide qualitative information, which was obtained via interviews. The second methodology used in this work is called participant observation. Data for the first part of the survey was obtained through semi-structured interviews with the parents of hospitalized children. Interviews were conducted on the basis of questions prepared in advance. If necessary, the interview was supplemented with other issues. The interview was to determine how children were admitted to the children's department, what information reached parents about the examination of the child, and also the overall impression of the nurses on the ward. We asked parents about the verbal and nonverbal communication of sisters. They described the errors they found in the communication and behavior of nurses. The second part of the research was anonymous on the pediatric ward of the hospital where nurses evaluated verbal and nonverbal communication skills. The research group The research set for the first part of the survey consisted of seven mothers of children hospitalized in the pediatric ward. The mothers were in different hospitals in the Czech Republic. The research set for the second part of the investigation, which was carried out by observation technique, consists of six nurses employed at the pediatric ward of a state hospital. Nurses were selected randomly. They are of different ages and they have different length of practice and other training.
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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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Specifics of nursing care in patients after transapical aortic valve implantation.
VOTRUBOVÁ, Nataliya
Transcatheter aortic valve implantation (TAVI) is a new and an attractive method in cardiology and as well as in cardiac surgery. It is constantly evolving method which has been developed as an alternative to standard open surgery, especially in patients with severe symptomatic aortic stenosis with unacceptably high perioperative risk or patients who are not suitable for conventional open heart surgery because of age and comorbidities.A teamwork is very importantfor this new method and approach. The choice for TAVI is discussed by the institutional multidisciplinary heart team, typically consisting of interventional cardiologists, imaging-specialists, cardiac surgeons and anaesthesiologists. The first implant in a human being was performed by Cribierin 2002. In Czech Republic this method was first used in 2008. Transcatheter aortic valve implantation (TAVI) was accepted as a minimally invasive alternative to open surgery. This method does not require the use of cardiopulmonary bypass, and cardiac arrest. Other several benefits includinglower risks of bleeding and stroke events, better wound healing, less pain, as well as more rapid early recovery due to preservation of continuity of the sternumthat result in shorter durations of stay in the hospital, earlier rehabilitation and faster returns to normal life. In the presented work was used a combination of qualitative-quantitative methods of investigation. The data was obtained by using the quantitative research. The main technique was using the questionnaires designed for nurses working at the Department of Cardiac Surgery, Hospital Czech Budejovice, a. s. These results were backed up by the implementation of qualitative research, which investigated the patients and physicians view on monitored issues. Questioning method using a semi structured interview technique was used for qualitative research. The results of the survey were processed using descriptive statistics charts in LibreOffice Calc and using diagrams created in LibreOffice Writer. Qualitative results of the research were transcribed from audio recordings and coded, and the base code was created nine categories of interviews with clients/patients and three categories of interviews with doctors. The aim of this work was to explore the specific problem of nursing care about the clients / patients after transapical aortic valve implantation. On the base of our obtained data it is evident, that the client/patient after TAVI may be positioned sideways, the use of surgical drains are less frequently, so the care about the surgical wounds is simpler, patients report less pain in the surgical wound and postoperative rehabilitation and recovery is shorter. H1 - The nurses take care about the clients/patients after transapical aortic valve implantation in the same way as about the clients/patients after open aortic valve replacement, without realizing the differences between the patients treated with different approaches, was not confirmed. The nurses'sees/reported major differences in invasiveness and extent of providing care, rehabilitation, convalescent, in the duration of the hospitalization and better cosmetic effect. The results of the research can serve as a basis for creating the standards of nursing care or educational material for clients/patients. It is also possible to present the results of this work at a specialized seminar for non medical healthcare workers and results can also increase the quality of nursing care about the clients/patients after transapical aortic valve implantation.
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A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
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Role of the nurse in screening for depression in the elderly.
VRZALOVÁ, Monika
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
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The role of nurses and their impact on the care of patients with total hip arthroplasty.
SLABÁKOVÁ, Květoslava
Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.
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Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
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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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