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Burnout by Nurses in Intensive Care
Jánová, Simona ; Mellanová, Alena (advisor) ; Honzák, Radkin (referee)
Burnout by nurses in intensive care Abstract: Objective of this thesis was to determine incidence of the risk of burnout by nurses in intensive care in the Motol University Hospital in Prague, compare to risk of burnout among nurses in intensive care for childern and adults and by age, sex, marital status, education, length of experience in health care and on the current department, satisfaction and performance in the workplace. The research method for data collection were two anonymous questionnaires: one prepared by author of the thesis and a standardized questionnaire by dr. Pines to determine the risk of burnout. It was found that more than hlaf of nurses in FN Motol had low risk of burnout and has not demonstrated that nurses have on children's or adult wards increased risk. Results confirmed that discontent and the increasing intensity of stress in the workplace is proportional to the risk of burnout. This research confirmed that although most nurses achieved good results has been shown a high percentage of nurses with alarmig score and even burnout. Therefore we should not ignore this issure, but rather to warn him and avoid unpleasant consequences through educational seminars, pleasant working environment and do not overload nurses. Keywords: burn-out, stress, nurses, intensive care, mental hygiene
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Nosocomial Infections on Intensive Care Units
Zavřelová, Martina ; Lutovský, Roman (advisor) ; Novák, František (referee)
The aim of this thesis is summarising the issue of hospital related infections on intensive care units in district hospitals. This issue is greatly underestimated. The background section discusses the different types of healthcare acquired infection, where they are most commonly found and the most common types. They use statistical data to confirm these points. Within this section risk factors and preventive measures are also discussed. The researchers use a questionnaire to assess the intensive care units staff's knowledge of the procedures to prevent a healthcare acquired infection. The data is expressed using tables and graphs to aid clarity. The results of research reveal, that the staff all downgrade the prevalence and prevention of hospital acquired infections. Key words: Healthcare acquired infections / Nosocomial disease Prevention of hospital related diseases Hand hygiene Intensive care
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Prevention and importance of ventilator associated pneumonia in the intensive care
Sekerka, Pavel ; Kolář, Martin (advisor)
Synopsis Ventilation-associated pneumonia (VAP) presents a severe complication in the care for the mechanically-ventilated patient and its importance rises with the increasing number of resistant microorganisms, which causes VAP. VAP increases morbidity and mortality of the patients, prolongs their hospitalization and leads to the increase of direct and indirect treatment expenses. Options of treatment are sometimes difficult, costly and inefficient, thereby the need to prevent the occurance of VAP by employing a set of preventive measures is needed. Employing and enforcing those measures can decrease the incidence of VAP and thus to improve prognosis of the critically-ill patients in the intesive care. The goal of the experimental part of this thesis was to audit the employment of these preventive measures in practice. A survey using questionnaires and observing the situation on KAR FNKV have shown, that some measures are performed correctly, while some present a space for improvement, some are performed incorrectly or not at all.
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Problem of sepsis in the intensive care unit
Škrabánková, Hana ; Marková, Eva (advisor) ; Jankovcová, Kateřina (referee)
The aim of the thesis was to determine the microbial colonization at the injection site of central venous catheter and its possible influence to maintain the lowest incidence of catheter sepsis. The culture results of skin swabs and taken blood cultures from two groups of patients were compared with each other using qualitative analysis methods. Those were Intensive Care Unit patients with established central venous catheter. The result was the discovery of microbial colonization of the skin and the representation of different pathogenic strains at the site of a central venous catheter for both established groups. Further showed that the higher the risk of microbial colonization with symptoms of catheter sepsis was seen where patients have central venous catheter established for longer period of time and have been treated under home parental nutrition program with stoma. The recommendation is the continuous education of health professionals to act in accordance with the latest preventive treatment recommendations, and the emphasis is mainly placed on hands cleaning and disinfecting as the hands of health professionals are one of the most common and risky way of transmission of pathogenic strains with potential nosocomial infection formation. Aseptic principles must be repeatedly communicated to all...
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Practical use of the document "The Adaptation Process Plan for Nurses in Intensive Care Unit" in the Czech Republic and its comparison with the practice in the United Kingdom
Skřivanová, Eva ; Di Cara, Veronika (advisor) ; Hladká, Petra (referee)
The Adaptation Process Plan document should serve as a tool for ensuring that the adaptation process of a new employee to an intensive care unit is properly led. It is also supposed to help with feedback and evaluation of the level of the newcomer's skills. The main goal of this thesis was to find out how effectively the Adaptation Process Plan document is currently used for nurses in intensive care units in the Czech Republic. We furthermore aimed to ascertain how the plans are filled in, whether their individual parts are filled in on a regular basis, as well as whether the parts which have been graded as insufficient are explained again to the employee. Last but not least, we tried to compare how the document is used in the Czech Republic and in the United Kingdom. The qualitative research was carried out by interviewing three nurses who have completed the adaptation process to intensive care units - one in the United Kingdom and two in the Czech Republic. The results show that according to our research group, the Adaptation Process Plan document is not effectively used in the Czech Republic, especially in comparison with the United Kingdom. The ways of filling in the document differ in these countries, particularly with regard to its regularity and thoroughness. The parts which had been graded...
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Multidisciplinary Cooperation and the Role of a Nurse in Patient Care Affected by Blast Syndrome
KOPULETÁ, Martina
Blast injury is a very serious lesion caused by the shock wave resulting from an explosion. Further secondary injuries can arise from burying under debris, pieces of shards from the explosive cover, at burning, poisonous gases created by chemical reactions during detonation. The injuries often happen to be fatal and the percentage of people who survive it depends on the fact how far from the epicentre they were situated. If the individual is very close, there is almost no chance to survive, if, however, the individual is situated further from the epicentre, a few tens of meters, the chance is higher. It is so called mass disaster, which includes more injured people at an explosion. Therefore it is necessary for nurses and the hospital staff to know what the procedures are at this incident and how to take medical and nursing care of higher number of such patients suffering from blast injury. The care itself is extremely demanding, since the injured are often in critical condition. The aim of this diploma thesis, the topic of which is multidisciplinary cooperation and the role of a nurse when taking care of the patients suffering from blast injury, was to find out the information based on the latest Czech and foreign literature and create a compact overview of the knowledge of this issue, for it is necessary to have this knowledge to carry out nursing care of such patients. The second aim of this diploma thesis was to map the role of a nurse in details when taking care of a patient suffering from blast injury. This aim was stated for the reason of the demanding character and complexity of nursing care at urgent reception and anaesthesiology and resuscitation unit because the nurses at these units are placed demands on high qualification and requirements. This diploma thesis was purely elaborated as theoretical thesis based on Czech and foreign sources. The given pieces of information were obtained from a great deal of professional and scientific publications, monographs, professional journals and internet sources for each chapter. The first part of the thesis was dedicated to the description of the given issue, pre-hospital care and classifying algorithms that are used at mass health losses in such way so that the injured people have a higher chance to survive. The crisis management at hospitals, the reception of the injured, the care at the urgent unit and finally the follow-up care at the anaesthesiology and resuscitation unit are worked out in the following part. Thereafter the theoretical part focuses on nursing care at the critical care department where the nursing care of a patient suffering from blast injury is described as well as the duties of a nurse. The needed competences of a nurse working at the urgent unit, anaesthesiology and resuscitation unit are also defined in this chapter. According to the valid Czech legislation, only specially trained nurses for intensive care should take care of the patients with blast injury because the extent of their competence for intensive care is many times higher than general nurses have. The last chapter deals with team and multidisciplinary cooperation among the doctors and hospital staff as well as the cooperation concerning the pre-hospital care of the emergency services at emergency incident, for their active and quality communication are the keys for good and well done work with the least consequences.
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Nurse's role in the nutrition of patients in intensive care
VACKOVÁ, Veronika
This bachelor thesis is divided into two parts theoretical and empirical and the purpose of this thesis is to deal with the topic of the nurse´s role in the nutrition of patients in intensive care. In the theoretical part of the thesis, complex issue of the nutrition ensure of intensive care patients is summarized. We have been dealing not only with the common concept of the nutrition on the intensive care units and the role of the nutrition therapist but also with the characteristics, causes and diagnosis of the malnutrition as the most serious issue in the nutrition field. In the thesis, the types of a nutrition support in the intensive care have been also defined as well as the indication, contraindication, types of serving, complications, types of medicines, monitoring and the related role of the nurses. The practical part provides with the results of the research, which have been found by using a qualitative research method. The main purpose of this bachelor thesis was to emphasize the role of the nurse by the handing enteral and parenteral nutrition and also a description of the cooperation with the nutritional therapist on the associated intern and neurological unit of intensive care at České Budějovice hospital. At the basis of above mentioned, two objectives have been stated. At first, our task is to find out the way how is the right handing of the nutrition to the intensive care patient by the nurse secured. The second task is finding out the way of cooperation of the nurse and the patient while securing the nutrition of the patients in the intensive care unit. For the first task, four research questions have been established, for the second task have been established one research question. For the high-quality data network, the method of hidden monitoring for keeping authenticity has been used. As a consequence of the insufficient amount of data to the reaching of the second task, half-structured interview has been chosen instead. Research dataset consisted of thirteen records of sighting and one interview on the above mentioned intensive care unit. As a basis for analyses, three observation sheets were made, into these sheets were then during the observation information assigned. Each sheet consisted of single points planned in accordance to theoretical part. The nurse follows these points when securing the patient´s nutrition. Remaining information, not included in observation sheet were written into the notes section or were included into the information about the performing of the particular point. The results were analyzed by using an open-coding. There are six categories coming out from the analyses, which are connected with securing the education, information providing, keeping an obstacle-free approach complications preventing, using tools, nurse´s cooperation with the patient and deciding processes during work performance. In the results, there is a conclusion of the analysis with illustrative examples to find. The sequence of the results is presented according to sequence of categories during performing. In each category, the results are evaluated according to research tasks stated. We believe, that the obtained information, which map the activities of the nurses when securing the nutrition at the intensive care unit patients and the acquainting the cooperation with the nutrition therapist helps in the future to the awareness of the potential weaknesses and following correction. The results may become inspiration for more detailed analysis of this topic.
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Nursing patients suffering in delirium at ICUs (Intensive Care Units)
VANIŠOVÁ, Štěpánka
Delirium is a very common and serious health complication which mostly affects elderly patients and is associated with multiple negative effects, such as prolongation of hospitalization, increase in financial expenses, higher mortality and more frequent need for further institutional solutions. Care for patients with delirium means increased mental and physical exertion for the nursing staff and is also more time-consuming. This bachelor thesis addresses the issues of nursing care for patients affected by delirium. It has three objectives. The first objective examines the specifics of nursing care for patients with delirium on selected surgical critical care units. The second objective examines the way nurses manage communication with patients affected by delirium, and the third objective maps the knowledge nurses have of care for patients with delirium. There are four research questions assigned to the objectives and they are based on the set objectives. The empirical part of this thesis used qualitative research method. It is based on a semi-structured interview, which was conducted with nurses working in intensive care units of surgical disciplines. The answers were analysed and then categorized. The research survey was complemented by participant observation of the nursing staff who took part in the interview. The research survey has found that the majority of surveyed nurses did not have the correct approach to patients affected by delirium. Nursing care for these patients was influenced by their mood. In some cases, there was an excessive use of restraints and disregard for the Restriction of patient's movement policy. The nurses who participated in the interview had good knowledge of proper communication methods with patients affected by delirium but in some cases did not use them in practice. They had less knowledge in the fields of prevention and nursing interventions of delirium. The results show that nurses lack theoretical and practical experience required to deal with this very common and serious health complication. This bachelor thesis could serve as a basis for organizing a seminar on this issue for nurses.
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