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Comprehensive Nursing Care for Clients after Cerebrovascular Accidents
KOVAŘÍKOVÁ, Jaroslava
Cerebrovascular accidents (CVA, a stroke) mean a major burden for both the patient and his family and caregivers. It is necessary to focus intensively on the care for patients already diagnosed with a stroke. Provision of quality nursing care of patients increases patients´ chance of their recovery and return to the normal life. Based on these facts, the bachelor thesis "Comprehensive nursing care for clients after a stroke" was prepared and presented. The objective was to find out what theoretical knowledge and practical skills are required from nurses who look after the clients after CVA. The theoretical part of the thesis is focused on the description of CVA and the issue of the nursing care. The research part is based on the quantitative data collection. The research methods applied were: a semi-structured interview, an involved observation and a survey. The research sample consisted of ten clients after CVA who had been hospitalized in Hospital for follow-up care in the town of Humpolec and ten nurses who looked after these clients. Based on the information obtained from the interviews with clients, case studies were compiled, which revealed specifics of nursing care and these were formulated into individual nursing problems. Clients after CVA mostly need help with mobility, food and drink intake, at discharge, hygiene and tidying up. The attention to the issue of speech therapy should be paid. The involved observation and the survey revealed theoretical knowledge and practical skills, which nurses looking after the CVA clients should have. As to the question whether the nursing staff has enough knowledge and skills to provide quality nursing care for clients after CVA, it was found out, that there are some gaps both in theoretical knowledge of CVA and in practical skills of provided nursing care for these clients. As for the theoretical knowledge, the gaps were found out in the approach to clients after CVA and in describing the principles of communication in clients with aphasia. As for the practical skills, gaps in speech therapy were revealed. Gaps were also revealed in the support of the self-sufficiency of the clients. Self- sufficiency is not supported in the maximum possible extent. The results of this work can contribute to improvement of nursing care for clients after CVA. The output of this bachelor thesis is a nursing care plan with emphasis on the most frequent nursing diagnosis.
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Rehabilitation Treatment of Patient with Stroke
BŘEZOVSKÁ, Lucie
This bachelor thesis is on the topic of rehabilitative nursing of stroke patients. It is analysing how the issue is dealt with in the rehabilitation department and Department of Neurology. The bachelor thesis is divided into two separate chapters, theoretical and practical. The theoretical part focuses on the causes, symptoms, diagnosis and Treatment of patients after a stroke and the current state of rehabilitative care. One of the parts of rehabilitative care is the collaboration of the nurse and the multidisciplinary team. Furthermore, the thesis describes the possible complications that may occur from the stroke. These complications include mainly pressure sores and immobilization syndrome. Rehabilitative treatment of patients with strokes include positioning, communication, passive movements, active movements, verticalization, breathing exercises. Other methods used in rehabilition nursing, application of heat and cold and basal stimulation. The thesis also includes chapters dealing with nursing management, medical documentation and evaluating the scale of a patient after a stroke. For the practical part there was a set goal, determine the working conditions for nurses who provide the patients rehabilitative treatment after a stroke. There were four main hypotheses defined, which were the subject of an anonymus questionnaire: Hypothesis - H1: There are only positioning aids available for nurses to provide rehabilitative treatment. Hypothesis - H2: Nurses are documenting the rehabilitative treatment regularly used in the nursing process. Hypothesis - H3: Nurses state that the problem of providing rehabilitative care is the lack of time. Hypothesis-H4: Results of rehabilitative nursing care are monitored by the nursing management. As additional research investigation case reports have been formulated with the Barthel index in four patients. Results of the research shows that nurses are using not only positioning aids, but other available tools as well. Rehabilitative care nurses regularly document treatments, especially in nursing documentation. Nurses stated that there is lack of time for providing rehabilitative nursing and nurses state that the treatment is monitored by nursing management.
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