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Increasing the efficiency of hazardous waste sorting at the hospital Česky Krumlov a.s.
SELINGEROVÁ, Šárka
This thesis deals with the handling of waste and linen. It is divided into a theoretical and practical part.The theoretical part describes the history of Česky Krumlov hospital and is followed by an in-depth look at the history and development of the handling of waste and linen in a medical facility etc. In the practical part of the research qualitative-quantitative methods were used in the form of observation, interview, questionnaire and secondary data analysis. In Česky Krumlov Hospital I observed the ongoing activities and gathered data. The research sample for the interview consisted of 10 respondents. The questionnaires consisted of 21 questions. A secondary analysis of operating rules, guidelines and waste management legislation was used. The main objectives of the research were to compare the system of waste and linen handling in Česky Krumlov hospital with applicable legislation and rules of operation. In so doing, to determine whether there are shortcomings in the separation of waste and the handling of laundry and in which department(s). In addition, to compare the production of waste in amount and time with regards to the use of disposable devices and instruments. Finally, to monitor the way employees separate waste in the hospital and compare the approach to it between smokers and non-smokers.For the purpose of this research five research questions and four hypotheses were put forward: V1: Does the procedure for handling waste meet legislative requirements and the current operating system? V2: Does the system of separation and disposal of waste differ in individual departments and if so why? V3: Can a more effective system for waste management be found? V4: Does the procedure for handling linen meet legislative requirements and the current operating system? V5: Can a more effective way of handling laundry be found? H1: The attitude to the separation of waste is different in smokers and non-smokers. H2: The sorting method depends on education. H3: The sorting method depends on the job position. H4: The sorting method depends on the amount of work experience of employees. Interviews were transcribed using MS Word 2007, and then processed using XMind 6. The hypotheses were statistically analyzed.In addition, information from my observations, interviews and the operating rules and directives for hospital staff helped me to answer the research questions. On the basis of the statistical findings all the hypotheses, with exception to H1, were confirmed. Hypothesis H1 was refuted. During the work all the objectives were met with exception to the fifth objective where problems relating to the quality of services provided by the laundry in České Budějovice Hospital, a.s. were identified. A comparison of the waste management system in Česky Krumlov Hospital a.s. with its operating rules, guidelines and legislation shows that overall the procedures correspond. There were just a few exceptions in the form of unlocked containers for infectious waste and a lack of signatures on labels of some of the staff responsible. During my observation no errors occurred in the separation of waste. The hospital has established a uniform system, whereby the procedures only vary according to the type of waste. The established system of waste separation in Česky Krumlov Hospital a.s. is very good, fully compliant with legislative requirements and is efficient. When comparing the production of general waste over time, the amount is decreasing. However, the amount of hazardous waste being produced is increasing. It was found that the attitude to waste separation does not differ in smokers and non-smokers and that university-educated workers separate less waste at work than others due to the type of job within the organization. Nurses recycle more and more responsibly. The same can be observed for employees with more work experience. I found minor discrepancies in the handling of laundry and the current operating rules.
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Identification and risk assesment in nurcing care
LUDÁNYIOVÁ, Sabina
Theoretical base: Safety of the Healthcare personnel is one of the key aspects in the good and safe care of patients. There are many risks threatening nurses while doing their daily job. It's necessary to perform a detailed identification, analysis and assessment of these risks. These processes lead to improved work life of general nurses and clients' stay in the healthcare facility. Important s of the theoretical part are chapters concerning the accreditation and certification of the healthcare facilities helping to achieve safe environment. Objective: The objective of this study is to identify risks for nurses while performing their medical profession, to analyze the problem of their physical workload, nosocomial infections and the risk of sharps injuries. Another objective is to describe preventive mechanisms of compliance with work safety standards and how they are perceived by nurses. The main objective is to analyze the overall standpoint of nurses towards risks in a way to show their individual perception. Methods: Form of qualitative research was chosen with in-depth interviews in order to fully understand risk perception of nurses. Thanks to using the pre-prepared thoughtful open questions, a number of extensive answers could be collected that illustrate various themes of work. After processing the interviews a subsequent coding and categorization of data took place. These categories have also been used for a survey of the results in the discussion. Participants: Intentionally ten nurses of different ages, length of service, department, and finally, opinions and standpoints have been chosen. Interviewed nurses are working in one of the hospitals in Central Bohemia. Size of the study sample was determined by theoretical saturation of data. Results: The results of the research are divided into seven categories, according to the data. Nurses are aware of the risks they face. They are able to name, describe risky behavior and prevention mechanisms that prevent the onset of these risks. Nurses demonstrated basic knowledge regarding nosocomial infections, but in the barrier care there is still room for a deeper understanding of the mechanisms and approaches that can help to reduce the frequency of nosocomial infections. Nurses are also aware of the risks that arise from excessive physical workload and they tend to eliminate them through sports. Another risk that nurses realized and considered as the most threatening, is the risk of sharp objects injuries. Although aware of this fact, the research shows that nurses do not comply with the preventive measures, despite they know them. Nurses have a rather negative attitude towards training regarding health and safety at work. This is due to poor quality in processing of such trainings. They have a positive attitude towards education, but they realize that trainings for general nurses which might be interesting are not for free and they take place usually during their free time. Conclusions and recommendations for practice: This work highlights the weak points in this topic and tries to look into the attitudes, feelings and concerns of nurses, which are related to the riskiness of such profession. Nurses should be aware of their importance to society and should take responsibility not only for performed procedures, but also for their own safety. Among the recommendations, which could minimize the risks associated with the performance of nursing profession, is the implementation of rigorous training of health and safety at work and quality of training provided by healthcare facilities.
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Sticking to the principles of berrier nursing care as a prevention of infectious diseases transmitted by blood in selected wards.
CANDROVÁ, Eliška
The topic of this bachelor's thesis is "Compliance with the principles of barrier nursing care as a prevention of infectious diseases transmissible by blood in selected wards". The important part of nurses' work includes complying with the principles of barrier nursing care. By following these principles we prevent the transmission of nosocomial infections as well as professional infections transmitted by blood. The theoretical part of the thesis describes infectious diseases transmitted by blood, especially viral hepatitis B, viral hepatitis C and AIDS. Another important chapter describes barrier nursing care. The aim of this thesis was to conduct a survey of nurses' compliance with the barrier nursing care principles in relation to the prevention of infectious diseases transmissible by blood in selected wards. The survey was carried out quantitatively, by the method of involved, hidden, direct observation. The observations were conducted from November 2013 to March 2015 and continuously recorded into a recording sheet. The survey was carried out in a selected hospital, where a total of 121 nurses in twelve wards were observed. Based on the results it is evident that the nurses do not fully respect the principles of barrier nursing care in all areas surveyed. The results of this thesis will be given to the head nurse of the hospital where the observations were made, and will serve as a basis for detecting weaknesses in compliance with the principles of barrier nursing care related to the prevention of infectious diseases transmissible by blood.
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Point prevalence survey of healthcare-associated infections in the specialized surgical facility
CHMELAŘOVÁ, Šárka
My thesis is focused on the healthcare associated infections. This area is under considerable control in the developed countries and their health systems, whether in terms of medical, organizational, social, economic, or political. Epidemiology is the world's fastest growing field which knowledge can be applied very soon into everyday practice. The results of that have effect on the patients, whose visit in the hospital is becoming safer. It has also have effect on the healthcare that becomes a better and more professional. In our country, you can still meet the lack of awareness of professional and especially the current context, which accompanies this issue during the contact with the staff of health facilities. Nowadays, we are trying to implement the issue in our laws according to the requirements of the European Union. I try to outline this new European perspective on infections related to the healthcare in the theoretical part. We need to realize the main idea that these infections from healthcare facilities never disappear completely. In the interests of healthcare providers and their staff, it should be to get these infections under the control and to try to minimize the impact of these infections on the patients' health. The meaning of the term healthcare-associated infections or outdated nosocomial infections, and possible types of them, their most common cause and the process of their spread is explained at the outset of work. Afterwards I focused on explanation of the meaning of the prevalence survey as one of the methods of active surveillance. Thanks to the results of the Point Prevalence Survey, which was conducted in the European Union, Norway, Iceland, and Croatia in 2012, it was found that the European prevalence of healthcare associated infections is equal to 5.7%. These results are also commented in the thesis. This prevalence corresponds to every inflectional 18th patient hospitalized in the European acute care hospitals. The European Union Council Recommendation worked out the Infection Prevention and Control Programme in the healthcare facilities to reduce this prevalence. This programme with its details and requirements is described at the end of the theoretical part. In the next part I am aimed to the research, whose implementation is one of my goals. I conducted the Point Prevalence Survey according to the methodology, which was developed by European Centre for Disease Prevention and Control (ECDC). I chose specialized surgical facility for my research. My control sample is consisted of departments that have the same focus as my facility. They are focused only on plastic and reconstructive surgery. The departments were selected from the all Czech hospitals, where the Point Prevalence Survey was conducted in 2012. I received the data from the previous survey thanks to the National Institute of Public Health. I intend to provide the thesis to the specialized surgical facility as a feedback to the research which was carried out in there. Not only for me, but also for the local staff, the benefits are to familiarize with the prevalence survey and to realize that the healthcare-associated infections may still be an actual issue.
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Nosocomial infections and their causes.
KROUPOVÁ, Lucie
The present thesis focuses on nosocomial infections and their causes. The theoretical part summarizes information on especially the sources of these infections, the way of their transfer and the most frequent infection agents. Clostridium difficile is studied in more detail. The illness caused by this pathogen leads to the complications especially with in-patients with a previous antibiotic therapy and immuno-compromised individuals. And this is the problem the present thesis is also concerned with. The thesis also divides nosocomial infections by their clinical manifestations and contains basic anti-epidemic measures and surveillance methods. Its empirical part focuses on the description of an occurrence of select nosocomial infections in Strakonice Hospital, a.s., especially an occurrence of the Clostridium difficile pathogen and methicillin-resistant Staphylococcus aureus (MRSA).
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The prevention of nosocomial infections at central venous catheters in standard inpatient departments and intensive care units.
PAŽOUTOVÁ, Petra
Nosocomial infections are one of serious problems of modern medicine and nursing also nosocomial infections mean real serious problems for future. Prevention of nosocomial infections, applied together with pointed and meaningful antimicrobial therapy is the only causal solution now. This work was aimed primarily at a comparison of knowledge of common nurses working in intensive care wards and common nurses in standard wards. In general, it could be said that the aim of this work was to map the scope of knowledge of common nurses as for nosocomial infections as well as aseptic care for central venous catheters including catheter sepses. The found deficit in knowledge of common nurses pointed out the occurrence of mistakes in nursing practices. Quality of nursing is connected closely with standardisation of nursing procedures. Quantitative research inquiry was realised in 4 medical facilities: Regional hospital Liberec, a.s., Masaryk city hospital in Jilemnice, Hospital České Budějovice, a.s. and Hospital with polyclinic in Semily. As the research method there was chosen a non-standardised questionnaire. The sample of respondents was chosen as an intentional selectionand and in to statistic processing included 290 relevantly filled out forms. The research investigation also included a comparison and quantification of nursing standards. In view of the performed comparison of standards in nursing we concluded that creation of incomplete or even inconsistent standards occurs here. We have prepared a "Proposal on a standard of nursing care for inserted venous catheter", of which form could enable to implement it in medical care facilities within the Czech Republic and define clearly basic nursing procedures within the scope of these problems.
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Nursing barrier care in the ICU
DUŠKOVÁ, Ludmila
Barrier nursing care is one of the important methods falling under the area of prevention of nosocomial infections which should be known and adhered to by nurses during the execution of their work. The theoretical part of the thesis deals with nosocomial infections and the characteristics of intensive care and it explains the principles of barrier nursing care. The practical part of the thesis inquires into the nurses´ knowledge of the principles of barrier nursing care, the adherence to these principles and the aids needed for caretaking using the barrier nursing technique. The research inquiry was carried out using quantitative research method. Data collection was realised by a questionnaire. Three goals had been set. Goal 1: Finding out what knowledge the nurses working in intensive care departments have about the principles of barrier nursing care. Goal 2: Finding out what principles of barrier nursing care are adhered to by nurses working in intensive care departments. Goal 3: Finding out what problems nurses working in intensive care departments identify in terms of the adherence to the principles of barrier nursing care. To specify the goals, four hypotheses were laid out. Hypothesis 1 stating that nurses in intensive care departments know the principles of barrier nursing care wasn´t affirmed. As the nurses do not adhere to the principles of barrier care during the execution of their work, we suppose they do not know them. Hypothesis 2 stating that nurses in intensive care departments research information concerning the principles of barrier nursing care wasn´t affirmed. Only 58.5 % of nurses are interested in educational events dealing with the principles of barrier nursing care. The remaining nurses (41.5 %) would not attend training events. Hypothesis 3 stating that nurses in intensive care departments work in adherence to the principles of barrier care was not affirmed. Out of seven questions testing work habits of nurses during caretaking according to the principles of barrier care, only one was answered correctly by more than 70 % of the nurses. Hypothesis 4 stating that nurses in the departments of intensive care do not identify the problem with caretaking according to the principles of barrier nursing care in the lack of aids was affirmed. Most nurses (89.6 %) think they have enough aids for caretaking according to the principles of barrier nursing care at their disposal in their workplace. The result of the research inquiry also point to the principles the nurses adhere to. These include using aids necessary for caretaking by the barrier nursing technique and isolating the patient in a separate room or a closable box. The nurses state that acute states of health related to intensive care represent a problem which sometimes leads to breaking the principles of barrier care while taking care of the patient. The research revealed the need to motivate nurses to acquire more profound information in this area of problems and to adhere to the principles of barrier nursing care. Furthermore, it is necessary to monitor nurses more during the execution of their work and point out their malpractice to them in time. The result will be submitted to the management of the hospital where the research inquiry took place. Our recommendations, which should contribute to raising more interest in the area of problems of nosocomial infections and barrier nursing care on the part of the nurses, can be proposed to the management. The cause of the low level of awareness and low interest in acquiring more knowledge about barrier nursing care on the part of the nurses could be a further research issue.
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Nursing care of a patient with multi-resistant strains
ZAJÍCOVÁ, Lucie
Occurrence of bacterial resistance appeared already five years after the antibiotics had been introduced in practice. Currently the occurrence of resistant or multiresistant strains is increasing. It is therefore highly important to adhere to barrier nursing techniques for clients colonized or infected with multiresistant strains. The risk of transmission of infection between patients and also between the medical staff is thus minimized. However, many of the nursing staff have not fully realized the importance of adhering to the barrier nursing care. A quantitative research by means of anonymous questionnaires was applied to collect the data. The research survey was carried out in the specialized departments of Nemocnice České Budějovice a.s. (The Hospital of České Budějovice). The following information was checked: identification data, the awareness of the nursing staff concerning the barrier care and the possibilities of the nursing staff to adhere to this care in practice when nursing clients suffering from multiresistant strains. 139 questionnaires have been distributed from which 110 (100%) have been included in the research. In the bachelor thesis the awareness of the nursing staff concerning the barrier nursing care and the possibility to adhere effectively to this kind of care for nursing clients suffering from multiresistant strains has been investigated, which was also stated in the aims of the paper (there were three of them), which were confirmed by the results of the research. Three hypotheses were set. The first one was to prove that the nursing staff adhere to the barrier nursing care for patients suffering from multiresistant strains, which was confirmed. The second one was to prove, that the nursing staff have enough aids to adhere to barrier care for patients suffering from multiresistant strains. This hypothesis was also confirmed. The third one was to prove that the nursing staff are acquainted with principles of barrier nursing technique as prevention of transmission of multiresistant strains, which was also confirmed. In general it can be stated that although the nursing staff are over strained in their work physically and psychically due to evident lack of nursing staff in all departments, the awareness and adherence to barrier nursing care and thus the minimizing the risk of transmission of resistant or multiresistant strains is evident. The research has shown that in spite of problems the nursing staff is to handle daily, the adherence to barrier nursing technique is important for them. The awareness in this field is on a very satisfactory level, as well as material equipment and aids necessary to adherence to barrier care. There is also a tendency from the part of the superiors to inform on topical subjects in nursing care for clients suffering from multiresitant strains in regular seminars organized within the hospital. The adherence to barrier nursing care is an essential part of care for clients suffering from multiresistant strains. The results of the paper shall be used to inform medical staff on this issue to make a positive impact on opinions of medical staff on adhering to barrier nursing care to prevent transmission of multiresistant strains.
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Barrier recovery system at the occurrence of nosocomial infections in the department
JAREŠOVÁ, Marie
Infections acquired during a treatment in a hospital or healthcare service unit are called nosocomial infections. Their history goes back to the first institutions where patients were gathered. To prevent nosocomial infections, so called barrier nursing is used. It is a set of procedures aimed at preventive measures to avoid the appearance or transmission of the infection. The awareness of observing all rules connected belong to the essentials. The aim of the Bachelor work was to find out if general nurses who work in in-patient hospital wards are aware of nosocomial infections. They were interviewed about barrier nursing rules and their observing. The survey was carried out in the hospitals in Písek and Strakonice. There were 110 anonymous questionnaires distributed and 90 of them were given back. All data were compiled and the findings were depicted in a graphic form. Two hypotheses were set at the beginning: Hypothesis 1: Nurses are familiar with barrier nursing regime rules and their use while nosocomial infection appears at the wards. Hypothesis 2: Nurses respect the rules when nosocomial infection appears at the wards. Both hypotheses were confirmed. The analysis of the data acquired from the questionnaires resulted into the finding that the nurses were keeping abreast of nosocomial infection prevention. The nurses are likely to attend seminars as a part of preventive measures of nosocomial infections. All findings will be offered to the management of the hospitals where the survey was carried out.
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Setting up a unified methodology for hygiene, disinfection, and sterilization at UZ, RTG, CT, MR and AG departments.
HLOUŠEK, Jan
The presented bachelor´s thesis {\clq}qSetting up a unified methodology for hygiene, disinfection, and sterilization at UZ, RTG, CT, MR and AG departments`` focuses on an area closely relatedto the field of radiology. The hygiene of the radiology ward, disinfection, and sterilization are an inseparable part of the work of the radiological assistant. In my thesis I wanted to set up guidelines for newly established wards specializingin imaging methods in order to easily tackle this issue. Some of the findings of this work may be applied also at established wards, for instance for the broadening of the range of their action. The risk of contamination by nosocomial infections in medical facilities is very high, especially in radiology wards where various people with different infectious diseases come into contact with hospitalised patients and people treated at outpatient wards. Each imafing method has its specific requirements and various hygienic demands. The evolution of diagnostic methods, new technologies and materials prompts the growing of the quantity of invasive and diapeutic operations, which leads to substantially increased risks. Medical facilities are not safe places for patients. Approximately each eighth to ten patient is infected with a nosocomial infection during hospitalisation. This is why every radiological assistant should maximise the elimination of all hygienic and epidemiological risks related to the performance of his profession by strict adherence to hygienic standards. The motto of every medical professional at work should be {\clq}qPrimam non nocere`` {--} First, do no harm.
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