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Tracheostomy from the client's perspective
Martinů, Kateřina ; Hošťálková, Monika (advisor) ; Mrákava, Vlastimil (referee)
The Bachelor thesis is focused on the topic of clients who endured tracheostomy. The theoretical part is mainly paying attantion to explaining the anatomical and physiological proportions of larynx and trachea. The next, quite large chapter, focuses on tracheonomic cannula, tries to sum up the information from first attempts to open the trachea, types of tracheonomic cannulas and their advantages and disantvantages, to hygiene of the throat and correct care. These basic informations should be helpful to clients taking care of tracheostomy in home enviroment. The next chapter introduces the educational process of the client from the begining of hospitalization until dispensary care. The practical part is focused on quantitative research on sufficient information towards clients before surgery and finding out to what level are the clients bothered by the cannula and how to compensate. From the obtained data it was possible to deduct that 65% of clients received information from the nurse about how to use a cannula, including a demonstration. 35% was informed about the treatment. The research also revealed that 55% of clients with temporary tracheostomy perceives the limited comunication posibilites as a major problem. Keywords in English Tracheostomy Otorhinolaryngology Intensive care unit Nursing...
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Nursing Care for Patients with Tracheostomy
Ebertová, Barbora ; Hošťálková, Monika (advisor) ; Maňasová, Taťána (referee)
The thesis is focused on nursing care of patients with tracheostomy. The work consists of two parts. The first part is theoretical. This section is devoted to anatomy and physiology of the respiratory tract, additional chapters devoted itself already the main topic and that is tracheostomy. The implementation presented here tracheostomy history, engineering design, types of procedures, types of cannulas tracheostomických, indications for the performance and possible complications. Another big part of the total nursing is where nursing care is devoted to a patient with tracheostomy and care of respiratory toilet, replacing the tracheostomy cannula and decanting. Then there is included a chapter on communication with the patient and possible alternative ways of communication and nursing diagnosis. The empirical part focuses on qualitative research, the method of data collection are two case reports of nursing. The survey was conducted at the clinic anesthesia, resuscitation and intensive care in two patients with tracheostomy. The aim of the research was to find out how the nursing care of patients with tracheostomy, method of communication with tracheostomy patients and to determine their nursing problems. Key words Tracheostomy, airway, tracheostomy tube, airway toilet, communication, nursing care
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Prevention of complication in the treatment of patient with established tracheostomy
Biačková, Michaela ; Nikodemová, Hana (advisor) ; Tomová, Šárka (referee)
Bachelor thesis is focused on the prevention of complications in the treatment of patients with established tracheostomy cannula. Tracheostomy is a standard, effi cient and indispensable procedure in securing the airways, but we think that changing physiological conditions in the airways and it is the nursing care that these conditions must be replaced. In the theoretical part I try to explain concepts related to the prevention of complications in the treatment of patients with established tracheostomy cannula. The practical part consists of an exploratory qualitative investigation. The sample consists of patients lying on the long-term intensive care unit. The aim is to map the individual respondents with a tracheostomy tube and to assess whether the right nursing care is suffi cient to prevention of complications.
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A Patient with Tracheostomy at an Intensive Care Unit and a Standard Ward
HLOCHOVÁ, Denisa
Tracheostomy is a surgical operation where a permanent or temporary opening is made in the trachea to ensure passability of the air passage. The aim of tracheostomy is to provide oxygen to the lungs, to improve breathing, to reduce consciousness sedation, and to improve the tracheal toilet. The bachelor thesis mainly focuses on nursing care of a patient with tracheostomy at an intensive care unit and at a standard ward. The theoretical part explains the problem of tracheostomy, aids and types of tracheostomy cannulas. It also focuses on the nursing care of tracheostomy. It deals with mouth hygiene and care of the air passages. The care of the air passages includes humidification, lavage and tracheostomy suction. The theoretical part of the thesis also deals with rehabilitation, diet and communication with patients with tracheostomy. The subject of the thesis was to map what the nursing care of patients with tracheostomy is like and how the needs of a patient with tracheostomy are satisfied. Three goals were set to meet the goal: Goal 1: To find out the specifics of the nursing care of patients with tracheostomy at an intensive care unit and at a standard ward. Goal 2: To find out the level of satisfying the needs of patients with tracheostomy at an ICU and at a standard ward. Goal 3: To map the level of adherence to the principles of nursing care of a patient with tracheostomy at an ICU and at a standard ward. Three research questions were set in relation to the goals. 1: What are the specifics of nursing care of a patient with tracheostomy at an ICU and at a standard ward? 2: What is the level of satisfying the needs of patients with tracheostomy at an ICU and at a standard ward? 3: What is the level of adherence to the principles of nursing care of a patient with tracheostomy at an ICU and at a standard ward? Qualitative research, namely the techniques of semi-structured interview and concealed observation, was employed in the practical part of the bachelor thesis. Six nurses from the České Budějovice Hospital were invited to the interview. The first part contains identification data, the second deals with the opinions on the specifics of nursing care of patients with tracheostomy among nurses, it also focuses on the level of satisfaction of the needs of patients with tracheostomy and the last part deals with adherence to the principles in nursing care of patients with tracheostomy. At the beginning of the interviews the nurses were informed on anonymousness of the interviews and they are numbered in the thesis. The research sample consisted of nurses from intensive care units and nurses from an otorhinolaryngology department. The data obtained from the interviews were processed by means of the "paper & pencil" and "card reading" methods into three categories, which were consequently subcategorized. The obtained data were processed into graphic schemes by means of XMind 2013 software. The information obtained from the observation was processed into graphs in Microsoft Excel 2010. The results from the interviews and the observation show that patients with tracheostomy are provided with relatively quality nursing care. The nurses showed good knowledge of the nursing care of a patient with tracheostomy. The nurses consider communication with a patient with tracheostomy the most frequent problem. All the set research goals were met in the research. The subject of the bachelor thesis was to show the weak points of the nursing care provided to patients with tracheostomy. This thesis may serve for improvement of the nursing care of patients with tracheostomy and may also be helpful to student as an additional study material. Elaboration of a brochure for patients with tracheostomy was the result of the thesis.
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Problems of communication barriers by patients with tracheotomy in intensive care units
POLÍVKOVÁ, Eva
The thesis is aimed at the problems of communication barriers in patients with tracheotomy at intensive care units. Communication is the basis of nursing care and nursing process is based on partnership relation between a nurse and a patient. Everybody who wants to communicate sometimes faces problems, obstacles complicating his/her interpersonal communication. Recognition of these obstacles is the first step leading to their overcoming. Tracheostomy disqualifies the glottal function and patients are not able to communicate by means of speech. Such a situation is new for the patients and is also very stressing, which is why these patients have to be paid extra attention and these problems have to be dealt with. The aims of the work and the hypotheses were focused on the area of communication barriers, but also on adherence to the effective communication principles and alternative ways of communication. The goal was to find mutual dependence between the individual variables. Quantitative research extended by qualitative research was used for reaching the goals. An important relation was proven in hypothesis number two upon the results of statistic examination. The fact that the communication barriers perceived by a nurse depend on the character of the department where the nurse works was found. Some relation was also proven in hypothesis number eight, which examined dependence of alternative ways of communication on the character of the hospital department. No dependence relation was found in the other hypotheses. An analysis of results obtained from nurses and from patients showed us that nurses realize many more communication barriers in patients than patients themselves. A hypothesis expressing a relation between selection of an alternative communication method and the overall patient condition arose from the qualitative research.
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Use of pictograms to improve communication with tracheotomised or laryngectomised client.
ŠTANGLOVÁ, Marcela
This work is focused on communication improvement in tracheostomized and laryngektomized patients. I have chosen the topic because, according to my opinion, communication between people is very important. If there is an obstacle on communication, it brings about a lot of problems in human life which is very stressful indeed. By tracheostomy and laryngectomy performing, a barrier in spoken verbal communication arises and therefore it is important to address this issue and focus ourselves on the help to these patients. After tracheostomy the function of vocal cords is disabled and laryngectomy means a surgical removal of the larynx. In these clients, either temporarily or permanently, disruption in spoken verbal communication occurs. There are several ways how to compensate the spoken verbal communication. As a substitute, however, the most frequently used is the written verbal communication. According to my opinion it would be appropriate to include pictograms into the care of these patients. Pictograms are cards with pictures. When they are used for communication in hospital, they are supplemented with words or short phrases that clearly express the particular notion or feeling. The cards are supposed to help a client who has problems with verbal communication, but also health care workers. Therefore we set a goal to create pictograms and bring them into practice, then to determine whether the use of pictograms in practice contribute to a better communication between nurses and a tracheostomized or a laryngectomized patient and to find out whether the use of pictograms has an influence on cooperation between the family of a tracheostomized or laryngectomized patient and members of the health care team. We also wondered if patients and nurses would recommend or would not recommend the continued use of pictograms in practice.
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Issues related to nursing process utilized with tracheostomized patients in Intensive Care Units.
FIEDLEROVÁ, Miroslava
Breathing is an integral part of the life as such. Some illnesses or injuries may endanger this necessity of life or make it start to fail. In such cases, the organisms in question face possible death. Up-to-date medicine allows to solve such issues by way of artificial ventilation of the lungs. Improvements in medicine and medical technologies have made the group of the states that require securing the airways and artificial ventilation of the lungs grow bigger. Free and unobstructed airways are the fundamental prerequisites for securing efficient ventilation. The aim of the thesis was to determine the most frequent issues faced by the nursing staff while taking care of the patients with tracheostomy cannula, and also to find out what tools are used by the said staff while communicating with such patients. Furthermore, the theses focused on finding out what procedures are utilized by the nursing staff so that tracheostomy cannula contamination is avoided. There was carried out a qualitative survey by way of two structured interviews. The first one was made with ten nurses picked at random who work in the Intensive Care Units of surgery and internal medicine departments and in the department of anesthesiology and resuscitation. The second interview was made with ten tracheostomized patients picked at random in the same departments. The outcome of the interviews shows that communication remains the biggest problem for both, the patients and the nursing staff. Further, the survey proved the nurses followed the prescribed standards concerning the maintenance of the tracheostomy cannula. The interviews with the patients revealed that food and fear of a cannula getting obstructed with consequent suffocating count among their biggest issues. The objectives of the thesis have been met. The outcome of the survey will be submitted to the collaborating departments and the results may be utilized to improve the nursing care for people with trachostomy cannula. It is recommended to educate and train nurses in communication techniques and rehabilitation provided to the ill. The best possible solution would be to arrange and organize a training dealing with such issues which would be meant for nurses. It is also recommended to establish a research concerning prevention of nosocomial infection in patients with tracheostomy cannulas.
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Problematic of nursing care about patient with long ventilation therapy
ŠAŠKOVÁ, Lenka
This thesis deals with nursing care problems of patients with a long term aspirial therapy. Thanks to progress in medicine and new modern technology, doctors manage to save more human lives, although these lives are not always of high quality. Therefore the number of clients requiring long term aspirial therapies grows. It has come out of the questionnaires that nurses can meet the needs of these patient and they also have sufficient knowledge. However they lack time to care of these patients during the nursing. This problem can be solved by adding to the number of staff but this is a financial question. There were also differences in care not only in different hospitals but also among different nurses. The solution for this situation might be setting up nursing standards and inspections of their keeping. We must not forget about nurses´ motivation to further work.
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