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The role of nurses in the care of patients with acute pain in intensive care departments.
LINHARTOVÁ, Lucie
Diploma thesis entitled focuses on acute pain in general, as well as on post-operation pain, which is one of the types of acute pain. The first part of the thesis deals with acute pain as such and its characteristics. The second part deals with intensive care units (ICU). The third part contains description of post-surgery pain, treatment thereof, and the nurse?s role in taking care of clients suffering post-surgery pain. Three goals have been outlined. Goal 1: Identification of the techniques that nurses use at ICUs to sooth clients? pain. Goal 2: Map the monitoring the pain of clients hospitalized at ICUs. Goal 3: Find out whether the techniques for reducing pain of clients hospitalized at ICUs are effective. A quality-oriented research was applied for evaluation of the results, using a method of non-standardized interview with nurses and clients.The results can be used as a comparative overview of the most common pain-reducing techniques and proof of their effectiveness for clients.
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Support for Nurses in Death Cases at Resuscitation Units and Intensive Care Units
LAYEROVÁ, Helena
At Resuscitation Units and Intensive Care Units nurses face the issue of dying and death every day. Very often they are in contact with the dying and their immediate family and they are expected to have professional approach and provide comprehensive care. Stress that the nurses experience in these situations results into mental, emotional and physical exhaustion, and can be manifested by psychosomatic problems. Preparation of nurses to these situations and support of their management is therefore a key factor for the management of this demanding profession. The theoretical part of the thesis contains a description of the current state of the issue, characterizes resuscitation and intensive care, and deals with the issue of death and dying in Resuscitation Units nad Intensive Care Units, managing situations associated with death and the support of nurses in these situations. The work has four goals. The first objective is to determine what method of preparation of nurses is in practice ensured in Resuscitation Units and Intensive Care Units for the performance of high-quality nursing care for dying patients. Another objective is to determine whether and how the nurses are prepared and trained in the field of management of situations connected with the death of a patient in Resuscitation Units and Intensive Care Units. The third objective is, whether there is and what is the form of assistance to nurses in RU and ICU provided by the team and the management of the Department in case of deaths of patients, and the fourth objective is to determine what form and manner of support nurses expect and require. Research part of the thesis was carried out by quantitative investigation using an anonymous questionnaire. Respondents were answering 38 questions, 13 questions were closed, 21 half open and 4 were open. The support is most frequently understood as a psychological support, good teamwork, communication, supervision and representation where necessary. Management is expected primarily to provide support through education, ensuring supervision, corresponding financial support and professional psychological assistance where necessary. On the basis of this work?s results a proposal for the course for paramedical professions working in RS and ICU called ?Course of the Strategy of Difficult Situations Management in the Care for the Dying and Their Close Family in Intensive and Urgent Care?, was made.
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Sepsis in intensive care, precautionary measures on the part of nursing personnel and department management
JANOUŠKOVÁ, Ludmila
Sepsis represents a serious medical, but also social problem. Hundreds of thousands of patients die from serious sepsis and septic shock every year. Patients with serious sepsis are treated at intensive care units and their treatment is long, costly and low efficient. These are the reasons why prevention of sepsis focused on prevention and effective treatment of nosocomial infections or timely solution of another problem, e.g. a shock is so much stressed. Nosocomial infections affect about 30 per cent of patients at intensive care units and may cause serious diseases, sepsis or even death. This thesis deals with the possibilities nurses have to influence sepsis, particularly by adherence to aseptic procedures and prevention of nosocomial infection, which might consequently develop in nosocomial sepsis. Combination of quantitative and qualitative methods was used for the research. There were two goals set for the quantitative research. 1. To find whether obstacles occur in adherence to proper aseptic procedures in nursing work as prevention of nosocomial infection occurrence and subsequent septic conditions in patients hospitalized at intensive medicine workplaces. 2. To map the weak points in adherence to proper aseptic procedures in nursing work in intensive care. The goals led to hypotheses H1 Obstacles obstructing thorough adherence to proper aseptic procedures in nursing work exist in intensive care. H2 Non-adherence to aseptic procedures occurs in nursing work at intensive medicine workplaces as a consequence of lack of time for particular interventions. The research sample consisted of nurses from the intensive care workplaces ARD and ICU from 8 hospitals. Questioning method through the questionnaire technique was used for data collection. 342 questionnaires were distributed in total. Hypothesis 1 was refuted, hypothesis 2 was refuted. We found that no obstacles obstructing adherence to proper aseptic methods occur, we mapped the weak points in adherence to proper aseptic procedures in nursing work in intensive care. There were two goals set for the qualitative research. GOAL 3 To find what measures preventing occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces are taken by department managements. GOAL 4 To find out how department management deals with possible occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces. The following research questions were set. 1. What are the measures preventing occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces taken by department managements? 2. How does department management solve possible occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces? The research sample consisted of 5 departmental nurses and 5 head nurses from intensive care workplaces from the same hospitals where the quantitative research took place. The research was performed by semi-standardized interview. The research questions were answered. A manual for nurses called ?Recommendation for nurses in prevention of nosocomial infection and nosocomial sepsis not only at intensive care units? was elaborated upon study of these issues and the performed research. A thought map for department management illustrating prevention and solution of nosocomial infection and nosocomial sepsis was also elaborated. Both the document and the research results will be provided particularly to the managements of the hospitals that took part in our research. The thesis may also be helpful to nurses, students and other interested people to gain overall insight into the issue.
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The Challenges of Providing Nursing Care to Delirant Clients in Intensive Care Units
VONDRÁKOVÁ, Radka
The theme of this undergraduate thesis is The Challenges of Providing Nursing Care to Delirant Clients/Patients in Intensive Care Units. The thesis pursues three objectives and elaborates three hypotheses. The first objectives was to assess the challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital, from the nurses{\crq} perspective. The second objective was to examine the nurses{\crq} knowledge of the specific challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital. The third objective was to ascertain whether nurses were acquainted with the principles of using inhibition as a means of controlling situation, according to the nursing standards of the České Budějovice Hospital. The first hypothesis was based on the presumption that nurses taking care of delirant patients feel exhausted. The second hypothesis was based on the presumption that nurses use inhibition as a standard means of controlling situations involving delirant patients. The third hypothesis was based on the presumption that university-educated nurses have a better knowledge of patients{\crq} delirant condition than nurses with lower education. For the purposes of my research, which I conducted in January and February 2009, I applied a quantitative method using a questionnaire. The questionnaire was distributed among the nurses working at the ICU of the České Budějovice Hospital. The resulting data were recorded in the form of diagrams. The validity of all the hypotheses has been confirmed and the outlined objectives have been reached. In the closing part of my thesis, I recommend that a seminar be organized for all the nursing staff of the České Budějovice Hospital, where nurses would be presented with the complexity of delirium problems, as well as mental hygiene and relaxation techniques. Furthermore, it was suggested to perform an audit of the nursing care standard no. 37 at the České Budějovice Hospital. The hardest recommendation to meet was to ensure adequate staffing of the ICU. However, solutions for this particular problem lie beyond the limits of my undergraduate thesis, as shortage of nursing staff is a nationwide problem. My last recommendation calls for improving the theoretical preparation of non-medical students by including specific practical care of delirant patients.
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