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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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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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Prevention of Nosocomial diseases in dental surgery
TESAŘOVÁ, Petra
The degree work is concentrated on basic characterization of nosocomial infections, on the prevention thereof and on the observance of antiepidemical measures in the sphere of stomatology. Although these infections were largely related to the mortality and morbidity in health service establishments in the past, their occurrence goes down significantly these days. The adoption and observance of fundamental hygienic principles and rules was of decisive importance in this sphare. The neglect of these principles can endanger the health and life of the patient seriously end bring about the increase of costs for further therapy of the patient. It is therefore necessary even at present time ot pay great attention to these diseases and to the prevention thereof. The research part of the work is devoted to the evaluation of preventive measures connected with nosocomial infections in stomatological practice. The literature search in the theoretical part follows therefore this orientation too. The theoretical part deals at first with the most frequent agents of nosocomial infections, that can be encountered. The attention is concentrated on brief characterization of these diseases, their sources and on the process of spreading. Then, the basic classification of these diseases and the concrete methods of prevention are mentioned. In the sphere of stomatology, the work resumes the basic historical relations and identifies particular sectors of this discipline. In conneciton with nosocomial infections, their impact upon the stomatology as well as the need of protection against these infections are discussed. It means epidemiological measures, importance of hand hygiene, necessity of sterilization, desinfection and of cleaning. The aim of the work is to point out the importance of prevention as to the origin and spreading of these infections and the necessity to observe the epidemical principles at the work in dental surgeries. The performed investigation resumes established facts about the observance of hygienic and epidemiological regimen and that not only as to the general judgement on problems, but in consideration of local differences, of differences in the duration of practice carried out by individual stomatologists and in relation to the frequency of conducted hygienic inspections as well. Problematic areas as to the nosocomial infections and as to the observance of decreed provisions by stomatologists are defined here. It refers also to the influence of the locality and to the frequency of inspections directed to the observance of these hygienic rules by physicians.
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The realization of the barrier care by students from Health-Social Faculty
STEHLÍKOVÁ, Jaroslava
The term barrier care is possible to define like a set of different working processes, whose aim is to destroy pathogenic organisms and to prevent them in repeated extantion. It is in principle about prevention of the hospital (in-patient) infections. Every student from Faculty of Health and Social Studies is during the studies notified of the principles of proper washing and desinfection of hands, of safe handling with laundry and biological material, but also of basic fundamentals personal safeness, to which come under e.g. the utilization of the personal protective aids, safe liquidation of the hospital waste et al. The work with title The realization of the barrier care by students from University of South, Faculty of Health and Social Studies is splitted into two parts. The theoretic part of the bachelor work tries to include the complex theme of barrier care, with a view to way of transfer of hospital infections, types of hand washing and hand desinfection, methods of sterilizing, the use of personal protective aids and some principles of safety. The results of nursing research are compiled in the experimental part of work. In the course of the research was used the quantitative method of collecting data with the technique of hidden observation. The students, which were observed, were from Faculty of Health and Social Studies, University of South, from 2nd and 3rd classes of present study called General nurse. The research was provided in Hospital Ceske Budejovice, Inc. The chosen wards for research were neurological, internal and surgical ward. In connection with the task of the bachelor work three targets were set together with six hypotheses to pertinent confirmation or negation. The authoress tryed to find out whether the students from Faculty of Health and Social Studies, University of South adhere a correct process of hand washing and hand desinfection, to what extent the students use personal protective aids and to what extent the students adhere to some fundamentals of their safety work. In conclusion there are the most important facts, which were ascertained and proposals on possible solutions. The authoress thinks that the bachelor work could serve as an informative material for another students and at the same time it could help teachers to aim the problematic parts of lessons or at training of practical skills, in which the students were slipped.
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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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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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Decontamination of devices in nursing practice
SMÍTKOVÁ, Šárka
Term ``decontamination{\crqq} is defined as a set of measures which constitutes killing or removal of microorganisms from the environment and items regardless of the degree of reduction of the germs quantity. Decontamination forms an integral part of nursing practice, preventing transfer and spread of infections. The qualitative research was conducted in the internal medicine ward of Nemocnice České Budějovice a.s. by the method of a non-standardized interview, supplemented by structured observation. The research set comprised eight nurses. The interview consisted of 11 questions and the observation was divided into six units. Four objectives were set. Objective 1: to ascertain what devices are decontaminated in the nursing practice; objective 2: to ascertain who prepares solutions intended for decontamination of devices in the ward; objective 3: to ascertain in what manner decontamination of devices is conducted; and objective 4: to identify the most frequently used decontamination preparations. On the basis of these objectives the following research questions were raised: What devices are decontaminated in the internal medicine ward most frequently? How is preparation of decontamination solutions secured? How do nurses proceed in decontamination of devices? What preparations are used for decontamination? On the basis of the in-depth interview and observation it was ascertained that plastic devices are decontaminated in the ward, most frequent being urinals, bedpans, vomit bowls, working surfaces, tableware used by patients and surgical tools. The solutions intended for decontamination are prepared by nurses and sanitation staff following the recommended procedure but not observing exact dosing of the disinfectant. When decontaminating devices, the nurses use a two-stage decontamination procedure. The decontamination preparations most frequently used by the nurses are 0.5% Persteril and Presept tablets. The results of the research will be provided to the ward where the research was conducted. As an opportunity for improvement, I propose holding a session of a small group of nurses in order to interact on the topic of decontamination of devices and to repeat the principles stipulated in the hospital standard so that the nurses realize what mistakes they make and what consequences may follow from the mistakes both for them and their patients.
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Epidemiologic characteristics of nosocomial contagions
VODIČKOVÁ, Šárka
The bachelor´s thesis for the topic {\clqq}Epidemiologic characteristics of nosocomial contagions `` has a character of a research. The thesis is divided into two sections, the theoretical and practical ones. The theoretical section presents the view of nosocomial contagions. It is divided into four chapters, in which there are concisely shown the pieces of knowledge on history of nosocomial contagions, on causative agents of contagions and their sources, was of transduction onto a sensitive individual, furthermore on kinds of nosocomial contagions and possibilities of prevention. In the practical section the attention is focused particularly on problems of state health surveillance within prevention of nosocomial contagions. The aim of the thesis was, on the basis of consultations with officers of the public health protection authority and study of documentation, to make familiar with problems of the state surveillance over operation of the health institutions including the range and sequence of acts within its performance. And subsequently to try to type of health workplaces, where there is the highest risk of origin of nosocomial contagions. And to ascertain, how the situation in question will develop for the four-year period. The Hypothesis 1 assumes that the highest risk of origin of nosocomial contagions refers to the health workplaces of surgical character, where there are carried out the performances, within which there is damaged the integrity of tissular barriers. The Hypothesis 2 expects that the frequency of defects in the health workplaces decreased for the monitored period. The Hypothesis 3 assumes that for the monitored period there came to improvement of situation in equipment of health workplaces with consumable medical material. For the purpose of verifying or rebutting the hypotheses it is applied the quantitative research in combination with the qualitative one, carried out by means of the analysis of documentation of the control departments in the health institutions. The file is formed by the control findings of hygienic stations for the four-year period. The sense of this thesis is the evaluation of pieces of knowledge of the control findings, elaboration of the survey of the most frequently occurring defects in health institutions and the attempt of ascertaining the trend of development for four-year period. The thesis may serve as a guideline of directing the control activities in the future period.
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Nozokomiální nákazy šířené pracovníky intenzivní péče nemocnice Liberec
MARCINKOVÁ, Helena
The topic of my thesis is Nosocomial infections spread by the personnel of intensive care unit in the hospital in Liberec. The main reason for the choice of this topic was my encounter with this infection when I worked as a nurse during my practical training course. Nosocomial infection can be defined as an infection originating from the encounter between a micro-organism and a patient. The patient can be weakened by his or her primary disorder and therapeutic interventions. This fact helps create an optimal environment for spreading the infection. Nosocomial infections occur only in specific conditions. They represent a problem which is necessary to solve. They affect on average 5 to 10 % of patients. If they are present in organism, the course of primary disorder can worsen and the permanent consequence or death may occur. They also bring adverse economic consequences because they require significant financial costs linked to treatment with prolonged stay in hospital. My thesis was divided into two parts-theoretical and practical. In both of them I tried to find answers to my questions (in form of hypotheses). In theoretical part I described the history of nosocomial infections, which is narrowly related to construction of hospitals; then I mapped the origin and spread of nosocomial infections and also their laboratory diagnostics, treatment and prevention. In practical part I devoted myself to research which is focused on evaluation of level of sanitary washing in medical personnel in intensive care units, and also on personnel ´s knowledge of nosocomial infections by means of questionnaires. I evaluated eighty questionnaires, which were distributed in the hospital in Liberec. The questionnaires were also filled in by students of nursing subject at university in Liberec. These students perform their practical training in the hospital in Liberec. The results of research show that sanitary washing of medical personnel in intensive care unit is adequate and their knowledge of nosocomial infections is average. The knowledge of students is average, too. The research proves that sanitary washing is not an adequate prevention of nosocomial infections.
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Nosocomial Infections in an In-Patient Department
Kopecký, Jindřich Bc. ; Střítecký, Rudolf (advisor) ; Lešetický, Ondřej (referee)
Nozokomiální infekce jsou v současné době významnou příčinou vzrůstající morbidity a mortality ve všech zdravotnických zařízení. Neznalost či ignorance metod prevence nozokomiálních nákaz může vést k závažnému ohrožení zdraví a života pacienta a výraznému zvýšení nákladů na léčbu. Práce komplexně představuje problematiku nozokomiálních nákaz a jejich efektů na lůžkové zdravotnické zařízení. Pozornost je věnována charakteristice procesu šíření nákaz, popsání současného stavu ve sledování a prevenci nákaz a konečně popsání situace v jedné nemocnici okresního typu.
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