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Competences of nurses and increase of their opportunities for general practitioners (primary care)
HLÁVKOVÁ, Blanka
The diploma thesis addresses the issue of increasing the authorities of nurses of general practitioners in primary care. The theoretical part summarizes the information about primary and community care, defines authorities and professional activities of general nurses and physicians, and deals with the roles of nurses in primary care and the relations between general nurses and physicians. The objective of the diploma thesis was to survey the opinions of nurses of a possible increase in their professional powers, and to ascertain whether nurses are ready to assume certain authorities. It was also ascertained what physicians think of a possible transfer of certain authorities to nurses, and whether nurses are satisfied with their growing independence and responsibilities in connection with the increasing requirements for their profession. The results of the qualitative survey were evaluated by their summarizing in thematic areas and subareas; the text also contains authentic quotes of respondents (written in italics). The research set consisted of 15 respondents who were selected systematically. The set consisted of six physicians (general practitioners specialized in adult or paediatric medicine and general dentists). The set of general nurses consisted of nine nurses working for general practitioners. The selected general nurses had the work experience of various duration and various educational backgrounds ? they had either secondary or higher professional education and one nurse had university education. It has clearly followed from the research that the nurses do not wish to assume any activities falling within the authorities of physicians. A large number of respondents are very busy and any other authorities would be beyond bearable. Physicians would not transfer many medical activities to the nurses; they would rather transfer most of paperwork to them, such as writing opinions in respect of traffic accidents, spa treatment requests and other requests. Nurses are not afraid of increased authorities but agree that the authorities will mostly result in greater responsibilities and paperwork. The nurses think that there are clear boundaries between the authorities of nurses and physicians. Clear boundaries are seen mostly in diagnostic and therapeutic activities, nursing treatments, prescription of medicines, application of intravenous injections, and statement of diagnosis. Above the scope of their authorities, general nurses are charged to perform activities of a mostly administrative nature, write requests and sick certificates, administer intravenous medicines without expert supervision, write various recommendations, and monitor warfarinisation of patients.
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Preventive examinations from the perspective of nurse
KVÁŠOVÁ, Iveta
The theoretical background: In society, the concept of health and illness is understood as two sharply separated values. The health affects the quality of human life. The aim of preventive health check-ups is to detect health problems and illnesses at an early stage. Each client is recommended to undergo a health check-up at the general practitioner each two years. Newborns, infants and toddlers under one year old should visit a practitioner nine times, another health check-up should be at the age of 18 months, then at the age of 3 years, and then every two years. Every citizen under the age of 18 years is entitled to undergo a preventive dental check-up every six months. A pregnant woman is entitled to visit the dentist twice during her pregnancy, an adult once a year. Girls from the age of 15 years should undergo a preventive gynaecological exam once a year. General practitioners and nurses, who guide patients their whole life in the health care system, symbolise a role of responsible and active approach to prevention. Preventive care service at work is carried out in order to report the statement of fitness for work. Aim: The aim of my Bachelor´s thesis was to describe the role of nurses during preventive check-ups at the general practitioner for adults. The research was carried out by a qualitative survey in form of non-standardized interviews. Firstly, we set three research questions: 1. What information about preventive check-ups do nurses give to clients? 2. How do nurses address their clients about the invitation for preventive check-ups? 3. What role do nurses have when carrying out preventive check-ups? During the research nurses cooperating with general practitioners for adults were interviewed. There were eight interviews in total in the region of Humpolec and České Budějovice. The interview itself contained 13 questions (see Appendix 1). The research took place in period February ? March. All respondents agreed with the research. The results of the research are presented in Chapter 4. Results: The results show us that all the respondents have got a secondary school education, only one of them has got a specialized training ?ARIP? (nursing care specialized in anesthesiology, resuscitation and intensive care). The respondents learn new modifications in preventive health check-ups from a doctor, or they follow trainings and seminars. The most of the respondents said that a lot of clients do not realize risks of not going to preventive health check-ups, except for university graduates who are aware of risks. Then, we have found that clients get information about the claim to preventive health check-ups from the respondents, doctors, leaflets, television, radio, and informative posters. The respondents give clients basic information about preventive health check-ups, schedules, home preparation for the medical examination, and a course of the medical examination. It has been found out that in some regions a low percentage of clients go to preventive health check-ups. The respondents try to convince risk groups, however, they do not insist on risk groups to come. The respondents invite clients orally for preventive check-ups, it is not used to send invitations anymore. The clients must look after their preventive check-ups by themselves. The respondents try to act positively with clients and to be a good example to them. It has been also found out that the respondents take care of sufficient consumer articles and hygiene and epidemiology mode during the preventive check-ups. In the waiting room the respondents and dealers are in charge of raising patients´ awareness. Conclusion: All the research questions were answered. The purpose of the Bachelor´s thesis was accomplished. Now, it will depend only on nurses and clients and their attitude to preventive health check-ups. As we say at work: "Prevention is better than cure."
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The awareness of primary care nurses about wet healing wounds
SEDLÁKOVÁ, Dana
The method of wet healing wounds is one of the most modern way how to take care of long term cureless wounds. In the past nurses nad doctors were use to heal chronic woulds with help of dry dressings, but today we have many possibilities how to improve the quality of nursing care. The application of moist healing is highly efficient for both sides. Pacients donť have to suffer from pain for long time, re-bandages are much less hurtfull. One of the biggest advantages is that the manipulation with this modern material is so easy, that pacient is able to make re-bandage on his own. Most modern wound dressings are designed to optimize a moist wound environment and have become very good at this task. The wound fluid contains many growth factors and nutrients that assist in the proper healing of superficial wounds. Wounds that are kept moist have fewer pathogenic bacteria than overwet wounds The method of wet wound healing is helpful for pacients who suffer from chronic, open, nonhealing wounds. The work with title The Awareness of Primary Care Nurses about Wet Healing Wounds is splitted into two parts. The theoretic part of the bachelor work tries to include the complex theme of wound healing, with a view to way to advantagases of wet wound healing. Some parts of these work also discuss the awarness of primary care nurses, the cooperation between nurses and patients and the area of primary care. 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 list of questions. The nurses which were asked to fill the questionary were from west of our country, concretely from Cheb, concretely from Cheb, Sokolov and Karlovy Vary. The research was made in offices of practicals doctors for adults and for children, on surgical units, by the dermatologist ambulances and in the home care centres. In connection with task of the bachelor work four targets were set together with five hypotheses to perminent confirmation or negation. The autoress tryed to find out if nurses who are working in primary care area have some knowledges about moist healing of wounds and if they are able to apply these knowledges in their profession. In conclusin there are the most important facts, which were ascertained and proposal on possible solution. The autoress thinks, that bachelor work could serve as an informative material for nurses and for students and at the same time could be also used as a motivation for nurses who want to provide the best care for patients at the same time.
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Midwife´s comunity care requirement within the sphere of district Domažlice
HOJDOVÁ, Martina
The central subjects of midwifery are a woman and a fetus {--} a new-born child. The task of taking care of a woman and her child is to look after not only their physical health but also to look after them in sense of the psycho-social sphere. The care should be holistic, complex and individual, preserving its continuity. All this fulfils the midwife{\crq}s community care. Going from the theoretic world and also Czech materials we could suppose that midwife{\crq}s community care plays an important role in woman{\crq}s and child`s care. Practically however, midwives meet obstacles. The main aim of this thesis was to find out women{\crq}s interest in midwife{\crq}s community care within the district of Domažlice. The next aim was to find out the opinion of those women who made use of a midwife{\crq}s fieldwork. The further aim was to find out the opinion of the community midwives{\crq} requirement of this care and also the interest of gynaecologists-practitioners in cooperation with a midwife working in the field. For the processing of the problem given, both quantitative and qualitative research was used. Hypothesis 1 ``Women in the district of Domažlice are interested in midwife{\crq}s community care in pregnancy{\crq}q was affirmed. The women were mostly interested in antenatal preparation and pregnancy exercises. Hypothesis 2 ``Women in the district of Domažlice are interested in midwife community care after childbirth{\crq}q was affirmed. The interviewees were mostly interested in the visiting service, breast-feeding consultations. Hypothesis 3 ``Women in the district of Domažlice mention at least 3 specific spheres that they would use the care of a midwife in the field{\crq}q, was affirmed. Mostly they were interested in the visiting service, antenatal preparation and pregnancy exercises. The research question 1 ``Are the midwife{\crq}s community care services regarded as useful by the women who used it?{\crq}q was answered explicitly positively by all of the interviewees. The research question 2 ``Is the community care regarded as useful by midwives who have experience with it?{\crq}q Was answered positively by 5 out of 6 midwives. To the research question 3 ``What spheres of woman{\crq}s care do the gynaecologists-practitioners regard as a possibility of cooperation with a midwife in the field?{\crq}q The practitioners explicitly expressed themselves for psycho prophylaxis and pregnancy exercises. This thesis is intended for a further support of development of the community midwife{\crq}s care in the Czech Republic.
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Requirements and expectations of nurses in primary care
KOPŘIVOVÁ, Lenka
The aim of the work was to find out what the expectations of nurses in primary care and their requirements are. The research was carried out by the method of a questionnaire and in total 160 respondents from Prague responded. The nurses´ data confirmed a great interest in extending their own knowledge. Also proficiency and independence in their work performance is put in the first place.
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Educator - role of nurse in primary care of children and teenagers
NETOLICKÁ, Jana
In my thesis the following issues are covered: education, the process of education, primary care for children and young adults and disease prevention. Its aim was to map educational activites in primary care for children and young adults perfomed by nurses in consulting rooms. To evaluate data the quantitative quastionnaire method was used. The questionnaire was aimed at nursing staff working at general practitioners for children and young adults in South Bohemian region. Filling the questionnaire was optional and anonymous. The questionnaire contained 35 semi-opened and closed questions. I analysed 76 out of the total number of 120 questionnaires handed out.
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Community care versus nurses in primary pediatric care
VAŇKOVÁ, Soňa
Paediatricians and nurses belong to primary health care providers in the in child care while nurses have been taking over a key role in the primary health care. Their position is becoming stronger under the conditions of growing demands in the current health system. This survey was carried out as a combination of quantity and quality research. A questionnaire and an interview for nurses and parents was worked out as a major tool of the research. The survey included 102 nurses in paediatricians' offices. 112 parents and five nurses were interviewed in the range of the research work. There were six objectives set for the thesis. The first objective was to find out whether nurses in primary paediatricians' offices use nursing procedures. The hypothesis set up for the first objective was as of the following: nurses in primary paediatricians office do not use nursing procedures. This was proven on the grounds of the answers received in the survey. The second objective was to find out whether nurses keep their own nursing books and records. The second hypothesis set up was worded as of the following: Nurses in primary paediatricians' offices do not keep their own nursing records. This hypothesis was proven as well. The third objective was to find out whether nurses from primary paediatricians' offices visit families as a part of their service to families. The hypothesis for the third objective was worded as of the following: Nurses from primary pediatricians' offices visit patiens in their homes. The hypotehsis was proven on the groundsof the survey. The fourth objective was to find out whether nurses in primary paediatricians' office observe children in familes with bad socio-economic backgrounds. The hypothesis was worded as of the following: nurses observe children in familes with bad socio-economic;backgrounds. This hypothesis was proven as a fact. The fifth objective was to find out whether nurses are informed about community care. The fifth hypothesis was worded as of the following: nurses in primary paediatricians' offices are not informed about community care. This hypothesis was not proven. The sixth and the seventh objectives were to find out what the range of awareness about community care in parents' minds exists and whether parents are satisfied with nursing care provided by paediatricians and nurses. The hypotheses were worded as of the following: parents are not aware of community care and they consider paediatricians' and nurses' care substantial. The sixth hypothesis abot the range of parents' awareness of commuinity care was not proven, while the seventh hypothesis about satisfaction of nursing care by paediatricians and nurses was proven. In the frame of quality reasearch and on the grounds of four research questions two hypothese were set up. The first one is worded as of the following: Paediatric nurses in primary paediatric care consider community care as necessary and inevitable to provide a thourough care in familes with bad socio-economic backgrounds. The second one is worded as of the following. Paediatric nurses consider cooperation with nurses in other fields of the system as necessary and that eduaction towards well-being is desperately needed. Nurses should be aware of their roles within the health care system. They are no longer just nurses providing care and doers of doctors' commands. They have to learn how to operate successfully in other roles such as: managers, researchers, legislative assistants, advisors, educators and etc.
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The School Nurse, and its elocation to the health care system in the Czech Republic
KUDLÁČOVÁ, Simona
There is a new trend of shifting the provision of health care from hospitals to the patient?s natural environment. We are increasingly aware of the expensive and sometimes ineffective late hospital treatment; therefore, there are stronger efforts for early diagnosis, prevention and health education from an early age. It is necessary to keep the future generations focused on their health and the health of their family members who live in the community. The initiative must originate not only in families but also in the school environment in which children find themselves almost every day. A school nurse is an expert in the field of community care working in school environment. The work load of the school nurse rests in maintaining and improving physical and mental health. The school nurse supports pupils in their responsibility for their health and she creates a system of formalized school activities, prepares and implements the school?s educational program focused on prevention. The data in the research part of the thesis was obtained through quantitative and qualitative research survey. The quantitative research was carried out using the technique of an anonymous questionnaire. The questionnaire was intended for general practitioners for children and adolescents, as well as nurses working with general practitioners for children and adolescents. The qualitative research data was collected through semi-structured interviews with the head teachers of elementary and secondary schools on the basis of which casuistries were created resulting in categorized charts. The objective of this thesis was to find out about the position of general practitioners for children and adolescents, and paediatric nurses working with general practitioners for children and adolescents on introducing the function of school nurses in the healthcare system of the Czech Republic. The research in this thesis showed a low level of awareness about the position of school nurses. The primary controversies related to the introduction of school nurses can be described as follows: the method of financing, the issues of authority of such nurses, and the way of preparing for this occupation. The main positive aspect of school nurses can be seen by the respondents in comprehensive care for pupils, prevention and better public education. School head teachers, general practitioners and nurses believe that school nurses should be placed in schools according to the number of school pupils and school head teachers assume greater use school nurses in primary schools than in secondary ones. The method of financing school nurses should be, according to the respondents, from multiple sources. This thesis may be used as a basis for further research work focused on the position of school nurses, and also as a proposal of establishing the school nurse position in the healthcare system of the Czech Republic, or as informative material for professional as well as lay public.
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Application of the possibilities to prevent breast carcinoma in women as a nursing issue.
NUSKOVÁ, Oldřiška
Application of the possibilities to prevent breast carcinoma in women as a nursing issue. Four objectives were set for the bachelor thesis Application of the possibilities to prevent breast carcinoma in women as a nursing issue. Objective 1: To ascertain the application of nursing interventions focused on the prevention of breast carcinoma in women within the scope of primary care. Objective 2: To ascertain what information about the risk factors of breast carcinoma development the nurses provide to women within the scope of primary care. Objective 3: To identify any obstacles that keep women from utilising a possibility of breast carcinoma prevention. Objective 4: To ascertain the reasons which make women to see a doctor when they have an advanced breast carcinoma. Four research questions were raised. 1. Which nursing interventions do the nurses apply in the prevention of breast carcinoma in women within the scope of primary care? 2. What information about the risk factors of breast carcinoma development do the nurses provide to women within the scope of primary care? 3. What obstacles keep women from utilising the possibilities of breast carcinoma prevention? 4. What reasons make women to see a doctor when they have an advanced breast carcinoma? The research set comprised two groups of respondents. The first research set consisted of six nurses working at primary care facilities in České Budějovice. The second research set consisted of eight women who were treated for breast carcinoma at the oncology ward of Nemocnice České Budějovice, a.s. The interviews with the respondents were conducted using the technique of a non-standardised interview based on questions prepared in advance. Based on the interview analysis, the research questions have been answered. It has also followed from the research that the nurses apply nursing interventions in the prevention of breast carcinoma in women and inform women about the risk factors of breast carcinoma development only if they know about the genetic load of breast carcinoma in the family of particular women or if they are asked by women. The application of nursing interventions in the prevention of breast carcinoma in women within the scope of primary care could be reached through educational aids for the nursing staff and executed projects focused on targeted preventive care and timely detection of breast carcinoma.
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