|
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.
|
|
A historical view of the army nurse profession.
PAVLÍKOVÁ, Andrea
The thesis deals with the profession of a military nurse. We can assert that the official study of military, non-medical health-care related qualifications and its use in practice not only for military purposes dates back to the fifties of the last century. However, women as health care professionals, consequently in uniforms, have always been an actual issue. The development of health care activities always existed, however, we must not neglect influence of scientific and medical findings. The historical timeline of development of medical care in the battle field was recorded and ranges from pre-historical healing. The way of Christian medicine was negatively influenced by the Catholic Church. The dark period of the Middle Ages had actually wrested medical performance from the hands of specialists and the suffering were left to the "tender" mercies of the priests. The following part of the thesis concerns modern medicine where enlightenment reforms were exercised. Some of the original six-month courses for military surgeons were organised in this period of time; they weretransformed into Military Surgical Academy, out of which the famous Josefinum originated. A expression of humanity which supported a form of health care of war veterans was demonstrated by constructing buildings for invalid people. The second half of the nineteenth century is characterized by the phenomenon of the presence of nuns in military hospitals. This study goes further in depth of professionally organized healthcare right in the battle field, which dates back from the era of wars in the Crimea.This stage describes the transformation of caring into nursing which requires the necessity of specialized preparation of persons providing nursing practice. In addition, Henry Dunant engraved himself into the history of the profession of a nurse, as the founder of the Red Cross, who first trained health care professionals for working within armed intentions of the state. The continuation of this action sketches out the process of providing first aid in principal armed conflicts of the twentieth century. It describes the functioning of commander operated military health service of that time. WWI drove Czech medical staff to both sides of the front where they provided medical help to the injured. Nurses of the WWII already performed their duties in uniforms as the rightful members of the army. The thesis also mentions post-war usage of military health care professionals in secret foreign missions and their specialized erudition.Last but not least, it marginally discusses contemporary possibilities of modern health care service of the Army of the Czech Republic. The goal of the endeavours of writing this thesis was to chart out clearly the development of the profession of a military nurse within the historical context, focusing mainly on women coming from Czech regions. In order to make the history background concerning specific female participants of the world war conflicts understandable to the reader, this paper reports, in broader extension, peculiar medical and nursing findings, already from the era of prehistoric civilisations. The history study method were applied for the purpose of the theoretical thesis. The methodology is based on searching, studying, sorting and the consecutive systematic objective describing of the events from the past times with the intention to propose comprehensive report on the subject given. It was necessary to study inexhaustible amount of sources to obtain awareness of historical connections. Factual information was derived by analysing of primary and mainly secondary documents. The thesis sketches out histories of military health care and the profession of a military health care professional stemmed from the exploration of appropriate written sources and conclusion of the basic findings. The intentions of the work are not only to clarify the past but also to contribute to solutions of every-day issues.
|
|
Role of the nurse in screening for depression in the elderly.
VRZALOVÁ, Monika
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
|
|
Gluten-free diet - reality in school facilities
JIRÁČKOVÁ, Marie
The topic of this bachelor thesis is gluten-free diet - reality in schools facilities. The goal of this work was to determine the number of school cafeterias in the Vysocina Region which provide gluten-free meals, to evaluate awareness of the canteen staff about preparation of the gluten-free diet and to describe the cooperation between the school cafeteria and family of the pupil with gluten-free diet. School meals are important to provide optimal intake of nutrition during the time the child spends in school, to establish proper eating habits and to better integrate the child into the group of its peers. Gluten-free diet is a necessary medical precaution especially for those with coeliac disease, in which case gluten can lead to villous atrophy, and for those with gluten allergy for whom gluten intake can cause anaphylactic shock. Adherence to the gluten-free diet is recommended also to those with non-coeliac gluten sensitivity diagnosis, although gluten causes only short-term complications, usually intestinal. The method of quantitative and qualitative research was used to make this thesis. The research sample consisted of 8 school cafeterias from the Vysocina Region which provide gluten-free meal to their pupils. Awareness about gluten-free diet principles of the managers of the cafeterias or of the cooks responsible for preparation of gluten-free meal was determined by means of semi-structured interviews. The calculation of the two-day menu of each cafeteria by means of the Nutriservis Profesional program was also part of this thesis. The results were compared with the recommended daily intake of energy, proteins, fat, and saccharides for pupils of elementary and secondary schools. The results of the quantitative research show that gluten-free diet is provided by only a small percentage of school cafeterias in the Vysocina Region. The qualitative research prove sufficient awareness of the cooks about gluten-free diet, with awareness of those cooks directly responsible for preparation of gluten free meals being at much higher level. It was also determined that the cooperation with parents of pupils with gluten-free diet is a usually one time occasion limited to an arrangement of nonperishable gluten free meal packages.
|
|
Card of Cryptosporidium infections by humans and animals
BLÁHOVEC, Ondřej
The representatives of the Cryptosporidium genus are one of the causes of gastrointestinal tract diseases in humans and animals. In animals the host may even be a respiratory apparatus. The disease is called cryptosproridiosis. In majority of cases this infection can bypass without any major problems, but in immunosuppressed individuals it can cause serious health problems. Cryptosporidium has a monoxenous development cycle, which basically means that the entire development takes place in a single host. Exogenous stage is represented by oocysts, which are in case of a gastrointestinal disease excreted in faeces. In case of a respiratory disease the oocysts make they way out via respiratory and nasal secretions. This leads to contamination of the environment or water. In general, it is expected that Cryptosporidium isolates, which are present in one class of vertebrates, are not infectious to a non-specific host from other classes. It is also expected that cryptosporidia have low host specificity. But this does not exclude that some kinds have gradually extended its specificity to more species. It is also apparent that cryptosporidium infections are common in animals that inhabit the external environment, so even a human can be endangered by this zoonosis, although the incidence in the Czech Republic is low. The reason for the low numbers may as well be that parasitological examination is not performed very often, so the estimated prevalence in the population is probably much higher. Therefore to reveal the originator of this disease it would be appropriate to perform a parasitological examination in persons who are in contact with animals, this way the cryptosporidium infection would be excluded or proven.
|
|
Charity Projects of Organizations Providing Care for Children with Disabilities in South Bohemia
LANDOVÁ, Lenka
The bachelor thesis "Charity Projects of Organisations Providing Care for Children with Health Disability in the Region of South Bohemia" deals with those projects that were founded by non-profit organisations and that provide care for children with health disability in the Region of South Bohemia. The aim of this thesis is to chart the charity projects of above mentioned organisations and to find out what is a proper and effective way to create them and what methods and procedures are used by non-state, non-profit organisations. The first research inquiry refers to a successful implementation of these projects. The result will be not only a realisation what kind of projetcs were created by the above mentioned organisations but also what is important for an organisation itself. Within the bounds of the second research inquiry I find out wheather there is an optimal procedure for the implementation of the charity projects of non-state, non-profit organisations. A qualitative method was used for a research part of this thesis. I used a method of a half-structured interview, a technique of a personal interview. A research group was selected for bringing the research into practice, which includes nine organisations seleceted from non-state, non-profit organisations providing a care for health disabled children in the Region of South Bohemia. It is more difficult for non-state, non-profit organisations it this field to obtain enough finances for providing services and for obtaining necessary aids than for state non-profit organisations because of different ways of fundraising . A non-state, non-profit organisation has several possibilities how to obtain necessary material and non-material sources. There are charity projects that offer means of selfless help; provided they are successful, they help the organisation to obtain necessary sources. It emerged from the research that it was very important for non-state, non-profit organisations to get a multi-source fundraising and supporters of their projects, mainly donors and sponsors, to obtain available care for children with heath disability. On the basis of the research, it is possible to state that non-state, non-profit organisations providing care for children with health disability, implemented many successful projects. The results of this thesis can be used in the way of an informative material for setting a complete view of a solution of the problems of the above mentioned organisations projects.
|
|
Summary of foreign knowledge about the origin and development of EDZ in crystalline rocks - research
Vavro, Martin ; Souček, Kamil ; Staš, Lubomír ; Vavro, Leona
Presented search summarizes findings of foreign research oriented on the origin and evolution of the excavation damaged zone in crystalline rocks with a particular focus on the essential results of experimental projects which were performed in Canada, Sweden, Finland, and Switzerland. The study is divided, excluding the introduction, into seven main chapters of the text, which gradually deal with: (1) definition of key terms, (2) overview of the main underground research laboratories in the world where EDZ assessment was conducted, (3) methods suitable for EDZ description and characterization, (4) main factors influencing the origin of failure around the excavations and time-dependent evolution of EDZ. An overview of important outcomes of EDZ experiments, focusing on the European hard rock laboratories (Stripa, Äspö, Onkalo/Olkiluoto and Grimsel), and their summary are presented in the final two chapters.\nThe review summarizing the published key findings and results of in situ experiments shows, that for rock in lower stress state, i.e. in no spalling environment, the extent and character of rock mass damage is typically dependent on the excavation method. Using mechanical excavation, rock damage zone with thickness less than 3 centimeters can be originated. The microcracks within this zone contribute to the increase of hydraulic conductivity of the rock mass. At some test sites (Äspö, Grimsel), where the tunnel boring machine technology was used, the damage zone was already detected in depth of less than 5 mm.\nOn the contrary, openings excavated by drilling and blasting are characterized by much more extensive damage zones up to several tens of centimeters in width. The damage progressively diminishes with the distance from the opening.
|
|
Relationship between the coat colour and melanoma occurrence in horses
Hovorková, Kristýna ; Hofmanová, Barbora (advisor) ; Majzlík, Ivan (referee)
The literary review is divided into two main parts, the first part is dealing with the coloring of horses and their genetic base and the second part is dealing with melanoma formations of horses and their division. In the chapter about several color types of horses there is a description of forming basic color types which is done by three locuses: COLOR, EXTENSION and AGOUTI. Locus COLOR (CREAM) controls whether or not to create pigment. EXTENSION locus controls about the type of pigment and AGOUTI locus controls the distribution of pigment.
The next subsection gives a breakdown of the white color in horses. Greying proces is related with locus GREY where there is a loss of pigment and the coat itself. This process and mutation is commonly connected with dermal melanoma. Non-pigmented spots called vtiligos are connected with the greying process, which is more intense with increasing age. Vtiligios are commonly found in grey horses, at the same locations as dermal melanoma. The places are perianal area under the tail, around the vulva, lips, eyes and around the penis.
Melanoma formations are divided according to whether they occur in Grey horses or other colored horses and whether they have a benign or malignant potential. A further breakdown of melanomas at grey horses is whether it is a separate, smaller segments or large, associated lesions, when this condition is called dermal melanomatosis.
At the end of the thesis there is a description of the treatment options for melanoma. The most effective appears to be a surgical removal of smaller formations. There were studies which have examined the anticancer action of the drug cimetidine but the results are not yet sufficiently conclusive. As preventing the occurrence of melanoma in grey horses it is appropriate to implement the necessary measures and individuals who are concerned should not be included in the next breeding.
|
|
Marketing comunication
Vašáková, Martina ; Štůsek, Jaromír (advisor) ; Marie, Marie (referee)
The thesis deals with marketing communications of a non-governmental,
non-profit organization NaZemi, which contributes to the development of Fair Trade
in the Czech republic. The thesis is divided into theoretical and practical part.
In the theoretical part is defined marketing, marketing mix, and various tools
of marketing communications, which includes advertising, sales promotion, public relations, personal selling, direct marketing, events and experiences.
Part of the theoretical part is characteristic of marketing research, modern trends
in marketing communications and outline of the concept of Fair Trade.
In the practical part is introduced the organization NaZemi with its tools
of marketing communication. Based on the survey findings are formulated proposals, leading to possible improvements in marketing communications. In the end there
is deeply descibed one proposal in detail of a particular campaingn.
|
|
Environmental Impact Assessment Follow up analysis of Pankrác administrative centre
Franclová, Alena ; Keken, Zdeněk (advisor) ; Karel, Karel (referee)
This diploma thesis evaluates issues of environmental impact assessment, focusing on post-project analysis of the Pankrác administrative center. Follow-up evaluation is one of the most important practice through EIA which can fulfil one's potential. Major contribution is mainly the EIA feedback which will be compared between real and predicted impact. Follow-up will provide knowledge to avoid possible non-conformances in EIA evaluation process in the future. Methodical of this thesis is based on international standards of good practice in EIA follow-up, which should always correspond with the specific circumstances of the project and the specific context. The main principles are results-oriented approach, learning, institutional commitment and responsibility. Meaning of the follow-up is the main research question to evaluate the environmental impact assessment. The thesis evaluates the implementation of the main comments from the various point of views. All opinions, changes and views of all participants must be reviewed in implementation and operation phases of the EIA process. Another sub-section provides a comparison of the noise pollution before and after realization of the project and analytical part concludes evaluate compliance with the general principles of good practice. The results collect comprehensive assessment of the EIA process. The follow-up for Pankrác administrative center was important and it proved that positive cooperation with the investor made processes more effective in the terms of the environmental protection of the area. In the future it would be appropriate to dedicate more effort and time for the follow-up. Especially raising awareness of the existence and positive impact of the entire EIA process and also to protect the environmental and public health.
|
guest ::
