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Nutritional care about immobile patient on standard department of internal type
AMBLEROVÁ, Michaela
Nutritional care for immobile clients at a standard department of internal type becomes still more important, because nutritional care is important for maintaining good health and supporting quality of life. Nutritional status of immobile clients is very important to diagnose as early as possible in order to avoid all risks of potential complications. Adequate nutrition is also very important to maintain good mental health. The central objective of this work was to explore the specifics of nursing care in the field of nutritional care for immobile client at a standard department of internal type. Following this goal, three research questions were set up: How is the nutritional status of patients at a standard department of internal type assessed? What are the possibilities of application of nutrition for immobile client at a standard department of internal type? What are the specifics of nursing care in the fields of nutrition of immobile client at a standard department of internal type? The empirical part of the thesis was processed using qualitative research, which was realized through semi-structured interview technique. The interview contained 3134 questions, which focused on nutrition care for immobile clients on standard unit of internal type. The research sample consisted of nurses working in the standard department of internal type in the České Budějovice Hospital, a.s. Overall, this study leads to two findings, both positive and negative. Within the positive findings we can say that nurses provide adequate care in the application of nutrition per os. Negative findings relates to the fact that the interviewed nurses provide only basic care in case of the introduction of enteral and parenteral nutrition. They do not know more detailed specifics of enteral and parenteral nutrition. Based on this finding, we think it would be useful to organize regular seminars and trainings for nurses to expand their knowledge about this type of care, or at least remind it. This thesis can serve as an informational material for nurses in practice or students of other health professions. This work can serve also as a basis for further research.
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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.
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The role of nurses and their impact on the care of patients with total hip arthroplasty.
SLABÁKOVÁ, Květoslava
Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.
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Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
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Patients satisfaction with the provided services. An important indicator of the quality of health care facilities.
MALANÍKOVÁ, Jana
My master's thesis which topic is "Satisfaction of patients with the services provided. An important indicator of quality of medical equipment " is mainly focused on satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. Furthermore, the mapping focused on overall satisfaction with care in the already mentioned Hospital České Budějovice and on exploring whether patients evaluate the quality of information provided by a medical doctor in this hospital affirmatively and whether they are satisfied with care of local nurses. The satisfaction of patients is an important indicator of the quality of care provided, which has an impact on their status of basic human needs. One main purpose was determined: Monitoring the satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. and this purpose was fulfilled. Quantitative research was executed, to its realization the interview method was used. By means of the technique of standardized anonymous questionnaires on the basis of the above-mentioned purpose,the 3 following hypothesis were verified: 1) Patients are satisfied with the overall care in the Hospital České Budějovice, a.s. 2) Interviewed patients evaluate the quality of information provided by a medical doctor in the Hospital České Budějovice, a.s. affirmatively 3) Interviewed patients are satisfied with the care of nurses in the Hospital České Budějovice, a.s. I processed the data to confirm or refute the pre-established hypotheses. The evaluation of the data was carried out using statistical nonparametric methods, Chi-square test and the chosen level of significance of p=0.05. The results of the research have been clearly processed into the tables and graphs. The program Microsoft Office Excel 2010 was used to process the results.
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Stress situations and nursing personnel
MAREŠOVÁ, Lucie
This thesis deals with the stressful situations in the profession of the nursing staff. The occupation of the nurse belongs to the most demanding ones. In this occupation, the nurse is permanently affected by many stressors of different types. She faces death, the suffering, dying and incurably ill people very often. She is there in times of pain, agony and suffering. Personal encounters with these difficult situations require highly professional approach but most of all, they present immense work stress for the nurse. The theory section describes mainly the stressful situations that are the most common and most difficult in the work of the nursing staff. The next part of the theory section describes possible consequences of the stressful situations and methods of managing them including the support by the management. This thesis has two objectives. The first objective was to map the manners used by the nursing personnel to cope with the stressful situations brought by their profession. The second objective was to find out the difference in the coping with the stressful situations between the hospital staff and hospice staff. The research section of this thesis contains the quantitative research done using the technique of an anonymous questionnaire with 20 question prepared by ourselves. The questionnaire was distributed to the nursing staff of all categories in the hospital and hospice care. It was completed by 269 respondents in total. The data was statistically processed using systems Microsoft Excel 2010 and Software R, version 3.0.2 (Chi-squared test, Fisher´s exact test, and Wilcoxon test). We determined four hypotheses. H1: Manners of coping with the stressful situations depend on the qualification of the nursing staff reached; not confirmed. H2: Manners of coping with the stressful situations are influenced by the length of practice of the staff; not confirmed. H3: Manners of coping with the stressful situations differ between the hospital staff and hospice staff; confirmed. H4: The nursing staff views their own mental hygiene as more efficient than the support from the management concerning the coping with the stressful situations; confirmed. The research results show that the nursing staff faces the stressful situations very often. They see as the heaviest stress the care of the suffering and aggressive patient, conflicts with the patient´s family, conflicts at work and workload. The manners of coping with the work burden which proved as the best for them are relax, rest and sleep. There were no differences proved in the manners of coping with the stress among respective members of the nursing team. Nevertheless, the coping with the work burden of the nursing staff in the hospital and hospice care is different. A minimum of the respondents notices any support during the stressful situations from the employer. On the other hand, certain support by the management could be viewed in the form of trainings, supervision or contribution to a "recovery" which are granted to the respondents from the employer according to their answers. However, the respondents would prefer, as the support by the management, the increase in pay or more days off. The respondents view as insufficient the preparation of the graduates for the future stressful situations in their profession, as well. They would recommend mainly various trainings dealing with the stress and its management. A good solution to alleviate the work burden of the nursing staff and quality enhancement of the services provided could be investments into better work conditions, both in terms of sufficient human and material resources and the very organization of the work processes.
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How to prevent the proliferation of Legionella pneumophylis in hot water in the hospital Czech Krumlov
TUREK, Jan
This diploma thesis deals with microbiological quality of hot water in a hospital in Cesky Krumlov as well as hot water piping condition with respect to Legionella. It also deals with arrangements for improving the quality of hot water in this hospital. The subject and target of this thesis are the findings of the mentioned parameters based on own observations, technical documentation and analysis of warm water performed by an accredited laboratory. The hospital in Cesky Krumlov, the construction of which began in 1909, was built in 1911 as the 'Nemocnice Císaře Františka Josefa I.' As the time went by, new buildings were built up. The hospital was renamed to 'Všeobecná veřejná nemocnice' in 1942. In the following years the hospital expanded until the current condition. Water quality and presence of Legionella is a world-wide issue, which we must fight against. The thesis is divided into two parts. First, theoretical part, which includes both general and specific knowledge about Legionella, its health risks, the environment in which it occurs, possibilities of eliminating, suitability of the material for hot water pipes, gained in professional literature and a part of the Czech legislation dealing with public health protection, the law 'No. 258/2004 Coll.' in actual version and quality of drinking water and hot water. In the second, empirical part, I focus on the situation of the hospital in Cesky Krumlov from 2009 till 2015, concerning newly built boiler room and the whole distribution system of hot water regarding Legionella. Particularly I focused on materials used for ecologisation of the gas boiler room and materials used for hot water pipes and actual state of water distribution in individual buildings of this health care facility. I mentioned the analysis of the water samples performed by an accredited laboratory with corresponding technical documentation, which concerns the water distribution system, provided by the medical facility. I used secondary data analysis to evaluate these documents. Regarding the results from 2009 to 2015 the microbiological quality of warm water doesn't meet the limits defined in the Attachment No. 3 of the above mentioned law Order 252/2004 Coll. Limit value for colony forming units of Legionella is set to maximum of 100 CFU. In most of the samples this limit was exceeded by series of units up to hundred thousands of units. The last results in 2015 prove improvement of the unfavorable situation. In that year the analysis was tested three times. First in February, where the CFU units were 'only' in hundreds, with the top value of 550 CFU in the Postacute Care ward. Second analysis was performed in June that same year. Results were acceptable. The highest value was 64 CFU. Last analysis in the hospital was performed in December. Increased concentration of Legionella was again in the Surgery building. There were established of 1400 colony forming units. There were 300 CFU in the Postacute Care ward and the limit value of 100 CFU was in the ward of Internal medicine. The answers to research questions 'How to prevent reproduction of Legionella peumophylis in the water distribution system of the hospital in Cesky Krumlov?' and 'How to ensure a sufficient amount of quality hot water in the medical facility?' are included at the end of the stated recommendations. A risk factor causing the fast reproduction of Legionella is the old water distribution system in most of the buildings and low water temperature of water leaving the boiler, which is 55°C. All mentioned results and evaluations are included in this thesis as well as attached pictures, which show the environment and situation within the Health Care Institutions.
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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.
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Use of e-learning education of universal nurses in Militari university hospital - University hospital Prague
JANKŮ, Kamila
The diploma work submitted is called The Use of E-Learning Education of Nurses in the Central Military Hospital Military University Hospital Prague. The theoretical part of the diploma work deals especially with the significance of e-learning, distance learning, history of education of nurses in the Czech Republic and e-learning in health care. In addition, the work includes information of the Central Military Hospital and describes its present circumstances and use of e-learning in the working process. 5 aims and 4 hypotheses were set for the quantitative research. The first aim was to determine the time demands of the e-learning courses study. The second aim was to determine the attitude of general nurses to e-learning education. The third one focused on contribution of e-learning education for general nurses and for the hospital management. The last aim focused on satisfaction of general nurses with the form, contents and diversity of e-learning courses. The fourth aim was used to determine reasons leading for development of e-learning courses for general nurses. Four hypotheses were determined: H1: It takes less time to complete e-learning course studies than regular studies. H2: Nurses younger than 30 years of age prefer e-learning education unlike nurses older than 30. H3: The effectiveness of regular studies is better than the effectiveness of e-learning education. H4: E-learning courses are not as financially demanding as regular courses. The data collection technique consisted in our own anonymous non-standardized questionnaire containing 32 items. The research file consisted of 212 general nurses working in clinical departments of the Central Military Hospital. An additional method was based on a dialogue with the Education Team Manager of the Central Military Hospital. The research results related to the hypotheses show that completing e-learning course studies does not take less time than completing a regular course. Nurses younger than 30 years of age do prefer e-learning education contrary to nurses older than 30. The effectiveness of regular courses in contrast to e-learning education has not been confirmed as well as the fact that financial demands of an e-learning course are lower than financial demands of a regular course. Further, nurses prefer regular forms of studies, mostly with their passive participation in an educational event; however, they find completion of e-learning courses more convenient. Most respondents also expressed a positive opinion on the form, contents and diversity of e-learning courses. Courses include enough information for preparation of a final test and nurses find the number of courses necessary for periodical evaluation adequate. What they consider limiting is the impossibility to retake the final test; they mostly suggested it should be allowed to take the final test twice or three times. The research implies that a higher percentage of the respondents spend as much time as they want studying. Nurses still prefer regular forms of studies with passive participation to the e-learning form. Most nurses have a positive opinion on the current contents of courses in the form of a text format. The course topics are mostly based on suggestions by members of the Non-Medical Professions Education Team of the Central Military Hospital. The research results will be presented at the next regular meeting of members of the Non-Medical Professions Education Team of the Central Military Hospital. Procedures for improvement of the form of the current courses will be presented and proposed as well as the possibility to develop communication between the author and students, the limiting impossibility to retake final tests and the suggestions concerning the number of possibilities to retake them.
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Management styles and their relation to the satisfaction of employees
GRAMANOVÁ, Kamila
Abstract - Leader empowering behaviours and their relation with worker's satisfaction Current state: Nurse's work is physically and mentally demanding. Adequate knowledge and skills are also needed. Nurse managers whose leader empowering behaviours administer to good functioning of medical institutions have therefore a crucial role. In these days a monitoring of job satisfaction is an upcoming matter. According to that we can look for drawbacks and problems and take corrective actions. There is a 9th year of the nationwide research of safety and satisfaction of employees of Czech hospitals. Aim: The first aim of the research was to find out what leader empowering behaviours are used the most by nurse managers. The second aim was to find out how leader empowering behaviours influence satisfaction with work conditions of nurses. Two hypotheses were given. The first hypothesis postulated that nurse managers use democratic empowering behaviours the most. The second hypothesis postulated that satisfaction with work conditions of nurses is changeable, depending on leader empowering behaviours. Methodology: A quantitative method of data capture was chosen. Non-standardised questionaires with 30 closed questions were given out. There were four questions at the beginning to identify respondents. Other set of 15 questions was focused on recognition of leader empowering behaviours. Satisfaction with work conditions was monitored in the last set of questions. Results of the research were processed into graphs and tables. Research set: The research set included nurses working under nurse managers in inpatient wards in České Budějovice a.s. hospital. The questionaire was appropriately filled in by 112 nurses, corresponding 74,7% recoverability. This was used to complete the aim of this thesis. Results: Results of the thesis were divided into two sets. The first set of questions aimed on leader empowering behaviours of managers under whom the questioned nurses of particular departments work. Democratic empowering behaviours were evaluated the most used, according to the first hypothesis. The second set of questions aimed on satisfaction with work conditions. The highest job satisfaction was reached with democratic empowering behaviours. Autocratic, liberal and nonspecific empowering behaviours were used in minimal degree and nurses reported lower job satisfaction among these behaviours. Therefore the second hypothesis was also confirmed. Conclusion: The research pointed out that leader empowering behaviours are one of the factors that influence job satisfaction. It is positive thing that an interest and research in this area increased in the last decade. Periodic evaluation of job satisfaction enables monitoring the direction of its values. According to the survey, a newsletter with recommendations for nurse managers was formed. This newsletter pointed out pros and cons of leader empowering behaviours.
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