|
High normal pressure and hypertension of children and adolescents
KRÁLOVÁ, Kateřina
In children and adolescents, high normal blood pressure is often present. People with high normal blood pressure show a short time prerequisite to the formation of arterial hypertension. Hypertension occurs most often in children as asymptomatic. Increased blood pressure in children is most often discovered during preventive examinations by a general practitioner for children and adolescents. This thesis contains information about the anatomy and physiology of the cardiovascular system, a blood pressure measurement sister, evaluation of blood pressure, high normal pressure, high blood pressure in children, the role of nurses in primary care pediatricians in the area of communication and education, and treatment of high normal pressure and hypertension. Objectives The first goal was to explore how children adhere regime measures for the prevention of high normal pressure and hypertension. It used this research question: How children adhere regime measures for the prevention of high normal pressure and hypertension? The second objective was to determine the role of nurses in the care of children with high normal pressure and hypertension. The second research question is: What is the role of the nurses in taking care of children with a normal high pressure and hypertension? Methods used In the research part of the thesis, we used the method of qualitative research, questioning method and technique-depth interviews. The interviews were recorded on a Dictaphone and then transcribed literally. Four sisters and three mothers did not wish to be recorded, so they were interviewed at polling literally written on paper. For research, two research files were created. The first sample consisted of six nurses, who were working in GP surgery for children and adolescents in the South Region. Second survey consisted of six people selected from among parents of children with high normal pressure and hypertension, also from South Bohemia. Results The transcribed interviews were investigated by open coding method, pencil and paper. Resulted in 9 categories: Cardiovascular disease, role of the nurse, pressure measurement, blood pressure, hypertension, pressure measurement, recommendation, Lifestyle, Leisure. Individual categories were assigned to subcategories, which are encoded core data. Conclusion The first research confirms nurses working in a pediatrician's office for children and adolescents, the most common cardiovascular disease in the general hypertension. They argue that the role of nurses in primary care pediatricians is properly measure blood pressure and make the education of children and parents in the area. The respondents concurred in the principles of how to properly measure blood pressure measurement are available for at least three cuff sizes. Informants have basic information about high normal pressure and hypertension, and said that, in the offices of primary care pediatricians to conduct checks blood pressure of preventive examinations or troubled child. Informants reported that blood pressure control and education on blood pressure occurs, but in the second research study showed that children and adolescents do not comply with the recommended recommendations in this area, perhaps because they are less motivated. Neither sister nor the parents have not mentioned, they would receive educational aids such as brochures and sample menus.The second research showed that parents most often found elevated blood pressure in primary care pediatricians, either for reasons of preventive examinations or difficulty a child. On the control measurements came at least three times. Respondents agreed on the recommendations they received in the office GPCY such as reducing the weight of the child, regular physical activity, restriction of salt and proper diet the child, but not all children and adolescents comply with these recommendations. The research results will be provided to the journal Pediatrics practice.
|
|
: Time Requirement for Basic Nursing Care Procedures
SOUMAROVÁ, Iveta
A large number of nursing procedures are carried out in each ward in every hospital every day. In its theoretical part, this Bachelor thesis presents twenty basic procedures. The goal of the thesis was to find out what the most used nursing procedures are and to map the time consumption for individual nursing procedures. The quantitative research method was applied in the Bachelor thesis. Data were collected by measurement of time consumption of ten individual nursing procedures. These ten procedures were selected from a list of most used nursing procedures. Performance of the procedures was observed at the internal and surgical wards of the Hospital in České Budějovice. Both wards were observed over a 3-day span. Ten most often used nursing procedures were selected from the total number of procedures identical for both wards. Correctness of inclusion of the procedures was evaluated by the chi quadrat test in a contingency table. In addition, each of the ten most used procedures was measured ten times at each ward, from the preparation to the clean-up of instruments. The individual time values were averaged and presented along with conclusive deviations. A conformity with or difference in the time consumed was tested statistically by using the F or T test, where the applied significance level equals 5%. The research group was composed of the nurses and ancillary nursing personnel. Results are presented in graphs and tables. The following procedures differed in the individual wards: administration of medicines per os, serving of meals, venous blood sampling and blood pressure measurement. The bachelor thesis is focused on the time consumption for individual nursing procedures. The time consumption and the frequency of the individual procedures can serve as a base of explanation of the number of employees to the nursing management.
|
|
Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
|
|
Specifics of nursing care in patients after transapical aortic valve implantation.
VOTRUBOVÁ, Nataliya
Transcatheter aortic valve implantation (TAVI) is a new and an attractive method in cardiology and as well as in cardiac surgery. It is constantly evolving method which has been developed as an alternative to standard open surgery, especially in patients with severe symptomatic aortic stenosis with unacceptably high perioperative risk or patients who are not suitable for conventional open heart surgery because of age and comorbidities.A teamwork is very importantfor this new method and approach. The choice for TAVI is discussed by the institutional multidisciplinary heart team, typically consisting of interventional cardiologists, imaging-specialists, cardiac surgeons and anaesthesiologists. The first implant in a human being was performed by Cribierin 2002. In Czech Republic this method was first used in 2008. Transcatheter aortic valve implantation (TAVI) was accepted as a minimally invasive alternative to open surgery. This method does not require the use of cardiopulmonary bypass, and cardiac arrest. Other several benefits includinglower risks of bleeding and stroke events, better wound healing, less pain, as well as more rapid early recovery due to preservation of continuity of the sternumthat result in shorter durations of stay in the hospital, earlier rehabilitation and faster returns to normal life. In the presented work was used a combination of qualitative-quantitative methods of investigation. The data was obtained by using the quantitative research. The main technique was using the questionnaires designed for nurses working at the Department of Cardiac Surgery, Hospital Czech Budejovice, a. s. These results were backed up by the implementation of qualitative research, which investigated the patients and physicians view on monitored issues. Questioning method using a semi structured interview technique was used for qualitative research. The results of the survey were processed using descriptive statistics charts in LibreOffice Calc and using diagrams created in LibreOffice Writer. Qualitative results of the research were transcribed from audio recordings and coded, and the base code was created nine categories of interviews with clients/patients and three categories of interviews with doctors. The aim of this work was to explore the specific problem of nursing care about the clients / patients after transapical aortic valve implantation. On the base of our obtained data it is evident, that the client/patient after TAVI may be positioned sideways, the use of surgical drains are less frequently, so the care about the surgical wounds is simpler, patients report less pain in the surgical wound and postoperative rehabilitation and recovery is shorter. H1 - The nurses take care about the clients/patients after transapical aortic valve implantation in the same way as about the clients/patients after open aortic valve replacement, without realizing the differences between the patients treated with different approaches, was not confirmed. The nurses'sees/reported major differences in invasiveness and extent of providing care, rehabilitation, convalescent, in the duration of the hospitalization and better cosmetic effect. The results of the research can serve as a basis for creating the standards of nursing care or educational material for clients/patients. It is also possible to present the results of this work at a specialized seminar for non medical healthcare workers and results can also increase the quality of nursing care about the clients/patients after transapical aortic valve implantation.
|
|
A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
|
|
Practical use of theatroterapy in the activation process of adults with intellectual disability
REJŠKOVÁ, Denisa
The aim of my bachelor thesis "A Practical Usage of Theatrotherapy During a Stimulation of Adult People with Mental Handicap" was to create, execute and evaluate a theatre performance focusing on a stimulation of mentally disabled adults. During leisure activities, it is possible to offer to mentally disabled people such activities that develop their personalities universally, lead towards their own activity and creativity. However, the mentally disabled people´s selection of activities is limited in comparison with the intact ones. Considering an offer of leisure activities for the target group, I decided to use theatrotherapy which has been created for them and then to implement a theatre performance. According to the specialised literature, by using it, it is possible to reach positive results in the field of communicative and locomotive skills as well as the memory and social relations. This thesis consists of three chapters. The target group will be defined in the first chapter in which I define the term of mental disability, characterise adult people with medium or severe mental disability and specify their social, mental and locomotive limitations in details. I define the theatrotherapy, describe its development, aims and methods in the second chapter. Simultaneously I mention it as a means of stimulation in the conclusion of this chapter. Theoretical part of the work is followed by in the third, practical chapter. I prepare a theatre performance based on specialised literature which I implement and evaluate here. The theatre performance was based on principles and rules of theatrotherapy. An original script adapted to the target group was used for its implementation. Classical teaching methods and drama teaching methods were used for rehearsing, namely methods verbal, graphically demonstrative, practical skills gaining, roleplaying, methods and techiques of training games and exercises, evaluation and reflection. During the evaluation and objective technique was used which aims for an analysis of actor´s activity, and a subjestive technique which aims for self-evaluation and actor´s feedback. The above mentioned activity was supported by IN Civic Society and ten people with medium and severe mental disability aged 25-45 participated. There was a process of involvement during a making of the performance and positive results in the field of communicative and locomotive skills were reached. The actors experienced new and unusual situation during the performance. They met new people too because some students of the University participated too. This resulted in social integration. The bachelor thesis is meant as an inspiration for the personnel of institutions providing social services.
|
|
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.
|
|
The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
|
|
Nutritional care of children at pediatric clinics and hospitals
METELCOVÁ, Jana
The main goal of this work called Nutritional Care in Children's Hospital and Hospital facilities is to verify whether the nutritional standards created for older child patients meet the needs and are checked and if their physiological needs are fulfilled in chosen hospitals. The next objective is to evaluate the satisfaction of the hospitalised patients with the meals given to them by hospitals. The theoretical part of this work deals with nutritional care, therapeutic care and nutritional needs of adolescents. It further deals with nutritional risks and marginally mentions technological processes regarding meal preparation. The method of qualitative research was used by using questionnaires filled in by chosen children patients who were then interviewed. Children aged 10 to 14 were supposed to be on diet number 13, half of them were boys and the other half were girls. The research was conducted in the children's ward in the hospital in Jindřichův Hradec in December 2015 and in the same type of ward in the hospital in České Budějovice in February 2016. The initial number of respondents was five patients in each ward, then using snow ball sampling method their number increased into ten in each ward. The weekly menu according to which the meals were distributed was obtained from the catering facilities of the hospitals. By using the program "Nutriservis Profi" the contents of nutrients in the meals were obtained. The results gathered from the program "Nutriservis Profi" were compared with recommended values for particular age group defined by The Czech Society for Nutrition, so meeting the physiological needs of the patients could be evaluated. From the results it was found that both hospitals have problems with supplying enough fibre content, phosphorus and calcium in meals for children's patients. There is also sodium, potassium, cholesterol and vitamin C surplus in the menus. Thanks to the internship in both hospitals in Jindřichův Hradec and České Budějovice meeting the physiological needs of the children could be evaluated. Considering the fact that the previous evaluation revealed some imperfections, therapists from both hospitals should concentrate more on checking nutritional values in meals, consequently it was recommended to focus more on the variety of the menus and their improvement. There were also inadequacies in attendance at the children's ward. There was a comparison of the results from both hospitals, based on questionnaires and interviews from the children's point of view. Based on the data, children hospitalized in Jindřichův Hradec were more satisfied with the meals. In the conclusion there is a summary of the research and suggested suitable improvements for hospitals. There is a model menu for diet number 13 in the attachment which could be used by hospitals.
|
guest ::
