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Outpatient delivery from the point of view of a midwife and child nurse
NOVOTNÁ, Kristýna
This thesis deals with outpatient childbirth, and the opinions of midwives, pediatric nurses and women on this topic. The first goal was to find out the opinions of midwives and pediatric nurses on outpatient birth and the second goal was to find out the reasons that women choose for outpatient delivery. This work is divided into two sections, the theoretical and the practical part. The theoretical part describes the competencies of midwives and pediatric nurses, the process of childbirth from admission to the delivery room, ultimately to the fourth stage of labor. Furthermore we describe the first treatment of the newborn, room-in neonatal care, examination of the newborn by a doctor and neonatal screenings. Furthermore, the theoretical work focuses on outpatient childbirth itself, following the law, and addressing outpatient childbirth complications from the perspective of both the mother and the newborn. The practical section consists of the methodology, results and discussion. The method of data collection was a semi-structured interview, whereby the research included midwives, pediatric nurses, and motherswho experienced an outpatient delivery. Interviews took place in March 2019. If the informant agreed, the interview was recorded, but in case of disagreement, spoken responses were recorded on paper. To maintain anonymity, the informants were designated as DS, PA, and Ž. Based on the obtained data categories and subcategories were created. Two categories were created for midwives and pediatric nurses (Outpatient Childbirth, Care during Outpatient Childbirth), which were subsequently developed into subcategories. Women after outpatient delivery had data divided into four categories (Previous births, Outpatient delivery, Postpartum care, Reactions of neighbors). Two goals were set for this bachelor thesis, on the basis of which three research questions were created. The first question dealt with the view of midwives on outpatient birth. Research has shown that none of the midwives took a negative attitude and are certainly not trying to change women's decisions about having an outpatient delivery. In this case, they are glad that women did not choose to give birth at home, this way the woman is under trained supervision in case of unexpected complications. The second research question examined the opinion of pediatric nurses on outpatient delivery. The research showed that more than half of nurses do not take a negative attitude towards this decision, and only one pediatric nurse doesn't recommend outpatient delivery even in a case of physiological pregnancy. Pediatric nurses educate women about the care of the newborn, necessary post-partum examinations, and where to go and what to do in case any complications occur. The third research question deals with the reasons for women to decide for outpatient delivery. Research has shown that women are most often led to this decision for the need of a more peaceful and their domestic environment, or negative prior experience that involved lack of communication or lack of sufficient information. The women also suffered from frequent staff interference, loss of privacy and the alienating regime of the delivery room, and therefore opted for outpatient delivery. The research showed that the majority of medical staff do not show a negative attitude towards outpatient births and try to reach a certain compromise related to hospitalization and dismissal. It also showed that the interest in outpatient births is risingslightly.
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Multidimensional view on the work of children's nurse in the emergency room of children's ward
PŘÍPLATOVÁ, Iveta
The work of nurses in the outpatient department belongs between discussed topics. The interplay and cooperation of all members of the medical team are especially important. Correct communication between all team members and communication with children and their accompaniment are also a matter of course. The aim of this diploma thesis is to map the work of a nurse in a comprehensive view in the outpatient area of the children's ward, the satisfaction of children and parents in the outpatient area of the children's ward and to suggest possible improvements for the outpatient sphere of the children's ward of České Budějovice a.s. The diploma thesis is processed by qualitatively quantitative investigation using semi-structured interviews, questionnaires and observations. The research group consisted of nurses, doctors, paediatric patients and their accompaniment at the children's ward, paramedics and the general public as well. The interviews were categorized and processed by the method of pencil and paper. Questionnaires were processed statistically. The hidden participating observation was focused on the collaboration and communication of nurses from outpatient department with other nurses, doctors, paramedics, children and their accompaniment; and it was also focused on the satisfaction of the children or their accompaniment at the outpatient department. The results of the work showed that the view of the work of the paediatric nurse is distorted both from the health care professionals and the general public, which means that the nurse is seen mainly as a nursing care provider. The results also showed the necessity of proper communication and knowledge of foreign languages. At the same time, the thesis was used to identify shortcomings or suggestions for changes in the paediatric outpatient department of the České Budějovice Hospital, including the satisfaction of patients and their accompaniment during visiting the department that depends on the time spent in the waiting room. Suggestions for improvement were drawn up, drafted and handed over to the children's ward management.
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Kawasaki syndrome in contemporary society from a nurse´s point of view
MIKEŠOVÁ, Annemarie
Mucocutaneous lymph node syndrome or Kawasaki syndrome is very severe disease.The most common symptom includes a high fever which is probably due to inflammation of blood vessels so-called vasculitis. . Several months old babies to preschool children are the most often affected group of patients. Specific and typical symptoms of Kawasaki disease include long term fever, conjunctivitis, erythema, lymphadenopathy, mucosal changes as red swollen lips and strawberry tongue and multiple rashes.Qualitative and quantitative research was applied in the diploma thesis "Kawasaki disease in the contemporary society through nurse´s eyes". Three basic objectives and three research questions were established in this diploma thesis.
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Role komunitní sestry v péči o novorozence, kojence a matky
SCHÖNBAUEROVÁ, Andrea
The main purpose of the research was to explore the role of the community nurse in the care of newborns, infants and their mother and how this kind of care could be included in the current system of preventive care for newborns and infants in the Czech Republic. The research was developed by qualitative and quantitative design. In the first stage of the research, interviews with nurses from the PLDD outpatient department and mothers of infants in the South Bohemian and Pilsen Regions were conducted. Non-standardized questionnaires for nurses and mothers were created from the obtained data. The statistical processing was carried out with MS Excel, where absolute and relative frequencies were calculated and the relationships among the variables at the significance level ? = 0.05 were tested by the use of the chi-squared test and the Pearson correlation coefficient was used. For the needs of the qualitative survey, a research group of six mothers of infants and seven nurses from the PLDD outpatient departments in the South Bohemian and Pilsen Regions was chosen by deliberate selection. For the quantitative survey, a research group of 254 mothers of babies aged 12-24 months was chosen by deliberate selection. The research group of nurses was chosen by deliberate selection and consisted of 196 nurses working in PLDD outpatient departments for more than one year. Multiparas have provably more information at leaving the maternity hospital about breastfeeding techniques, breast milk pumping, nappy changing, hygienic care and bathing, dressing, sleeping, umbilical cord care, and safe handling of the baby. Information about the prevention of sudden infant deaths or the storage of breast milk is at the same level for primiparas as for multiparas. It was found out that there is a statistically significant relationship between the level of awareness and the occurrence of problems in the first year of the child's life. The personal experience of nurses with the visiting service has an influence on whether they attach importance to this service. The current model of preventive care of newborns and babies needs to be critically analysed and appropriately complemented by interventions of the visiting service.
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Transcultural differences in the care for children´s patient
KOBZOVÁ, Andrea
Due to the higher migration rates, there is more cultural diffusion. The healthe care personnel will be dealing with patients from different cultures more often. This is why it is important to use an appropriate approach and give competent heathcare considering cultural backround of the patients. The goal of this thesis was to map the cultural differences in care for an underage patient and to trend the minority groups that are being cared for by nurses in the children's ward. To achieve the goal of this thesis, there were four specified questions and to achieve the result, there was a threephase trial, specifically qualitative trial supplemented with quantitative method using a questionnaire. The first phase was the pilot poll and a techniquire "snowball slamping" was used. The second phase of the trial consisted of pre-structured interviews with the nurses. The third phase consisted of pre-structured interviews with the parents. On the basis of this trial, it was concluded that the nurses are caring for Romany and Vietnamese minority groups most often. The other most patiens from Ukraine, Russia, Germany, Poland, Muslims and Jehova witnesses. The most common problems that occur during the care are: language barrier, cultural customs, communication and co-operation. Based on the data collected from interviews with nurses and parents, there are specific variations in expectency of care, such as food, daily regime, differences in behavour, communication, reliability to adhere to given rules and consequent care after the hospital stay. There are other different specifics such as rituals and traditions during child labour or at the time of death, celebration of different festivals, fasting and other spiritual needs. Traditions relating to refusal or demand of specific care were also mentioned. Results of this thesis were presented at the 13th Student conference in Pardubice and will be published in a technical journal.
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Early age pertussis - the role of a nurse in prevention and treatment.
DOUBKOVÁ, Pavlína
Abstract The aim of the thesis: To determine most common causes of pertussis in childhood is the aim of this submitted research thesis. It also describes the possibilities of child prevention from the point of view of nurses. The other aims are description the specifics of nursing care for children with pertussis. Five research questions have been defined in relations to these objectives. The way of achieving the aim: The qualitative research method was chosen to achieve the objectives of the thesis. This method was implemented through in-depth interviews. On the basis of identified research questions, individual categories have been formulated in order to get answers to individual questions. For selection of communication partners the method of intentional selection was chosen. Research was realized at Jihlava Hospital in Children's Department. Anonymous interviewing was attended by a total of 20 communication partners. All of them have a nursing education and have performed nursing care for a child with a pertussis disease. In-depth interviews with parents were carried out in General Practitioner for children and adoration. Anonymous survey were agreed by 7 parents whose children suffered from pertussis. Scientific benefits of the thesis: This research study deals with the current issue of pertussis as an omitted infection. The scientific results of the research are intended for both the lay and professional public. The research study presents a complex and comprehensive overview of nursing care for children with pertussis. It will find use in both preventive care and also in taking care of the patient directly on the bed. Part of the scientific thesis is application into practice. The lessons learned and conclusions: Diseases of pertussis are most at risk for newborns and infants, for whom their parents pose a significant threat of infection without the parents becoming aware of it. One of the main measures is to vaccinate not only children but also parents and close relatives who come to close contact with the newborn. Parents are often unaware of adult vaccination in the prevention of childhood illness. Nursing care for a child with pertussis disease has its specificities in that it is highly contagious illness and can endanger the life of the child.
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Home visiting service as the responsibilites of a nurse in the surgery of a pediatrician
KNEIFLOVÁ, Andrea
Abstract Paediatrics and neonatology have changed a lot. There has been big progress in perception of children's diseases, in their treatment and in the general attitude to children. Nowadays even premature babies at 24th week can be saved. The standard of surgical interventions has improved either- various defects, which used to be incompatible with life, can be eliminated. In my work I have focused on home care and community care, on the differences between them and what their aims are. Primary care has a big role there. Both healthy children and ill ones are provided with care by doctors who follow their psychomotoric development and the development of speech. Vaccination forms an integral part of this care as the prevention of infectious diseases. A doctor and a nurse form a good team,make balanced friendly atmosphere so that children and parents could feel safe and a good cooperation among medical staff, children and parents could undergo. It is important to know all the specifics of developmental periods children's lives and adapt attitude and actions to children. A nurse pays attention to changes and it is possible to prevent various developmentai defects. It is essential to know children's basic needs and their satisfaction in hospitals and pediatrician's surgery.These are not only physical needs but mental ones either. If children's needs are not satisfied their development can be influenced. A nurse's duties in a surgery are to make contact with children and their parents, to find all information about children, families, and environment, where children grow up. A nurse should manage both nursing and assistance in surgery, paperwork, keeping records, working of surgery in respects of its materials and operation. She should have aestetic sense of environment. Adequate communication with small and young patients and their parents is a must. A nurse should be professional. Nursing process is applied in paediatrician's surgery too. Getting information, setting aims, planning of nursing service and its evaluation. Basic children's needs are nutrition or diet, excretion and metabolism, aktivity and sleep, safety and protection, comfort and pain, growth and development. Nursing process is applied within visiting service in families. The origin of nursing service underwent its development when at first there were clubs, which took care of children and old ill people. At present home nursing fully covered by health insurance. Aims of the work The aim of this work was to find out if home nursing is performed and what its extent is, if mothers are aware of the service, what mothers' interest is and what care mothers want. Two questions have been chosen: What are the reasons of nurses' visits at homes? Why mothers make use of nurses' visiting service? Results Talks were rewritten and analysed with the method of open coding with help of a pen and paper. There were two research files- nurses and mothers. Considering nurses there were five categories: Reasons of home visiting service, Positive views on visiting service, Negative view on visiting service, Benefit of visiting service for a nurse and Performance of a nurse visiting service at home environment. Considering mothers there were three categories: Idea of visiting service from the point of view of mother, What are mothers interested in and Benefit of visiting service for a mother. Subcategories with codes were matched to all categories, which showed most frequent correspondence. All figures are recorded in transparent charts of named categories. From the research emerged that not all the nurses , who took part in the research, do visiting service due to large extent of the district, due to the use of devices and paperwork. Those who do it are from a small town or locality. All the nurses agree that they see the main benefit in their work in ambulatory care. Mothers, who took part in th
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The nursing care of newborns with Hyperbilirubinaemia
KUCHAŘOVÁ, Petra
This thesis is focused on the nursing care of newborns with neonatal jaundice. Given the focus of the work, the theoretical part describes the newborn, bilirubin, neonatal jaundice, its diagnosis, treatment, nursing care during hospitalization and neonatal care after discharge to home care. The research was conducted with nurses or midwives in the neonatal wards during the months of March and April 2018. A qualitative method was used to conduct the research section. The data collection was conducted through semi-structured interviews. The interviews were conducted after prior arrangement and with the approval of the head nurses. The interview contained 12 open questions. Data analysis was performed by hand coding, also called the pencil and paper method. Responses by individual respondents were identified by codes that were then categorized under different subcategories. As a supplementary method of research, observation was used. It contained 8 open questions and an observation sheet, all of which were done after prior agreement and consent of the mothers of newborns. One goal was set for this thesis: to map the nursing care of newborns with neonatal jaundice. Based on this goal, a research question focused on how midwives and pediatric nurses care for newborns with neonatal jaundice. The research showed that all respondents have an overview of the issue, and that the information they have is subsequently carried out into practice. The results of this research can serve as informative material for midwives and nurses who want to improve their care of newborns with neonatal jaundice, or who are currently preparing to work in this profession.
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Nursing care in pediatric primary care
HOTAŘOVÁ, Zdeňka
Child care is one of the most important tasks important for the health of entire population. Many social structures are involved in comprehensive child care. The family is an irreplaceable part of society. However, in the health sector, pediatric represents the basic part of childcare, as a field of development of an individual. The largest volume of health services represents ambulatory primary care, ie General practitioner for children and adolescents in cooperation with a nurse. The nurse organizes and manages nursing care in pediatrics, takes care of healthy and sick children, and focuses on cooperations with families of the children. The main of the thesis was to find out what is the content of nursing care provided by a nurse in primary pediatric care. Among other things, we were also interested in the staffing of GPs for children and adolescents area and, last but not least, the possibilities of further education of nurses in this area. Then we have put five research questions. We gained the necessary data for processing the empirical part of this thesis through a semi-structured interview. Altogether, 15 interviews with respondents from the South Bohemian Region were analyzed. From the research data we were able to answer research questions. The research showed that the dominant activities of the nurse's work in the general practitioner's office for children and adolescents are preventive examinations, vaccinations, education, documentation, and good office practice. In addition, we found out that nurses do not have nursing documentation, most nurses do not perform patient care at home and do not recommend vaccination against rotavirus infections. Both pediatric and pediatric nursing carers they rated as being of a good quality, compared to the world. However, what they do not like is the current nursing education. We believe that this thesis could be very useful as a study material for medical students and also for the general public, as an outline of the nurse's work contents in GPs for children and adolescents.
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