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Community care in psychiatry
BÍNOVÁ, Romana
Abstract Diploma thesis deals with the issue of community care in psychiatry and its objective is to describe the importance of a nurse in providing this care. Community psychiatric care is a very wide area of an intermediary patient assistance designed to help the patients in any areas of their lives. Although in the Czech Republic community care has not achieved the appropriate development yet, its benefits for patients are important now and its importance has been growing. In the theoretical part, after a brief introduction to community care issues, history, principles, but also community care connection with nursing care, are mentioned. Subsequently, attention is paid to particular areas of community care that are important for the mentally ill and the role of a nurse in these areas is described. The approach to the mentally ill, the issue of stigmatization and psychiatric care organizations are mentioned. In the theoretical are part, psychiatric illnesses that may occur in community care are also analyzed and it is explained how community care may be beneficial for psychiatric patients. In the practical part, the objective was to find out the level of psychiatric nurses´ awareness of community care and to determine if they see the sense of community care in psychiatry. Making a survey of community care in which nurses can be involved was another objective of the work. The nurses´ responses to the stated hypotheses were statistically analyzed within quantitative research. The purpose of hypotheses stated was to determine whether nurses with the work experience longer than ten years are more likely to believe that psychiatric care is more beneficial for patients than hospitalization., And also, if nurses with an education higher than secondary have better awareness of community services provision. Other hypotheses were focused on finding out whether nurses consider the most common community care services issue in the Czech Republic to be housing promotion and if nurses aged over thirty years are more aware of the nurses´ role importance in community care. None of those hypotheses were confirmed. The hypothesis assuming that nurses obtain more information on community care from the Internet and literature than at workshops was confirmed. Psychiatric nurses working in mental homes in the South Moravian region and the Vysočina region took part in this research. A component of the practical part is also an analysis of community services in these regions. In both the regions 13 civic associations and community centers were mapped.
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Cooperation between nurses and physicians from the perspective of nursing management
KADLECOVÁ, Ivana
Cooperation of nurses and physicians from the perspective of nursing management Master's thesis was focused on the cooperation of nurses and physicians from the perspective of nursing management. Nursing care and nursing management has an irreplaceable role in health care. The world of medicine, nursing care and health care is an extremely complex organizational system, which is not surely represented only by physicians and nurses, but these, however, are still the dominant persons on the scene. The first objective of this thesis was to make a survey of cooperation between nurses and physicians during the nursing process in the care of patients from the perspective of nursing management in departments of surgery and internal medicine. The second objective was to identify problem areas in cooperation between nurses and physicians from the perspective of nursing management in departments of surgery and internal medicine, and the third objective was to find out the way the nursing management tackles problem situations in cooperation between nurses and physicians in departments of surgery and internal medicine. To meet these objectives four research questions were stated: 1. In what areas do nurses and physicians cooperate during the nursing process while providing care for patients from the perspective of nursing management in their respective departments? 2. How do nurses assess and perceive cooperation with physicians from the perspective of nursing management in their respective departments? 3. Are there problem areas in cooperation of nurses and physicians from the perspective of nursing management in their respective departments? 4. How does nursing management tackle problem situations in cooperation between nurses and physicians in their respective departments? The research was conducted in the hospital, where I was given information under the condition of anonymity of the respondents interviewed. The responders were chief nurses and senior staff nurses working in departments of surgery and internal medicine. The investigation conducted is a qualitative research. Interviews with the structure of questions to non-standardized interviews were conducted with the respondents according to question structures of the non-standardized interview. Subsequently, transcripts of interviews and data categorization in tables according to the Ritchie and Spencer´s framework analysis were made. The survey suggests the following conclusions. Nurses and physicians cooperate within the nursing process in providing care for patients from the perspective of nursing management in departments of surgery and internal medicine at the stage of problem solving. Nurses appreciate cooperation with physicians on the basis of mutual respect, but they still feel the prevailing dominance of physicians. From the perspective of nursing management there are problematic areas in cooperation between nurses and physicians. Nursing management tackles problem situation in cooperation between nurses and physicians by seeking common solutions. It will be possible to provide the health care facilities, where the research was conducted, with the outcomes of the research. Thinking about the possible improvement in mutual cooperation as early as during physicians´ and nurses´ studies, to introduce various measures to improve cooperation between nurses and physicians by organizing joint seminars and cultural events could lead to meeting the purpose. It is necessary to raise physicians´ awareness of nursing process and to carry out further research on this topic.
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The use of evaluation methods in the practical nursing care.
KUBÁTOVÁ, Jitka
The aim of this study was to survey evaluation and measurement techniques that are used in practice. I have chosen this topic because demands on individual work of nurses are increasing and evaluation techniques and rating scales may help nurses in their work.Through the quantitative survey using questionnaires, opinions of 354 nurses at the bedside, and 61 nurse managers from 22 hospitals in the Czech Republic were surveyed. We wanted to identify the most common scales used in our hospitals and to find the reason why those specific scales are used. What problems nurses find in evaluation by scales, or what benefits the scales bring about. The respondents were also asked questions relating to risk management and the use of scales in this field. If prevention is the primary objective by which nurses try to anticipate more serious complications, what benefits the system brings to patients. The results of the investigation could be a clue to the efficient use of scales in practice and suggestions for managerial decisions when choosing suitable, acceptable parameters that will meet patients´ as well as medical staff members´ requirements.
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Nursing and medicin - partners proffesion
PAVLÍKOVÁ, Lenka
Abstract The relation between nursing and medicine has been undergoing a number of changes in recent years. Optimization of synergy and competences between healthcare professions is one of the priorities of the healthcare system development. This research addresses the issue whether nursing and medical professions are partner professions in healthcare of clients. The objective of the thesis was to ascertain whether nursing and medical professions can be declared as partner professions in healthcare. This objective was fulfilled through a quantitative research using the method of a questionnaire survey. The questionnaire contained 17 questions for doctors and 18 questions for nurses. The respondents of this questionnaire survey were 132 nurses and 97 doctors. The data were processed by means of descriptive statistics using charts. It follows from the data analysis that nursing and medicine cannot be regarded as partner professions yet. According to nurses and doctors, the partner relation between these two professions is of crucial importance for client care. Higher education and professionalism of nurses contributes to improvement of mutual relations. The research has revealed that it is necessary to continue addressing this issue. Within the research we explored several areas that, as we believe, are closely connected with this issue, and we based the research on its theoretical part. This thesis is beneficial by exploring the opinions of nurses and doctors on the relations between nursing and medicine, and by ascertaining their opinions on the effect of the partnership between these two professions on quality improvement of client care. We also investigated whether nurses and doctors believe that higher education and professionalism of nurses contributed to improvement of the relation between nursing and medicine. It is apparent from the research that nurses and doctors realize that partnership between nursing and medicine is of fundamental significance for care of clients. If they endeavour to trust each other, communicate effectively and show mutual respect, nursing and medicine will become partner professions. The research may initiate drawing attention to problems in relations between nursing and medicine, and may provide guidance to finding the solution. It may also stimulate nurses, doctors, students of nursing and medical branches, and managements of healthcare facilities to think about the issue.
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Nursing care and compensation aids and their usage in patients suffering from rheumatoid arthritis
RAZIMOVÁ, Lada
The present thesis deals with the issues related to rheumatoid arthritis, the nursing needs of patients suffering from rheumatoid arthritis, the roles of a nurse while taking care of such patients, the collaboration of the nurse with physiotherapist, ergotherapist, and use of compensation aids by the patients while conducting private or self-service activities. The thesis has 4 defined goals. Goal 1: To find out whether the patients suffering from rheumatoid arthritis are familiar with compensation aids. Goal 2: To identify the areas of self-care where the patients suffering from rheumatoid arthritis need to use the compensation aids. Goal 3: To determine the availability of compensation aids for the patients suffering from rheumatoid arthritis. Goal 4: To find out whether the patients suffering from rheumatoid arthritis do have information about the compensation aids in hygienic care. All goals were met. Based on the goals, 4 hypotheses were defined. H 1: Patients suffering from rheumatoid arthritis are familiar with compensation aids. This hypothesis has been confirmed. H 2: Patients suffering from rheumatoid arthritis use compensation aids most often in hygienic care. This hypothesis has not been confirmed. H 3: Compensation aids for patients suffering from rheumatoid arthritis are easily available. This hypothesis has been confirmed. H 4: Patients suffering from rheumatoid arthritis have all the necessary information about compensation aids used in hygienic care. This hypothesis has been confirmed too. The survey was carried out at rheumatology clinics and at the League against Rheumatism. The data were collected in a quantitative research using the method of interview and the technique of questionnaire. All in all, 170 questionnaires were distributed among the patients. The research group contained 131 respondents. Analyzing the respondents{\crq} answers, it was found out that the patients suffering from rheumatoid arthritis are familiar with the compensation aids in hygienic care, defecating, catering, dressing, walking, and such aids are affordable and available to them. Most patients suffering from rheumatoid arthritis do not need or do not use such aids. Following the outcome of the thesis and the issues related, an information leaflet came into existence and is distributed to the patients suffering from rheumatoid arthritis in order to provide them with useful information or links. The leaflet distribution through rheumatology clinics seems to be very efficient. The outcome of the thesis is to give more background information to the clients of the League against Rheumatism. Subsequently, the thesis might serve as an additional material for students in nursing training.
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Standard of non-pharmacological relieve and evaluation of pain by newborn and suckling children
PAVLÁSKOVÁ, Ilona
The importance of this thesis lies in finding about the current state of pain assessment and palliation at neonatal and infant wards of selected hospitals, in finding out about the extent of use of standardized rating scales for pain, in identifying the obstacles in pain assessment and non-pharmacological pain palliation, and particularly in the development of a standard for pain assessment and pain palliation for neonatal and infant hospital wards.
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Role of a nurse in the care of patients with post-puncture cephalalgia after an operation in spinal anaesthesia
KŘIVKOVÁ, Jana
The objective of this diploma paper was to answer the question whether nursing for patients after an operation in spinal anaesthesia has any effects on the occurrence of post-puncture cephalalgia and on the satisfaction of patients with spinal anaesthesia. The paper is divided into two parts: a theoretical one and a practical research one. The theoretical part sums up the current knowledge of spinal anaesthesia; it provides anatomic and physiological aspects, possible complications and the importance of nursing in this type of anaesthesia. It deals with the syndrome of post-puncture cephalalgia in detail, the mechanism of its origin, typical symptoms, its treatment, and the importance of nursing for patients suffering from this syndrome. With regard to the importance of education in nursing jobs, one chapter of the theoretical part deals with education and educational process. The research part consists of qualitative as well as quantitative surveys. The research was carried out with a group of patients who were hospitalized at the surgical and gynaecological departments of Domažlická nemocnice a.s. (Domažlice Hospital Ltd.) and have undergone an operation in spinal anaesthesia. The quantitative survey was done using a questionnaire that contained 27 questions. Seventy-eight patients, selected at random, took part in this research stage. The objective of the qualitative survey was to find out the following: whether patients were aware of the aspects of spinal anaesthesia, whether they have experienced any complications in relation to the administration of spinal anaesthesia, how have they been informed, and what was their overall satisfaction with spinal anaesthesia. The qualitative part involved 10 patients who had been divided randomly into two groups: a group with ``standard{\crqq} education and a group with above-standard education using a purpose-made brochure. A semi-standardized interview, consisting of 18 questions, was carried of with each patient. The patients in the latter group were also asked additional questions aimed at the benefit of the informative brochure and the completeness of the presented information. The former group was asked whether they would be interested in a brochure focusing on spinal anaesthesia. Based on the results of this survey, the basic research question of the paper can be answered. Nursing does have positive effects on the occurrence of complications and on the satisfaction with spinal anaesthesia. A detailed result analysis shows that patients do not feel any subjective need to be educated by a nurse and they are not interested in the brochure. Most of the patients think they are informed sufficiently and they do not want more information. However, the results of the qualitative survey into the group educated by a nurse show a higher informedness about the method, lower occurrence of complications, higher satisfaction, better observance of recommended regimen measures, and highly reduced level of stress in relation to spinal anaesthesia. The educative brochure was accepted by the educated patients as beneficial and useful. Based on the above-listed results, the informative brochure, being an integral part of this paper, will be introduced as a standard education tool for patients undergoing an operation in spinal anaesthesia at Domažlická nemocnice a.s.
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Perspective as structural common of nursing
POLÁKOVÁ, Lenka
Perspective and structural elements, as the pivotal part of a scientific analysis of nursing as a field of study, helps categorize and sort the above individual items into logical units. This thesis aims to contribute to the scientific grasp of the dynamics of selected factors and development trends in nursing. Starting from the above terms, we will be dealing with perspective and its structural impacts on nursing, with the main focus on the analysis of selected factors of influence and their potential use for the examination, view and implementation of individual steps in the further development of nursing.
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The care of a sickbed as a nursing problem.
PŘÍHONSKÁ, Lucie
Taking care of beds is part of nurses{\crq} everyday work. The way a bed looks influences the patient{\crq}s physical and mental state. Care of the bed involves its arrangement, exchanging used bed-linen and especially disinfection, which prevents the transfer of nosocomial infections. The objectives of the thesis was to survey the way nurses take care of beds, identify obstacles associated with the care of beds, and propose a basis for creating a standard care of beds. 3 research questions were set. Research question 1: How does the length of patients{\crq} stay on the bed depend on the frequency of its disinfection in practice? Research question 2: Do nurses consider the care of beds from the point of view of the work schedule or the patient{\crq}s comfort? Research question 3: What are the most frequent obstacles in the care of beds? The research was conducted by means of a structured observation, followed by a follow-up recording in the record sheet. An anonymous questioning was conducted to obtain results. 8 nurses present in the department took part in the observation and questioning in the course of research investigation. The research set consisted of nurses in the subsequent care of the CTM Hospital a.s. in Humpolec. The investigation results let us set hypotheses. Hypothesis 1: The overall disinfection of the bed is done after the patient is discharged from the hospital. Hypothesis 2: Nurses take care of beds according to work schedule. Hypothesis 3: An obstacle in the arrangement of the bed is the lack of clean bed-linen. The investigation results may be provided to the management of the department in which the investigation was conducted. They may result in an improvement of the care of beds. A proposal of the nursing standard of the care of beds was drawn up as the result of this investigation. This proposal may serve for unifying the care of beds in individual departments. Setting principles and the overall procedure in the care of beds.
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