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Hostile and aggressive behaviour of patients towards nurses in clinical practice
ŠMEJKALOVÁ, Alžběta
Current state: Aggressive and hostile behaviour of patients towards nurses in clinical practise is an alarming and common phenomenon that jeopardizes the safety and well-being of healthcare personnel. Objectives: The first objective of this thesis was to evaluate the number of adverse events in the "Behaviour of Individuals" category reported to the "National Portal for Reporting Adverse Events" during the period 2018-2021. The second objective was to assess the occurrence of aggressive behaviour of patients toward nurses in clinical practise. The third objective was to describe a spectrum of preventive nursing procedures that minimize the risk of aggressive behaviour of patients towards nurses. Methodology: The first research method involved a secondary analysis of statistical data from the National Portal for Reporting Adverse Events (ÚZIS ČR, 2022). The second research method utilized a quantitative study conducted through the administration of a standardized questionnaire called "Aggression of Patients towards Nurses in the Course of Their Profession (Lepiešová et al., 2015) ". This survey technique involved nurses from internal and surgical departments. Additionally, third research method was used, and it involved qualitative research through in-depth interviews with nursing care managers. Results: The results indicated that the most frequently reported event to the National portal of Reporting Adverse Events was category called "pressure ulcers ". The results of the qualitative study showed that patient aggression was not related to the field of care (p= 0.587). Furthermore, the results revealed that nurses with longer clinical experience encountered aggression from patients more frequently (p< 0,001). The results of the qualitative study described the most common preventive measures to minimize the risk of patient aggression towards nurses, including training and education of nurses and proper reporting of adverse events, addressing staff shortages, use of restraining measures and pharmacological interventions and appropriate communication with patients and their families. The hospital management prepares for the risk of patient aggression through staff training. Conclusion: The practical outcome of this diploma thesis is a set of recommendations for non-medical healthcare personnel.
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Nurse education about thromboembolic disease about their risks and prevention.
HAVLOVÁ, Jitka
The bachelor thesis titled Nurse education about thromboembolic disease about their risks and prevention deals with patients' knowledge regarding the thromboembolic disease, education activities of nurses and determining the effectiveness of such education activities of nurses regarding thromboembolic disease. The theoretical part focuses on the anatomy of the vascular system and the heart as well as on the process of blood clotting. Furthermore, the theoretical part is devoted to the characteristics of thromboembolic disease, its symptoms and risk factors. The diagnosis, treatment and prevention of thromboembolic disease are also presented. Finally, the nursing care of patients with phlebothrombosis and pulmonary embolism and patient education are described. Three objectives were set for this bachelor thesis. The first objective was to map the patients' knowledge of thromboembolic disease, about its risks and prevention. The second objective aimed to map the educational activities of nurses in the context of thromboembolic disease. The third objective was to discover how nurses determine the effectiveness of educational activities about thromboembolic disease. Based on these, following three research questions were established: What do the patients know about thromboembolic disease, about its risks and prevention? What kind of educational activities do the nurses in the hospital do regarding the prevention of thromboembolic disease? How do nurses determine the effectiveness of educational activities about thromboembolic disease in the hospital? In order to obtain the results of the research investigation, two research sets were established. The first research set consisted of the nurses providing care and the second research set consisted of the patients. These patients were hospitalized in the ward where the nurses worked. The actual research investigation was conducted by meeting the nurses and patients in person using qualitative method and semi-structured interviews. All interviews were recorded with the consent of the persons on a mobile device voice recorder. The data collected from the interviews were processed and analyzed using the pencil-and-paper method. The main categories and sub-categories were created based on these data. Three and seven subcategories were established for nurses providing care. There were three categories and six established for the patients. The first research question asked was: What do the patients know about thromboembolic disease, about its risks and prevention? According to the research conducted, it was found that patients do not have enough information about thromboembolic disease and are not fully informed by nurses in the hospital about the symptoms of phlebothrombosis and pulmonary embolism, risk factors and preventive measures of thromboembolic disease. Within the second research question, it was asked: What kind of educational activities do the nurses in the hospital do regarding the prevention of thromboembolic disease? The research showed that nurses educate patients about the importance of exercise, any activity, the proper application of low molecular weight heparin before discharge to home treatment and the proper loading of compression bandages before surgery. Regarding the third research question, How do nurses determine the effectiveness of educational activities about thromboembolic disease in the hospital?, the investigation showed that the most important thing for nurses is communication with the physiotherapist, monitoring the patient at each room visit as well as obtaining the feedback from the patient after education on the correct application of low molecular weight heparin. Based on the results of the survey, an information leaflet on thromboembolic disease has been developed and will be provided to private practices or hospitals.
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Ethical approach to hospitalized patients during a pandemic
Ryšavá, Kateřina ; Hogenová, Anna (advisor) ; Blažková, Miloslava (referee)
Úvod Hospitalizovaným pacientům se ve zdravotnických zařízeních věnují odborníci z řad zdravotnického personálu současně zástupci sociálního sektoru. Náplně jejich činností jsou odlišné. Nicméně je spojuje to nejdůležitější. Všichni se intenzívně podílejí na uzdravení pacienta, zmírnění projevů jeho nemoci, zlepšení kvality života pacienta nebo se snaží napomoci umírajícímu k důstojnému odchodu ze života, pokud možno bez bolestných útrap. Veškeré jejich konání nese požadavek etického přístupu k pacientovi. Nedávno svět zasáhla pandemie nemoci covid -19. Mezi impulsy vedoucími k sepsání této práce bylo zamyšlení nad etickým přístupem k pacientovi v pandemickém období vycházející i z osobní zkušenosti se zdravotnickou a sociální péčí o hospitalizovaného pacienta. Cílem této práce je odpovědět na otázku, zda je zapotřebí podrobit etické přístupy těchto profesí k pacientům dalšímu zkoumání ve světle dopadů pandemického období, zda je třeba v těchto přístupech zohledňovat nastalou specifickou situaci.
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Communication as part of nursing care in the emergency department
KREJČÍ, Natálie
Abstract The aim of this thesis was to chart the specifics of communication between nurses and patients in the emergency department. Two research questions were formulated based on this goal: "What are patients' experiences with communication from nurses in the emergency department?" and "What communication problems occur between nurses and patients in the emergency department?" Additionally, two hypotheses were developed, namely: "Nurses' knowledge of communication principles differs according to their level of education" and "Nurses' knowledge of communication principles differs by length of experience." A mixed research strategy was used, including semi-structured interviews and an unstandardised questionnaire. The study involved 12 patients treated in the emergency department and 216 nurses working in the department. The interviews were evaluated with the open coding method, using pencil and paper, and the results were subsequently categorised. Hypotheses were tested using nonparametric correlation Spearman's correlation coefficient in IBM SPSS Statistics 28 program. The results of the qualitative research emphasise the importance of communication in the emergency department. Patients evaluate their experiences primarily based on the approach and communication from the staff. The most frequently reported communication issues are unsuitable communication from nurses, followed by the staff not having enough time, high numbers of patients in the waiting room, and insufficient information. The quantitative results demonstrate a statistically significant effect between nurses' educational level and knowledge of communication principles. The test result yielded a p-value of 0.01%. Thus, the higher the educational attainment, the higher the knowledge of communication principles. In contrast, there was no statistically significant association between the length of experience and knowledge of communication principles. According to the test result, the p-value was 19.6%. Therefore, knowledge of communication principles is not related to nurses' experience. The most common barriers from the perspective of nurses are aggression from patients and a lack of time. One of the solutions to the barriers is certainly to increase the number of staff and to ensure lifelong communication skills education for nurses.
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Social isolation of in-patients problems
GRIMM, Viktor
Abstract The presented diploma thesis explores the social isolation hospital and sanitary facility clients suffer from, raising a live issue to tackle. Research aims and questions: I framed three aims, including defining the needs of socially isolated hospital patients, assessing the impacts of social isolation on the patients, and analysing how to mitigate the feeling of loneliness. The goals involve three research questions: 'What are the needs of socially isolated hospital patients?' 'What are the impacts of social isolation on hospital patients?' and 'How can we mitigate social isolation of hospital patients?'. Research methods and sample: The empirical part involves a qualitative methodology - a semi-structured interview. The research sample comprises probands classified into three groups. They include nurses attending socially isolated patients, patients and their relatives. I addressed 17 probands within one hospital and sanitary facility in South Bohemian Region. The data analysis involved open coding - a paper-pencil survey, splitting the data into three main categories, each containing ten subgroups. Findings: The survey revealed that hospital or sanitary facility patients often feel lonely, unveiling critical psychosocial needs for alleviating these feelings. Nurses and relatives are highly instrumental in showing compassion, while family hospital visits are imperative to prevent social isolation. The findings also indicate that loneliness severely undermines patients' mental health. Contribution to practice: The study may contribute to educating students of health and social care and licensed practical nurses and informing the general public. As the thesis's outcome, I will hold a workshop with nurses to identify and deal with socially isolated patients.
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Pain management in the recovery room of the anesthesiology department
FRÜHAUFOVÁ, Tereza
The diploma thesis is focused on the issue of patients experiencing postoperative pain in a Post Anaesthesia Care Unit (PACU). The thesis is aimed at three basic goals. The first one is focused on the analysis of the pain a patient experiences in a PACU. The second goal is the in-depth comparison of the pain the patients experience after various surgeries and the third goal is to get the feedback on the nurses' approach to the pain assessment. The theoretical part of this thesis is focused on the detailed explanation and the division of pain, treatment of pain and the function and the equipment of a PACU. The research part of this thesis was carried out in the form of quantitative research. A form with 22 questions, which was targeted on nurses working at the PACU, was used for the data acquisition. The questions were aimed at obtaining detailed data related to the evaluation of postoperative pain, but also at obtaining the information regarding staffing in particular hospitals. 183 nurses working in 79 hospitals filled out the form. There was also monitoring of pain carried out with 83 patients in the PACU in the Military University Hospital Prague. The patients experienced various types of surgeries. The results could help to find suitable strategies of evaluating and postoperative pain treatment in the PACU. During the research, it became obvious that patients who underwent neurosurgical operations of the spine experience the most intense pain. On the contrary, patients who underwent urological surgeries experience the least intense pain According to nurses'opinion the most important factors in evaluating patient's pain are the verbal expression of the patients and the change of physiological functions. Neither the lenght of practice nor the education has statistically a significant influence on the final evaluation of patient's pain. The experienced nurses with long-term practice predominate in the PACU. Based on the information given by nurses, it is safe to assume that the current treatment of postoperative pain is sufficient. It's rather rare for a patient to have strong pain after running out of options in analgetic treatment. It's worth noting that there are significant differences in the staffing of the PACU across hospitals.
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Interaction between nurses and family members and their view of patients admitted to the anaesthesia-resuscitation department
DAŇKOVÁ, Pavlína
The present Master's thesis examines the topic of anaesthesia-resuscitation ward visits, interactions, and communication, seen from the perspective and views of nurses and family members of the patients. The primary objective was to examine the interaction between nurses and family members of patients admitted to the anaesthesia-resuscitation wards; the second objective was to investigate the nurses' and family members' perceptions of these patients. The author has achieved the goals mentioned above through qualitative research using two methods: semi-structured interviews with family members of patients and questionnaires involving nurses working in the anaesthesiology-resuscitation wards. The research has established the following: nurses keep an open, positive attitude towards supporting the patient's family; nurses' cooperation with the family members does not depend on their shift difficulty; however, the demandingness of the shift can be influenced by the amount of time the nurse spends with the patient's family; and the nurse's view of the patient is not subject to their education or length of work experience. It is hard for families to see their relatives admitted to the anaesthetic and resuscitation ward; such experiences are associated with very negative feelings; moreover, the family members expect the nurse to behave and act in a role-defined manner. Families usually want to be involved in their loved one's care and appreciate when the nurse is helpful, proactive, supportive and does not shun them; on the other hand, the unfamiliar and strange environment of the ward, and their loved one fighting for life, impacts negatively on families. The present thesis has resulted in drafting an information leaflet that nurses can use for the education of anaesthesia-resuscitation ward visits, containing basic information about the ward, general instructions and a description of the patient, accompanied by illustrations.
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Hospice Care in the Eyes of the Public
HAVLÍČKOVÁ, Hana
This bachelor thesis deals with the issue of hospice care. Its goal is to compare the perception of hospice care of those people who had some personal experience with it and those who have not dealt with it. Another goal is to find out how this experience affects their perspective of dying. To achieve these goals the quantitative research strategy has been used. The method of data collecting has been realized via questionnaires. The researching cohort consisted of individuals whose relatives used the services of sv. Jan N. Neumann Hospice in Prachatice and also of the individuals who have not used such services. 89 respondents have participated on these questionnaires. The hypotheses were tested by the contingency table, chi-squared test and the T-test. The results of the research have shown that the experience with hospice care affects the potential selection of hospice care for the respondent himself or for his relatives. It also affects the appropriateness of hospice care for the last days of a dying person, and it projects into the appraisal of deceasing in hospice. The experience with hospice care also affects the arrangements for death - those with no experience are more likely unprepared. On the other hand, the experience with hospice care has not affect the appraisal of deceasing at home as a proper place for dying. It does not even have an impact on whether the respondents think or talk about their own mortality. The experience with hospice care also does not affect their opinion about the necessity of increasing the support and the public awareness about this type of care. It also does not affect the amount of fear or anxiety about respondent's death. With the issue of awareness about hospice care those respondents who had previous experiences with hospice care proved more knowledge. Nevertheless, it is still necessary to encourage the public awareness about hospice care.
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Nurse Work Management in Septic Orthopedics
HRACHOVÁ, Jana
Abstract The diploma thesis deals with the work management of the nurse in septic orthopaedics from the point of view of the nurse and patient as the recipient of care. Since the operative medicine goes generally very fast ahead and surgeries are performed in different terrain, often in infected or potentially infected areas, the surgical wound can be infected by microorganisms from outside or inside. Therefore, it is essential that nurses working with such patients should know the management of the work on the patient with infectious complications. The aim of the work is to map the management of the nurse's work in septic orthopaedics. To achieve this, 3 hypotheses and 4 research questions were set. To achieve the aim, quantitative research was used in the form of questionnaires for nurses who encounter patients with septic diagnosis or complications in their work. 365 questionnaires were included in the research. The qualitative research was conducted in the form of semi-structured interviews with 9 participants who met the inclusion criteria. It can be said that although septic orthopaedic patients come in contact with nurses in all types of hospitals across the republic, it cannot be said that there is a single model in the provision of care. The truth is that the provision of care depends on the education, the length of the nurse's practice, but also on the type of hospital where the patient is hospitalized. A qualitative research survey found that the most important factor for patients is not the way of providing care, but the human approach to them, communication with them and the time that the staff is willing to devote to them. A happier patient is the one to whom the staff is dedicated. In conclusion, we would like to say that septic orthopaedics from the perspective of the nurse work management is under-discussed and it would be advisable to change this.
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The use of restraints in internal branch departments in Hospitals of the South Bohemia Region
RŮŽIČKOVÁ, Monika
This Bachelor thesis is both theoretical and practical. The first part of the theory focuses on an aggressive patient, the causes of aggression, expression, prevention, treatment and access to an aggressive patient. It also mentions aggression in hospitals. In the second part, the theme is restrictive devices, which are often used precisely in aggressive patients. It discusses in more detail the types of restraints, the principles in their use, the laws governing them, the documentation and the nursing care of the patient under restriction. Research goals: In this bachelor's thesis, 3 goals were set. The first was to map the nurses' experience with restrictive devices in practice. The second aim was to explore the nurses' attitude to these means. The third aim was to identify what shortcomings nurses saw in the issue of the use of restraints. Research questions: Three research questions were identified on the objectives of the work. 1. What experience do general nurses have in the use of restraints? 2. What is the general nurse's position on restraints? 3. Do general nurses perceive any shortcomings in the use of restraints? Methods: A qualitative research strategy was used in the practical part. The data collection took place through semi-structured interviews conducted with general nurses in the internal departments of hospitals of the South Bohemia Region. The selection of informace was deliberate, with a total of 12. Results: Using the pencil paper method of data analysis, we created 3 categories of questions and 21 subcategories. All nurses have experience of using curtsies and medication from their practice. The frequency of their use varies according to the ward they work in. Almost half of the nurses had a bad experience concerning the improper use of restrictive medication. Nurses' attitudes are slightly more positive positive mainly due to patient and staff protection. From the nurses' perspective, the positives outweigh the negatives when it comes to restrictive measures. Half of the nurses expressed that they were aware of the shortcomings of this issue. The most frequently mentioned was the lack of availability of orderlies or security guards on the ward.
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