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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).
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Role of the nurse in screening for depression in the elderly.
VRZALOVÁ, Monika
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
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The role of nurses and their impact on the care of patients with total hip arthroplasty.
SLABÁKOVÁ, Květoslava
Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.
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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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Nursing care in a hygienic and epidemiological regime from the patient's perspective.
KŘEPELOVÁ, Lenka
Considering contemporary lifestyle and possibility of travelling imported infections accrued and some illnesses come back that have not occurred nearly at us more. Not only haemorrhagic fevers and other highly infectious illnesses but also hospital multiresistant bacterial strains that mean high risk for patients constitute a threat. The number of nosocomial infectious grows still. The patient is in the case of suspicion or already diagnosed infectious illness isolated and treated in the infectious department or in the tribal department in the room with increased hygienic-epidemiologic regime. The patient is saved in a single room, the possibility of visits is reduced and the staff uses personal protective equipment. The man is holistic being and it can come due to isolation to lack of satisfaction of his/her bio-psycho-social needs. The aim of this thesis is to identify unsatisfied bio-psycho-social needs of patients in increased hygienic-epidemiologic regime and to describe changes in needs of the patient depending on the time of hospitalisation. The theoretic part describes the problematics of infectious illnesses, system of the care for the patient with infectious illness and changes in human needs in the period of the illness. The empiric part of the thesis deals with unsatisfied bio-psycho-social needs of isolated individual through quantitative research. The research suite was made up of 10 patients who were hospitalised in the room with increased hygienic-epidemiologic regime. The survey was carried out in the Hospital Jihlava by semistructured interview and the results of the survey were processed by opened coding by method paper and pencil. It is emphasized that the most needs of the patient have biological, psychical, social and even spiritual aspects. The rate of satisfaction with caregiving depends on the health condition and personality of the patient. Not small influence has the length of the hospitalisation, too. It was found out during the survey that the patients have not enough information about specifics of the care in the infectious department and that is why there is often a misunderstanding of necessity of barrier measures. It is possible to avoid useless misunderstanding through timely and suitable education. It was created an educational material with the title "Guide for patients hospitalised in the infectious department of Hospital Jihlava" for this purpose. Employees of the infectious department of Hospital Jihlava were informed with results of the research during a workshop, too.
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Diets for food allergies
DOBRUSKÁ, Klára
I have chosen topic Diet with Food Allergy as a topic of my bachelor thesis. This illness is quite common these days. It affect infants mostly but allergy of cow´s milk protein of children under three years disappears itself mostly. There is increasing amount of causes when patient suffers more allergies. Number of people who have the most serious reaction the anaphylactic shock, icreeases. It can end with death. Doctors recommend to patients to strictly follow the elimination diet which is basic treatment of this illness. The most accurate diagnosis of illness (immunological or not) is another important factor for effective treatment. I have chosen three aims for this bachelor thesis. First to find out if patients are informed about their illness. Second to map eating habbits of people with food allergy. Third the evaluation of correctness of daily menus. I used approach of guality research. Research group consisted of six respondents with different food allergy. Those respondents wrote down their weeks menus. Menus were evaluated with program Nutriservis and it was assessed if it follows recommended dietary value. Suitable intake of energy and essential nutrients was calculated for every respondent. It was evaluated if respondents follows priciples of rational diet and if their diet contains sufficient amount of minerals and vitamins. Questionnaires were another key point of this research. Questionnaires were about illness know-how of patients and who has instructed them about it. It was found out the patients hasn´t got enough information about their illness and half of them has no idea which essential nutrients, minerals and vitamins could lack in their diet. It resulted from menus simultaneously that five of six respondents do not follow principles of rational diet and eat very monotonously. Only one respondent follows strictly elimination diet others violate diet exceptionally. Respondets would appreciate other research would focus on creation of special centres and training of doctors and nutritional therapist who would be focused on food allergies. Spreading the information about illness not only to patients but to public also is really important. Another important point is to increase amount of books about food allergies at the market.
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Role of physical activity in the prevention of childhood obesity
VRTALOVÁ, Jana
The thesis deals with physical activity in the prevention of childhood obesity. It is focused on children, namely pupils of the eighth and ninith grades of elementary school. Obesity is responsible for more human lives than both of the world wars and if we want this epidemic of obesity and problems associated with inactivity minimized, we have to start where it is most efficient and that is with children. The main objective is to explore physical activity in a selected group of pupils. Partial aim is to determine the prevalence of overweight and obesity in the investigated group of students using somatometric measurements in the selected location. Another objective is to determine how many of childrens parents did sports in the past or actualy do sports. The final goal is to prepare educational material for students about the importance of physical activity. The work is divided into two parts theoretical and practical. The theoretical part was compiled as a secondary data analysis. Sources of data and information originated from the Czech Republic and abroad in the form of scholarly books, journals and electronic resources. The contents of the theoretical part is focused on explenation of terms such as obesity, its consequences, complications, ways to prevent obesity, physical activity, appropriate kinds of physical activity and its effects on the human body. Distinctive part is the chapter dealing with the myths of obesity some of them are really surprising. The second part is practical part and includes its own research. The investigation was conducted in a primary school Komenského alej in Žatec for pupils of the eighth and ninth grades. File featured 107 pupils. The research was conducted as a quantitative survey complemented by measurements of somatometric indicators. The data were collected using a custom non-standardized questionnaire. The questionnaire contained 14 questions and two columns separated by line for recording the exact weight and height. We checked these data at pre-agreed periods.
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Poliomyelitis and contemporary issues of its eradication
PETRÁŇOVÁ, Monika
This diploma thesis deals with the issue of the eradication of infectious polio and its current problems. Polio is a highly infectious disease of viral origin. The most effective form of protection from the disease is vaccination. The main aim of this work was to determine the major issues in polio surveillance in the Pilsen region at present. Intermediate goals were determined in relation to the main aim: to ascertain the awareness of practicing paediatricians about the principles of poliomyelitis surveillance with an emphasis on diagnosing and reporting cases of acute palsy and further to ascertain the quality of the cooperation between the locally competent public health authority and practicing paediatricians in the field of poliomyelitis surveillance. The work is divided into two parts, theoretical and practical. The practical part was elaborated using a qualitative method based on semi-structured interviews with practicing paediatricians and with the locally competent public health authority. The research was participated in by 9 practicing paediatricians and one public health authority worker from the Pilsen region, with an average length of practice of 20 years. The resulting data was then evaluated by a coding method and divided into schemes according to Švaříček and Šeďová (2007). Three research questions were defined based on the set aims: RQ1: What do practising paediatricians see as the prime problems in polio surveillance? RQ2: How many cases of acute palsy do practising paediatricians record and subsequently report to the competent public health authority? RQ3: What is the quality of the cooperation between practising paediatricians and the locally competent public health authority? The research revealed that, according to the practising paediatricians, the problem in poliomyelitis surveillance is refusal of the vaccination and the associated decreasing immunisation coverage of the population. The next most commonly reported problem was population migration. Furthermore, it was found that not one practising paediatrician recorded or reported cases of acute palsy in their surgery. Only one respondent encountered acute palsy 10 years ago. The answer to the last research question is also apparent from the information obtained. More than half of the respondents agreed that so far there is no cooperation on this issue. Although four respondents stated that the cooperation is at a high level and is of very good quality.
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Charity Projects of Organizations Providing Care for Children with Disabilities in South Bohemia
LANDOVÁ, Lenka
The bachelor thesis "Charity Projects of Organisations Providing Care for Children with Health Disability in the Region of South Bohemia" deals with those projects that were founded by non-profit organisations and that provide care for children with health disability in the Region of South Bohemia. The aim of this thesis is to chart the charity projects of above mentioned organisations and to find out what is a proper and effective way to create them and what methods and procedures are used by non-state, non-profit organisations. The first research inquiry refers to a successful implementation of these projects. The result will be not only a realisation what kind of projetcs were created by the above mentioned organisations but also what is important for an organisation itself. Within the bounds of the second research inquiry I find out wheather there is an optimal procedure for the implementation of the charity projects of non-state, non-profit organisations. A qualitative method was used for a research part of this thesis. I used a method of a half-structured interview, a technique of a personal interview. A research group was selected for bringing the research into practice, which includes nine organisations seleceted from non-state, non-profit organisations providing a care for health disabled children in the Region of South Bohemia. It is more difficult for non-state, non-profit organisations it this field to obtain enough finances for providing services and for obtaining necessary aids than for state non-profit organisations because of different ways of fundraising . A non-state, non-profit organisation has several possibilities how to obtain necessary material and non-material sources. There are charity projects that offer means of selfless help; provided they are successful, they help the organisation to obtain necessary sources. It emerged from the research that it was very important for non-state, non-profit organisations to get a multi-source fundraising and supporters of their projects, mainly donors and sponsors, to obtain available care for children with heath disability. On the basis of the research, it is possible to state that non-state, non-profit organisations providing care for children with health disability, implemented many successful projects. The results of this thesis can be used in the way of an informative material for setting a complete view of a solution of the problems of the above mentioned organisations projects.
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Use of e-learning education of universal nurses in Militari university hospital - University hospital Prague
JANKŮ, Kamila
The diploma work submitted is called The Use of E-Learning Education of Nurses in the Central Military Hospital Military University Hospital Prague. The theoretical part of the diploma work deals especially with the significance of e-learning, distance learning, history of education of nurses in the Czech Republic and e-learning in health care. In addition, the work includes information of the Central Military Hospital and describes its present circumstances and use of e-learning in the working process. 5 aims and 4 hypotheses were set for the quantitative research. The first aim was to determine the time demands of the e-learning courses study. The second aim was to determine the attitude of general nurses to e-learning education. The third one focused on contribution of e-learning education for general nurses and for the hospital management. The last aim focused on satisfaction of general nurses with the form, contents and diversity of e-learning courses. The fourth aim was used to determine reasons leading for development of e-learning courses for general nurses. Four hypotheses were determined: H1: It takes less time to complete e-learning course studies than regular studies. H2: Nurses younger than 30 years of age prefer e-learning education unlike nurses older than 30. H3: The effectiveness of regular studies is better than the effectiveness of e-learning education. H4: E-learning courses are not as financially demanding as regular courses. The data collection technique consisted in our own anonymous non-standardized questionnaire containing 32 items. The research file consisted of 212 general nurses working in clinical departments of the Central Military Hospital. An additional method was based on a dialogue with the Education Team Manager of the Central Military Hospital. The research results related to the hypotheses show that completing e-learning course studies does not take less time than completing a regular course. Nurses younger than 30 years of age do prefer e-learning education contrary to nurses older than 30. The effectiveness of regular courses in contrast to e-learning education has not been confirmed as well as the fact that financial demands of an e-learning course are lower than financial demands of a regular course. Further, nurses prefer regular forms of studies, mostly with their passive participation in an educational event; however, they find completion of e-learning courses more convenient. Most respondents also expressed a positive opinion on the form, contents and diversity of e-learning courses. Courses include enough information for preparation of a final test and nurses find the number of courses necessary for periodical evaluation adequate. What they consider limiting is the impossibility to retake the final test; they mostly suggested it should be allowed to take the final test twice or three times. The research implies that a higher percentage of the respondents spend as much time as they want studying. Nurses still prefer regular forms of studies with passive participation to the e-learning form. Most nurses have a positive opinion on the current contents of courses in the form of a text format. The course topics are mostly based on suggestions by members of the Non-Medical Professions Education Team of the Central Military Hospital. The research results will be presented at the next regular meeting of members of the Non-Medical Professions Education Team of the Central Military Hospital. Procedures for improvement of the form of the current courses will be presented and proposed as well as the possibility to develop communication between the author and students, the limiting impossibility to retake final tests and the suggestions concerning the number of possibilities to retake them.
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