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Burnout by Nurses in Intensive Care
Jánová, Simona ; Mellanová, Alena (advisor) ; Honzák, Radkin (referee)
Burnout by nurses in intensive care Abstract: Objective of this thesis was to determine incidence of the risk of burnout by nurses in intensive care in the Motol University Hospital in Prague, compare to risk of burnout among nurses in intensive care for childern and adults and by age, sex, marital status, education, length of experience in health care and on the current department, satisfaction and performance in the workplace. The research method for data collection were two anonymous questionnaires: one prepared by author of the thesis and a standardized questionnaire by dr. Pines to determine the risk of burnout. It was found that more than hlaf of nurses in FN Motol had low risk of burnout and has not demonstrated that nurses have on children's or adult wards increased risk. Results confirmed that discontent and the increasing intensity of stress in the workplace is proportional to the risk of burnout. This research confirmed that although most nurses achieved good results has been shown a high percentage of nurses with alarmig score and even burnout. Therefore we should not ignore this issure, but rather to warn him and avoid unpleasant consequences through educational seminars, pleasant working environment and do not overload nurses. Keywords: burn-out, stress, nurses, intensive care, mental hygiene
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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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The issue of education of nurses in basic and advanced resuscitation according to applicable Guidelines.
SLABÝ, Petr
Theoretical background The thesis is about education in area of basic and advanced resuscitation according to valid Guidelines for nurses. The department of internal medicine was chosen for research investigation. The theoretical part briefly describes sudden circulatory arrest. In context the resuscitation is explained and categorized into basic and advanced. There is also described what are Guidelines, what are the trends in CPR. Furthermore the shockable heart rhythms are described. The defibrillation is summarized and characterized. The theoretical part also contains the term AED (automatic external defibrillator). There is also information about rate of sudden circulatory arrests in hospitals. Priorities are defined for work of nurses in case of sudden circulatory arrest and priorities for CPR. The theory of andragogy is presented as a science discipline for education of adults. In the end of the theoretical part Hal is presented as a hi-tech modern robotic patient. The educational method of e-learning is described as well. Goals and research questions In the empirical part of the thesis two goals were established. One goal was to find out if the nurses that work in the department of internal medicine are interested in a course in basic and advanced resuscitation and problems involved. The second goal was to map awareness of nurses of CPR. The task was to educate nurses from department of internal medicine in basic and advanced resuscitation according to valid Guidelines and recommendations of European resuscitation council 2010, and also to teach them how to use the automatic external defibrillator. The primary research question is the following: How are the nurses from department of internal medicine educated in basic and advanced resuscitation in case of sudden circulatory arrest? The secondary research questions are the following: 1) What kind of knowledge of sudden circulatory arrest and CPR do the nurses have? 2) How are the nurses educated in CPR in case of sudden circulatory arrest? 3) How big is the interest of nurses in a course in CPR in case of sudden circulatory arrest? 4) How to efficiently educate nurses in CPR in case of sudden circulatory arrest? 5) How competent do the nurses believe they are in defibrillation of the heart? Methodology The method used for research is qualitative research which is divided into three phases. The research sample in the first phase was made of at least seven nurses from department of internal medicine. Structured interview is used in this phase which consists of fifteen questions to probe the knowledge of CPR, sudden circulatory arrest and use of AED. In the second phase a short educational course was put together with help of a doctor from anaesthesiology and resuscitation department. Findings The of the is to research satisfaction of nurses from department of internal medicine with education in sudden circulatory arrest and CPR. Conclusions The thesis gives us a look at education of nurses from department of internal medicine in sudden circulatory arrest and urgent resuscitation, competences of nurses for defibrillation, presence of automatic external defibrillators in departments of the hospital. From the finding we can conclude that the nurses from department of internal medicine are actively interested in learning more about cardiopulmonary resuscitation in case of sudden circulatory arrest. They are interested in manipulation with defibrillator and automatic external defibrillator. We can also see the benefit in the course which could improve the odds of survival for people affected by sudden circulatory arrest in hospitals.
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Failure of nurses in the care of patients
MUSILOVÁ, Saskie
Theoretical basis: Every patient has the right to safe nursing care. If health care professionals make mistake, it is perceived very negatively by the health care professional and the general public. Objective: I specified three object of research in this thesis. The first one is to find out, how nurses face to providing care fails. The second one is, what are they able to do to avoid faults. And the last one is, how can they solve this situations, is described in this thesis. Research questions: The question, which could be answered, were specified. I asked with first question, how could nurses solves the situation when the nursing fail is happened. the second one is, which fails are most common, in nurses opinion. And the last one is, how could nurses faces their own fails? Methods used: To achieve the main research was used the qualitative research, in form of semistructured dialogues. Results: Results which emerged from the interviews were transcribed and arranged subsequently and after that were results categorized.In the research work, I have also dealt with the most common errors in internal and surgical department. The most common mistakes on both departments were: nurses prepared the wrong medication, they have not identified and brought wrong cure for the patient, performing occasional incompetent performance. On the internal medicine department most frequently occurring errors as failure of standard procedures for the exercise of individual performance, due to simplify the work. The surgical ward nurse overwritten in the documentation office for the doctor, who then signed. The most common cause of error is the human factor, when during a hectic day nurses feel stress and tideness. Conclusions and Recommendations for Practice: This research may serve as a reference for nurses practice what to do if the nurse is forced from higher positions perform incompetent performance. Furthermore, nurses can learn and realize their most frequent errors in the department. And based on advices, which are given in this work to avoid it.
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Mental Hygiene as Prevention of Burnout Syndrome in the Nursing Profession
VÁŇOVÁ, Kristýna
The bachelor thesis deals with mental hygiene as the main means of prevention of nurses fighting burnout syndrome. The theoretical part describes the main cause of burnout - stress. It also describes the profession of nurses and the entire process of burning out. The end of the theoretical part characterizes mental hygiene, mental health, and describes the methods of relaxation. The practical part is devoted to research in utilizing mental health nurse issues in the profession in relation to the preventing burning out. The aim of the study was to determine whether nurses know and respect the principles of mental hygiene and what experience they may have with it. Another goal was to determine how nurses perceive and assess the psychosocial burdens of their profession.
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The Physical activity of working people focusing to nurses
KOLINGEROVÁ, Hana
Physical activity has been lately discussed around the whole world mainly because of its impact on human health. Due to huge technical development and current life style it turns out that the society is almost inactive. Physical activity is completely insufficient which brings a lot of negative effects on an individual and their health. The aim of thesis was to study the specialized literature in the field of physical activity and its impact on human health, processing of the given literature in the ´research part´ of my thesis and summary of that literature. Further parts of thesis are devoted to gathering of the necessary data, analyzing the results from IPAQ - long (International Physical Activity Questionnaire) questionnaire and monitoring the results from pedometer. To ascertain the amount of physical activity I opted for the IPAQ-long fulfilled by 120 probed people and also for the monitoring of the number of steps a day for a period of one week. The monitoring was performed on 30 individuals with the help of pedometers. The pedometers were individually set for the given person. According to the information gathered from the questionnaires and monitoring with the pedometer is obvious that some individuals miss physical activity in the field of intensive load and the number of steps in a day. Overall, it is possible to say, that according to the recommendation made by USDHHS, all respondents comply with the standard recommended for and adult individual in case of staying healthy.
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Parents´ and nurses´ attitude from the general pediatrist surgery, to obligatory and optional children vaccination.
SUCHANOVÁ, Martina
Abstract Vaccination is an important part of medical prevention, particularly as prevention of some infectious diseases. A primary care nurse checks vaccination status and informs parents on vaccination terms. She is responsible for trouble-free course of vaccination. Apart from compulsory vaccination parents may have their children vaccinated against some diseases, which is non-compulsory and paid from private funds. The practical part of the thesis is a combination of quantitative and qualitative research. A questioning method, the questionnaire technique was chosen for the quantitative research, the research sample consisted of parents of children between 0 and 10 years of age. The 1st goal of the research was to map how well parents having 0-10 year old children were informed on compulsory and non-compulsory vaccination in České Budějovice. A hypothesis was set upon the chosen goal: Parents of 0-10 year old children are informed on compulsory and non-compulsory vaccination. The hypothesis was confirmed. The 2nd goal was to find out what the most frequent fears of vaccination were among parents of 0-10 year old children. The hypothesis formulated to this goal, that parents of 0-10 year old children were afraid of vaccination side effects was not confirmed. A half of the questioned parents have fears. The 3rd goal was to find whether parents were was interested in non-compulsory vaccination. The hypothesis set to this goal, that parents of 0-10 year old children are interested in non-compulsory vaccination was confirmed. The quantitative research employed a questioning method, the technique of depth interview with nurses working at paediatric surgeries in České Budějovice. The fourth goal was to map the role of a nurse in motivating parents to have their children vaccinated. A research question was based on the chosen goal: What is the role of a nurse in motivating parents to have their children vaccinated? I found from interviews with the nurses that a nurse motivates parents through information on vaccination, vaccination terms, on contradiction and adverse responses. She helps solve vaccination related problems. The bachelor thesis may improve knowledge among students, parents and nurses working at paediatric practitioner surgeries and among the public interested in vaccination.
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Urinary Inkontinence as a Stress Faktor on Seniors- Women
MARŠÍKOVÁ, Jana
Abstract Urinary incontinence is involuntary leakage of urine, which causes medical, psychological, social and hygienic problems. Incontinence is a common problem of senior age and influences all fields of women´s life. Almost every senior woman has some kind of experience with this issue, either personal or linked to someone she knows. This thesis deals with causes of incontinence origin, its diagnostics and treatment possibilities. The aim was to find out whether incontinence influences mental condition of senior women and if so, in which way the problems connected with the incontinence are present. The thesis further examines how senior women cope with information about their problems, whether they have sufficient information and whether the information is understandable. It is also important to know what the modern-day options for treatment of this problem are, and whether senior women are willing to undergo the procedures and examinations. The thesis also deals with the question whether senior women have sufficiency of incontinency aids, whether they are satisfied with the nursing care and whether their privacy during sanitation is satisfactory. The survey shows that senior women are stressed by urine leakage, they reduce their activities, socially isolate themselves, are dissatisfied with the quantity of the incontinency aids, limit the fluid intake. The finding, that senior women are not much interested in receiving more information, in further detailed examinations, or in pelvic muscle rehabilitation, was surprising. It has been proven that doctors offer mainly pharmacological and compensational treatment to senior women. Regarding the privacy issue, it has been proven that senior women are satisfied with the nursery care and have adapted to the lack of privacy. It resulted from the survey that nurses do not have enough professional information for education of senior women. Elaboration of a new educational plan for the Senior House clients and nurses working in the facility is the output of this thesis.
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Influence regulation charges on relationship between nurses and klients
DIVOKOVÁ, Jitka
Influence regulation charges on relationship between nurses and klients ABSTRACT On 1.1.2008 Act No. 261/2007 Coll. on stabilization of public budget came into force and became effective. This law implements into practice the long-prepared regulation fees, defines precisely what medical procedures will be subject to CZK 30, 60 or 90 fee. This way the financial involvement/contribution of the clients becomes legislatively valid and justified. Introduction of fees is aimed at reducing the excessive use of medical care, making the existing medical care more effective. The result of that should be the clients better taking care of their health and thinking of prevention, maintaining proper regimen and directing their investments at the right direction. In the theoretical part we have dealt with the concept of regulation fees in health service which work as a financial contribution of citizens to health care funding, and with the fact how and where the regulation fees are levied to. The administration of collection of regulation fees is treated as well. The theoretical part also mentions the experience with health service reforms in abroad, that is in Slovakia, Germany and Austria. An important part of the health care reform is the role of a nurse, her communication skills and duties in relation to regulation fees. We treated the ethic and psychological viewpoints of the relationship between the patient (client) and a nurse, and the factors which affect the behaviour of a nurse. The aims of the degree paper were determined within the survey: to ascertain the impact of regulation fees on the relationship between general nurses and clients, to ascertain the level of awareness of nurses regarding the collecting of regulation fees, to ascertain the abilities of nurses to provide correct information to patients, and to find out whether the patient, as a client, expects better medical care. The aims were investigated on the basis of hypotheses created. Hypothesis 1 in which we assumed that regulation fees in health service had negative impact on the relation between general nurses and clients; Hypothesis 2 in which we assumed that both the nurses and clients evaluated general awareness of fees as insufficient; Hypothesis 3 assuming that nurses are not able to provide patients with correct and complete information regarding the issues of regulation fees; and Hypothesis 4 assuming that patients require better medical care based on regulation fees. Improvement of medical care which can be implemented immediately irrespective to the collection of regulation fees is within the compass of every individual. This improvement requires a smile, patience, introducing of both the nurse and a patient and holding out a hand which should become a matter of course. In connection with the improvement of care each health care facility should issue publicly available regular reports, about how it spends the collected regulation fees which should help to improve the awareness of the clients/patients.
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The retirements homes nurses´knowledge of how to provide the first aid as an assumption of decreasingt the mortality
ULBRICHOVÁ, Dagmar
The subject chosen by me is knowledge of first aid principles of nurses in Pensioner´s Houses as a precondition of death rate reduction, since first aid is the first, essential element of the rescue chain. First aid must be often provided also in number of health institutions, for example in Pensioner´s Houses. Pensioner´s Houses are home for old people, who are the most risky group considering injuries and acute sickness. In order to achieve the above objective a qualitative research has been applied in the form of asking open questions in interviews as well as observations. Data collection has been performed with nurses in Chýnov Pensioner´s House. Data collected during interviews were recorded in a record sheet providing space for answers to all questions. Observations were more of the type complementing and extending information on knowledge concerning resuscitation obtained from the interview. Observations focused on situation when nurses solved a practical task with a figurine used for first aid training. The target and subject group included ten nurses working in Chýnov Pensioner´s House, who may experience situations requiring their first aid skills. The research has been conducted between February and March 2008. Prior research initiation I have been granted permission of the Pensioner´s House´s management to perform this research in their institute. The objective of the work was to map knowledge of first aid principles of nurses in Pensioner´s Houses. This objective has been achieved. Nevertheless in my opinion nurses would benefit from training concerning new first aid practices. The following hypothesis have been defined on the basis of the completed research. H1 Nurses do have knowledge of first aid principles. H2 Nurses are not aware of new recommendations for resuscitation. The following research question may be formulated based on the achieved results: {\clqq}Wouldn{\crq}t it be beneficial to organize periodical fist aid training for health staff in Pensioner´s Houses?`` Results of this research will be provided to Pensioner´s House management to assist them in improvement of their care provided to old people. Chýnov Pensioner´s House will provide first aid training to nurses.
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