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Problematics of transferring the patient onto home artificial pulmonary ventilation
HRBKOVÁ, Lenka
Home artificial lung ventilation (DUPV) is very current topic these days. It provides great hope for the possible return of a patient permanently dependent on artificial lung ventilation back to the home environment. Due to injuries or the development of the disease, some patients are permanently dependent on the support of artificial lung ventilation (UPV). Staying at home with the support of DUPV brings many benefits for these patients. The theoretical part of the diploma thesis is divided into six parts. The first part is devoted to a historical view of the development of artificial lung ventilation. The second part describes the respiratory system. The third part is devoted to artificial lung ventilation, where in the subchapters the indications for connection to UPV, physiological goals, clinical goals and also the subsequent intensive care are analyzed in more detail. The third part comprehensively describes DUPV. The subchapters are devoted to indications for connecting the patient to DUPV, there are described organizations dealing with DUPV. It describes the application for the implementation of DUPV, preparation before the patient goes home, provided nursing care and equipment and medical supplies necessary for implementation. The fourth part focuses on an overview of social benefits and the fifth part on the implementation. Two goals were set for the diploma thesis: 1. To find out, with what problems, including artificial nursing care, do patients face with artificial lung ventilation. 2. Identify what problems, including nursing care, patients experience with home artificial lung ventilation. To meet the objectives, three research questions were created: 1. What problems, including nursing care, occur to patients dependent on artificial lung ventilation in the Follow-up Intensive Care unit? 2. What problems, including nursing care, occur to patients dependent on home artificial lung ventilation? 3. What are the changes in the quality of life and nursing care of patients dependent on ventilator in the hospital and patients dependent on ventilator at home? The empirical part of the diploma thesis is processed in the form of a qualitative research survey. The method of semi-structured interview with NIP general nurses of an unnamed district hospital, caregivers and patients at DUPV was chosen. The method of self-observation and examination of decurses was also used. The interviews were conducted on the basis of pre-arranged questions with four nurses, three caregivers and three patients. The "pencil and paper" method and the open coding method were used to analyze the interviews. For grater clarity, the categories and subcategories were visualized in graphic diagrams. They were also used to compile three case studies. The results of the research survey show that general nurses deal with nursing care, respiratory care and also listen appropriately to the needs of patients. The most common problem that was mentioned was the implementation of personal hygiene, due to the mental and physical dufficulty for patients. Furthermore, problems with defecation, immobility and problems with gestures and communication. An unpleasant problem was also the irritation of the airways during suction. Patients 'and carers' responses show that the most common problem is dependence on the carer for personal hygiene and excretion. Also problems with falling asleep. Social isolation and deteriorated possibility of communication are also problems. A change in the quality of life and nursing care of UPV-dependent and DUPV-dependent patients at home was also found. The answer to this question is that a hospital stay is physically and mentally demanding. It has been said that being at home is real luck. The opportunity to be with family and be able to do everything by yourself. I believe that the work could serve to improve the awareness of family members of patients at DUPV. The work could be used to collaborate in a GAIA grant project.
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The care of the airways in the patients hospitalized at the unit care in view of patients
Klozová, Ivana ; Hocková, Jana (advisor) ; Hladká, Petra (referee)
Introduction:The management of patients with a tracheostomy tube is still current. It brings stress situation not only for the patients but also staff who care for them. This issue occurs across all disciplines. The aim of this study was to determine how they feel patients at the care of the tracheotomy while hospitalization of the intensive care unit. Methodology: The research was carried out during 2015 and 2016 at the surgical intensive care unit. The group of respondents consisted of patients with established tracheostomy tube. 80 pieces were distributed questionnaires, 73 patients responded return reached 91.25%. Results: The investigation showed that the comprehensive care of a tracheostomy for patients burdensome and unpleasant. Everyone clearly stated as the most annoying and most exhausting bother them forced to cough. 90,41% of patients reported that their aspiration meets at regular intervals to be able to prepare this fact. All of the respondents perform respiratory physiotherapy and 67.12% felt that they benefit. 95.89% of respondents suffer from a sense of social isolation. 82.19% would welcome the presence of a psychologist at the ICU. Group 80.82% think that it is adequately cared about their tracheostomy during hospitalization and all have the possibility of alternative communication.
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Nursing Care for Patients with Tracheostomy
Ebertová, Barbora ; Hošťálková, Monika (advisor) ; Maňasová, Taťána (referee)
The thesis is focused on nursing care of patients with tracheostomy. The work consists of two parts. The first part is theoretical. This section is devoted to anatomy and physiology of the respiratory tract, additional chapters devoted itself already the main topic and that is tracheostomy. The implementation presented here tracheostomy history, engineering design, types of procedures, types of cannulas tracheostomických, indications for the performance and possible complications. Another big part of the total nursing is where nursing care is devoted to a patient with tracheostomy and care of respiratory toilet, replacing the tracheostomy cannula and decanting. Then there is included a chapter on communication with the patient and possible alternative ways of communication and nursing diagnosis. The empirical part focuses on qualitative research, the method of data collection are two case reports of nursing. The survey was conducted at the clinic anesthesia, resuscitation and intensive care in two patients with tracheostomy. The aim of the research was to find out how the nursing care of patients with tracheostomy, method of communication with tracheostomy patients and to determine their nursing problems. Key words Tracheostomy, airway, tracheostomy tube, airway toilet, communication, nursing care
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Nursing process of the tracheostomized patient
Körblerová, Jana ; Kordulová, Pavla (advisor) ; Maffei Svobodová, Ludmila (referee)
Tracheostomy is a mutilating procedure and It may be a source of physical, psychological and social trauma for the patient. An average of 170 permanent tracheostomies per year are performed in the Czech Republic. In the theoretical part I focused on species, indications and complications of tracheostomy and tracheostomy cannulas. I also described a complex care of a patient with the permanent tracheostomy including education. I drew on information from the available materials of the Czech Society of Otorhinolaryngology and Head and Neck Surgery of the ČLS JEP, from guidelines of the Australian Agency for Clinical Innovation Chatswood and The Royal Children's Hospital Melbourne. My other resources of information were BMC, EBSCO, ProQuest, Medline databases. In the case study, I described the nursing and educational process in the patient who underwent total laryngectomy surgery, from admission to dismiss. The case study includes an assessment of the patient's health status according to Majory Gordon's functional health model. I got all the information from an interview with a patient, from medical records, and from the provision of nursing care. Methods: The case study of the patient after the total laryngectomy surgery including the model of functional health, according to Majory Gordon. Aim of the...
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The issue of education of family members caring for patients with home mechanical pulmonary ventilation
Polášková, Veronika ; Kordulová, Pavla (advisor) ; Hocková, Jana (referee)
Introduction: The number of patients dependent on prolonged mechanical ventilation is still increasing (Chau et al., 2017). Once the child's condition is stabilized, it is possible for him to be discharged to home care and transferred to a home mechanical ventilator. The care of this patients is very difficult, therefore, it is important to prepare family caregivers on all necessary care (Borought a Dougherty, 2016). The aim of thesis: The aim of this thesis was to find out what is included in the educational process in intensive care unit. Secondarily, to get opinion of caregivers on the quality of the education process and finally to present problems, that family caregivers face at home. Methodology: The research was based on the qualitative study. Data collection was conducted by semi-structured interviews with family caregivers, who take care of children on home mechanical ventilation. A total of 9 respondents participated in the research survey. Data analysis was performed in open coding steps followed by categorization and subcategorizations. Result: The research identified important aspects about the education of family caregivers. We found that caregivers perceive the education very positively. However, they also met with several problems - lack of staff time to educate them in hospital, or...
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The nurses role in adult tracheostomy in intensive care - percutaneous versus surgical tracheostmy
Chvějová, Bronislava ; Hocková, Jana (advisor) ; Kulířová, Veronika (referee)
Breathing is one of the basic life functions and for its proper functioning it is necessary to have the airways free and clear. One way to maintain free and open airways is the tracheostomy. Tracheostomy may be performed either by surgical or puncture method. Nursing care and its quality in patients with tracheostomy are important factors that can significantly affect postoperative complications, their course and overall clinical outcome of treatment of patients. Sufficiently qualified, knowledgeable and experienced nurse applies her knowledge in practice with a holistic view of the patient and his needs. The theoretical part of the thesis introduces us to the anatomy of the respiratory tract, the history of tracheostomy, individual methods of tracheostomy - surgical versus puncture and nursing care for adult patients with tracheostomy for intensive care. Methods: In the empirical part, the data obtained on the basis of a quantitative survey in the form of a questionnaire will be evaluated. The sample of respondents will be nurses working in the intensive care department for more than 1 year with experience in nursing care for tracheostomy. Aim of the work: Analysis of nurses awareness about different tracheostomy methods - surgical versus puncture, role of nurse in these methods, their experience...
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Nursing process of the tracheostomized patient
Körblerová, Jana ; Kordulová, Pavla (advisor) ; Maffei Svobodová, Ludmila (referee)
Tracheostomy is a mutilating procedure and It may be a source of physical, psychological and social trauma for the patient. An average of 170 permanent tracheostomies per year are performed in the Czech Republic. In the theoretical part I focused on species, indications and complications of tracheostomy and tracheostomy cannulas. I also described a complex care of a patient with the permanent tracheostomy including education. I drew on information from the available materials of the Czech Society of Otorhinolaryngology and Head and Neck Surgery of the ČLS JEP, from guidelines of the Australian Agency for Clinical Innovation Chatswood and The Royal Children's Hospital Melbourne. My other resources of information were BMC, EBSCO, ProQuest, Medline databases. In the case study, I described the nursing and educational process in the patient who underwent total laryngectomy surgery, from admission to dismiss. The case study includes an assessment of the patient's health status according to Majory Gordon's functional health model. I got all the information from an interview with a patient, from medical records, and from the provision of nursing care. Methods: The case study of the patient after the total laryngectomy surgery including the model of functional health, according to Majory Gordon. Aim of the...
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The care of the airways in the patients hospitalized at the unit care in view of patients
Klozová, Ivana ; Hocková, Jana (advisor) ; Hladká, Petra (referee)
Introduction:The management of patients with a tracheostomy tube is still current. It brings stress situation not only for the patients but also staff who care for them. This issue occurs across all disciplines. The aim of this study was to determine how they feel patients at the care of the tracheotomy while hospitalization of the intensive care unit. Methodology: The research was carried out during 2015 and 2016 at the surgical intensive care unit. The group of respondents consisted of patients with established tracheostomy tube. 80 pieces were distributed questionnaires, 73 patients responded return reached 91.25%. Results: The investigation showed that the comprehensive care of a tracheostomy for patients burdensome and unpleasant. Everyone clearly stated as the most annoying and most exhausting bother them forced to cough. 90,41% of patients reported that their aspiration meets at regular intervals to be able to prepare this fact. All of the respondents perform respiratory physiotherapy and 67.12% felt that they benefit. 95.89% of respondents suffer from a sense of social isolation. 82.19% would welcome the presence of a psychologist at the ICU. Group 80.82% think that it is adequately cared about their tracheostomy during hospitalization and all have the possibility of alternative communication.
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Intensive home care - Home care with elements of intensive nursing
Králová, Eva ; Hošťálková, Monika (advisor) ; Meisnerová, Eva (referee)
The master thesis deals with an intensive home care - home care of intensive nursing and maps the situation concerning the home mechanical ventilation. The theoretical part draws from the researchers' reviews. It clarifies the basic concepts, intensive home care and trends in providing the home mechanical ventilation. Furthermore, this part of the thesis explains the term mechanical ventilation. To facilitate long-term ventilation of a chronic patients it is necessary to ensure an adequate airway. Therefore, it is included a chapter dealing with a tracheostomy and its treatment.The first part of the survey summarizes a statistical overview of the home mechanical ventilation used in the Czech Republic till 31th March 2013. Next section includes a qualitative form research, which is observing the whole indicating and transferring process of a patient from a hospital to the home environment where the home mechanical ventilation is assured. I have concluded that men are more ill and women, mothers or wives are taking part in the healing process according to the investigation results. We have 81 ventilated patients in home care in total. Mechanical ventilation is mostly indicated for children with spinal muscular atrophy disease. Men compared to women are more often affected by traumatic conditions,...
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