|
název v anglickém jazyce není uveden
Kališová, Lucie ; Paclt, Ivo (advisor) ; Höschl, Cyril (referee) ; Schreiber, Vratislav (referee)
At present, depressive disorders affect a considerable proportion of population, their incidence showing an increasing tendency in the developed world. Depression mostly afflicts people in the age of 25-35. It occurs in females twice as often as in males. Depression involves an intense subjective suffering accompanied with a disruption of normal everyday functioning. Moreover, when compared with the healthy population, there exists a thirty times higher danger of suicide in the people affected with depression. The illness unfortunately tends to become chronic, the probability of recurrence of an episode being 50%. Furthermore, some patients suffering from the depressive disorder do not adequately respond to an antidepressant therapy; we call such patients treatment-resistant. There certainly exists a close relation between the endocrine and the central nervous system, most endocrine disorders being potentially accompanied with changes of psyche and vice versa. With affective disorders the most frequently reported disruption involves an interference with the function of the hypothalamicpituitary- adrenocortical (HPA) axis, though various studies repeatedly acknowledged also deviations of the hypothalamic-pituitary-thyroid (HPT) axis. The most frequent findings comprise an altered serum thyrotropin response...
|
|
Specifics of nursing care for patients with spinal muscular atrophy
HRBKOVÁ, Lenka
This thesis is focused on defining the specifics of nursing care for patients with disease spinal muscular atrophy. SMA is classified as an incurable genetic disease that causes progressive muscle atrophy and deformity of the body but sensory perception and intellect remain preserved. The incidence of the disease in the neonatal and childhood prevails, however the outbreak of the disease in adulthood is not any exception. Suitable nursing care is of great importance in maintaining the health of the patients for the longest possible time and delaying the onset of worsening health. The thesis is divided into theoretical and empirical part. The theoretical part deals with SMA disease, incidence, classification, treatment options and nursing care. In connection with the theme of this thesis, we choosed three targets. 1.: Map out the specifics of nursing care of pediatric patients with spinal muscular atrophy from the perspective of nurses. 2.: Map out the specifics of nursing care of adult patients with spinal muscular atrophy from the perspective of nurses. 3.: Comparison of the specifics of nursing care of pediatric and adult patients with spinal muscular atrophy. We used qualitative research method using a semi-structured interview to achieve our goals. To assess quality goals, we used the following research questions: How nurses specify the nursing care provided to a pediatric patient with spinal muscular atrophy? How nurses specify the nursing care provided to an adult patient with spinal muscular atrophy? With which needs of patients suffering with spinal muscular atrophy have the most experienced nurses experience? The research group consisted of six respondents, three of which respondents had experience with care of pediatric patients and the other three with care of adult patiens. As a processing technique we used open coding, through pencil and paper. The information obtained was divided into categories. The research shows that for nurses caring for pediatric patients the age is important at first occurrence of the disease as that influences the possibility of communication. Prevails ensure physiological needs. For nursing care, throughput of the tracheostomy cannula and status check of the oral cavity is important. In terms of nutrition the nurses prefer serving food through the PEG. They also agreed on the need for positioning. Emptying urine is ensured by the PMK or urinating in diapers. The nurses agreed on serving laxatives and manual defecation. The survey of nurses caring for adult patiens explains that the most common barrier is a state of consciousness, mental status and impaired verbal and nonverbal communication. For the needs of the nurses they state the physiological needs, as well as the fulfillment of psychological needs. In the nursing care of respiratory ways nurses report caring for tracheostomy cannula and a suctioning. In the case of nutrition they prefer per os (orally) and after that they use the help of NGS or NJS. The most common way of serving the diet they indicate the PEG. In case of immobility of the patient they all agree on positioning. For emptying urine they use PMK, one also mentioned epicystostomy. For defecation they agree on serving of laxatives, enemas and manual defecation. The results of our survey highlight the differences in nursing care provided to children and adults. The most relevant in the category of barriers in communication, is the age of the children and adults state of consciousness, the willingness and the ability to communicate. Adult patients desire to fulfill even higher requirements,while with children it is about fulfilling the physiological and social needs. In the nursing care, significant differences are not found. The results obtained in the practical part, I would like to use the knowledge to broaden awareness of nurses who have experience in caring for patients with SMA and to better inform the general public about this rare and often fata
|
|
Identification of medication errors by nurses during simulated situations
KELBLOVÁ, Kateřina
Current status: Medication errors within the context of safe and high quality health care are one of the most frequently discussed topics of recent years. They are part of the medical process, occur in different forms, affect patients of all ages and decrease the quality of provided health care. Prescriptions of medication in medical documentation have to be clearly legible and include all the required information. Nurses' role within the medicaiton process could be described as an ultimate "safeguard" that can prevent medication errors. Goals: The objectives of this research are to assess nurses' awareness of medication errors, ssess their ability to detect medication errors and find out the level of their knowledge regarding the correct procedures and measures following medication error detection.Methodology: The research was conducted using a qualitative research method. The in-depth interviews with nurses were carried out at a surgical critical care unit at the hospital in Jindrichuv Hradec. Following the collection of a sufficient amount of data the interviews were coded using the "pen and pencil" technique and then divided into categories.Research file: In order to achieve the highest level of objectivity the research was carried out with a group of nurses who work at the same unit of a hospital department. The research file included nurses who had varied levels of education and numbers of years of experience. Results: Surgical critical care unit nurses are not aware of the exact definition of medication errors. Only one nurse was able to discuss adverse events with related consequences. The remaining nurses' awareness of medication errors corresponded to the classification described in the relevant foreign and Czech academic literature. None of the interviewed nurses detected all the errors included in the simulated scenarios. Only one nurse, who is currently completing her qualification in this specialty, detected a wrongly prescribed antidote. The simulated scenarios also included a group of high-risk medications that is commonly used at the unit. The first medication included in this group was a 7.45% solution of potassium (KCl). A majority of the participants detected the high concentration of this high-risk medication. Another high-risk medication was a 10% concentrate of NaCl in an infusion; this error was also detected by the majority of the nurses. The third high-risk medication was a wrongly prescribed insulin (it lacked the detailed description of units, time and route). This prescription error was not detected by the majority of participating nurses. Another type of medication error included in the simulated scenarios was a group of medications used specifically in critical care. Only half of the participating nurses successfully detected the errors related to the prescription of this group of medications. The last type or medication errors focused on incomplete prescription by doctors. The most frequently detected error was a prescription of an opiate that lacked the route and the least frequently detected error was a wrong prescription of an infusion administration. It is evident that the nurses always inform the doctor when they detect a medication error. They are more willing to inform the ward sister in cases of incidents caused by somebody else. Only a small group of nurses are willing to inform the senior consultant, the head nurse or the hospital management. Only one nurse associated medication error reporting with an audit. However the majority of nurses agrees that it is important to report any medication errors.Conclusion: The analysed data suggested that the nurses were aware of medication errors. The analysis of the results of the simulated scenarios suggested that nurses' ability to detect medication errors in prescriptions was related to the number of years of experience and the level of education.
|
|
Importance of nutritional screening in the scope of general nurses
JANÍK, Martin
Current status: Although it was developed and published in many studies pointing to the impact of malnutrition and its relationship to the patient and the economy of the health systems, malnutrition remains a silent guide of hospitalized patients. In the year of 2014, the authors of the study group feedM.E. indicate in their articles the worldwide prevalence of malnutrition as a common and a costly (especially for the elderly). The rate of prevalence of malnutrition in a group of hospitalized patients is around 50%, according to this working group. Objectives: The goal of the project was to describe the methods for screening the patients with nutritional needs interventions by the nurses, the continuity of the care for patients in the risk of malnutrition, transmitting the information about the nutritional status of the patient during his hospitalization and delivery of care to another provider of health services and interdisciplinary co-workers involved in the care of patients in the risk of malnutrition. Methods: The research investigation conducted by the method of the qualitative research. The research subject was the process of detecting malnutrition and continuity of nutritional care for recipients of health services from the perspective of persons providing these services. The research method was chosen a depth interview. The sample of respondents was intentional and the file size was determined by saturation of the collected data. For data processing was used open coding and following categorization of the data which was obtained from interviews. The results were interpreted by using the "showdown". Participants: The request to facilitate the initiation of research has been mostly refused and addressed to the health service providers. Selection of interviewees was intentional by the circle of my former colleagues. With research have expressed their consent five nurses and five dietitians, which are working in the Czech Republic. Results: For identification of patients at the risk of malnutrition, all respondents have described the identification of patients at the risk of malnutrition on admission to the hospital by collecting of nursing history. During the interviews, the respondents have reported the problems both with the absence the reports including detection of patients at the risk of malnutrition from some stations at hospitals, as well as the jurisdictional disputes about the role of the dietitians in patient nutrition at intensive care unit, the complications with material and technical equipment of nursing stations and its applicability for use in specific patients. Also expressed the ignorance of screening tools which are used at the sites of all respondents, including dietitians. The inaccurate ideas of some respondents were in the terms of the skills and the competencies of individual professionals which are involved in the care of patients in the risk of malnutrition. Three nurses of the five indicated that information about the nutritional balance of the patient and their needs should affect the assessment of the patient's overall condition and could lead to changes in the nursing care plan or risk assessment (eg. the risk of pressure ulcers, etc.). Conclusion: The method of providing nutritional care in hospitals, in which respondents are employed, is headed toward pursuing the recommendations of the professional associations. In detail, however, they differ and are often close to the boundaries defined as a legal standards. Breaks are noticeable in continuity of the care, or are put excessive approval procedures, which can lead to delay of required nutritional interventions. Here is a lack of information about the various screening tools and their applicability to the certain groups of patients. Therefore I recommend issuing guidelines by professional society, in the direction of the definition of screening tools and their using in the certain groups of patients, for the healthcare providers in
|
|
Diagnosis of deep vein thrombosis with ultrasonography
Pinka, Jiří ; Karetová, Debora (advisor) ; Chochola, Miroslav (referee)
This thesis is retrospective study group of patients who visited the internal medicine clinic at hospital in Vyškov during the year 2010 with a suspected thrombotic closure of limb veins. As a source of information were used outpatient and inpatient discharge and sonographic reports. A total of 1000 patients were examined, of whom were 379 men and 621 women. Thanks to graphical process groups were formed, which included examined patients with common causes of thrombosis, clinical symptoms, sonographic findings, and lateral extent of disability thrombosis. These groups were subjected to statistical evaluation and comparison to identify traits and patterns of side differences in the limb affection, the clinical problems related to the extent of thrombotic disability, the relationship of embolization risk of thrombotic events to the extent of thrombotic disability. There was available sonographic machine Toshiba Nemio SSA-550A year of manufacture 2002 with a linear probe for vascular investigations and it was equipped with color Doppler. The source of information was anamnestic data obtained during an outpatient consultation or hospitalization. In the in-hospital reports were objective clinical examinations, numerous laboratory data characterizing the extent of the inflammatory response, affected...
|
|
The Balance of Fluids as a Nursing Problem
SOUKUPOVÁ, Martina
Basic theoretical background: The thesis deals with fluids, micturition, factors affecting micturition, diuresis as medical term, changes in quality of miction, disorders of passing urine, observation of quality of urine, fluid balance not only as a term, but also options and principles of collecting urine and recording and evaluating of fluid balance. Incontinence, involuntary passing urine, belong to the best known disorders of urine excretion. This problem causes very unpleasant fefling, affecting mainly psyche very much. Incontinence is not an illness, but symptom, which may be caused by more reasons. Imporatnt part od monitoring of fluid balance is also evaluation of its qualities. Colour quantity, odour and other qualities may be meaningful. All the abnormal qualities must be reported to the doctor immediately. Monitoring of fluid balance is part of nursing care. Results of proper monitoring of fluid balance is valuable indicator for doctors as well as nurses. Very important is to take into account all the ways of intake and output of fluids. In cases, where monitoring of diuresis is not infallible, checking the clients weight periodically might be chosen instead. Evaluation of fluid balance is carried out in time defined by doctor. The thesis also deals with errors and mistakes in urine collection and nursing process of emptying of urine container. Main aim of the thesis: The primary aim of this thesis is to map, how nurses monitor fluid balance. There is one hypothesis established: Nurses wih academic education instruct clients about monitoring fluid balance more properly than nurses wih secondary school education. There are two research questions established. Do the nurses instruct clients about monitoring fluid balance? Do they monitor the fluid balance properly? How do they write down the results? What are the most common mistakes in this area? Methodology: There was used the method of hidden observation of the nurses and observation sheet There were also used anonymous questionnaires, so there was no preessure put no respondents. The questionnaire consisted of 17 questions including 3 multiple choice.
|
|
Foreknowledge of patients with total hip replacement at orthopedic department of Jinřichův Hradec hospital a.s.
DOUDOVÁ, Klára
Basic theoretical background: Because this thesis mainly deals with the awareness of clients, it was necessary in the beginning to mention the importance of the communication in a medical environment. Communication takes place between two or more people. During communication, people communicate necessary information, feelings, attitudes, talking about relationships and moods. There are several communication rules that one should follow, however, it depends on the individual, whether follow it or not. Communication skills can be developed gradually for they are important to us and in our personal lives. If a person loses the ability to communicate, it can lead to danger to his relationships with others. For healthcare professionals, it is very important social skill ( Mikuláštík 2003). Main aim of the thesis: To verify the information rate of clients in preoperative phase of total hip arthroplasty and in postoperative care. Discover also whether patients after total endoprosthesis have possibility of aftercare (rehabilitation, spa treatment). From these targets were developed following questions : In what areas are the clients in preoperative stage informed? How are clients reporting in a post-operative care ? What options of aftercare patients after total endoprosthesis have? Methodology: For the research was used the qualitative survey data collection. A qualitative investigation was approved by head nurse of the hospital, where the research has been done. The interviews was realized at home of clients. Survey was conducted through semi-structured interviews, interviews were anonymous. The data were collected in March 2015 in the set of seven respondents. Despite the fact that interviews were realized in the clients' home, we needed approval for the research from the head nurse. Especially because the subsequent care for patients after total prosthesis was also investigated. It was therefore important to identify initially the applicable patients in the hospital and up to a certain time after the surgery to interview them.
|
|
Injuries in equestrian sport in medical rescuer perspective
KŮTOVÁ, Nela
Bachelor's thesis deals with accidents in riding sport from the perspective of paramedics. Injuries in general, can be assigned to states, which are indicated by the departure of emergency medical services. It is therefore essential that the paramedic provides the injured patient appropriate pre-hospital emergency care. Riding sport has recently been easily accessible to the general public and many people do not realize the risks that this sport brings. The theoretical part is focused on riding. Significant part of the theoretical work is dedicated to the most famous riding sports. In every riding discipline was attempt to introduce the sport and its basic rules. The second chapter is formed by the safety equipment designed to protect the health of riders. There are introduced possible causes of accidents. It also focuses on prevention and to introduce basic rules of how to behave with horses. The last chapter deals with first aid at the accident in riding sport. In this part of the thesis is process of the injury from its origin, as well as non-professional help but mainly is incorporated professional pre-hospital emergency care. The research part of this thesis was formed through qualitative research. Data were obtained by semi-structured interview and by studying case studies of selected records about the departure of emergency medical services. Interviews were conducted with selected paramedics in the South Region. The survey which was made, sought only paramedics who has met in their profession the injuries resulting in riding sport in the last decade. Interview contained questions that were surveyed, with which particular type of injury, the respondents met and were interviewed for the implementation of pre-hospital care for patients with these injuries. Partial aim of this thesis has been prepared on the basis of case studies of selected records of departures, which were obtained in the regional center Prachatice. By analyzing of the case reports were received the types of injury caused in riding sport. The research results were compiled and illustrated by tables. The main objective of this work was to obtain information on the procedures of paramedic in prehospital emergency care for injuries incurred in riding sport and the partial objective was to map the types of injuries caused by riding sport. The theoretical part of the thesis can serve as study material for riders and paramedics. Based on the research results will be created an information leaflet with the types of injuries that occurred in the riding sport, together with the methodical process of their treatment in prehospital emergency care.
|
|
název v anglickém jazyce není uveden
Kříž, Jan ; Saudek, František (advisor) ; Jendelová, Pavla (referee) ; Haluzík, Martin (referee)
Islet transplantation represents an alternative approach in the treatment of patients with type-1 diabetes mellitus. It makes possible to give insulin-producing tissue to patients, which could not underwent surgery operative due to ill health. The second benefit of tissue transplantation is utilization of pancreases unsuitable for organ transplantation in term of surgical criteria. The dissertation includes two studies focused on study of some problems of islet transplantation. In the first study was tested a new method for induction of microchimerism by bone marrow transplantation and its effect on islet allograft survival. We reported, that short-term tacrolimus therapy significantly prolonged insulin independence in fully allogeneic rat model even if the immunosupresants were discontinued. Conditioning of recipients with bone marrow cells transplantation had not additional effect. In the second study there is presented an approach for imaging of intrahepatally-sited islets. The technique is based on labeling of islets by non-toxic superparamagnetic agent during two day culture. After transplantation islets are imaged as hypointense spots on T2 weighing magnetic resonance sections in both in vitro and in vivo experiments. Outstanding changes in MR images were demonstrated during acute rejection of...
|
|
Quality of life after unilateral nephrectomy
BUREŠOVÁ, Lenka
At present, quality of life is a closely monitored and discussed topic not only in the medical field, psychlogy and other social sciences. The diploma thesis ``Quality of life after unilateral nefrectomy{\crq}q deals with this issue from the subjective point of view of those who were subjected to unilateral nefrectomy on their quality of life. The diploma thesis aims at reporting on the subjective quality of life of patients after unilateral nefrectomy and to compare it with the quality of life of the common population. The standardized questionnaire SQUALA was used to study the quality of life. Partial goals of the paper were the diagnosis and comparison between the quality of life of the patients after unilateral nefrectomy and the quality of life of common population in particular fields determined by the above mentioned research tool. The fields are: abstract values, health, relations with the next of kin, leisure time and basic needs. A hypothesis was set for the research: The quality of life of people who had suffered a unilateral nefrectomy does not significantly statistically differ from the quality of life of the common population. The basic file was created by patients treated after having been subjected to unilateral nefrectomy. The criterion for choosing the informants was the diagnosis (patients who were subjected to nefrectomy since they suffered from tumor nefrectomy), the time period since the nefrectomy had been carried out (the informants were subjected to nefrectomy at least one year before), occurrence of other diseases (patients who did not suffer from recurrence of the tumor and who have one fully functional kidney). The control group was made up by patients who do not suffer from any serious chronic disease and whose age corresponds to the age of the patients in the unilateral nefrectomy group.
|
guest ::
