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Nutrition of patients in a geriatric departments
ARNOŠTOVÁ, Zuzana
This bachelor thesis is dedicated to the nutrition of patients in geriatric wards. The theoretical part is divided into five main chapters. The first chapter explains the term "geriatric patient", the second chapter describes the physiological and biochemical changes and use of nutrients in old age. The third chapter deals with prescription drugs in old age, the fourth chapter nutrition of geriatric patients and the fifth chapter is devoted to nutrition disorders in old age. The practical part is divided into two parts. The first part is the quantitative research which was done in three hospitals in aftercare departments via questionnaire. The questionnaire focused on patient satisfaction with meals, the quality and quantity of food and drinking regime. The research group consisted of patients in geriatric wards at the age over 60 years. There were distributed 61 questionnaires and their total return was 100%. The second part evaluates a specific menu which was provided by Hospital in Písek. Standard portions in the menu were evaluated in the "Nutriservis Profesional", they were calculated: energy intake, protein, carbohydrates, fat and fiber. Results of energy intake and nutrient value of the menu were compared with diet recommendations for the people older than 65 years given by the literature "Reference values for nutrient uptake, 2011". There were laid down three objectives. The first objective is to describe the level of catering in geriatric wards in terms of quantity and quality of the food. The second objective is to determine whether patients at geriatric wards adequately comply fluid intake. The third objective is the satisfaction of geriatric patients with catering at geriatric wards. The catering in terms of quantity and quality is optimum. According to the survey and also evaluation of the menu, the portion size of main dishes is excessive, but the meals are served only 3 times a day. According to the survey, more than half of the patients eat only half portions, thereby decreasing energy and nutrients intake, therefore providing snacks would be the appropriate solution. Regarding the quality of food, it would be advisable to diversify the menu and include foods from all quadrants of food pyramid. Drinking regime is optimum. Half of the patients complies drinking regime the other half of patients neglect the drinking regime. A possible solution for these patients is to increase controlling or supplement of drinking regime by own drinks. Half of the patients are satisfied with the catering, the other half would like to change the flavor of food, the problem is mainly seasoning. Patients in geriatric departments would welcome more information on catering and preparation of meals, and also a greater possibility to choose main dishes. This bachelor thesis might be used for making the information material, which could be used for better awareness of geriatric patients catering. The nutrition of geriatric patients is a hot topic and its importance should not be forgotten.
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The importance of nutritional support in the treatment of wounds.
PUCHNAROVÁ, Jana
This bachelor thesis is devoted to the importance of nutrition support for therapy of wounds. Today the importance of nutrition support is generally known in all branches of medicine. Due to malnutrition bad healing of wounds occurs. From this reason each nurse should be aware of the importance of proper and balanced nutrition together with proper care of healed wounds. Proper nutrition protects people against infections, facilitates the process of healing and improves therapeutic results. The theoretical part is engaged in the importance of nutrition support, malnutrition, nutrition team, peroral support, and enteral and parenteral nutrition. It further deals with acute and chronic wounds, phases of healing, factors influencing healing, and nursing care of wounds. Two targets were set within the research. The first target was to monitor the knowledge of the importance of nutrition support for healing of wounds nurses have. The other target was to find out whether nurses have active attitude towards the questions of nutrition support when healing wounds. The empirical part uses the method of quantitative research survey together with the method of data collection using a non-standardised questionnaire. The research group consisted of nurses working on shifts and charge nurses working in internal medicine wards, surgical wards and after-care wards in the Jindřichův Hradec Hospital a.s and the České Budějovice Hospital a.s. The questionnaire consisting of 31 questions was filled in by 126 nurses. Processing of the survey was carried out using Microsoft Office Excel 2007. The questionnaire is stated in Annex No.2. Three hypotheses were assessed on the basis of the targets. H1: Nurses are aware of the importance of nutrition support for healing wounds. H2: Nutrition support is provided to patients on the basis of nutrition screening. H3: Nutrition support records are made by charge nurses.
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The Specifics of the nursing care in catering for long- term dialysis patients
ŠRÁMEK, Kamil
Haemodialysis is a method of removing waste substances such as potassium, urea and excess water from the blood during renal failure. Hemodialysis is one of three renal replacement therapies. Other treatments are a kidney transplant and peritoneal dialysis. Hemodialysis can be performed either in the hemodialysis center, or in a hospital, but home hemodialysis is not too frequent. Eating for dialysis patients differs significantly from the forward dialysis diet period. A well balanced diet is the foundation of everything. The patient may neither be malnourished, nor to have surplus of any components in their diet. A diet for patients in dialysis program must meet two basic requirements; the diet must provide enough energy and substances needed by the body mainly amino acids required for the production of protein, calcium, vitamins, iron, restrict certain substances that accumulate in the body is harmful, for example, fluid restriction, excess protein from which the formation of urea, excess phosphorus, which accelerated calcification of blood vessels, excess potassium, which at high levels in the blood can cause heart rhythm disturbances. Qualitative research was carried out by interview. The interview contained a total of twenty semi-structured questions and was prepared in advance. Each interview was anonymous and each respondent had the opportunity to refuse it. With the consent of the respondent and the ward nurse, the interview was recorded on a tape recorder and later adapted into an electronic form, which became the basis for the research. From the research arose categories. Qualitative research file conducted in hospitals Prachatice, České Budějovice and Třebíč. The research sample consisted of five respondents in the Nemocnice Prachatice a. s. Another research sample consisted of five respondents in Nemocnice Třebíč and two respondents in the Nemocnice České Budějovice a. s. All respondents were patients who regularly attend to hemodialysis centers in these cities. Interviews with respondents were conducted from February to April 2014. In the Nemocnice České Budějovice a. s. the research survey was conducted with the consent of the Deputy for nursing care, Mgr. Kyselová. In Nemocnice Prachatice a. s. the research survey was conducted with the consent of the head nurse in the hospital Janoušková and in the Nemocnice Třebíč the research was conducted with the consent of the Deputy for nursing care Mgr. Andělová. The results of the survey provide mapping meals in the hospital for long-term dialysis patients. The benefits of the research will be to develop an information leaflet on the topic: The importance of catering for dialysis patients.
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Principles of nutrition in chronic hemodialysis patients
MATĚJKOVÁ, Miroslava
Nutrition plays a major role in the treatment and preventing the progression of renal disease. Malnutrition is the determining factor for morbidity and mortality in dialysis patients. Patients with renal disease tend to have reduced food intake, due to loss of appetite, depression, but also as a consequence of chronic inflammation or lack of antioxidant mechanisms. Poor nutritional status of these patients must be recognized early and treated. It is important to ensure adequate intake of energy, protein and calcium, and at the same time to reduce intake of potassium, sodium, phosphate and fluids. A supplementation of vitamins and micronutrients may be appropriate. The nutritional status should be checked regularly. The research part demonstrates the dependence of laboratory values on nutritional status and a positive effect of education on patients' compliance with the recommended diet.
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Specifics of feed nutrition to patients in acute and septic state
HOLOUBKOVÁ, Martina
This bachelor thesis describes specifics of nutrition for patients in acute and septic state. It is aimed at improvement of awareness and information of nurses that care about these patients, on the problems of malnutrition and possibilities of specific nutrition. The theoretical part describes malnutrition - imbalanced diet, as a risk factor that complicates the course of disease, extends the hospitalization time and increases mortality. There is also an outline of cooperation with nutrition specialists, diet recommendations and methods of feeding patients in acute disease stage. Enteral end parenteral feeding is analyzed here. The conclusion of the theoretical part deals with the organism inflammatory response syndrome, sepsis, multiorganic dysfunction, like complications threatening a patient in acute state. There are also diet recommendations for patients in septic state. The practical part of this thesis contains results of quantitative research based on data collection by means of an anonymous questionnaire designed for nurses or healthcare rescuers of anaesthetic-resuscitation departments and intensive care units. A nursing care standard focused on assistance in introduction of central venous catheter and consequent patient care was elaborated as the output of the work upon study of the issues of nutrition for patients in acute and septic state, specific possibilities of its administration and evaluation of the research results. The bachelor thesis may also be used as study material for education of healthcare staff caring about patients in acute or septic state.
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Risk of malnutrition for people with schizophrenia
GIERTLOVÁ, Petra
Schizophrenia is a servus mental illness. The majority of people suffering from this illness require lifelong treatment. The prevalence of risk factors such as development of cardiovascular dinase, diabetes, dyslipidemia, overweight, obesity is higher with regard to the patiens with schizophrenia. A large number of these people have bad rating habits, lack of physical aktivity and nicotine dependence. The use of antipsychotik mediactions also contributes to increased storage of fat and overweight.This Bachelor Thesis consists of teoretici and practical part. The theoretical part, based on the professional literature, describes malnutrition, schizophrenia and its different types, treatment and risks associated with this illness. The practical part focuses on research the main objektive of wich is to find out the incidence of malnutrition among patiens with schizophrenia, the influence of antipsychotik medication and surfy whether the nursing staff at the Nursing home with special care in Libníč is sufficiently informed. The survey is accomplished by means of the qualitative method using non-standardized interview. Research file consists of data submitted by four general nurses from the aforementioned Nursing home. The analysis of health documentation reveals that the majority of schizophrenic patiens suffer from other illness, such as obesity, hypertension, diabetes and hyperlipidemia. The results of this surfy prove that nursing staff are sufficiently informed and aware of possible risk factors associated with the development of cardiovascular dinase with regard to the schizophrenic patiens due to incorrect rating nabits or antipsychotik medication. The interview with the nurses implicates that malnutrition is considered as undernourishment. Accordingly, they identify nutrition care with the work of nutrition therapist and his care of patient nutrition. The nurses are aware of nutrition support. However, they have low level of knowledge regarding the products of modular dietetics.The main objective of this work is to demonstrate that schizophrenic patiens are in Langer of higher mortality and morbidity rate, not only as a results of thein illness, but also due to the antipsychotik medication treatment and inappropriate life style. This is the mason why the nutrition care should not be marginalized, nor neglected during the treatment of mental illnesses.
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Specifical nutritional requirements of oncological patients
KRAUSOVÁ, Lada
Nourishment in oncological patients is a very complicated problem. Up to half of the patients experience a lack of appetite that borders to food aversion which is often followed by an almost immediate sense of fullness after first few bites. Furthermore, some of the treatments themselves may lead to nausea, diarrhea and problems with swallowing. Malnutrition, consequently, will often worsen the prognosis for patient with a malignant tumor; lower his susceptibility to oncological treatment and increase the probability of further complications. A complete clinical picture of malnutrition, called cachexia, is characterized by noticeable gauntness, loss of both musculature and subcutaneous fat. Studies show that 30% to 90% of oncological patients suffer from malnutrition. Also, a continuous weight loss considerably lowers the quality of life, and this must not be overlooked for nutrition should not only lead to a prolonged survival, but also to an appropriate life-quality. The aim of this study was to find out how nutritive registry is kept at oncological wards in selected hospitals in the Czech Republic. Further, to find out if nurses are familiar with the causes of malnutrition in oncology patients and have sufficient knowledge of the specific nutritional principals. The hypotheses set were {--} 1) at the selected oncological wards nutritive registry is used, 2) the nurses there do know about causes of malnutrition while 3) nurses in other wards do not have this knowledge. 4) Nurses know about the necessary nutritional principals in oncology patients. Quantitative approach was used for this research. The questioning method was to collect data by distributing questionnaires. The results show that at oncology wards but at other, non-oncological wards as well, nutritive registry is used, and furthermore, a position of nutritional therapist has been appointed and nutritional staff established. The first hypothesis has been proven to be correct. The second and fourth hypotheses are correct as nurses do know the causes of malnutrition in oncology patients and have the knowledge of the necessary nutritional principals. The third hypothesis presumed that nurses from non-oncological wards lack this knowledge and has consequently been proven wrong. These nurses are indeed knowledgeable of the nutritional problems. In practice, a stressed necessity of nurses{\crq} efficient knowledge of the nutritional problem for patients with malnutrition and cachexia at both oncological and non-oncological wards is recommended, together with the introduction and observance of nursing standards concerning the nutritional problems of oncology patients, proper information given to the patients relating their special diet as a consequence of the illness and its subsequent treatment, and finally, a multidisciplinary approach and collaboration (nutritional staff).
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The dangers in the treatment of old age patients hospitalized in the long-term disease department in the hospital České Budějovice a.s.
FALUŠIOVÁ, Helena
Abstract In the thesis the course of nursing care for seniors with the focus on malnutrition, falls, immobilization syndrome and the decubitus ulcers development is studied. For the quantitative part of the research two aims were stated: Aim 1: To find out whether nurses know the precautionary mechanisms to prevent risks in taking care for seniors and Aim 2: To find out whether nurses comply with precautionary mechanisms to prevent risks in taking care of seniors. The following hypotheses were stated: Hypothesis 1: Nurses know the precautionary measures to prevent risks in taking care of seniors and Hypothesis 2: Nurses comply with the precautionary measures to prevent risks in taking care of seniors. To confirm the hypotheses, the method of an anonymous questionnaire for nurses, which was supplemented by the method of participant observation of nurses in providing nursing care, was used. After evaluating the results of the quantitative part of the research we have come to the conclusion that nurses, although aware of preventive measures, do not always follow the standard procedures. We believe that aim 1 and aim 2 were met. Hypothesis 1 was confirmed. Hypothesis 2 Hypothesis 1 wasn?t confirmed. Another part of the thesis was a qualitative survey that was conducted by interviews with seniors. For the qualitative part of the survey aim 3 was stated: To identify the views of seniors on the ways how to avert certain risks in their hospital. The following research questions were stated: Question 1: According to the senior´s view, how do nurses in the after-care department use possibilities to prevent malnutrition? Question 2: What are the seniors´ opinions on nursing care aimed at preventing falls during their hospitalization in the after-care department? Question 3: What are the seniors´ opinions on nursing care aimed at preventing immobilization syndrome and the decubitus ulcers development? Question 4: How do nurses manage the care of the seniors´ psychological well-being that is important to their recovery? The objective 3 was met. The survey has shown the areas in which changes would be appreciated by seniors, where and how nurses should improve their approach to patients. The purpose of the thesis was to help identify bottlenecks in nursing care for seniors, to find out whether nurses are active at their work, if they have a human approach and provide quality care. We believe that the results of the thesis can serve as an educational material for nurses working not only at the after-care beds, but also in the acute beds wards because seniors are present in all clinical wards. To be able to prevent the risks in taking care of seniors effectively, it is necessary for nurses to be aware of the risks and to pay adequate attention to them.
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Nutritional screening as an indicator of nursing care quality
LENKOVÁ, Klára
Proper nutrition is essential for every human being, whether healthy or sick. Nutrition is, according to associate docent Kohout, one of the areas that is most neglected in health and social facilities in the Czech Republic. Standardized nutritional care should be established in all hospitals, representing a comprehensive nutritional and qualified solution for clients/patients. The standardized nutritional care involves systematic assessment of nutritional status of a client/patient and a search for clients/patients at nutritional risk. It further includes an appropriate diet according to the needs and capabilities of a client/patient and timely provision of adequate nutritional support to clients/patients who were identified as nutritionally at risk. Finally, standardized nutritional care also includes monitoring and documenting the effects of nutritional therapy, because the effect of individual measures cannot be monitored without proper documentation. The objective is to monitor the process of identification, evaluation and implementation of actions to ensure nutritional care in selected medical facilities from the perspective of the senior nursing management. Another objective is to map how significant quality indicator this is and what problems are seen in creating and maintaining a standard situation. Data collection was carried out by an interviewing technique using questionnaires. Respondents were from hospitals in the Czech Republic where we addressed the members of their senior nursing management. H1 ``The hospitals use established control mechanisms to find out about the nutritional status of compliance with established standards of nutritional care{\crqq} has been confirmed. H2 ``Nutritional screening is performed by nurses on all clients/patients at reception{\crqq} has been confirmed. H3 ``Nutritional screening during hospitalization is repeated only in clients/patients at risk{\crqq} has been confirmed. H4 ``Nurses develop nutritional screening within the cooperation of nurses with a nutritional therapist in the provision of standardized nutrition care{\crqq} has been confirmed, and H5 ``The results of nutritional screening are used by nurses as the basis for the saturation of clients{\crq}/patients{\crq} nutritional requirements{\crqq} has also been confirmed. The second objective was to map how significant quality indicator this is and what problems are seen in creating and maintaining a standard situation. The performance of nutritional screening has become the second most important quality indicator according to the research. As for the problems seen by respondents in relation to creating and maintaining a standard situation, it can be said, on the basis of the research results, that the biggest problems in creating and maintaining a standard situation is the lack of personnel, economic demands and approach of the personnel, their reluctance and disinterest. We attempted to explore the process of identification, evaluation and implementation of actions to ensure nutritional care in selected medical facilities from the perspective of the senior nursing management and then, based the results, to suggest ways of potential improvement of the current situation in the field of clients{\crq}/patients{\crq} nutrition.
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Risks concerning malnutrition and obesity in the nursing process
HORČIČKOVÁ, Marie
The care for nutrition of patients is given more attention these days than before. Patients with malnutrition and obesity represent a huge nursing problem in internal and surgical fields. In this thesis we focused on nursing process in clients with malnutrition and obesity. The research was quantitative, for the data collection the anonymous questionnaires addressed to nurses were used. It was carried out in internal and surgical departments and departments of follow-up care in hospitals in Písek and Tábor. 120 questionnaires were distributed, in each hospital 60, to particular departments 20. 95 (100 %) questionnaires were used for the research. In the thesis seven objectives were stated. The objectives were focused on carrying out the nursing process in clients with malnutrition and obesity, the most frequent nursing problems in these patients and the awareness of nursing staff in the problems of malnutrition and obesity. Seven hypotheses linked to the objectives were stated. The research showed that nurses meet the clients with malnutrition and obesity in all mentioned departments. Most nurses consider the care for these patients very demanding. It is pleasant that the part of nursing documentation is nutritional screening, which is carried out during an admission of each client. Further the research showed that for these clients no valid nursing standard, which would improve nursing process, has been carried out yet. In clients with malnutrition the most frequent nursing problems are decubital ulcers and in clients with obesity sore spots. Information on the problems of malnutrition and obesity is gained at professional seminars and conferences. Nursing process in patients with malnutrition or obesity is demanding and it is necessary to have a sensitive and considerate approach. The results of the thesis will be used to make nursing staff acquainted with these problems.
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