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The role of the nurse in providing care to patients with short bowel syndrome
BUNDOVÁ, Jana
Short Bowel syndrome characteristically belongs whithin a groop of recognizable symptoms which result from the loss of small intestine or damaged absorption. Because of the advancement of complex medication and intravenous feeding, home patient care is continously increasing. In the year 2008 intravenous feeding was used upon 57 adult patients in 15 health centres. These patients are vulnerable to the full range of complications. Among the most freekvent complications are infections of the location where the needle is injected. The role of the nurse towards the patient is irreplaceable due to the importance of the care resting upon the nurse to ensure no infection can originate. This research deals with the difficulty of the nurse´s role assigned care of the patient with Short Bowel syndrome. The goal of this project is to map out the level of information and experiences which nurses have regarding the care of those patients whit this afliction. A further goal is to discover how careful the patients are regarding the use and care of intravenous catheter to keep infection away. From the analysis obtained, the majority of the nurses have enough informations conserning the care of patients with Short bowel syndrome. These nurses consider the care of these patients to be every bit as demanding as the care required for patients with other condicions. Nurses are now capable of taking control of this care. This viewpoint is supported by even patients who have this condition who have had faverable experiences. Patients are now well enough informed to be able to indepenndently administer intravenuous injections in ther own home envirement, but always in the copany of family members or a home care assistent
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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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Discharge of a pacient and nursing care
ŠPŮROVÁ, Milena
The thesis is focused on nursing care during discharging of patient from hospital. Thesis{\crq} goal is to monitor whole process of discharging from hospital, from the nursing care standpoint namely from the nurse point of view as well as patient point of view. High quality nursing care does not consist only of satisfaction of all patient needs during hospitalization but it consist also of assurance of smooth transition to home care, which has to be supported by all members of multidisciplinary team.
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SPECIFIC FEATURES OF PSYCHOANALYTICAL NEEDS OF PATIENTS AFTER MYOCARDIAL INFARCTION.
MERUNKOVÁ, Michaela
The diseases of the vascular system are the most important cause of the death generally (up to 30% of the world-wide mortality). The myocardial infarction represents 13% of all the death cases due to cardiovascular illnesses. Men often suffer myocardial infarction already after 40th year of life, as for women, it appears after the climax. After the 60th year of age the myocardial infarction is equally frequent in case of both sexes. In the last years also the myocardial infarction in case of people younger than thirty-five years is not a rarity. In the bachelor{\crq}s thesis the method of quantitative research by the technique of questioning was applied. In the questionnaire, there are in total 30 questions. 17 of them were closed and 13 half-open. The questionnaires were distributed to patients of the cardio-surgical and cardiological ambulance of the Hospital in České Budějovice, a.s. during their first check after the myocardial infarction. In total 100 questionnaires were distributed and 86 questionnaires were applied for processing the data. The data collection was performed during January, February and March 2009. The thesis focused on specifics of the psychological and social needs of the patient after myocardial infarction. The target of the thesis was to find out where the patients after myocardial infarction look for social support (target 1). Determination of the most frequent problems of the patient after myocardial infarction (target 2). To find out moreover if the saturation of higher needs of patients after the surgical solution of myocardial infarction differs from that of the patients healed in a conservative way (target 3). Three hypotheses were determined based on these goals. First hypothesis: For the patients after myocardial infarction the most frequent support is their family. This hypothesis was confirmed by the research. The most respondents stated as the most important social support their wife or husband, other family members and last but not least a common-law husband or wife. Second hypothesis: The change of life style is among the most frequent problems of the patient after myocardial infarction. This hypothesis was confirmed by research. The change of the life style was stated by 56% of respondents as the most important problem. In spite of the sufficient education the patients have not enough motivation or firm will to change their hitherto life. Third hypothesis: The saturation of higher needs is achieved sooner in the group of patients healed in a conservative way than in the group of patients healed in a surgical way. It followed from the results of the research that the type of myocardial infarction healing may be reflected in the return of the patients into the normal life, however, it has no influence on the occurrence of the stress, fear, sadness and hopelessness after myocardial infarction. This hypothesis was refuted by the research. It follows from the results of the research that it would be suitable to continue the co-operation after the release for the home treatment. To help them to find a suitable way for the change of the lifestyle, to learn them to treat themselves carefully. To motivate for the co-operation not only them, but also their close surroundings, mainly the family. As the family is the most support for them and it could facilitate the deciding of patients in some items and to support them positively.
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The comparison of communication skills of nurses with a deathward client in hospitals and hospice homes.
ADAMCOVÁ, Lenka
This Bachelor's work examines nurses' skills in communicating with terminally ill patients in hospital and hospice facilities. The aim of this work is to present a detailed overview of the communication skills of nurses treating dying patients in hospital and hospice facilities as well as to identify what approaches nurses working in hospital and hospice facilities are not taking when treating terminally ill patients and to identify the specific issues that nurses must deal with when treating terminally ill patients in hospital facilities. A method of quantitative research was used to obtain findings for this Bachelor's work, and questionnaires were used to collect data. The addressed respondents were medical staff treating patients at the Central Military Hospital in Prague as well as at the St. Agnes of Bohemia Hospice in Červený Kostelec, the St. Lazarus Hospice in Plzeň and the Hospice on the Holy Little Hill in Olomouc. A total of 129 questionnaires were distributed, and only 33 were not returned. Therefore, 74% of the respondents did complete and return the questionnaires. However, 12 questionnaires were excluded for being incomplete. A total of 85 questionnaires, 66% of the original number of questionnaires distributed, were used to process the data. Therefore, the answers of 85 respondents were used for the research. Four hypotheses were established: 1. The methods and the level of communication of nurses caring for terminally ill patients are influenced by education and awareness {--} this was confirmed; 2. The process of caring for terminally ill patients depends on the conditions for providing comprehensive treatment care in hospital departments and in hospital facilities {--} this was confirmed; 3. Nurses in hospital facilities lack sufficient education for communication with terminally ill patients, and the conditions for providing comprehensive care are insufficient as well {--} this was confirmed; 4. Nurses in hospice facilities are familiar with communication techniques and regularly use them when accompanying dying patients {--} this was confirmed. The results of the research will be provided to employees in management positions in the examined hospital facilities and two hospices in order to improve the quality of the care provided to terminally ill patients.
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The role of nurse in education of patients with implanted intravenous port catheter
VODIČKOVÁ, Petra
Intravenous port catheter is a special type of central intravenous catheter ensuring a reliable, safe and longterm access into the central vein by means of hypodermic injection. In recent years the intravenous port catheters have become common part of treatment and they are mainly used in patients suffering from oncological malignities for repeated doses of chemotherapy and pain killing medicine. Intravenous port catheters are also applied in other chronic states when a quality and reliable vein access is necessary. The care for intravenous port catheters is very special and the attitude of the nurse plays an important role. It is important to include the patient in the care for the intravenous port catheter, communicate with him/her effectively and to provide him with sufficient information. Thus a good cooperation between the patient and the nurse can be ensured the result of which is a fully functional intravenous port catheter with a long use. This paper deals with the role of the nurse in educating patients with an intravenous port catheter. It is divided into a theoretical and a practical part. The theoretical part contains information on the intravenous port catheter and education of patients. The practical part consists of a qualitative research. The method of individual, partially prepared interviews with patients with intravenous port catheter was applied to data collecting. Three research questions were set: 1. Are patients with an intravenous port catheter interested in receiving information on this system? 2. Are patients with an intravenous port catheter interested in receiving printed information material? 3. Is printed information material beneficiary for patients? 12 patients made up the research file. The research was carried out at the haematological-oncological department of the University Hospital in Pilsen. The first goal of the paper was to find out what information patients with an intravenous port catheter need. The second goal was preparation of a printed education material for the patients based on the information found out. The third goal was to find out whether the prepared information material is a help to the patients. These goals were fulfilled. Based on the information from the first group patients an information leaflet was prepared. This leaflet was then applied to educate the second group patients. Patients acquainted with the leaflet and the information it provided were satisfied. Patients consider the benefit of the leaflet in that they can check the needed information and that they can write down in the leaflet questions for the nurse and write down notes. The analysis of the interviews has also shown that patients wish to complete information in the leaflet by a discussion with the nurse. The role the nurse is irreplaceable and the most effective method is to use the printed material together with a discussion. The results of this paper shall be applied in the work of nurses to provide quality information to patients with an intravenous port catheter.
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The differencis of nurse treatment by Patients with TEP(total hip replecament) and with CCEP(cerviko capital replecament).
BUKÁČKOVÁ, Kristýna
This bachelor thesis focuses on the differences in nursing care of patients after TEP (total endoprosthesis) and after CCEP (cervical-capital endoprosthesis). The reason that led me to deal with this subject was the fact that I consider the knowledge of this matter as well as observing its principles by nurses for necessary. The objective of the thesis was to find out whether nurses know the difference in the nursing care of patients after TEP and CCEP, and whether they observe the differences in the nursing care. These objectives were fulfilled in the bachelor thesis. Two hypotheses were laid down. Hypothesis 1: Nurses know the difference in nursing care of patients after TEP and CCEP. Hypothesis 2: Nurses observe the difference in nursing care of patients after TEP and CCEP. The hypotheses were confirmed. The theoretical part of the thesis is focused on the anatomy and physiology of the hip bone and the historical development of endoprostheses. Further, the subject of the TEP and CCEP is dealt with here. It contains descriptions of the differences in the nursery care that nurses should put a lot of emphasis on and observe them. In the research part, the quantitative investigation by means of the questioning method, in the form of a questionnaire, and the qualitative research by means of the method of participating hidden observation, were chosen to verify the hypotheses. In practice, this thesis may be used in seminars, in which even the results of investigations may be dealt with, thus increasing the quality of the nursing care of patients after TEP (total endoprosthesis) and CCEP (cervical-capital endoprosthesis).
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The role of the nurse by patient with Holter transmitted home
ČEČKOVÁ, Monika
Diseases of the cardiovascular system rank among the most frequent causes of death. This thesis called ``The role of the nurse taking care of patients with the Holter monitor when they are discharged home`` deals with this non-invasive examination of the cardiovascular system. Timely diagnostics is of high importance to show a number of diseases. The theoretical part of the thesis deals with diseases of the cardiovascular system. The diseases mentioned include: the syncope, arrhythmia, ischemic heart disease and hypertension. Further, it deals with the non-invasive examination by means of the Holter monitor, which is connected with the diseases mentioned before. This is followed by informing the patient in connection with this examination, communication skills of the medical staff with the patient and the education in this non-invasive examination. The practical part of the thesis lays down three objectives. The first objective was to find out whether patients with the Holter monitor, when being discharged home, have sufficient information on this examination. The second objective focused on nurses, and finding out the way nurses view their role as the educator of the patients with the Holter monitor. The third objective was to find out whether patients were afraid of this examination. Next, three hypotheses were set up. The first hypothesis supposed that nurses working in outpatient and inpatient cardiac care facilities had enough information on the electrocardiograph monitoring and blood pressure by means of the Holter monitor. The second hypothesis supposed patients with the Holter monitor, when being discharged home had sufficient information on this examination. The third hypothesis supposed that nurses educated patients with the Holter monitor on discharging them home. All objectives were fulfilled and hypotheses confirmed. To fulfil the objectives and confirm the hypotheses, I used the quantitative method. To collect data I used a questionnaire for patients and another one for nurses. The research set consisted of nurses working in selected outpatient facilities of the Kardiologie Medipont s.r.o. and Kardioecho s.r.o. in České Budějovice and in selected inpatient cardiac care facilities. Further, a questionnaire investigation with patients with the Holter monitor from the same health care facilities as the nurses. 80 questionnaires were handed out to patients and 80 questionnaires to the nurses. 53 questionnaires were given back by the patients and 39 questionnaires by the nurses. This thesis could acquaint the public and medical staffs with the prevention and symptoms of cardiovascular diseases, thus attracting their attention to the importance of timely diagnostics and treatment. Further, it could be of beneficial to inform the health care facilities the survey was conducted in, with the results. Nurses have a lot of roles during their work. Their role as the educator, which undoubtedly ranks among them, is essential in the diagnostics by the Holter monitor.
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Demans put on nurses work when providing nursing care on hemodialysis department.
KADLEČKOVÁ, Aneta
Abstrakt In our Bachelor Diploma Work we dealt with the problems of the difficult of the work of nurses in the department of haemodialysis. We have chosen this topic because of the growing higher demands made on the nurses. It can be said that the profession of a nurse is very demanding, they are even jeopardized both by the psychological and physical influences. Because of that there are several advices the nurses should know and observe them. The professional literature encourages the nurses in the department of haemodialysis to find at lest a short moment to learn how to rest and to relax. Unfortunately it is not like that in reality. In the theoretical part we focused on the haemodialysis characteristics, on its indications, contra-indications, on the nursing care in this department and naturally on the psychological and physical impacts on the nurses in the department of haemodialysis. For the research investigation I used a semi-structured discussion. It contained 21 questions, the nurses had to answer. The data collection took place during March 2009. The total numer of enquired nurses was 16. The topic was based on the three targets. To find out what demands have been made on the treatment care for the patiens in the department of haemodialysis, to find out, what impact the care has on nurses in the department of haemodialysis and to find out whether the nurses in the department of haemodialysis suffer from the burn-out syndrome. Based on my Bachelor Diploma Work we would like to organize a seminary for the nurses, working in the department of haemodialysis, focused on the burn-out syndrome and correct relaxation.
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Measure attendant stress on Neurology Department of Hospital in České Budějovice, a.s.
KAVKOVÁ, Darja
The present is a time rife with change, and healthcare is no exception. The aim is to provide the best quality healthcare at the lowest possible cost and with as few staff as possible so as to allow clients to recover quickly and ensure that they are satisfied with the services they have been provided with. České Budějovice Hospital is currently the fourth largest hospital in the Czech Republic. It provides medical care to the whole of South Bohemia. The Neurological Ward is situated in the internal pavilion of the hospital{\crq}s Upper complex. It provides 36 beds for seriously ill patients. Where patients are ill, the hospital tries to nurse them back to health as quickly as possible, while ensuring that they are self-sufficient and alleviating the after-effects of their illness. The standard of medical staff{\crq}s qualifications is rising to match the increased demands on the quality of care provided. In order to maintain standards a nurse needs not only to be skilful, but also well-educated and able to work independently. In this research I set three goals, from which there arose three hypotheses. In order to determine the workload and performance of the nurses on the Neurological Ward of České Budějovice Hospital I used two methods from the authors Karla and Otakar Pochylý. The method of quantifying nursing care to determine the number of nursing staff is based on three basic areas: assessment of the self-sufficiency of patients, a point rating for special nursing care, and daily one-off ratings which encompass all other activities. The ``new method{\crqq} is used to determine the number of nursing staff and the amount of workload. The research was carried out from 23.2.2009 to 20.3.2009, i.e. for 20 working days. The research set comprised the nurses on the morning eight-hour shift. After having assessed the results I came to the conclusion that the first two methods proved true, but the third did not, although this is disputable. In practical terms this research can be used as a general source of information about nursing workload, nurses{\crq} performance, and the number of people missing from the Neurological Ward. However, it should be followed up by more detailed long-term research which would eventually lead to modification of the staffing situation on the Neurological Ward.
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