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Nursing care of patients with nephrostomy
ZIKOVÁ, Jana
The subject of the Bachelor thesis is Nursing care of patient with nephrostomy. Despite the fact that creation of nephrostomy is not as common as for example colostomy, patients with nephrostomies are on the increase. Nursing care is based not only on complex nursing of patient but also on careful raising his awareness and education contributing to complete self-sufficiency in the area of the care of nephrostomy. Nurse has to approach patients with nephrostomy individually with consideration to their current needs. The Bachelor thesis is divided into a theoretical and an empirical part. In the theoretical part there is a description of nephrostomy intervention itself, its indication, complications, advantages and disadvantages. In the next chapter notion of nursing and of nursing process is defined. It is followed by a description of nursing care in the preoperative period. In the postoperative period there is described the work of nurse which is monitoring physiological functions of the patient. Next, the thesis focuses on patient´s life after the creation of nephrostomy and on its skills in the area of care of nephrostomy. In the empirical part it is detected if nurses of chosen departments of the České Budějovice Hospital (Department of Internal Medicine, Department of Surgery and Aftercare Department) have not only theoretical knowledge in the area of the care of nephrostomy, but also the fact if they know particularities of the care and if they are able to care of patient with nephrostomy. Research inquiry was realised also at patients with an inserted nephrostomy. Three aims of the bachelor thesis were set. First aim detect if nurses are able to care of patient with nephrostomy. Second aim detect if patient is limited in relation to inserted nephrostomy and third aim detect if patient is able to care of nephrostomy. In the thesis three hypotheses were set. The first hypothesis nurses are not able to care of patient with nephrostomy. The second hypothesis patients in the home milieu are able to care of nephrostomy and the third hypothesis nephrostomy limits patients in everyday life. To verify hypotheses questionnaire method of data collection was used. Research inquiry was realised in the period from December 2013 to March 2014 at the Department of Internal Medicine, at the Department of Surgery, at the Aftercare Department and at Urology Ambulatory Surgery. First questionnaire was designated for nurses. Definitely 105 questionnaires were processed, 31 from the Aftercare Department, 36 from the Department of Surgery and 38 from the Department of Internal Medicine. Second non-standardized anonymous questionnaire was designated for patients with nephrostomy who are regularly dispensarized at the Urology Ambulatory Surgery or hospitalized at other departments of the České Budějovice Hospital. Because of relatively low occurrence of patients with nephrostomy 70 questionnaires were distributed altogether. From it 10 questionnaires did not return and it was not possible to use 5 questionnaires because of data incompleteness. Results of questionnaires were then processed by means of computer programme Microsoft Excel 2010 and transferred into charts. From the research inquiry it results that nurses are able to care of patients with nephrostomy, that is why the first hypothesis was not confirmed. The inquiry confirmed the second hypothesis that patients in the home milieu are able to care of nephrostomy. The third hypothesis was also confirmed, patients feel limited in everyday life. The thesis should serve to familiarization with nursing care for nephrostomy and to a possible elimination of mistakes which could arise at general sisters in relation to care to these patients. Results of the thesis will be used in practice in the form of an information booklet. This booklet could be used not only by sisters but also by patients to acquire knowledge and skills related to this issue.
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Education of nurses, implementation in practice and the effect of its outputs
KOVÁŘOVÁ, Miroslava
The dissertation is divided into theoretical and practical parts. The theoretical part deals with the historical equipment of nursing and nursing education in the Czech Republic, further the legislation, the implementation of nursing education and a personality of a nurse. For the processing of the empirical part there was chosen the method of quantitative and qualitative research inquiry. For the quantitative inquiry there was chosen the method of asking by means the technique of a questionnaire and for the qualitative part of the research inquiry there was chosen the method of asking, namely the method of half-structured interview with opened questions. For the quantitative inquiry there were prepared two sorts of questionnaire, the first for the nurses, namely the universal nurses from experience and the second for patients, it means for the non ? professional public within the Southern Bohemia. There were set six surmises for this part of inquiry. The results of the inquiry were elaborated into diagrams and tables. In the quantitative part of the research inquiry were verified six hypothesis, that were set in advance: 1. The interest of nurses for the education follows more from the legislative aiming than from interest about more quality nursing care of a patient. The results show us that the need of credit is for the nurses more important than the need of more quality care for a patient. The first hypothesis was confirmed. 2. Choice of the courses of lifelong learning depends more on the amount of financial claims than on the orientation on care that provided. There follows from the research inquiry that for the nurses is more important the interestingness of an event than the amount of financial costs. The second hypothesis was disproved. 3. Motivation for the nurses for education is more the system of university education than the increasing of the quality of care. The results show that the nurses are more motivated by the need of a university education than by a better care of a patient. The third hypothesis was verified. 4. Implementation of an output of education isn´t incremental to its application in the real environment. The research inquiry showed us, there is no big possibility for the nurses to implement the results of their education in practice. The fourth hypothesis was verified. 5. The patient?s don´t distinguish, if the nursing care is provided by a qualified nurse or by another member of a nursing team. The fifth hypothesis was verified. 6. The patient?s don´t perceive nurses according to their education, but to a uniform. The results show, that the patients are not knowledgeable in the nursing staff neither according to their uniform nor their education. The sixth hypothesis was disproved. There were approached 12 respondents for the qualitative part of the research inquiry, within the Southern Bohemia again. The interviews were taken down, rewritten and analysed. The obtained data were categorized. There was set Research question for the qualitative part of the research inquiry: What is the meaning of nurses about the implementation of their education I the praxis? There was finding out by the research inquiry, that the nurses generally welcome the university education, mainly because of the reason, that the nurses come in praxis in a higher age. The lifelong learning should be also beneficial for them, but this has its shortcomings, namely in the financial part and it isn´t supported by the employers. They can also see the problem in implementation of their obtained knowledge from education in non ? interest of their employer and other members of nursing team.
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Position and function of general nurses at senior homes
HYNKOVÁ, Miroslava
Social residential facilities are obliged to provide their clients with nursing and rehabilitation care. They are however not obliged to provide the care through their own competent healthcare staff. This is why provision of nursing care to users of senior homes by general nurses is a frequently discussed topic, particularly because of nursing care funding. Founders of residential social services more and more often reduce the numbers of healthcare staff and substitute them with cheaper workforce, social service workers. However as Malíková (2011) says such a social service would not be complex and complete without quality nursing care. A general nurse in a senior home can only provide medical care to the extent specified by a physician, who duly and completely enters the required care into a special form. Only health problems may be the reason for indication of medical care. The present structure of users of numerous senior homes would definitely deserve the status of healthcare facility, as the health condition of seniors often corresponds to the long-term treatment hospital. The work of a nurse in such facilities is very responsible and demanding as a physician that might assess a change in health condition of a client and solve acute changes is not permanently present in a senior home. A nurse is usually the only healthcare staff member and at the highest position. However a nurse can only measure physiological functions and perform basic examination of a client within her competence without presence of a physician. She evaluates the situation upon this base and has to decide on further proceeding. She bears responsibility for her decisions. Recognition of symptoms and assessment of situation requires a lot of knowledge and experience. The goal of the thesis was to find how the position and function of a general nurse in a senior home is perceived by physicians, general nurses, seniors and the general public and whether a general nurse is irreplaceable in the care of seniors in residential social services. Four research questions were set for these goals. How does a physician perceive the role of general nurses in a senior home? How do general nurses perceive the role of general nurses in a senior home? How do representatives of the general public perceive the role of general nurses in a senior home? What is the importance of a general nurse for seniors in provision of medical care? Qualitative research in the form of semi-structured interview was chosen for data collection. Before each interview the respondents were assured that their anonymity would be preserved and that all the information obtained would only be used for the purposes of this bachelor thesis. The research was conducted in March ? April 2013. Physicians and nurses providing medical care to users of senior homes perceive the position of a nurse in the healthcare team as necessary and irreplaceable. For the general public the nursing and medical care in a senior house is a commonplace. There is still the model from the times when general nurses and attendants worked in senior homes in the awareness of the public. In fact they are not interested in who provides the care, but mainly how. Worsened health condition and subsequent worsened self sufficiency is the reason why seniors go to senior homes. They do not think about who will care about them in the senior home, but they expect that nurses and attendants. They trust the nurses that provide them with care and have the feeling of safety and security that in the case of sudden health condition change qualified medical care will be provided to them at their presence. The information obtained from this bachelor thesis might be useful for managements of social care providers and officers of health insurers in deciding whether healthcare staff is necessary in this sphere of social services or not.
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Competences of nurses and increase of their opportunities for general practitioners (primary care)
HLÁVKOVÁ, Blanka
The diploma thesis addresses the issue of increasing the authorities of nurses of general practitioners in primary care. The theoretical part summarizes the information about primary and community care, defines authorities and professional activities of general nurses and physicians, and deals with the roles of nurses in primary care and the relations between general nurses and physicians. The objective of the diploma thesis was to survey the opinions of nurses of a possible increase in their professional powers, and to ascertain whether nurses are ready to assume certain authorities. It was also ascertained what physicians think of a possible transfer of certain authorities to nurses, and whether nurses are satisfied with their growing independence and responsibilities in connection with the increasing requirements for their profession. The results of the qualitative survey were evaluated by their summarizing in thematic areas and subareas; the text also contains authentic quotes of respondents (written in italics). The research set consisted of 15 respondents who were selected systematically. The set consisted of six physicians (general practitioners specialized in adult or paediatric medicine and general dentists). The set of general nurses consisted of nine nurses working for general practitioners. The selected general nurses had the work experience of various duration and various educational backgrounds ? they had either secondary or higher professional education and one nurse had university education. It has clearly followed from the research that the nurses do not wish to assume any activities falling within the authorities of physicians. A large number of respondents are very busy and any other authorities would be beyond bearable. Physicians would not transfer many medical activities to the nurses; they would rather transfer most of paperwork to them, such as writing opinions in respect of traffic accidents, spa treatment requests and other requests. Nurses are not afraid of increased authorities but agree that the authorities will mostly result in greater responsibilities and paperwork. The nurses think that there are clear boundaries between the authorities of nurses and physicians. Clear boundaries are seen mostly in diagnostic and therapeutic activities, nursing treatments, prescription of medicines, application of intravenous injections, and statement of diagnosis. Above the scope of their authorities, general nurses are charged to perform activities of a mostly administrative nature, write requests and sick certificates, administer intravenous medicines without expert supervision, write various recommendations, and monitor warfarinisation of patients.
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The proffesional career and opinions about studies of the first graduates of bachelor studies General nurses at The Faculty of Health and Social Studies of The University of South Bohemia.
JIRÁKOVÁ, Marcela
The diploma work deals with the proffesional development of the first graduates of bachelor studies The General Nurse at The Faculty of Health and Social Studies of the University of South Bohemia since their graduation till the present. The goal of this work was to ascertain the opinions about the bachelor studies of the discipline General Nurse at the The Faculty of Health and Social Studies of the University of South Bohemia, namely of the first graduates of this discipline. The goal was to find out, how the studies and their succesfull graduation affected their proffesional career and social credit. Moreover to ascertain the attitude of the first graduates of the discipline The General Nurse at the The Faculty of Health and Social Studies of the University of South Bohemia to follow-up master's degree study Nursing care by selected clinical branches at The University of South Bohemia. The diploma work is divided into two parts ? the theoretic and empiric. The theoretic part deals with nursing and the conclusive part is educational. It includes the history and equipment of the nursing and the education of nurses in the Czech Republic, afterwards the problems of the profession of nurses and the related legislation . The educational part deals with the attitude as a social problem and the evaluation of the university education of the students themselves. In the empiric part of the diploma work were chosen both the quantitive and qualitative methods of an investigation research. The quantitive research had the form of a anonymous questionnaire for the first graduates of bachelor studies The General Nurse at The Faculty of Health and Social Studies of the University of South Bohemia. There were determined four assumptions. The results of the investigation have been processed into charts and tables. For the qualitative part of the survey research has been used in-depth unstructured interview, which was realised with the selected graduates. The results of the qualitative investigation have been adapted in the form of transcription of the interview. The results of this work can be used as an informational materiál for students and tutors of The Department of Nursing at The Faculty of Health and Social Studies of the University of South Bohemia. The results can help to be well informed in the education of nurses and to realise, which field of study needs to be strengthened.
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The issue of life-threatening conditions in emergency medicine
KELBLOVÁ, Kateřina
Issues relating to life-threatening conditions in emergency medicine The purpose of this bachelor?s thesis was to determine how nurses in Intensive Care Units cope with common emergency situations. The theoretical part explains acute care, its three stages, staff/bed rate, and education and skills of the nurses. It also contains descriptions of possible acute life-threatening conditions, which may result in sudden cardiac arrest. It also describes specifics of cardiopulmonary resuscitation, and stress the nurses experience in intensive care. The target was achieved through four sub-goals: To determine the level of preparedness of nurses to work in such departments. To determine whether specialized study program can influence preparedness for crisis situations. To determine whether nurses change their attitudes to crisis situations after a period of practice. To determine how nurses in this field experience and cope with crisis situations. The practical part contains a qualitative research based on semi-standardized interviews held with eight nurses, and consequent content analysis accomplished through open coding. There were determined 23 categories and other sub-categories. For better clarity, data in categories 2,3,7,9,10 and 19 were put into categorization tables. The conclusion is: half of the nurses that claimed secondary school of nursing had been their only completed study program said this education prepared them inadequately for real situations. Only one nurse who had completed the specialized program felt ready for ICU. Partial preparedness was found in the nurse who had completed a higher vocational school. Preparedness can also be assessed from feelings the nurses experienced soon after they started their careers at ICU. Only one nurse felt all right; the others felt anxiety and stress. This means, nurses are not sufficiently prepared on theoretical level when they start their careers; and it results in negative feelings, eg. stress. The hypothesis No. 1 is: Nurses are insufficiently prepared on theoretical level when they start their careers. The survey showed that 6 nurses had completed specialized study program; one before she joined ICU, and one is currently in the program. All nurses who finished the study program find it helpful; only the nurse with no program completed feels she is not ready for crisis situations now. Therefore, the hypothesis No. 2 is: Specialized study program has a positive impact on how nurses handle crisis situations. Reaching the third objective, the survey looked at how nurses dealt with crisis situations at the start of their careers and at the time of the survey. Three nurses had identical answers. Two found no situation critical, and one still finds the fight for patient?s life burdensome. Two nurses replaced ?resuscitation? with ?no crisis situation?; one mentioned ?conflicts in the workplace?, and two remaining nurses described insignificant changes. Yet, all nurses but one responded that the length of their practice has positive impact on how they handle crisis situations. Even though the length brings safety and peace, it does not necessarily improve the care provided. Objective No. 4: What feelings do nurses have when they handle crisis situations? Most frequent answer was staying balanced and composed, rational thinking, and speed in decision-making process; also a certain form of stress. Interestingly, if asked about possible reasons for leaving the department, nurses mentioned general management, problems in the team and in relationships; only two nurses were fully happy with their jobs. The results and conclusions of this bachelor?s thesis may serve as inspiration to managers in nursing.
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Nursing care about patients with dementia at a retirement home and at a home with a special regime in view of a general nurse
DOLEJŠOVÁ, Jarmila
Higher age is connected to many diseases and one of the serious problems which affects seniors worldwide has become dementia. It is estimated that these times there is about 38 million of people suffering dementia worldwide and according to forecasts the amount will rise three times by year 2050. The disease affects mostly seniors older than 65 years. The situation in the Czech Republic is similar. I work at a retirement home and I encounter these problems every day. It was the reason why I chose this issue as a theme for my bachelor thesis. The name of the bachelor thesis is Nursing care about patients with dementia at a retirement home and at a home with a special regime in view of a general nurse. The theoretical part is aimed at general characteristics of a retirement home, a home with a special regime and at a role of a general nurse in these social residential places. Additionally, it describes dementia, its partition and stages. Within the next part, there is described nursing care of these patients. At the end of the theoretical part I mentioned the Czech Alzheimer Society. In our state it has an irreplaceable place in offering help to people suffering Alzheimer disease and also to those who take care about them. Within the practical part I did a quantitative research by using anonymous questionnaire. The results were analysed and used for graph processing. I established four aims together with four hypothesises. The first aim was to discover which positive and negative factors have the particular centres in providing a nursery care according to general nurses. In order to fulfil the aim, the hypothesis was established: In the homes with a special regime, there is provided nursery care with more respect for the specific needs of the patients with dementia. This hypothesis was confirmed by the research. The second aim of the thesis was to discover motivation of the nurses for working with seniors with dementia. The specified hypothesis was that a common motivation is a social conscience and the need to help old people. This hypothesis was also proven. The third aim was to discover whether the retirement homes and the homes with a special regime have compiled standards of nursery care for patients with dementia and whether the homes work in accordance with these standards. The specified hypothesis was that in contrast to the homes with a special regime, the retirement homes do not have established the standards of nursery care for patients with dementia. Opposite to my hypothesis, 64% of nurses working in classic retirement homes stated that the standards are established. I have to state that this hypothesis was refuted. To find out whether the general nurses are being informed with new knowledge in the area of nursery care for patients with dementia and whether this care in the retirement homes differs from care in the homes with special regimes was the fourth aim of the thesis. The specified hypothesis was that the nurses in the both types of the homes arrange their life-long education in the area of care for the patients with dementia predominantly by themselves and not through their employers. This hypothesis was not proven. The reason for choosing this particular topic for the bachelor thesis was to find out whether a permanent coexistence among patients with dementia and their mates in the classic retirement homes is convenient. This aim was fulfilled thanks to the results obtained by surveying the opinions of the nurses working at social centres given at this research. The results of the bachelor thesis will be used and realized practically at The Retirement Home in Sušice, in August 2013, when the capacity of the beds will be increased by 14 units obtaining a special regime status.
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Back pain prevention nurses.
BERANOVÁ, Kristýna
The thesis: Backache Prevention in General Nurses, examines whether general nurses practice backache occurrence prevention. The following goals were set for the quantitative research: Goal 1: To find out whether general nurses are sufficiently informed on backache prevention in performance of their job. Goal 2: To find out whether nurses have an opportunity to participate in preventive programmes focused on backache prevention in the organizations they work for. The following hypotheses were set: Hypothesis 1: Backache, as a symptom of overload is a frequent health problem among general nurses. Hypothesis 2: Nurses practice backache prevention. Hypothesis 3: Nurses regularly keep fit. Hypothesis 4: Nurses that attend seminars or training sessions aimed at backache prevention are sufficiently informed on these problems. Hypothesis 5: Organizations where nurses work provide them with some preventive programme aimed at backache prevention. The method of anonymous questionnaire focused on general nurses working in a hospital was used for confirmation of the hypotheses. After assessment of the quantitative research results we discovered, that the first hypothesis in the quantitative research was confirmed. Hypotheses 2 and 3 were not confirmed by the research. Hypothesis 4 was conformed, nevertheless not many nurses participate in seminars or courses aimed at this issue. Hypothesis 5 was confirmed with the comment that an employer should do more for health of nurses. The research has shown that general nurses are actually aware of how to prevent backache occurrence, however not many of them use that. Neither the employer contributes remarkably to prevention of the fact that healthcare is the profession where backache occurs most frequently of all. I am convinced that thorough training of new healthcare staff should be sufficient for remarkable reduction of backache occurrence. A brochure that will be the output of this thesis may serve this purpose, as well as continuous training by a qualified physiotherapist or a physician together with provision of an all-hospital seminar.
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The issue of taking capillary blood for glycemia
KOPAČKOVÁ, Lucie
The proper technique of capillary blood sampling to determine the level of glycemia plays an important role in diagnostics and therapy of diabetes mellitus. There has been a large shift in this disease in recent years, especially in diagnostics and treatment. It is a disease characterized by high blood sugar levels. In practice, it often happens that although it is a procedure nurses carry out almost daily, during capillary blood sampling to determine the level of glycemia, a number of errors occurs. This fact inspired me to write a bachelor thesis on the topic "The issue of capillary blood sampling to determine the level of glycemia?. The empirical part of the thesis deals with both the disease Diabetes Mellitus itself and the capillary blood sampling. In the introductory part history and definition of diabetes are given, the causes of the disease, complications, diagnostics and treatment of Diabetes Mellitus are described. The issue of capillary blood sampling to determine the levels of glycemia is discussed in detail, as well as the recommended procedure of capillary blood sampling and devices designed for the sampling . The practical part of the thesis is focused on selected objectives, research questions and hypotheses. The objective of the research was to identify the factors that may affect the results of the examination, to find out whether nurses follow the recommended procedure for capillary blood sampling and to identify the most common errors nurses make during the sampling. To achieve the objectives both quantitative and qualitative research surveys were carried out. The qualitative research was conducted by observations of six nurses working in inpatient wards in České Budějovice Hospital, plc, supplemented by interviews with the nurses. The three research questions can be answered as follows. The most common factors that may affect the test results is poor sample handling, sample exposure to unsuitable temperature conditions, and forced squeeze of blood from a finger. While collecting capillary blood nurses often make mistakes in communicating with the patient, when they do not give information about the performed punction and do not properly explain the whole procedure to the patient. They wash their hands before blood sampling without using a disinfectant. The interviews gave the answer to the last research question that the most common problem the nurses are aware of during capillary blood sampling is forced squeeze of blood from a finger, poor disinfection of the punction site and a delayed transport to the laboratory. Qualitative research survey was supplemented by quantitative research, which consisted of 66 observations of capillary blood sampling, which were carried out by nurses in České Budějovice Hospital, plc. This research survey was conducted to verify the results obtained from the qualitative research. This hypothesis was formulated: H1: During capillary blood sampling to determine the level of glycemia nurses most often make mistakes in communication with the patient. Based on the quantitative research, it has been found out that the most common mistake made by nurses is a failure to use a disinfectant for hand hygiene before sampling blood (16%). The mistake in communication took the third place (14%). Based on the above results the conclusion can be made that H1: During capillary blood sampling to determine the level of glycemia nurses most often make mistakes in communication with the patient, has not been confirmed. Using the knowledge earned from literature and the conducted research I have proposed a standard of nursing care for nurses called "Capillary blood sampling to determine the level of glycemia." Nurses will have an opportunity to have a manual at hand that will serve them as a quide to correctly perform capillary blood sampling to determine the level of glycemia and they will not be consider the blood sampling to be a routine procedure.
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Meaning of communication skills for students of nursery expressed by themself
DRÁBIKOVÁ, Martina
In this work communication skills of students of a bachelor program of nursing of the second and the third year at Faculty of Health and Social Studies, University of South Bohemia in České Budějovice were assessed. Communication skills are important both for successful study at university and for successful work in healthcare services. They especially important for nurses who build very close relationships with patients. There are four parts of the bachelor thesis: 1. theory of communication including details of communication process, function of communication and verbal and non-verbal communication; 2. communication in healthcare services with emphasis to nursing; 3. teaching of communication during the first year study of nursing and 4. quantitative investigation of communication skills of the students using questionnaires of nursing followed by discussion. There were two aims: 1. to reflect self-evaluation of the communication skills by the students; 2. to evaluate practical applicability of the communication skills acquired during university study. Two hypotheses were formulated: 1. The students consider their own communication skills to be good.; 2. The students apply the acquired communication skills in their work. The results obtained in this work can give a feedback to the teachers of communication skills in healthcare system.
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