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Cooperation of a stoma nurse with multidisciplinary team
VOTRUBOVÁ, Veronika
A stoma is an opening of a hollow organ on the surface of the body. The care for a stoma aims at returning a patient to ordinary life and it is exactly in this process that a stoma nurse should help the patient. The stoma nurse guides the patient through the pre-operative preparation, the post-operative preparation and also through the outpatient preparation in which the patient visits the stoma nurse in a stoma clinic. Cooperation of the stoma nurse with other members of the multidisciplinary team is important because it makes it possible for the stoma nurse to meet all the needs of the patient. The theoretical part deals with the anatomy and physiology, definitions stoma stoma and also the history of its development in nursing. The next chapter deals with the indications, types of stoma and possible complications. The chapters on preoperative and postoperative care, nutritional advice and clubs for stoma patients. Other chapters are devoted to stoma nurses. The primary intention of the thesis is to meet one objective which is to find out how a stoma nurse cooperates within the framework of a multidisciplinary team in various departments of a healthcare facility. The following hypothesis was set for this objective: "The integration of a stoma nurse in a multidisciplinary team is different in every department." The research question was: "How is a stoma nurse integrated in a multidisciplinary team?" The research was carried out by means of a quantitatively qualitative investigation. A method of questioning using the technique of questionnaires was used for collecting data in the quantitative research of the bachelor's thesis. The questionnaires were addressed to nurses in the internal medicine and surgical wards. The collected data were evaluated by means of processed graphs. The qualitative research was carried out with stoma nurses in the surgical ward by means of interviews. The quantitative survey implies that the shift nurses in a surgical ward cooperate much better with the stoma nurse than nurses in an internal medicine ward. In the surgical ward the cooperation is better in terms of communication with shift nurses because they exchange information about patients with stomas, the occurrence of complications and the nursing procedure. On the other hand, in the internal medicine ward this communication in many cases does not work. In most cases the nurses at the internal medicine ward do not feel a need to communicate and discuss the care for a patient with the stoma nurse. The stated objective was achieved using the research question and the confirmation of the hypothesis. From a qualitative investigation implies that stoma nurses are integrated in the education of patients before and after operations. The pre-operative preparation includes also the drawing of a suitable place for a stoma on the body of a future stoma patient. In most cases they discuss a suitable procedure of caring for a stoma patient with shift nurses and inform each other about the occurrence of complications. If they are interested, the stoma nurse informs the nurses of new appliances and findings from seminars. She has got also her own specific documentation where she writes down details about patients. Two stoma nurses also point to the option of cooperating with a nutritional therapist as a part of the nutritional consultation of a patient with a stoma. When cooperating with a physical therapist the stoma nurse informs him of the patient's overall condition and the physical therapist provides total rehabilitation. The results of the findings established by this bachelor's thesis will be provided to the management of hospitals where this research took place.
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The role of a special educator in delivering of early intervention (early intervention services)
KOČEROVÁ, Nikola
This bachelor thesis deals with a role of a special education teacher in providing of the early care and the early intervention. The early care as a social service offers help and support to children with health disabilities or handicaps or with any threat to their development. This care, respectively the support, involves more than just a disabled child, but his entire family. In the theoretical part of the thesis I devote to a special education teacher who belongs to the so called helping professions as well as to his place in a framework of a multidisciplinary team. I also draw my attention to his professional competencies and personal dispositions which I consider to be crucial for his professional work with clients. Marginally I devote to a description of the health disability, its different types and characteristics. Finally, I define concepts of the early care and the early intervention (support).Further I deal in detail with an Early Care Centre, in particular its characteristics, types and locations of the Early Care Centres in the territory of the Czech Republic, including their financing and grounds in our current legislation. In this context I try to define the role of the special education teacher as an important member of the staff in the performance of the social service the early care. I also pay my attention to the Special Education Centres, which can provide, inter alia, as well as so called the early intervention (support). The early intervention is a difficult task and that is why I included also activities of Arpida Centre in České Budějovice in the theoretical part just with regard to a different way of an implementation of this social service, because they provide it primarily for outpatients. The practical part of the bachelor thesis defines objectives of the research. The main objective is to compare professional competencies of the special education teacher acting in the early care defined in the current legislation of the Czech Republic with a description of his real job. The partial objective is to determine actual experience and opinions of special education teachers working within the early care, respectively the early intervention (support) on the appropriate legislation that addresses that issue. Then there relates to it an effort to try to determine the role or the task of the special education teachers which they receive on basis of their professional work with clients in the context of the early care. Based on the target there are defined research questions: Their specific wording is: Has the special education teacher enough competencies to do his job? More: Where do the special education teachers see the biggest problems in the content of the legislation? What role the special education teacher feels to play in providing his services in the framework of the early care, respectively early intervention? In the practical part I also defined a methodology for data collection, when I chose the qualitative research. Data acquisition was carried out by an interviewing technique with a help of a standardized interview that respondents answered freely without my intervention. In the practical part of my bachelor thesis there I also describe the research group and the terrain. The target groups are: two special education women teachers from the Centre of Early Care in České Budějovice, two special education women teacher from the Special Education Centre at Arpida Centre, than one special education woman teacher from the Special Education Centre at the Kindergarten, Elementary and Secondary School for hearing impaired in České Budějovice and a responsible person for the social service of the early care provided by Arpida Centre in České Budějovice. The research was conducted in workrooms of individual interviewed during the months of March and beginning of April.
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Multidisciplinary approach to clients with schizophrenia
DÁVIDOVÁ, Lucie
This thesis deals with a multidisciplinary approach to clients suffering from schizophrenia. The main aim is to reflex the multidisciplinary approach to schizophrenic clients, appealing to social work and having respect to ethical principles of participating branches. The work includes chapters that are necessarily coherent to this topic. These are mainly the social work in the context of schizophrenia, specifics of schizophrenia, the structure of the multidisciplinary team, team work and all ethical aspects arising out of team work and individual experts' work. This thesis tries to link up theoretical and practical knowledge, mainly by means of casuistry and practical observations.
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Coordinated rehabilitation of clients of selected wards of the Hospital in Ostrov
FRYDRÝNOVÁ, Anna
This thesis is called Coordinated rehabilitation of clients from selected wards of the Hospital in Ostrov. The aim of the thesis was to compare course and schedule of the coordinated system applied on the clients from selected hospital wards in Ostrov Hospital. Secondary goal was to survey services provided within the frame of the coordinated system of rehabilitation in Ostrov Hospital. In theoretic part of work was performed author?s knowledge of special scientific literature. Notion Coordinated rehabilitation was defined as well as its incorporation within legal regulations. Furthermore International Classification of functional abilities, disabilities and health were referred to briefly.Last subchapter of the theoretical section was dedicated to the introduction of the Ostrov. Observational part was compiled by using method of the qualitative research. Selected technique of the data collection was documentary analysis, survey and questionnaire. Author worked with health documentation of the three clients that was transformed into three casuistries. Those are listed in the chapter Results.Author had asked clients for their permission to be mentioned and published in her work and she received from all casuistic clients their advance agreement in written form. Last supplementary method of the data collection was knowledge questionnaire. This was compiled on the basis of the theoretical part of this work and distributed among staff of the above mentioned wards where the clients were hospitalized. The aim of the research was to answer question, whether single units of the coordinated rehabilitation system applied on the clients from selected wards of the Ostrov hospital are well interconnected? Author?s detailed statement is listed in chapter called Discussion, where she associates herself with theories of specialized publications on Coordinated rehabilitation system written by other authors. During the research phase author came to the conclusion, that both medical and social elements of the Coordinated rehabilitation system work perfectly.Both elements were linked together. However they lacked continuity, contingency or client awareness in the area of working and pedagogical rehabilitation. In neither of casuistries was applied this elementary unit of the Coordinated rehabilitation system. Author?s presupposition was intensified by partial unfamiliarity of the staff with pedagogical and working rehabilitation. For example in question no. 11 where 43 % of the interviewees declared that the only job opportunity available for the handicapped people is protected workshop and protected job for the disabled people.This fact resulted from the knowledge questionnaire given to the staff of Ostrov hospital. Hence functionality and connectivity of the system was primarily influenced by the cooperation of the individual specialists who are part of the client?s multidisciplinary team. Secondly the efficiency of the provided care resulted from the cooperation of the individual clients. This work can be used for educational purposes of individual staff in Ostrov hospital, alternatively in other health centres. Additionally it can be used as valuable source of information for students of health and social care studies, helping health workers, but also for non-professional laic public.
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Influence of accreditation on patient
KRASNIČANOVÁ, Lucie
Nowadays the accreditation of hospitals is very current topic. During the last years there has been a change in the way of life of society. Within the provided services, the number of patients seeking higher quality medical facilities with specialist care rises. The basic lead for patient is the information about accreditation of the medical facility. The accreditation of the hospital is guarantee for patient that procedures used in the hospital comply with the prescribed standards. Standardization of care provides a unified approach to the patient and leads to safer and higher quality care. Thesis objectives Objective 1: To find out how the selected hospitals introduce "Program of improving the quality and safety of the services provided in a hospital accredited (JCI)" Objective 2: To explore the impact of accreditation (JCI) on patient satisfaction and quality of feedback. Objective 3: To define the benefits of accreditation at the hospital with JCI against the facility without JCI from the patient's perspective. Research questions 1) How does patient perceive the level of care, its accessibility and continuity in the accredited facility? 2) How does patient perceive the complex care of team of trained personnel (doctors, nurses, educational nurses, nutritional therapists)? 3) How does patient evaluate the awareness about all care related to his/her health during hospitalization? 4) What difference in care is there for patient at the hospital with accreditation from the other facility without it? Methodology To obtain the necessary information, a qualitative research was carried out and the methods of questioning with the technique of semi-structured interview on a pre-prepared set of questions were used. A total of 6 patients hospitalized in Hospital Na Homolce were interviewed. The hospital management was informed about the research in writing. Results and Conclusion The interviews revealed that the patients were provided by nursing care according to general or functional method during the hospitalisation in JCI accredited hospital. The care was available according to the patients? needs in terms of time and organisation. In one case a bed wasn?t arranged. The situation was resolved by agreement of staff with the patient. An important part of patient admission to the accredited hospital was staff presentation to patients, which was done, except for one patient. Furthermore, all patients agreed that a physician in the department had attended them every day. The cooperation of the multidisciplinary team worked well according to the patients, they particularly appreciated the work of a psychologist. Patients saw differences in the care in the security measures and in terms of availability, the interviews revealed that two respondents had experienced a long waiting time to scheduled surgery at a hospital without accreditation. The patients evaluated positively the level of provided nursing care. The results of the survey show that most of patients were aware of the differences in provided care. There is surely an influence of education of the nurses in the communication with patients, when was found out that it is needed to develop the communication more. The output of this thesis is a proposal of practical seminar for nurses, which should contain basic information about an effective communication with the patient, particularly aimed to feedback.
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Nurse and nursing documentation
VČELOVÁ, Stanislava
This bachelor thesis deals with the issue of using nursery documentation and working with this documentation. The nursery documentation forms fundamental material contributing to the correct operation of the patients? hospital care. These documents should be unconditionally maintained about each hospitalized patient as this fact also arises from the Czech legislation. The nurse?s work with the nursery documents is based on its correct, faultless and legible maintenance. The nurse records quality, actual, complete and essential information regarding the patient?s health condition in this documentation and works with these data which she uses in the nursing process. The most used form of the maintenance of the nursery documentation is a written form. Nowadays a nurse meets also with an electronic form of the nursery documents which is to help her to get more time for communication and care for the patient. The aim of this bachelor thesis was to discover the use of the nursery documentation in the selected hospital facility. The research investigation was executed by quantitative method. Case interpretations were processed based on interviews and the most important data were put in categorization tables. The research investigation was executed with ten randomly selected sisters who work in a neurosurgical and cardio-surgical department in the hospital Na Homolce. A wide spectre of problems occurred with the maintenance of the nursery documents.
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Co-operation nurses and doctors within intensive care
HALAMOVÁ, Veronika
Jako téma bakalářské práce jsme zvolili problematiku spolupráce sester a lékařů na jednotce intenzivní péče. Práce ve zdravotnictví není práce pro jednotlivce. Jedná se o týmovou spolupráci, kde kaţdý člen týmu má svoje povinnosti, ale také práva a pravomoci. Sestry chtějí, aby byli v péči o klienty rovnocennými partnery, coţ se zatím na mnoha místech nedaří. Pro většinu lékařů je sestra stále ještě pomocnice, která pouze vykonává lékařské ordinace a její vlastní práce je povaţována za podřadnou a nedůleţitou. Toto téma jsem si vybrala také z osobních důvodů, protoţe na pracovišti, kde pracuji, se bohuţel setkávám se stejným postojem lékařů, o kterém jsem se zmiňovala výše. Pro sběr dat byla zvolena technika dotazníku. Byly vypracovány dotazníky jednak pro sestry a také pro lékaře, aby měly moţnost se vyjádřit obě strany. Dotazník pro sestry obsahoval 25 poloţek. Pro lékaře byl vytvořen podobný dotazník, který obsahoval 19 poloţek. Dotazníky byly pro obě skupiny respondentů dobrovolné a anonymní. Výzkum probíhal v Nemocnici Na Homolce na jednotkách intenzivní péče s chirurgickým zaměřením. Byly zvoleny 3 hypotézy. První z nich byla, ţe lékaři a sestry na JIP spolupracují. K této hypotéze se vztahovalo více otázek z dotazníku. Jednalo se o různé oblasti spolupráce a hypotéza byla potvrzena. Druhá hypotéza se vztahovala ke vzdělání sester. Předpokládala jsem, ţe sestry s vysokoškolským vzděláním jsou z pohledu lékařů vnímány jako rovnocenní partneři. Tato hypotéza byla zamítnuta. Zjistila jsem, ţe pro lékaře není rozhodujícím kritériem pro spolupráci výše vzdělání, ale praktické dovednosti sestry. Třetí hypotéza se týkala kompetencí sester. Předpokládala jsem, ţe sestry na JIP provádějí výkony v rámci svých kompetencí. Tato hypotéza byla zamítnuta, protoţe 85,85 % sester souhlasí s tím, ţe lékaři vyţadují výkony, které nejsou plně v sesterských kompetencích. Druhým cílem bylo zjistit oblasti, ve kterých mohou vznikat problémy. Z šetření vyplynulo, ţe jde v podstatě o problémy ve slušném chování a to u obou skupin ? jak u sester, tak u lékařů.
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Social activation services and their ethical reflection
KASTNEROVÁ, Tamara
This thesis focuses on the explanation of the concept of social activation services for families with children and touches on the concept of family rehabilitation with which social activation services are associated. It also discusses frequent and less frequent questions and problems, which are deal with by this service and it explains how these problems arise. Using specialized literature and the experience of family support center staff, it characterizes specific work of social activation services, such as the program of the preparation for the return to family and to home, family rehabilitation inside the frame of preliminary measures, social work with families, who have the described problems and basic characteristics of multidisciplinary teams. The goal of this thesis is to critically reflect work of social activation services on the basis of some ethical principles and ethical codes of social workers, with the help of the Center of family support in Aš. Thanks to this reflection it is trying suggest possible ways of solving every day work of social activation services.
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Utilization of the role of a nurse as a decision-maker in practice in connection with provision of quality nursing care
STEHLÍKOVÁ, Jaroslava
The thesis attempts to outline the extent to which the decision-making role of nurses is utilized, and the main factors that affect decision-making of nurses within the scope of provision of nursing care. The research has found out that nurses utilize their decision-making role to an insufficient extent hence the sense and purpose of decision-making must be emphasised again. This task may be assumed by managing nurses. Managing nurses may also contribute by more effective defending of competences of nurses. From the factors needed by nurses for effective decision-making, attention should be paid particularly to education. It is necessary to make possible for nurses to extend their knowledge and thus to obtain theoretical insight (e.g. in respect of decision-making) to be used by them while providing care to a patient/client.
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The application of Vojta Method within complete rehabilitation system in the ARPIDA Centre in České Budějovice.
SOUKUPOVÁ, Věra
The diploma thesis at hand aims to find out to what extent Vojta method can stimulate child?s ability to receive and actively participate in other means of the comprehensive rehabilitation system. The diploma thesis observes application of Vojta method within the comprehensive system of rehabilitation provided in ARPIDA in České Budějovice. The diploma thesis is divided into two parts. The theoretical part deals with the current state of the issue in question, provides characteristics of individual means of the comprehensive system of rehabilitation, and acquaints the reader with the technique named reflex locomotion, which is referred to as the Vojta method. The practical part comprises of two chapters. The first chapter provides the reader with a description of the selected facility. The second chapter introduces case reports of the clients completed with analyses of interviews held with parents and other members of the multidisciplinary team. Using the mentioned materials, the author produced six case reports of selected clients of ARPIDA centre. Five out of six observed clients were diagnosed with infant cerebral palsy in different forms with combined defects. For the purposes of the diploma thesis, the author used the method of qualitative research. The practical part is based on analyses of medical records and personal documentations of selected clients of ARPIDA centre; author?s own direct observation; analyses of interviews held with parents and other members of the multidisciplinary team; and observations made by the author while performing her duties as a physiotherapist. Finally, it was concluded that application of Vojta method is necessary within the comprehensive system of rehabilitation which strives to reduce the effects of the disability and improve the quality of life in subjects with the said disability. The author?s own research was designed to verify the findings learned from the literature reviewed for the purposes of the theoretical part. The conclusion of the practical part contains a summary of results, assessment of accomplished goals; and research outcomes and recommendations. The thesis may be found useful by both experts and students who have professional interests in the issue; yet, it should also be made available to the members of the multidisciplinary team as a feedback.
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