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Cooperation of a Canistherapeutic Team with a Multidisciplinary Team in the Center Arpida in České Budějovice
FRAŇKOVÁ, Zuzana
This thesis deals with the cooperation between the canistherapeutic and multidisciplinary team at Arpida, the registered center for the rehabilitation of disabled people.Animal assisted therapy and preferably canistherapy becomes an integral part of the therapy in a variety of social services, we can see it as a part in educational institutions and even medical devices. It is proved among the many studies that canistherapy is based on the interaction between man and dog and also affects the overall quality of life.Since the beginning of the targeted use of animals in therapy specialists have gained a lot of experience, but in the field of canistherapy they still see the lack of link between services, as well as other shortages among the cooperation with other experts.The author in the theoretical part of the thesis deals with description of parts of animal assisted therapy.She outlines the historical origins of therapy using animals, describes a division, methods and the forms used.The next chapter is devoted to the therapy using a dog. It describes the beginnings of canistherapy in the Czech Republic, conditions for practicing the professional kind of therapy and targets of canistherapy.Because the author sees the importance of linking treatment with the help of a dog within other therapies, the following chapters is devoted to a coordinated rehabilitation, its resources and members of the multidisciplinary team. The thesis also mentions the concept of circular care.As an extension of the circular care, the social worker stands on top. One chapter is also devoted to the quality of life. The last chapter is devoted to a brief description of the Arpida center, a multidisciplinary team and canistherapeutical teams which attend the Arpida center.This thesis continues with practical part where the author describes the aim, research questions and research methodology. The aim of the thesis was to determine the extent of cooperation between canistherapeutical and multidisciplinary team in the center of Arpida.For research in the thesis a qualitative strategy was used, meaning an interviewing method and a technique of semistructured interview.The multidisciplinary team experts in the Arpida centre, and the clients´ parents regularly visited by the canistherapist became the research group. It was an occupational therapist, physiotherapists and special needs teacher among the experts. Two main research questions were established: HVO1: In what multidisciplinary team expert´s care is the client using canistherapy? HVO2: Does their professional activity go before or does it follow the canistherapy? The interviews were recorded on a Dictaphone and then transcribed into written form. The results are published in the form of open coding, where the author has defined categories. The research results are divided into chapters according to the categories that have emerged from open coding. The results show that collaboration between multidisciplinary and canistherapeutical team does not exist. Thanks to the openness of informants and their answers, the author has found out that cooperation among these experts is possible. The interviews identified areas where cooperation could begin and with such experts would be the best. Results are supplemented by a table which categorizes streamline and SWOT analysis. The author, in the discussion conclusion has applied her knowledge of practicing professional canistherapy and has proposed recommendations for practice and cooperation in the fields of physiotherapy and occupational therapy.It is very easy to see from the research conclusion that cooperation is possible, and therefore the author would like to recommend the work to a multidisciplinary team from and parents of clients, who see canistherapist regularly. This thesis could serve as an inspiration for canistherapists who cooperate with other professionals and want to elevate their volunteer activities on valid therapeutic or rhb method
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Comprehensive system of rehabilitation in younger individuals after stroke
BEČVÁŘOVÁ, Lucie
Title of the bachelor thesis is Comprehensive rehabilitation in younger individuals after stroke. The aim of this thesis was to determine the subjective perception of individuals´ needs after stroke. The theoretic part is divided into two main chapters. The first one contains brief information about the disease, its types, anatomy and physiology background and symptoms. The second chapter deals with the issue of comprehensive rehabilitation and its parts. Particular approaches are defined and described in detail, health professionals working in this area are also mentioned here. The research part was processed by a method of qualitative research strategy. Semi-structured interview technique and observation were used. The research set included 5 respondents - four men and one woman. Past history of stroke and age of individuals between 45 and 55 years were the inclusion criteria for this research. Interview was held according to scenario questions, where I focused on two areas. First section included information about the respondent, his disease and treatment in the way of comprehensive rehabilitation. In the second part, respondents were asked how their life had changed after the experience of stroke. The interview was audio-recorded and then verbatim transcribed. One of the respondents did not wish to be audio-recorded, thus written notes were taken during the interview. Interviewing results are presented in a narrative format. By conducting this research I tried to answer the following question: What are the needs of individuals at various stages of stroke recovery? Need of self-sufficiency was mentioned by all respondents. In early stage, it was mainly coping with basic activities such as food intake, control of excretion, verbal expression and movement. In the later phase of treatment, there are increasing demands on self-care, understanding ability, memory and social interaction. Individuals often went through an intensive therapy. After returning back to their home environment, the need of self-realization, activation and meaningful ways to spend a free time are the most significant issues. This work should provide more information on the given topic.
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Merged Nursing Inpatient Ward from the Perspective of Nurses and Management
KUBEŠOVÁ, Hana
Merged nursing inpatient ward is in the last few years becoming a trend of smaller, but also medium-sized hospitals. Due to the restructuring of beds of acute inpatient care in the Czech Republic, separate inpatient wards are merged to one joint ward, in the context of surgical as well as internal medicine. Merged inpatient ward is a combination of various disciplines (specialisms) of inpatient care under one senior consultant, or there is a common nursing ward, where senior consultants of individual disciplines are retained, while nursing care is merged. The main reason for the establishment of a merged inpatient ward is the optimization of beds and the related effective use of bed capacity in connection with an effort to preserve access to health care. The aim of the thesis Merged Nursing Inpatient Ward from the Perspective of Nurses and Management was to evaluate the contribution of a merged nursing inpatient ward, to identify the reasons for the project and the complications that accompanied the project. This research should analyze the problems in nursing care in connection with the origination of the project, to assess the demands of nursing on the ward and map errors in the field of nursing care in the context of the realization of the project. The thesis should evaluate interdisciplinary collaboration and map the occurrence of conflicts in a multidisciplinary team. During the survey it was found that the main reasons for the project were the financial savings associated with the restructuring of acute care beds in the Czech Republic. The establishment of a merged nursing inpatient ward helped the hospital to keep some expertise and it unified nursing care of the separate wards. In connection with the establishment of a joint nursing care, some complications and disadvantages that accompanied the project initially were analyzed. The survey showed how sensitively employees responded to the major change in the organization and how the cooperation between superiors and subordinates functioned. The study analyzed in what form the selection of employees for a common bed fund was realized and whether managers themselves could choose subordinates for their departments. One part of the research was the evaluation of the quality of nursing care on the merged inpatient ward, which showed that the establishment of the project did not have a negative impact on the quality of nursing care. In contrast, nursing care was united and there was also unified organization of nursing on the ward. The research evaluated the feedback from the subordinates to the top managers which was implemented through meetings and sessions. The survey refers to the greater workload on nurses in the working process on the merged ward. The origin of the project had an impact on the creation of new multidisciplinary teams and interdisciplinary collaboration. The project of a joint nursing inpatient ward was realized that the hospital can continue to provide quality health services to all patients. Research has shown that although the project had certain disadvantages and complications, it was certainly beneficial for the organization. The conclusions of the thesis may be presented in seminars, conferences and may be offered to professional journals for publication. The results of the research can help organizations that are going to realize the project of merged nursing inpatient ward.
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Prevention of immobilization syndrome in elderly hospitalized at the Department of aftercare in the context of the multidisciplinary approach.
KRÁLOVÁ SOMMEROVÁ, Jana
This bachelor thesis focuses on an actual topic in the care of the elderly. It is prevention of immobilization syndrome of the elderly in context of a multidisciplinary approach. The thesis is focused on the elderly hospitalized at an after-care unit. In the introduction to the theoretical part the current state of a quality of an elderly life is assessed. Subsequently particular terms related to old age and senescence are defined. An inseparable part of the assessment of the quality of the elderly life is the classification of self-sufficiency and efficiency. Here the International Classification of Functioning, Disability and Health is mentioned as a meaningful tool for the availability of social services, but also as a clinical tool. The definition of immobilization syndrome emphasizes that this is a geriatric syndrome, which is closely connected to hypomobility, decondition, instability, falls, sarcopenia and other geriatric symptoms and syndromes. The main topic of the thesis - the multidisciplinary approach - is summarized in seventh subchapter and its sections. Individual team members and their basic activities while working with the client are defined here. The research part of the thesis is divided into several chapters. It is processed in a form of qualitative research. It follows the theoretical observations and assesses the work of particular members of the multidisciplinary team in practice. The analysis of personal documents was used on purpose, medical records of selected clients were used as source. Case reports were created afterwards. Case reports are processed using the medical records of clients from the after-care unit. They are also supplemented by the client's point of view, using questions within a semi-structured interview. In the course of case studies, commentary from involved observation is inserted. The conclusion consists of evaluation tables. Detailed expression , comparison of the results and overall summary are in chapter "Discussion". The research question should be answered whether the attitude to clients of the after-care unit is multidisciplinary and whether it corresponds with the needs of clients. The most important finding of this bachelor thesis is that a major factor is the client's diagnosis, and the individual team member's approach to the client. In "Discussion" chapter a comparison based on specialized literature is provided, discussing the long-term care in the international context. Research may be used as feedback to organizations providing long-term care to ensure better conditions of quality of elderly life. It can also be used as a basis for the realization of specific preventive measures. It would definitely be useful to chart the basic research situation in other healthcare facilities or private facilities providing health and social services.
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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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Cooperation nurses and nutritional therapist in the multidisciplinary team
VĚTROVSKÁ, Lucie
The bachelor thesis deals with the cooperation of nurses and nutrition therapists within one multidisciplinary team. The theoretical part focuses on the multidisciplinary team, its tasks and also on what members of medical staff belong to the team and their role in the team. The next part describes the relations between medical staff members and their problems. The following parts describe the education, competences and responsibilities of the nurses and nutrition therapists. The closing part of the theoretical work concentrates on nutritional care and nutritional screening options. The practical part contains the results of the qualitative research. First, an objective was set, which focused on finding out about the cooperation between the nurses and the nutrition therapist within one multidisciplinary team. The objective was established six research questions. The semi-structured type of interview was used for the research. 20 respondents took part in the research, 10 nurses from the departments of dermatovenerology, gastroenterology, surgery, neurology, carcinology and 10 nutrition therapists from the Všeobecná fakultní nemocnice v Praze (General TeachingHospital in Prague). During cooperation, the nurses should focus on the hospital diet system, on the diet types, how to order meals through the hospital information system. They should also learn about the options and news in nutrition therapy at workshops and courses. The nutrition therapists should give the nurses more information about the news in nutrition care and subsequently consult it with them. Both parties should communicate more with each other and make an effort to improve mutual relations in general.
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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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