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Sampling of biological material in outpatient health care facilities viewed by a nurse.
SRBOVÁ, Kateřina
Sampling of biological material is one of the most frequent duties of nurses working in outpatient health care facilities. The nurse takes biological samples daily and has to respond to possible problems. Sampling of biological material is an important component of the patient´s examination and therefore it must be carried out correctly and properly. The quality of the procedure is affected by the nurse´s experience, skills and knowledge. It is important for a nurse working in an outpatient health care facility to master the sampling technique so that patients were satisfied and the samples did not get devaluated. The objective of my research was to give an account of the most frequent problems occuring when samples of biological material are taken in outpatient health care facilities, and to find out if nurses give patients enough information before the procedure. I set three hypotheses: the H I - nurse do not use protective aids while taking samples of biological material, the H II {--} nurse do not follow the recommended standards, the H III {--} nurse do not inform patients about preparations before taking samples of biological material. To achieve the objective and to verify the hypotheses the questionnaire method was used. Questionnaires were addressed both to patients and nurses. The research sample included 103 outpatients and 73 nurses from outpatient health care facilities in the South Bohemian and the Central Bohemian regions. The obtained data analysis showed that the H I {--} nurse do not use protective aids while taking samples of biological material {--} was not confirmed. H II {--} nurse do no follow the recommended standards {--} was not confirmed. The H III {--} nurse do not inform patients about preparations before taking samples of biological material {--} was not confirmed either. The results of my research reflect the fact that the most common problem is communication between a nurse and the patient. But there is more to be improved - patients education, the fixed placement of aids and the early transportation of samples to laboratories. I would like to make use of these conclusions and pass them over not only to nurses who took part in the research but also to the hospital managements. I intend to give a presentation on my research conclusions to nurses working in outpatient health care facilities.
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Comparison of paliative care by clients in hospice establishment and oncology department
KADLECOVÁ, Ivana
Comparison of palliative care for patients in a hospice and at an oncology ward This thesis was focused on the various aspects of palliative care for oncological patients. Palliative care and its principles have been defined and it seems crucial to apply these principles not only in hospices but also at hospital wards where there are patients indicated for palliative care. The objective of this thesis was to find out whether the care provided to hospice clients and to dying patients at hospital oncological wards corresponds to the methods and procedures defined for palliative care and to find out whether there are any significant differences between the nursing care provided to the dying in a hospice and the dying at an oncology hospital ward. Four survey questions were formulated and the question dealt with maintaining palliative care standards, differences in providing palliative nursing care for the dying at the individual institutions, whether the dying clients{\crq} needs are answered in a holistic and humane way, and the nurses{\crq} approach to the dying at the individual institutions. The carried out research is a qualitative one. The research part {--} data collection {--} was carried out in the form of uncontrolled interviews with selected members of nursing teams in a hospice and at an oncology ward. Observations and case reports were used in case of several patients in at the individual institutions. The research was carried out in St Stephen Hospice in Litoměřice and at the oncology ward of an undisclosed health care institution by which information was provided in exchange for absolute anonymity. The research part resulted in the finding that the palliative care provided in the hospice corresponds to the methods and procedures defined for palliative care. There are efforts at the oncology ward to provide as perfect care for their dying patients as possible but this care does not correspond to the methods and procedures defined for palliative care. There are problems in providing palliative care especially in inadequate spatial conditions, equipment, shortages, high workloads, and strictly specialized focus of the personnel and these clients need very individual care that cannot be frequently provided under everyday operating conditions at a standard ward that concentrates primarily on curative care. The results of this thesis will be provided to those who may be interested in the various aspects of palliative care.
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Home violence and primary care
VRTIŠKOVÁ, Eliška
Domestic violence and primary care. Domestic violent is the most frequent form of violence. But it is also the least observed and the most underestimated form of domestic abuse. It often refers to physical violence, sexual and emotional abuse between spouses that occurs hidden away and does not draw attention of others despite the intesifying abusive behaviour of a family member. The victim feels humiliated and distressed and suffers from a high level of fear. The theoretical part of my thesis gives the definition of domestic violence, its forms and causes. Other issues within the context of domestic violence are also addressed: characteristics of persons commiting domestic violence, medical care and assistance rendered to victims of domestic violence, primary care, the role of a nurse in identification of domestic violence, administrative measures relevant to domestic violence. The practical part of my thesis examines the role of a nurse in treatment of a victim of domestic violence. The aim of the research was to learn if nurses often come into contact with such patients and have enough information on the issue. I suggested 3 hypotheses to be confirmed or rejected. The information was obtained by a quantitative research in the form of questionnaires handed out to nurses working at general practitioners´, pediatricians´ and gynaecologists´ offices. The hypothesis I was rejected, hypotheses II and III were confirmed. The conclusions of the research show that nurses get into contact with the victims of domestic violence but do not have access to enough information on the issue to be able to treat them properly.
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Clients foreknowledge problems of postoperative and subsequent care after replacement of the cardiac valve
PRŮŠOVÁ, Vendula
Problems of clients` knowledgeability of postoperative and follow-up care in the case of heart valve substitute. Heart valve defects are unpredictable diseases that can exist without any symptoms for a long time. Heart valve operations comprise the most frequent group second to by-pass operations and nearly a half of all heart-surgical interventions with adult clients. The aim of the thesis was to find out about clients` knowledgeability of postoperative and follow-up care in the case of heart valve substitute, and what kind of information is needed to achieve by the clients from nurses; what educational materials are used to inform the clients with heart valve substitute and also to find out who are the clients with heart valve substitute informed by. Two hypotheses were predefined: 1 {--} Clients are satisfied with the provided information about postoperative and follow-up care in the case of heart valve substitute; 2 {--} Clients are informed about postoperative and follow-up care in the case of heart valve substitute. Three research inquiries were formed: 1 {--} Which is the most frequent information needed by clients with heart valve substitute from nurses? 2 {--} What kind of education is used for clients with heart valve substitute? 3 {--} Who are the clients with heart valve substitute informed by? Collecting data was performed using the combination of quantitative and qualitative research methods. The quantitative ones were performed as questioning using the technique of a questionnaire, while the qualitative methods used the technique of a semi-standard dialogue. The research sample were the clients with heart valve substitute hospitalised in the cardiosurgical departments of the teaching hospitals in Motol, in Plzeň, in the Hospital České Budějovice, a joint-stock company, and nurses working in those departments. 80 questionnaires for clients were distributed, 74 of them were filled in and returned. Ten nurses were addressed. The above-mentioned four aims were fulfilled. Hypotheses H1 and H2 were confirmed. The nurses answered the research inquiries 1,2 and 3; the answers were analysed and the analyses were used for forming the hypotheses: 1. The most frequent information needed by clients with heart valve substitute from nurses are about moving activity, pain, physiotherapy, connection to instruments, possible complications, about housework, possible staying in spa, return to the occupation, principle of taking Warfarin, about regullary cardiology control. 2. The clients with heart valve substitute are educated by discussion and by the informational brochure. 3. The clients with heart valve substitute are educated by the doctor and the nurse. The results of this thesis will be submitted to the managements of the above mentioned hospitals as material to consider amending the informational brochure for the clients so that they would get the missing information about postoperative and follow-up care in the case of heart valve substitute. I suppose that education{\crq}s efficiency and forknowledge of the clients with heart valve substitute could be improved in this way.
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Knowledge of outsider public about services which is offer of home care agency
LENKOVÁ, Klára
Home care is a modern form of health and social care which has been provided in the Czech Republic since 1990. It is focused on persons who would be hospitalized if it were not for home care. The costs are fully covered by health insurance. Those who make use of this service are people of all ages, with various diagnoses and medical indications. Home care is focused mainly on health support and maintenance, health restoration and self-administration development, pain management of incurable patients and terminal care to ensure patients meeting their death fearless and reconciled. The objective of this thesis is to learn more about the public awareness of services provided by home care agencies. The other objective is to find out if nurses working for these agencies promote the home care service well enough. The data collection was carried out by the questionnaire method and the method of public inquiry. The first sample was a group of people living in the South Bohemian region aged 18 49 years. The second sample was a group of people living in the South Bohemian region aged over 50. These two groups were supposed to fill in the same type of a questionnaire. The third sample were nurses working in home care agencies in the South Bohemian region who were handed out inquiry sheets. The hypothesis I {--} the public are not informed enough about services provided by home care agencies {--} was confirmed. The hypothesis II {--} there are differencies in awareness of the public in relation to the age of respondents -was confirmed. The hypothesis III {--} nurses promote home care services only among their patients {--} was not confirmed. It is advisable to hospitalize patients only when it is inevitable. In other cases there is an option to make use of home care services. The aim of my thesis was to bring up a survey of services provided by home care agencies and give some suggestions for the awareness of the public to be enhanced.
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Psychosocial support of children around the surgery planned operations
BLÁHOVÁ, Ilona
The study is focused on sufficient psychosocial support for children before and after planned surgical operations. This area of nursing has been still underestimated although medicine and nursing has been developing very fast in the Czech Republic. The importance of this support is often forgotten even if the contact between a child and his mother [parent] in such a difficult situation can definitely bring many positives. Unfortunately, children indicated for an operation are separated from their parents just at the hospital receptions or entering the operating room. The following preoperative preparation usually miss any psychological aspects and satisfactory explanation to children. They are often frightened and cry so it becomes very difficult for a nurse anesthetist to calm them down. Therefore the premedication and anesthetics have to be much stronger. Furthermore the psychic burden and total discomfort can cause many complications during the operation itself or in the postoperative care. The aims of this work was to find out if parents are interested in active attendance in preoperative preparation and postoperative care of their children, map out anaesthetist opinions on the fact that parents can accompany their children up to the operating room and compare advantages and disadvantages of it. In addition I tried to compare the occurrence of postoperative complications with children they have psychosocial support of their parents and those who are unaccompanied. This work was also focused on international comparison of the level and range of psychosocial care of children surgical patients among the Czech Republic, Hungary and Austria. All aims stated at the beginning were fulfilled. Within quantitative research five hypotheses were stated: 1/ Parents are interested in active attendance in preoperative preparation of their children indicated for operations. 2/ Parents are interested in taking part in postoperative care of their children. 3/ Anaesthetist nurses prefer children accompanied by their parents to the operating room. 4/ There are much less operative and postoperative complications if children are supported by their parents. 5/ Other countries (Austria, Hungary) encourage parents to accompany their children for operations much more than it is in the Czech Republic. Two research questions focused on the comparison of the level and range of psychosocial support of children surgical patients in the Czech Republic and abroad were defined for qualitative data analysis. 1/ Are there big differences in psychosocial care of children surgical patients in the Czech Republic and abroad (Austria, Hungary)? 2/ Are there good conditions for solid psychosocial care of children patients in the Czech Republic?
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Problems of morning waking up patients in the hospital and it´s influence on a patient
BERÁNKOVÁ, Barbora
The thesis deals with problems of morning waking up of patients in the ward and its influence on a patient. Morning waking up of patients is a situation faced by everyone who find themselves in a hospital {--} both a hospital employee and a patient. It is an everyday activity, although it may be one of great problems for hospitalized patients. The first aim of my thesis was to find out how morning waking up is perceived by patients hospitalized in a standard hospital ward. The second aim was to identify negative factors connected with morning waking up of patients hospitalized in a standard hospital ward. The third aim was to learn whether nurses working in a standard hospital ward respect the needs of their patients concerning morning waking up. The aims were fulfilled with the help of a questionnaire. A group monitored was formed by patients of an internal ward block. Three hypotheses were determined for these aims. Hypothesis one confirms that hospitalized patients are satisfied with morning waking up in a standard ward. Hypothesis two confirms that the most frequent factor concerning morning waking up with patients hospitalized in a standard ward is the time of waking them up. Hypothesis three confirms that nurses working in a standard ward respect the patient´s needs concerning morning waking up. The results will be handed over to senior executives of the ward where the research was carried out. They will have an opportunity to consider the problem of morning waking up of patients in their ward and, as the case may be, they can improve the situation.
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A nurse and physical examination of a client/patient
BENEDIKTOVÁ, Martina
My thesis deals with physical examination of the patient by a nurse and its right technique. Physical examination generally follows the taking of the medical history - an account of the symptoms as experienced by the patient - in internal and surgical wards. It becomes part of the medical record. The theoretical part describes the complete physical examination and gives its definition. Physical examination is focused on the somatic condition of the patient. A systematic examination generally starts at the head and finishes at the extremities. The main organ systems are investigated by inspection, palpation, percussion, auscultation and per rectum examination. For physical examination a nurse uses her senses - sight, hearing, touch, sometimes also smell. My thesis examines the right technique of physical examination and why this examination should be carried out by a nurse. I also wanted to give reason why the physical examination should become a common part of the nursing process.
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Anticipating versus reality of work of nurses in cardiosurgery department
BÁRTOVÁ, Marie
In my bachelor paper I dealt with expectation of nurses before their entry in practice and confrontation with the reality of work at hospital units. Expectation plays an important part in coping with the nursing occupation. There are many factors that can influence it both in a positive and negative way. The fast pace in current medical establishments requires that a nurse should assess, predict and evaluate the state of patients and that she should react to it within several minutes so that the care for the ill is most efficient and coordinated. Such a task is difficult for every-one but for a nurse disappointed by the health system it is an impossible task. Therefore it is important that there is a correspondence between expectations and the final reality of work.
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Therapeutic communication in nursing process
POLÁKOVÁ, Lenka
The therapeutical communication is inseparable part of nurse work. Because of this fact is unambigously needed to pay more attention particularly at quality nurse education how to communicate therapeuticly with a patient. Treatment communication can influence on significant way to better communication with patient and also positively change his physical and mental state.
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