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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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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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Improvement of the Family Life in the Czech Republic (Analysis of the situation Písecku)
PEKÁRKOVÁ, Martina
Thesis deals with Improvement of the Family Life in the Czech Republic, mainly analyzes the situation in Pisek area. It is divided into two parts, theoretical and practical. The theoretical part describes the various chapters by literature relevant terms, such as family (functional, at risk), parenthood, family rehabilitation. Subsequently, explains the factors affecting the rehabilitation and aspects, working methods, cooperation with the family, an individual rehabilitation plan, cooperation with experts in the multidisciplinary team. Further described the current legislation and the transformation of care for vulnerable children in the CR. The practical part is devoted to mapping and description of organizations providing rehabilitation to families in Pisek area. The practical part was conducted qualitative research, which dealt with the form of work with clients, cooperation with other agencies and assess is needed for remediation. Respondents were employees of the research organization providing remediation. The practical part of the bachelor combines theoretical work.
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Implementation of hospice fieldwork
PFLEGROVÁ, Petra
This work deals with the idea of dying patients in the terminal stage at home. In the theoretical part I describe the concepts relating to the care for the dying and dying itself, as well as the potential risk of marginalization, which is associated with dying. Furthermore, the mention of palliative care in the form of a mobile hospice, with its multidisciplinary team that should try as far as possible to avoid marginalization. There is also the issue of euthanasia, in contrast with the use of palliative care. Hospices are the last topic in the theoretical part, the history and current state of hospice fieldwork. In the practical part I try to determine through research if and how mobile hospice avoid marginalization. Another aim of the research was to map the motives of the workers in hospice care, identify their goals and the problems they must overcome.
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Role of a Nurse during an Acute Hospital Admission of a Patient with Trauma
KOTRČOVÁ, Ivana
Incidence of injury is currently the third leading cause of death in the Czech Republic. A good link between pre-hospital emergency care and hospital care becomes a priority. Nurses play an important role during an acute admission of patients with trauma to in-hospital care, they are the connecting link of all members of the multidisciplinary team, whose common mission is the patient and saturation of his /her needs. With the changing role of nurses in the modern concept of nursing, nurses become equal partners of physicians and other health care professionals. To be accepted by other members of the team and to be able to work with the full extent of her sphere of action in the acute phase of a trauma patient admission, she has to know perfectly her competencies under the applicable legislation. In the theoretical part the roles and responsibilities of nurses under the applicable legislation are defined. There are also chapters dealing with individual injuries and the organization of care for patients with trauma. In the final section of the theoretical part there is a chapter dealing with the holistic care for patients, including ethical care issues, the role of a patient and the importance of cooperation with the family of the trauma patient who is acutely admitted into the hospital. In the empirical part of the thesis three objectives were stated. To determine the cooperation of nurses with other members of the multidisciplinary team, as well as to find out whether the nurses involved in the admission of a trauma patient into hospital know their own competencies under the Decree No. 424/2004 Coll. The third objective was to determine how trauma patients perceive the process of admission to the hospital. Based on these objectives two hypotheses and two research questions were established. The objectives were successfully met, both hypotheses were confirmed and the questions answered. The research was conducted on the basis of a quantitative qualitative survey at departments of selected hospitals where the patients with acute trauma emergency were directed by emergency medical services. For the quantitative research the interviewing method using questionnaires was selected. Interviews with patients were conducted by the qualitative research method. The respondents were 117 nurses and 5 patients.
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A Social Worker in a Mobile Hospice (A Position of a Social Worker in a Multispecialty Team
NOVÁKOVÁ, Markéta
This dissertation deals with a question of dying, accompanying and a service of incurable patients in all forms of hospice treatment only marginally. I am mainly focusing on a homecare service as well as on the role of a social worker there. The first part is about a principle of hospice, accompanying and palliative care. It is describing several forms of hospice service including ethic problems. The next part is telling about begining of social work as a part of paliative medicine and describing a contexture between these two branches A question of voluntary work is also mentioned there. The third part is dealing about multispecialty team and a contexture among particular professional occupations, including social worker and his role, his position in the team, activities, competences, knowledge and abilities etc. The fourth part of this essay is about social work in a mobile hospice and about the importace of taking care of oneself as a burn-out prevention. The last, (fifth, sixth, seventh) parts introduce operative part , where I am trying to introduce information achieved through descriptive metod of interwiev with particular members of the multispecialty team and with the concrete mobile hospice social worker.
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Incorporation of university graduated nurses into the multidisciplinary team.
MINAŘÍK, Martin
My bachelor thesis {\clqq}Integration of university-educated nurses into multidisciplinary teams``deals with integration of nurses into working teams where such cooperation takes place. The theoretical part of the thesis refers to the history of nursing, the today´s conditions for this profession, roles played by nurses and relations they have to cope with. The thesis outlines the concepts of team, medical multidisciplinary team and advantages of multidisciplinarity. It also points to potential pathological phenomena in case of poor acceptance and cooperation. University-educated nurses have been working in various departments as members of nursing teams, as well as multidisciplinary teams. The first objective of my thesis was to find out whether university-educated nurses are included into multidisciplinary teams. The second objective of my thesis was to find out how the university-educated nurses are accepted by medical doctors. A quantitative method using anonymous questionnaires was used to collect the data and to meet the established objectives; the questionnaire was developed based on information obtained from professional literature and it was divided into two sections. The first section contained questions for all members of the multidisciplinary teams and the other section was intended specifically for the university-educated nurses. The results of the quantitative survey have shown that university-educated nurses have been included into teams, i.e. the hypothesis - The university-educated nurses are included into multidisciplinary teams - has been confirmed. The second hypothesis {--} The university-educated nurses are not accepted by medical doctors - has been also confirmed. On the contrary, the third hypothesis - University-educated nurses are accepted by nurses with secondary education - has not been confirmed.Results of this thesis may be used by the higher and top management of the surveyed hospital and they should be also used for improvement of care of the clients.
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