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Specifications of nursering care of patiens with complications after direct SKG/PTCA
BLÁHOVÁ, Ilona
Abstract In the Czech Republic there is no doubt about the tendency of gradual increase in median life expectancy, which is significantly affected by the fact that mortality from cardiovascular diseases, especially from acute coronary syndromes, has been decreasing. Besides the provable effect of a healthy lifestyle, diet and, by all means, a quality and effective pharmacotherapy, a significant development in the field of interventional cardiology contributes to this accomplishment. The number of coronographies, coronary angioplasties and implanted stents have multiplied, and today the invasive coronarographic diagnostics and percutaneous myocardial revascularization belong to the the most common diagnostic and therapeutic methods in treatment of acute forms of ischemic heart diseases. An obvious prerequisite for such a rapid development in the field of intervention coronary angiography was the establishment of a sufficiently dense network of catheter laboratories and specialized facilities, which provide a highly professional and intensive care for patients. This thesis is focused on three basic objectives: ? To survey and characterize differences in nursing care concerning various complications in patients after SKG / PCI ? To survey bio / psycho / social impacts of complications after SKG / PCI on a patient ? To identify and summarize personal and material prerequisites and requirements to ensure quality nursing care for these complicated conditions The research was conducted by using a qualitative methodology. The methods used were observation, non-standardized interviews and medical and nursing records analyses. The research survey samples on which the investigation was focused were patients with the acute coronary syndrome hospitalized in the coronary care unit in the Cardio Center in České Budějovice, their family members and also the nursing staff providing the comprehensive nursing care. The outcomes of this survey were eleven descriptive case reports characterizing the occurrence of the most frequent complications in patients with ACS after SKG / PCI. To ensure clarity, each case study is complemented by a thought map with an account of the most important nursing interventions in the management of specific acute conditions. The paper also contains a framework analysis of bio / psycho / social impacts of complicated situations on patients. It is interesting to compare this matter from the perspective of nurses and patients, which is seen in correlation graphs. The section describing the organizational and personnel provision is introduced with the characteristics of the medical process and it also contains the list of medical personnel with their qualifications and the length of experience in the Coronary care unit in České Budějovice. Summarization of the instrumental medical equipment is also based on the analysis of previous cases and is accompanied by photographs of the equipment typical and indispensable for the care of patients in the Coronary care unit, which primarily has an informative and complementary character to get an integrated view of the Coronary care unit running and the nursing staff work.
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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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