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Securing the airway in pediatric patients at ARO
KUBEKOVÁ, Martina
The thesis titled Securing airways in pediatric patients on ARD deals with the specifics of nursing care of airways. Care of airways of children hospitalised at the Anaesthetic Resuscitation Department is an integral part of comprehensive nursing care. Each nurse must have a sufficient theoretical and practical knowledge, as well as experience to independently perform nursing care of airways of pediatric patients. Free and patent airway is a prerequisite for ensuring one of the basic life functions. The aim of the theoretical part of the thesis was to summarise the issue of securing airway in children and to focus on nursing care for airways in pediatric patients. The aim of the research was to determine the specifics of nursing care for children hospitalised at the Anaesthetic Resuscitation Department due to impaired breathing. Based on the aim of the thesis, the author set out four research questions: 1. What nursing activities are performed by nurses when securing an airway in a child? 2. How nurses treat airways of intubated children? 3. What nursing care do nurses provide for children before, during and after extubation? 4. What nursing care do nurses provide for children with a tracheostomy? In the empirical part of the thesis the author employed qualitative research. Data collection was performed by the use of individual interviews with nurses. The survey was conducted at a pediatric ICU and a children's Anaesthetic Resuscitation Department. Based on the research questions and information obtained from literature sources the author drew up the basic points for interviews with nurses. The interviews were supplemented by an observation performed on a children's Anaesthetic Resuscitation Department. Interviews and observation were complemented with two case reports of pediatric patients. The reports were processed in accordance with Henderson's model. The thesis's results show specifics and difficulties of nursing care of pediatric patients hospitalised at an Anaesthetic Resuscitation Department. The thesis maps nursing care for pediatric patients when securing airway, it focuses on intubation, tracheostomy tube, extubation, aspiration, and care for oral and nasal cavities. The objective of the thesis is to show not only the specifics of this kind of nursing care and also to demonstrate the importance of communication and emotional support to pediatric patients before, during, and after the medical intervention. The intensive nursing care is continuously improving thanks to new methods and devices. The results will be provided to the nursing management of the pediatric ICU and the children's Anaesthetic Resuscitation Department. They will also be presented at professional seminars and in professional journals.
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Tuberculosis as a nursing problem
KUBEKOVÁ, Martina
Tuberculosis (TBC) is an infectious disease affecting mostly the respiration system. According to the World Health Organization (WHO), every year approximately eight million new cases of tuberculosis are reported and around two million people die of this disease. The Czech Republic ranks among the countries with the lowest annual incidence of tuberculosis. Patients suffering from tuberculosis are hospitalized in tuberculosis and respiration diseases (TRN) wards where they have to follow a certain medical regimen. They are hospitalized in isolated rooms, have to observe increased hand hygiene, use disposable tissues for coughing, spit the sputum into sputum containers, cover their month while coughing and use their own eating utensils and drinking glasses. In terms of comprehensive nursing care of tuberculosis patients, the problematic issue is observance of the barrier nursing care. While providing nursing care to a tuberculosis patient it is important that the nurse uses disposable protective aids and observes hand hygiene and disinfection principles. For these reasons the theoretical part includes the barrier nursing care, hygienic-epidemiologic techniques and principles of the medical regimen of tuberculosis patients. The research was qualitative and used interviews and monitoring. The research set were the patients and nurses in the TRN ward in Nemocnice Jihlava a.s. The objective of the thesis was to ascertain whether the TBC patients observe the medical regimen and whether the nurses observe the principles of the barrier nursing care of TBC patients. Two research issues were set in respect of the objectives. 1. Do the tuberculosis patients observe the medical regimen? 2. Do the nurses observe the principles of the barrier nursing care of tuberculosis patients? The research revealed that the monitored patients observed the medical regimen. The monitored nurses observed the barrier nursing care and hygienic-epidemiologic measures. Based on these results it can be stated that the nurses have both theoretical and practical knowledge in the area of the barrier nursing care and use the knowledge while providing nursing care to tuberculosis patients. Three hypotheses followed from the research. H1: The patients in the TRN ward observe the medical regimen. H2: The nurses know the principles of the barrier nursing technique. H3: The nurses observe the principles of the barrier nursing care. The results of the research will be provided to the nurse manager of the hospital of Jihlava and to the head nurse of the tuberculosis and respiration diseases ward of Nemocnice Jihlava a.s. as a source of information for continuous improvement of quality of the nursing care of tuberculosis patients in the tuberculosis and respiration diseases ward.
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