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The level of knowledge of health worker in selected performances on the post-operative cardiac intensive care
Petrů, Miroslava ; Marková, Eva (advisor) ; Chmaittiliová, Alena (referee)
The aim of this thesis is to describe the use of Swan-Ganz catheter, epidural catheters and temporary pacemakers in intensive care. Another objective is to investigate the level of knowledge and their subjective evaluation of health workers operating in the post-operative cardiac surgery in nursing care of patients with implantable Swan - Ganz catheter, the epidural catheter and temporary pacemaker. The selected nursing interventions are crucial in the field of cardiac surgery. In the theoretical part deals with the definition of basic concepts to selected performances from a nursing perspective. In theory I connected the few literary sources with knowledge from my own experience. In the practical skills required are concretized and processed on a quantitative approach using statistical procedures. To obtain the data questionnaire technique was used. The level of knowledge of respondents postoperative cardiac surgery department responsible level sufficient knowledge or very good. The investigation found alarming was the fact that half of all respondents in the knowledge test erred in ruling wedge pressure measurement parameters of the pulmonary artery catheter. The nursing interventions, which often occurs in the intensive care deserves more attention from management facility that would provide...
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The level of knowledge of health worker in selected performances on the post-operative cardiac intensive care
Petrů, Miroslava ; Marková, Eva (advisor) ; Chmaittiliová, Alena (referee)
The aim of this thesis is to describe the use of Swan-Ganz catheter, epidural catheters and temporary pacemakers in intensive care. Another objective is to investigate the level of knowledge and their subjective evaluation of health workers operating in the post-operative cardiac surgery in nursing care of patients with implantable Swan - Ganz catheter, the epidural catheter and temporary pacemaker. The selected nursing interventions are crucial in the field of cardiac surgery. In the theoretical part deals with the definition of basic concepts to selected performances from a nursing perspective. In theory I connected the few literary sources with knowledge from my own experience. In the practical skills required are concretized and processed on a quantitative approach using statistical procedures. To obtain the data questionnaire technique was used. The level of knowledge of respondents postoperative cardiac surgery department responsible level sufficient knowledge or very good. The investigation found alarming was the fact that half of all respondents in the knowledge test erred in ruling wedge pressure measurement parameters of the pulmonary artery catheter. The nursing interventions, which often occurs in the intensive care deserves more attention from management facility that would provide...
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Epidural catheter for orthopedic wards - the benefits for patients and nurses?
MAŠÁTOVÁ, Milada
Epidural analgesia causes a temporary cessation of nerve conduction via administration of low concentration of local anaesthesia, or opioid, into epidural space. The resulting temporary discontinuation of nerve conduction is called central neuroaxial anaesthesia and it facilitates the process of surgical intervention. An epidural catheter is usually inserted during epidural desensitisation. It helps to control the amount of administered anaesthesia and hence to respond to surgery progress, but it also enables to keep the catheter within the epidural space for the following postoperative analgesia, which will promote timely postoperative rehabilitation and pain management.The research project was conducted on basis of quantitative and qualitative investigation. The quantitative research was performed via questionnaires directed at the nursing staff, and the qualitative research took form of semi-structured interviews with patients. The quantitative investigation was conducted in fourteen health care facilities in the Czech Republic. Respondents of the quantitative research were nurses working in orthopaedic departments, multidisciplinary ICU or ARO (Anaesthesiology Resuscitation Dept.), who provided care to patients after TKR or THR with an epidural catheter insitu. Qualitative research respondents were patients hospitalised in orthopaedic departments for TKR or THR, with epidural catheter insitu and who agreed to participate at the interview. Quantitative research data were processed in Excel 2010 and presented in graphs, frequency and contingency tables, whereas the qualitative research data were processed using charts of the Smart Art program. After the agreement with the management of health care facilities, this dissertation will promote education and aid situation improvement. The Standard of Nursing Care Assisting a Patient with Epidural Catheter during Insertion and Care will be an outcome of this project. Moreover, we will design a patient information booklet and a quality of care indicator that will focus on monitoring of complications occurrence such as infections in patients with epidural catheter. The findings may help to design a training course specialised in nursing care provision to those patients and also to provide basis for further research.
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Treatment of a pain from the perspective of nurse.
RŮŽIČKOVÁ NEUŽILOVÁ, Michaela
The theoretical section of a bachelor thesis deals with pain treatment, specifically of urgent post operational pain management treatment from the nurse's point of view. It is divided into several sections. First section is focused at pain in general, briefly characterizes the pain itself as well as its formation and division. This part also contains brief description of pain score and mostly used methods pain measurement. Then follows the part, where the urgent post operational pain as well as its specifics and cure possibilities are described. A post operational analgesia appearing by geriatric patients and kids is marginally mentioned here. In the conclusion of theoretical section there is mentioned the issue of urgent post operational treatment quality management. Thesis aim The main purpose of the bachelor thesis is to chart an evaluation of the level post-operative pain by general nurse in the post-operative unit. There are ways and technics, which are in general used on one side, on the other side opinion including practical experience. The second target is general information how to treat pain and to find shortage in management of quality treatment of postoperative pain. The third target is about to map the general nurse's practical skills in the care of patients with epidural catheter. Research methods A qualitative research was chosen for the empirical section of this bachelor thesis. A form of a half structured interview was used for data mining. The interviews with respondents were recorded in written way into in advance prepared form, consequently the qualitative data were analysed and organized according to their importance into categorization group with the coding technic pencil & paper. Results The research resulted, that nurses use VAS technic to chart the urgent post operational pain, which is also standardized pain record of particular medical institution. This technic is absolutely suitable for interviewed nurses, no other technics of pain score are used in daily routine. The nurses report clarity and intelligibility of the record of progression and pain treatment to be the main advantages in scoring pain according to VAS, which simplifies the communication with the other nursing team members participating on pain treatment of particular patient. Next result: Nurses working on post-operative units are not active enough to find symptoms of acute post-operative pain. Nurses wait for patients themselves to verbalize the pain. Nurses give a main cause of post operational pain postoperative wound, they don't accept other reasons. The next problem was discovered in organization of management of post operational acute pain. The main reason is bad accessibility or inaccessibility of attended physician. Also bad multiprofesional communication is guilty. Cooperation reaches on dead lock on bad communication, on confused records from preoperational and post operational period. Nurses have plenty of experience of treatment of urgent pain. Nobody from nurses has special education in algesiology. Care of patient with epidural catheter taken is provided in accordance with standard approach. Is an epidural analgesiology contributing for patients? Nurses answer positive. The main contribution is better cooperation in line patient staff and more effective care process. Conclusion The bachelor thesis is concerned on problematic and specify of care of patients with acute post-operative pain. Acute post-operative pain is good managed symptom, it is impossible to pass it. It could be negatively influenced postoperative recovering, it could be a reason of prolonged hospitalization, increasing costs of treatment. Untreated postoperative pain could lead to chronical problems with health in general.
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Nurses´ care of patients with the epidural catheter.
BROŽOVÁ, Miroslava
The bachelor thesis research is focused on nursing care of patients with epidural catheter in cancer pain treatment from the perspective of nursing staff and patients. The pain accompanying this disease presents a serious problem. In recent years we have been witnessing the rising use of regional analgesia techniques with the potential to achieve cancer pain relief. This also has significantly improved the patient´s comfort and raised the standard of nursing care of patients with chronic pain. The thesis is divided into two parts, theoretical and practical. The objective of the thesis was to make a survey study on nursing care of cancer patients with epidural catheter and to determine the nurses´ knowledge of treatment principles in patients with epidural catheter. Another objective was to find out patients´ expectations after the epidural catheter introduction and to identify how the epidural catheter introduction affects patients with cancer pain. The practical research is based on data collection by using anonymous questionnaires. The questions were closed and half-open. The introductory questions had an identifying character, other questions were focused on specifics of nursing care. Qualitative survey was conducted by questioning, interview techniques. The respondents were oncological patients with epidural catheterization. The research was carried out in the health facilities mentioned below with the permission of the head nurse. The research sample consisted of six patients. Another sample for the research study consisted of nurses working in a standard department and in the outpatient pain department. 120 copies of questionnaires were distributed. The research sample was composed of nurses working in Motol Faculty Hospital, Rudolf and Stefanie Hospital in Benešov, Mulačovy Hospital Plzeň and Plzeň Faculty Hospital. The objective of the thesis is to confirm the hypothesis according to which nurses working in the outpatient pain department have better knowledge of nursing care of patients with epidural catheter than nurses working in standard departments. After the research conduction and evaluation, the hypothesis was confirmed. The objectives have been met.
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