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The principles of the safe administration of medication and it's impact on the quality of care.
Sedláková, Dana ; Vaculíková, Barbora (advisor) ; Slanina, Petr (referee)
8 ABSTRACT This thesis discusses the theme: "The principles of the safe administration of medication and it's impact on the quality of care". This work is divided into two sections - theoretical and practical. The main purpose of the theroretical part is to focus on recapping the theories of quality in healthcare, especially in terms of safety for patients during medication administration. The drugs are the most frequently used therapeutic means of the modern medicine and therefore the topic of safe administration is so often the matter of discussion. Theoretical part of my thesis defines quality in healthcare and also includes chapters about methods for improving the quality and standardization of health care. This work presents an effective tools for dealing with misconducts and describes possible reasons and causes of patient's harm during the administration processes. The practical part of the thesis is dedicated to the content analysis of the selected nursing standards from hospitals within the Czech Republic. The main objective of this thesis is to compare the formal and practical aspects of nursing standards (injection administration) in three different health care facilities with regards to the structural, procedural and results criteria. The results of the content analysis are compared with respect...
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The principles of the safe administration of medication and it's impact on the quality of care.
Sedláková, Dana ; Vaculíková, Barbora (advisor) ; Slanina, Petr (referee)
8 ABSTRACT This thesis discusses the theme: "The principles of the safe administration of medication and it's impact on the quality of care". This work is divided into two sections - theoretical and practical. The main purpose of the theroretical part is to focus on recapping the theories of quality in healthcare, especially in terms of safety for patients during medication administration. The drugs are the most frequently used therapeutic means of the modern medicine and therefore the topic of safe administration is so often the matter of discussion. Theoretical part of my thesis defines quality in healthcare and also includes chapters about methods for improving the quality and standardization of health care. This work presents an effective tools for dealing with misconducts and describes possible reasons and causes of patient's harm during the administration processes. The practical part of the thesis is dedicated to the content analysis of the selected nursing standards from hospitals within the Czech Republic. The main objective of this thesis is to compare the formal and practical aspects of nursing standards (injection administration) in three different health care facilities with regards to the structural, procedural and results criteria. The results of the content analysis are compared with respect...
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Administration and documentation of nursing care in the nursing career
NOVÁKOVÁ, Kateřina
Administration and documentation are inseparable and obligatory parts of nurse's everyday work. Documentation in healthcare serves to communication of necessary patient information. Medical documentation is kept by physicians. Nursing documentation is conducted in parallel with medical documentation. Nursing documentation records facts of the nursing care provided to a particular patient. Duly kept nursing documentation is a quality indicator of qualified nurse's work. It has to comply with applicable legislation and reflect the latest research results. Documentation has to be brief, clear, concise and factual. It should definitely not be extensive, time consuming, complicated and it should not contain useless information and duplicities. Nurses should not be overloaded by document keeping and should not spend more time on it than with patients. The aims of the thesis: Aim 1: To map the approach to documentation among nurses at selected hospital departments. Aim 2: To map how nurses perceive document keeping in terms of time, how much time they really spend on documentation within their working hours. Aim 3: To analyse nursing documentation at selected hospital departments. Research questions: Research question 1: Do nurses feel overloaded by nursing documentation keeping? Research question 2: How much time do nurses have to spend on documentation within their working hours? Research question 3: Is the time spent on documentation used effectively? Research question 4: Would nurses welcome changes in nursing documentation? Applied methods: The research part of the thesis was based on qualitative research method applied at selected departments of a regional type hospital.The research results from the interviews, document analysis and working hours scanning will be provided to the examined hospital management. They may help the hospital management with better insight into their documentation and lead to improvement of the document keeping in general and particularly ease the work of nurses as they are overloaded anyway.
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The Giger and Davidhizar transcultural assessment model
SOUKUPOVÁ, Jaroslava
Abstract The Giger and Davidhizar Transcultural Assessment Model. Because of the globalization we live in the world where {\clqq}the borders are getting closer`` which also means to live our lives in more multicultural society. That is why a nurse must react to modern nursing care and must be well prepared to cope with specific problems of various communities in their health and illnesses. In my diploma work we deal with transcultural evaluation of nursing care according to the J. N. Giger and R. Davidhizar Nursing Care Models. These models are about regardful and tailored care which we apply to members of Vietnamese community living in the Czech Republic. The theoretic part contains problems of the globalization, migration of foreign people, transcultural nursing, the Giger and Davidhizar nursing care models, information about Vietnam and the model application to members of Vietnamese community living in the Czech Republic. In the practical part we created standard of nursing care named Nursing of Vietnamese patient/client in health care institutions and we are interested in its using in the working practice. Then we found out opinions of people working in health care institutions who work with this standard and found out expectation of Vietnamese patients/clients hospitalized in health care institutions whose findings could help with prevention of hospitalization problems. The goals of the work: 1. Using of modification the Giger and Davidhizar nursing care models with giving care to Vietnamese people in health care institutions 2. To find out cultural changes in nursing process and their influence on behaviour of Vietnamese people in an illness 3. To identify problems and expecting of hospitalized Vietnamese people The research was conducted with the help of quasiexperiment and interview in the Regional Hospital Příbram. We addressed 10 nurses and 6 Vietnamese patients/clients. We must point out that in the year 2007 only 6 Vietnamese people were hospitalized there. The goals of the work were achieved. We hope that our work may help to increase quality and efectivity of the nursing care given to Vietnamese people.
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Qualitative investigation of nursing practice for blood donations
NEUMANNOVÁ, Jana
Venous blood sampling poses one of the basic professional skills of a nurse. As in other fields of medical professions, new techniques, standards, instruments and auxiliary instruments are steadily developed here. Their use in practice should facilitate the work of nurses, increase the comfort of patients and, last but not least, increase the costs of health centres and hospitals resulting from repeated samplings and consequently repeated analyses of blood samples. The obtained blood test results facilitate the diagnosis as well as the monitoring process of the individual treatment effectiveness. When taking blood samples, nurses should comply with the current nursing standards ensuring that the result of the given venous blood sampling is correct and non-distorted by an incorrect venepuncture. A violation of the nursing standard may endanger the health safety of both the patient and the nurse. This baccalaureate work monitors the compliance of stipulated nursing standards related to blood sampling. The research was carried out within the surgical ward of the Klatovy Hospital. The monitoring method of disguised participating observation and consequent interviews with monitored nurses was selected. Thus, the research questions could be sufficiently answered. The first question was focussed on the rate of compliance with the principles of correct venous blood sampling. The observations showed that nurses not always proceed in compliance with the appropriate venous blood sampling standards. The second research question dealt with the sampling safety standards both in terms of the patient and the nurse. The research results suggest that nurses are not always fully aware of their own or patient's safety issues. The nurses are not yet sufficiently skilled in the application of protective equipment. The third research question was focussed on the individual preferences of the available sampling techniques. The results of the interviews with nurses suggest that nurses tend to prefer the closed technique. The ward sister of the surgical ward as well as the deputy executive manager for nursing issues of the Klatovy Hospital shall be made acquainted with the results of my research. I plan to propose to hold a seminar in the co-operation with the staff of the clinical biochemistry ward of the Klatovy Hospital.
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Caesarea section- perioperative nursing care during regional and total anesthesia
MAŠKOVÁ, Šárka
In my thesis I focused on perioperative nursing care for women with a caesarean section in regional and general anesthesia. The thesis is divided into a theoretical and research part. In the theoretical part of my thesis history, conditions, indications and contraindications, and also complications during a caesarean section performance are described. Information about anesthesia which is used for a caesarean section is also given. Conditions for general, epidural and spinal anesthesia administration are described. Advantages, disadvantages, indications, contraindications and complications of different types of anesthesia are also mentioned. A substantial part of the theoretical part is devoted to perioperative nursing care. The preoperative nursing care is described, the preparation for it is divided according to the type of anesthesia. Nursing care during the intraoperative and mainly postoperative phases is mentioned in detail. The aim of my thesis was to identify differences in perioperative nursing care for women with a cesarean section in regional and general anesthesia. My work was also focused on women's level of awareness about possibilities of anesthesia for caesarean section. Another goal of my work was to make up standards of perioperative nursing care for women during a caesarean section delivery in regional and general anesthesia, which is administered in the delivery room. Two hypotheses were stated. The first hypothesis is the supposition that women after a caesarean section need a different nursing care, which depends on the type of anesthesia administered. The second hypothesis is the supposition that women are adequately informed about the possibilities of anesthesia for a caesarean section. Quantitative research conducted through questionnaires was chosen to conduct the survey. Questionnaires were distributed to women after a caesarean section at the confinement department. Research results are shown in graphs .The both hypotheses were confirmed by the research investigation. The research has revealed a new finding that women need different nursing care not only after a caesarean section, but also during the intraoperative phase. I used this finding to develop a standard of perioperative nursing care for women during a caesarean section delivery in regional and general anesthesia. The standard is designed for midwives and is intended to improve nursing care for women in the course of a caesarean section delivery during the intraoperative phase. The research has proved that women with a cesarean section need a different perioperative nursing care, which depends on the type of anesthesia administered. It is therefore necessary to differentiate between the two groups and provide them with a different nursing care. The research has also shown that women feel sufficiently informed about anesthesia for a caesarean section. Women´s awareness is a prerequisite for a good cooperation with the patient and successful nursing and medical care. The nursing care provision according to the perioperative care standard will ensure a quality professional nursing care for women before, during and after a caesarean section.
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Problems of Nursing the Patients Self-intoxicated in Suicidal Intention.
DRÁBKOVÁ, Iveta
Suicide as an individual event as well as a social phenomenon attracts great interest and attention in various spheres, both in the immediate environment of the self-murderer and in broader public. The definition of suicide differs according to authors and changes in the course of historical development. Most definitions are identical in two essential aspects of suicidal behavior. These are a voluntary individual's intention to terminate his life and a purposeful behaviour leading to death. Suicide is the conscious and intentional killing of oneself. About 95% of suicidal attempts are just acute intoxications by any amount or kind of a poisonous substance. Acute intoxication belongs to a group of serious conditions threatening human health and life. Acute poisoning is one of the frequent admission diagnoses in the Departments of anesthesiology and resuscitation and Intensive care units. 80% of poisonings are caused by drugs. Damage to the organism by ingesting a poisonous substance is the more significant the longer is the interval between the exposure to noxae and the professional medical assistance provision. For the future fate of the patient the medical equipment and the competence of health professionals who provide intensive care for these patients is crucial. After stabilization of all physiological functions, balancing inner environment of the patient and after the time that may have led to late complications of intoxication, the following phase of treatment is provided by psychological and psychiatric interventions. Determination of suicidal risk among the most common challenge in urgent psychiatry is suicide risk assessment. The aim is to prevent further suicide attempts. The objective of the thesis was to determine, with regard to the competence of nurses, the predominant character of patients´ experience after intoxication, and also the reasons for aggressive behavior of intoxicated patients towards the nursing staff. The third objective was to establish a standard of nursing care of intoxicated patients. The research was designed as explorative with the goal to map the nursing process in intoxicated patients and to provide information for the establishment of the standard of nursing care, which should include both somatic and psychological aspects. Quantitative and qualitative methods were combined. The outcomes of the thesis should lead to detection of the most frequent problems in nursing care for patients with intentional intoxication with suicidal tendency and the establishment of nursing standards to help improve the care of these patients.
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Changes of the attitude of a nurse towards the nursing care after his/her ranging to a higher position.
PROCHÁZKOVÁ, Marie
The Thesis deals with a change of an approach of a nurse to nursing care provision after her promotion to a managerial position. A nurse appointed to the position of charge or head nurse has different responsibilities, she becomes a manager, her colleagues have suddenly become her subordinates, whose work she has to organize, lead and control. A wide range of new responsibilities might change her approach to provision of nursing care. The aim of the Thesis was to discover whether and how the approach of a nurse to nursing care changes when she is appointed to a managerial position and how a nurse promoted to a managerial position achieves authority among her subordinates. The following hypotheses were chosen in relation to the aims of the Thesis. Hypothesis 1: The approach of a nurse to nursing care changes after being promoted to a managerial position. Hypothesis 2: A nurse promoted to a managerial position requires provision of nursing care in line with nursing standards. Hypothesis 3: A nurse promoted to a managerial position is responsible for nursing care quality. Further research questions were put: 1. Is it difficult for a nurse promoted to a managerial position to achieve authority among senior nurses? 2. Is it difficult for a nurse promoted to a managerial position to control nursing care provided by shift nurses? 3. Is it easier for a nurse promoted to a managerial position to organize work for shift nurses she did not work with before? Quantitative research in the form of questionnaires was applied to confirmation or refutation of the hypotheses. The research sample consisted of head and charge nurses from South Bohemian hospitals and from hospitals in Příbram and Pelhřimov. Qualitative research was organized in the form of unstructured interviews with head nurses from Hospital České Budějovice. After evaluation of the results all the three hypotheses showed confirmed. The research results confirm that an approach of a nurse changes after their promotion to a managerial position. They are much more responsible for quality work among her subordinates. The results of the work will be presented at all-house seminars and conferences and published in a specialized journal. The results will also be provided to the hospital management {--} to the Nursing Care Manager {--} and finally to the respondents involved in the research.
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