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The effectiveness of aids for incontinence patients in aftercare
MUSILOVÁ, Jana
This thesis deals with the effectiveness of use of aids intended for incontinent ill people in subsequent care. The thesis is divided into a theoretical part and experience part. The experience part of the thesis has been implemented by means of qualitative research. The data have been obtained on the basis of two different half pen and paper interviews with patients/clients who are using incontinence aids prescribed by a doctor on a coupon or by a matron or a ward sister from the subsequent care department in hospitals with the state-funded organization and in hospitals with the joint-stock company organization. The result of the qualitative research showed, that both groups of respondents use mostly only plastic pants or nappies out of the whole assortment of aids. For patients/clients living at home the reason is that on the basis of anamnesis the general doctors prescribe the incontinence aids only in the most serious incontinence cases. At the subsequent care department the situation is caused by a big number of immobile fully incontinent patients/clients. The results show, that the quantity of absorb aids prescribed by general doctors is insufficient. It does not reach the quantity limits given in the documents by VZP (Public Health Insurance Company). Taking into consideration the low income of seniors, the respondents have to pay considerable amounts of money for incontinence aids which are necessary for them. There is an absolute lack of absorption aids in the hospital with the state funded organization. The incontinence aids are financed by three different ways. Patients/clients themselves have to get and pay the absorption aids at the Geriatrics department I and subsequent care department 2. The hospital provides them only with one-off mats and hygienic aids free of charge. The reason for this is a low limit of material. The respondents regard this system of financing negatively. It burdens patients/clients and nurses too. If patients/clients do not have the aids, the hospital has to lend the aids, make a list of debts and collects them back. On this account conflict situations often arise in families. At these departments there are reserved five social beds which enable patients/clients the prescription of aids by a doctor on a coupon likewise the patients who are ill and cure at home. At the stopgap department patients/clients pay a monthly fee; this includes the costs on incontinence aids too. At the subsequent care department 2A, B of the hospital with the join-stock company organization the aids are fully paid by the hospital. There is available a sufficient assortment and quantity of absorb and hygienic aids, which enable an individual attitude.
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Importance of nurse´s work providing nurishment to senior patients
KOPAČKOVÁ, Lucie
Theoretical Foundations Ageing and old age are natural parts of every individual during their lives. Most of the population wants to live an active life of the best quality possible. Nutrition is a factor that influences healthy aging most significantly. Adequate nutrition plays an important role in maintaining the quality of life and good physical condition. Nutritional needs of the elderly are highly specific. The nutritional needs of the elderly are defined mainly by changes in the organism and a wide range of influencing factors resulting from a person's lifestyle. An important role is played especially by eating habits, social and cultural environment, education, social status, economic standards and, ultimately, health and psychological condition of a person. Proper nutrition of the elderly contributes to their health and wellbeing; it is also important for recovery from the illnesses to which the elderly are more vulnerable. When providing nutrition to the elderly in hospitals, the role of nurses is important. Objective of the Thesis Four objectives were specified for the thesis: 1 To find out whether nurses follow the principles of providing nutrition to the elderly. 2 To identify the most common factors that affect nutrition of the elderly in hospitals. 3 To map the most common nutritional disorders in the elderly occurring in hospitals. 4 To find out what diet is the most common in the elderly staying in hospitals. Methodology The research qualitative inquiry was conducted in the form of covert observation. The objects of observation were the nurses working at a department of aftercare, which were observed in serving food to the elderly. The covert observations were complemented with depth interviews, also with the observed nurses working at the department aftercare. The observations were processed in Microsoft Excel in the form of tables and the interviews were processed in the Atlas.ti programme. Results The observations of the nurses in serving of food to the elderly showed that all the observed nurses failed to comply with the principles of providing nutrition to the elderly in the hospital. More or less each of the observed nurses made some mistakes. The most frequently occurring mistakes were as follows: While serving food, the nurses did not use aprons or serving overalls; the nurses did not prevent direct hand contact with the food. Almost half of the observed nurses did not provide the patients with sufficient time and the support to the patients while serving the food by the observed nurses was also inadequate. Further, nearly half of the observed nurses did not wish a Bon appetite to the patients. Also noteworthy is the latest most frequent mistake: nearly half of the nurses did not put away their aids after serving food. In the interviews, the nurses surveyed identified the most frequent factors influencing nutrition of the elderly in hospitals as follows: biological changes in old age, various types of dementia, psychological condition of the individual, co-morbidities, medication use, eating habits of the individual, the state of dentition (dental prosthesis), and the influence of the family. The most common nutritional disorders identified were as follows: absence of appetite, dehydration, excess weight, obesity and malnutrition. The most common diets eaten by the elderly in hospitals were identified as follows: diets no. 3, 9, 4, 0 and also diets in ground form, puree form and food served through an NGS (nasogastric tube). Conclusion Based on the research survey and the review of expert literature, a standard of nursing care, called "Serving food to patients with deficient self-care in nutrition", was designed for nursing staff. Nursing staff will have the opportunity to use the manual that will serve them as good practice when serving food to patients with deficient self-care in nutrition, and nurses will not consider the activity as a routine procedure.
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Benefits and barriers to the transfer of information nurses at the bedside of patients.
MERUNKOVÁ, Michaela
The nursing handover report belongs to everyday activities of nurses. In the work of a nurse it is important to know exactly who, when, where, what and how. This is what the following activity and responsibilities of the duty period are derived from. This diploma thesis, focused on the Nursing Handover Report at a Patient´s Bedside, has a theoretical and practical part. The first, theoretical part, is composed of three chapters, the modern trend of nursing, the nursing report and legislation. The second, practical part, is based on quantitative and qualitative surveys with three defined objectives and four hypotheses. The first objective was to determine what nurses regard as a major contribution of the nursing handover report at a patient´s bedside. The second objective was to define the greatest obstacle in the nursing handover report at a patient´s bedside. The third objective was assessing the patients´ attitude towards the nursing handover report at their bedside. All three objectives were met by the research. The qualitative part of this diploma work was based on a conducted kvasiexperiment and subsequent questions for patients and nurses. The research sample was 5 nurses and 5 patients from the intermediate care unit (IMCU) and 5 nurses and 5 patients from the resuscitation station (RES) of the České Budějovice hospital, PLC. The semi-structured interview consisted of six to eight questions, surveying the feelings, contents, visualization, integration, advantages, disadvantages, departments, nursing handover at the bedside and the quality. The data collection was carried out by means of an anonymous questionnaire designed for nurses to find out how nurses hand the report over or how they would like to hand it over. 303 nurses from the České Budějovice Hospital, PLC, and the Příbram Hospital, PLC, took part in the research. The results were used to confirm or to reject the hypotheses. The first hypothesis: Nurses do not consider an oral handover report as a quality one when done without a visual completion, this has not been confirmed by the investigation. The second hypothesis: In terms of the risk of the patient's damage, the quality of the handover report done by the nurses in the IMCU and the RES is better than that done by the nurses in a standard unit, this has been confirmed. The third hypothesis: Nurses consider the time consuming nature of the handover report at the patient´s bedside as the greatest difficulty, this has not been confirmed. The fourth and last hypothesis: Patients have a positive attitude towards the nursing handover report at the bedside, this has been confirmed by the research. The output of this thesis is to suggest a standard for the nursing handover report at a patient´s bedside. The results can be used for nursing managers, deputy directors of nursing, medical students and nursing professionals.
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The role of a nurse concerning subsequent care of a patient after reimplantation of total hip joint endoprosthesis.
KLAPAČOVÁ, Kateřina
The topic of my Dissertation is a role of a nurse in subsequent care at a patient after reimplantation of a total coxe endoprosthesis. The aim of this Dissertation is to find whether nurses provide patients with specific (medical) intervention (after reimplantation of a total coxe endoprosthesis) according to the diagnosis for care or in a standard way according to the performed act. Another aim was to find specific needs of patients (after reimplantation of total coxe endoprosthesis) and to create a plan of care, as possible. The last aim is to find whether patients after reimplantation of a total coxa endoprosthesis are provided with sufficient information about prevention of possible complications.To gain the necessary data, quantity research in combination with quality one was carried out. The hypothesis that nurses provide nursing intervention in a standard way, no matter if patients are after a primary implantation of a total coxa endoprosthesis or after a reimplantation of a total coxa endoprosthesis, was not proved. The other hypothesis, that nurses does not differ nursing care of clients after a reimplantation of a total coxa endoprosthesis from nursing care of clients after a primary implantation of a total coxa endoprosthesis, was not proved.
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Importance of Nonverbal Communication for a Patient
STUDÍKOVÁ, Monika
Importance of Nonverbal Communication for a Patient The research of the bachelor{\crq}s thesis is focused on assessment of importance of nonverbal communication for a patient/client. The theoretical part analyses communication as a whole and addresses individual parts of nonverbal communication. Communication is a word used very frequently. But it does not mean only spoken words. Its importance has been increasing in both health service and common life. It leads to more appreciative and decent behaviour of staff and to increasingly humane environment in medical establishments. The task of a nurse is not only to send these nonverbal signals but also to accept and understand them. It enables her to understand clients with all their needs. Despite all efforts for education in the area of communication, there have still been variously large communication barriers. The objective of the research is to ascertain whether patients/clients of medical establishments consider nonverbal communication to be important in a contact with a nurse. The research was conducted by the quantitative method using anonymous questionnaires. One type of a questionnaire was drawn up for the research set selectedby us. The set was composed of patients/clients who visited an outpatient{\crq}s clinic or hospital. The questionnaire was absolutely anonymous. The objective of 27 questions was to ascertain the importance of nonverbal communication for a patient/client. The research set comprised 126 respondents. The following hypotheses were raised in order to achieve the set objective: Hypothesis 1: Nonverbal communication is important for patients/clients. Hypothesis 2: The level of nonverbal communication skills of a nurse increases willingness of a patient/client to cooperate in the therapy. On the basis of the statistically processed results, both the hypotheses have been confirmed. The objective of the thesis has been fulfilled. From the results of the research, another possible hypothesis has arisen, namely that nonverbal communication between a patient/client and a nurse will influence the trust in the visited establishment. The results of the research may be used for better appreciation of the effect of nonverbal communication between a nurse and a patient. The thesis should trigger considerations of importance of nonverbal communication for a patient/client. It should also raise interest of nurses in education in the area of communication and inspire the management to monitor communication skills of medical staff, particularly nurses. One of possible solutions is elaboration and introduction of a communication standard or conducting of a communication audit.
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Specifies of nursing care for patiens with non-invazive ventilation.
TICHÁ, Věra
The use of the non-invasive ventilation of the lungs is connected with the positive pressure ventilation. When the endotracheal tube was developed, this method was put aside. Recently, its use has gone up again. It is indicated for the patients with acute respiratory insufficiency, cardiogenic pulmonary oedema. The non-invasive ventilation of the lungs does not require any sedation. In addition, there is no risk of intubation of the airways. The contraindication includes acute ischemic myocardium, a non-cooperating patient and inability to ensure the face seal. The research used qualitative and quantitative data collection methods. The qualitative research was done in the form of interviews and content analyses of data. The research sample composed of six patients from the intensive care units in the hospital Nemocnice Tábor, a.s. The research sample of the quantitative data collection was made up of nurses from four hospitals in the Czech Republic, who work at the intensive care units and at the anaesthesiology and resuscitation unit. In total, 100 questionnaires were distributed and 84 properly filled in questionnaires were returned. The questionnaire included 40 closed questions. Objective 1 was to find out whether the nurses know and use the standard of the nursing care for the patient with non-invasive ventilation of the lungs. Objective 2 was to map actual conditions of the nursing care for the patients with non-invasive ventilation of the lungs. Objective 3 was to map which problems the patients with non-invasive ventilation of the lungs have. The objectives of the work were fulfilled. This work has got one research question. Which problems do the patients with non-invasive ventilation of the lungs have? The research found out that the patients most often have problems with rubbing and soreness to their face, dry mouth and throat and problems with sleeping. Hypothesis 1 (the nurses know standards of the nursing care for patients with non-invasive ventilation of the lungs) was disproved. The standard is not established in any hospitals. Hypothesis 2 (the nurses use the standards of the nursing care for the patients with non-invasive ventilation of the lungs) was disproved. The output is the development of the standard called "The nurse assistance of the patients with non-invasive ventilation of the lungs". Hypothesis 3 (the way of the nursing care for the patients with non-invasive ventilation of the lungs is different in the selected hospitals) was disproved. The nursing care in the selected hospitals is provided at the same level. The nursing care for these patients is a very demanding task for a nurse. An important element of successful treatment is a good psychological preparation of the patient and almost continuous presence of the nurse at the patient´s bedside. We hope that some of the results of this research will draw attention to the problems of the nursing care for the patients with non-invasive ventilation of the lungs and will help to solve them. The developed standard could also become a part of the nursing care procedures in medical facilities. .
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Mentally ill patiens/clients at standard wards.
PAVLÍKOVÁ, Hana
The bachelor thesis Mentally Ill Patients/Clients at Standard Wards is based on a quantitative survey using a anonymous questionnaire for nurses in standard units. The work itself is divided into two parts - theoretical and practical. The theoretical part covers the view of mentally ill throughout the history, the definition of mental illness, principles of communication with mentally ill patients/clients. The practical part describes the research leading to verifying the hypotheses.Two objectives were identified. The first objective was to identify barriers in communication between a nurse and a mentally ill patient/client. The second objective was to determine what nurses lack when caring for mentally ill patients/clients in standard units. Three hypotheses were determined. Hypothesis 1: Older nurses working in standard units have more experience in communicating with mentally ill patients/customers. This hypothesis was confirmed. Hypothesis 2: Organizational work conditions do not impede nurses working in standard units in communication with a mentally ill patient/client. This hypothesis has been disproved. Hypothesis 3: Nurses working in a standard unit have an interest in communicating with a mentally ill patient/client. This hypothesis was confirmed. On the base of the processed results it can be stated that the quality of communication with mentally ill patients is affected by experience, sufficient time and interest in the issue.
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The application of the King´s model in the care of client to the orthopedic department
KREMSOVÁ, Alžběta
My thesis deals with the possibility of applying King?s model to client care at an orthopaedic department. King?s model is focused on interaction between a nurse and a patient. Achievement of harmony in interaction between a nurse and a patient/client creates better conditions for attainment of the care goals and thus saturation of his/her needs. In combination with Gordon?s model better satisfaction of needs and thus improvement of the care at the orthopaedic department would be achieved.
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Barrier recovery system at the occurrence of nosocomial infections in the department
JAREŠOVÁ, Marie
Infections acquired during a treatment in a hospital or healthcare service unit are called nosocomial infections. Their history goes back to the first institutions where patients were gathered. To prevent nosocomial infections, so called barrier nursing is used. It is a set of procedures aimed at preventive measures to avoid the appearance or transmission of the infection. The awareness of observing all rules connected belong to the essentials. The aim of the Bachelor work was to find out if general nurses who work in in-patient hospital wards are aware of nosocomial infections. They were interviewed about barrier nursing rules and their observing. The survey was carried out in the hospitals in Písek and Strakonice. There were 110 anonymous questionnaires distributed and 90 of them were given back. All data were compiled and the findings were depicted in a graphic form. Two hypotheses were set at the beginning: Hypothesis 1: Nurses are familiar with barrier nursing regime rules and their use while nosocomial infection appears at the wards. Hypothesis 2: Nurses respect the rules when nosocomial infection appears at the wards. Both hypotheses were confirmed. The analysis of the data acquired from the questionnaires resulted into the finding that the nurses were keeping abreast of nosocomial infection prevention. The nurses are likely to attend seminars as a part of preventive measures of nosocomial infections. All findings will be offered to the management of the hospitals where the survey was carried out.
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Message nurses and ward sister in practice.
NOVÁKOVÁ, Jana
The ward sister round presents an integral part of the nursing profession. The ward sister round comprises a regular visit of the nurse directly at the patient´s bed. Its objective consists in determining and satisfying the unsaturated needs of patients, further in ensuring and providing a high quality and efficiency nursing care in a close link with medical care. Nursing handover can be divided into two main sections: written and oral handover. The oral handover takes place directly in the patients´/clients´ room under the use of nursing documentation. Its advantage consists in the direct involvement of the patient/client in the handover process. The written handover is then entered by the nurses into the Handover Book. The significance of my diploma work consists in increasing the nurses´ standard of knowledge related to the modernization of ward sister rounds and nursing handover as an integral part of the nursing profession.
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