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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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Departmental safety objectives
LYSÁKOVÁ, Adéla
Abstract The goals: The goal of the present thesis is to describe the principles of safe identification of patients by a nurse and the application of the medicines with higher risk rate. Another goal is to define procedures for prevention of a confusion of an intervention, a location or a patient at the operation theatre and to characterize the hand hygiene procedures in healthcare. The next goal was to describe a programme of prevention and reduction of falls and decubiti in hospitalized patients. The last goal focuses on the oral and telephonic prescription of medicines, on the reporting of patient examination results, and on the procedure of patient handover. Eight research questions were set in relation to these goals. Methodology: A qualitative research method based on in-depth interviews was chosen to reach the goals of the thesis. The intentional choice method was chosen for the selection of the communication partners. The research was performed in three selected hospitals of the South Bohemia Region. 20 communication partners participated in the anonymous questioning. The in-depth interviews were performed with a head nurse, with a quality manager, with perioperative nurses, with nurses from a neurology department and an after-care department. Scientific contributions of the thesis: The research deals with the current safety problems of hospitalized patients. The scientific results of the research are intended for both, specialist and the general public. The research study could serve to hospital managements as a stimulus for the improvement of the safety in the healthcare provision system. The achieved findings and conclusions: Hospitalization always brings some risk to a patient. From the point of view of the minimizing of adverse events and damage to a patient healthcare staff need to identify a patient safely, to apply risky medicines in safe manners, to prevent adverse events in operations, to adhere to the hand hygiene and the barrier nursing techniques. The healthcare staff also have to proceed correctly in the oral or telephonic prescription of medicines, in reporting of patient examination results, and in the patient handover procedures. It is in also the interest of the healthcare staff to minimize the risk of falls and to prevent the occurrence of decubiti in hospitalized patients.
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Safety process in anesteziology care and perioperative care
Benáková, Miluše ; Heczková, Jana (advisor) ; Kordulová, Pavla (referee)
Patient safety is one of the top priorities of anesthesia and perioperative care in the operating room. The patient safety is greatly compromised due to administered medication and the actual operating performance in the perioperative care. The risks of anesthesia and the operational performance are many, starting with the fall of the patient, the possible wrong- site, wrong-procedure, wrong-patient errors, adverse reactions to administered medication, difficult airway management or an unexpected perioperative bleeding. Patient harm in hospital care leads not only to increased costs for additional treatment, prolongation of the hospitalization time, but also significantly affects the subsequent quality of life. Most adverse events are preventable, since most of them are caused by susceptible factors, such as incomplete or incorrect information or the lack of communication between the members of the operating team. Due to the increasing number of such adverse events around the world, including those of the most serious, The World Health Organization has created a program called The Save Surgery Saves Lives, whose aim was the identification of key risk areas in ensuring the safety of patients. On the basis of the identified risk areas the Surgical Safety Checklist was introduced in 2008. It is aimed...
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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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Failure of nurses in the care of patients
MUSILOVÁ, Saskie
Theoretical basis: Every patient has the right to safe nursing care. If health care professionals make mistake, it is perceived very negatively by the health care professional and the general public. Objective: I specified three object of research in this thesis. The first one is to find out, how nurses face to providing care fails. The second one is, what are they able to do to avoid faults. And the last one is, how can they solve this situations, is described in this thesis. Research questions: The question, which could be answered, were specified. I asked with first question, how could nurses solves the situation when the nursing fail is happened. the second one is, which fails are most common, in nurses opinion. And the last one is, how could nurses faces their own fails? Methods used: To achieve the main research was used the qualitative research, in form of semistructured dialogues. Results: Results which emerged from the interviews were transcribed and arranged subsequently and after that were results categorized.In the research work, I have also dealt with the most common errors in internal and surgical department. The most common mistakes on both departments were: nurses prepared the wrong medication, they have not identified and brought wrong cure for the patient, performing occasional incompetent performance. On the internal medicine department most frequently occurring errors as failure of standard procedures for the exercise of individual performance, due to simplify the work. The surgical ward nurse overwritten in the documentation office for the doctor, who then signed. The most common cause of error is the human factor, when during a hectic day nurses feel stress and tideness. Conclusions and Recommendations for Practice: This research may serve as a reference for nurses practice what to do if the nurse is forced from higher positions perform incompetent performance. Furthermore, nurses can learn and realize their most frequent errors in the department. And based on advices, which are given in this work to avoid it.
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Culture safety of medical devices and pacient safety
ŠTĚRBOVÁ, Denisa
The quality issue of provided health care is the topic which is constantly getting more attention. In this area there is always even probably will be always - something to improve. The patients´ safety in healthcare facilities is affected by the so-called culture of safety.The research was conducted in six medical institutions of the South Bohemian Region, though seven were originally planned. However, I was not given the data here, probably due to the long term incapacity of the respondent. The research was focused precisely on the area of care quality and patient safety. A mixed method research (qualitative and quantitative) was deliberately used in this task. The aim was to map the most common causes of adverse events and then, based on the causes, to propose possible arrangements to prevent the occurrence of the causes. For this purpose five research questions were established.The outcomes obtained were processed into tables, plus the graphical representation of some was accompanied. Then, in the "discussion" chapter, the results were compared and analyzed in more detail.
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Assessment of safety culture in selected hospitals in the Ústí nad Labem and Liberec regions
VOLENÍKOVÁ, Kateřina
Current status: The issue of medical errors has recently gotten considerable attention among organizations at the global and national levels. In its report the Institute of Medicine recommended the development of a safety culture where employees want to provide the safest health care. Assessing the current culture of safety is the first stage in the development of patient safety. Subject: The main purpose of the research was "to evaluate the safety culture in select hospitals." Method: A standardized method was chosen for the research: The AHRQ Hospital Survey on Patient Safety Culture. A quantitative method was implemented using polling. Obtained data were tested in SPSS version 16.0. For statistical testing Person's chi-square and sign scheme was elected. Research group: The research survey addressed 301 non-medical staff of Krajské zdravotní a.s. Masarykova nemocnice, o. z. (Regional Health a.s. Masaryk Hospital) in Ústí nad Labem and Krajské nemocnici Liberec, a.s. (Liberec Regional Hospital) Results: The survey results showed that the surveyed health care professionals assess the organizational culture as friendly. The respondents indicated that they are praised by the manager for conducting their work safely and that they can suggest changes in management practices. The results showed that addressed health care professionals support each other (58.1%) and cooperate better (72.4%). According to the respondents, better teamwork leads to better patient safety. An analysis of the results shows that health professionals have an active approach to safe care (82.7%) and in their opinion, errors and mistakes lead to improved patient safety (40.9%). Paramedics have confirmed that they receive feedback on reported incidents (37.9%). Based on team discussion about errors the respondents' evaluation of patient safety has significantly improved. An analysis of respondents' answers revealed a lack of reporting of adverse events. Most respondents consider the number of staff in the workplace deficient (42.5%). Conclusion: Hospital management should be involved in changing the detection of individual errors from individual to systemic. In order to improve the safety culture there should be regular supervision or teambuilding activities that support the development of teamwork. Feedback on the results of reporting errors must be given in an appropriate way to motivate staff to continue to report future errors. The results require a change in how medical staff report errors and greater consistency among management when checking reports. Complaints of work overload by medical personnel must be taken seriously. Improvements can be brought about by changes to work organization or the use of temporary workers.
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Specifics of nursing care for patients at risk for fall
ČERVENKOVÁ, Marcela
Patients´ falls not only in home environment but just when they are hospitalized are not pleasant for the hospital medical team, and are much more uncomfortable for the patients themselves. Falls are unintended situations into which the patient gets unintentionally and involuntarily, resulting in a reduced quality of life. In summary, complications arising from falls have an adverse bio-psycho-social impact. As the patients´ falls are considered undesirable events and their frequency is being monitored by many health care facilities, falls belong to indicators of the nursing care quality. Informed health professionals, providing active nursing care, take targeted preventive measures aiming to prevent patients´ falls. The aim of this thesis is to determine the specifics of nursing care for patients at risk for fall and to find out the patients´ at risk of fall views on implemented prevention measures, since the feedback from patients is an important factor for evaluation of this care. This research work is composed by using qualitative research methods. Two research groups were involved in the survey. The first research group consisted of eight nurses working in a standard hospital ward, and a second group consisted of seven patients hospitalized in these wards. The resulting data were processed into summary and categorized tables. The outcomes of the research have confirmed that the patients at risk for fall need a specific nursing care and this care is received positively by those patients. The results of this thesis will be provided to the management of České Budějovice hospital, where the research investigation was carried out, and this can help improve the quality of care provided to hospitalized patients who are at risk for fall.
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Selected safety risks in nursing practice
MIŇHOVÁ, Monika
In the nursing care there are numerous risks that may endanger the patient or damage or worsen his/her health condition. In order to ensure patient?s safety it is necessary to keenly look for ways minimizing such risks. The theoretical part of the bachelor degree thesis focuses on the issue of safety of hospitalized patients, risks of error and undesired events, as well as on potential prevention in this area. The thesis deals in detail with the risks of falls in hospitalized patients. The objective of the research investigation was to evaluace selected safety risks in the nursing practice that may endanger patients during hospitalization and to find out whether nurses observe principles for prevention of falls in patients. Based on the established objectives two working hypotheses were formulated: H1: The highest level of risk is that of nosocomial infection. H2: Nurses observe the principles for prevention of falls in patients. A quantitative research method was used to achieve the objective and to verify the set hypotheses. The data were collected by means of inquiring and observation using the questionnaire and audit techniques. The research group for the questionnaire investigation consisted of nurses working at standard hospital wards, intensive care and after-care departments in the hospital in Tábor (Nemocnice Tábor, a.s.) the research group for the audit called ?Prevention of falls in hospitalized patients? consisted of nurses working at the internal medicine and orthopedic wards in the hospital in Tábor. The evaluation of results of the questionnaire investigation, using the weighted arithmetic mean, indicates that the highest risk from the selected safety risks in nursing practice is that of an accomplished suicide (3,9). This means that the first hypothesis has not been confirmed. On the contrary, the evaluation of the nursing care in respect to falls has confirmed the second hypothesis to the effect that nurses observe the principles for prevention of patients? falls, both at the orthopedic ward, where the overall audit success was 85 %, and at the interior medicine ward, where the overall audit success was 81 %. We wanted to encourage nurses to reflect on the risks in nursing care. The results of the research will be offered to the management of the hospital in Tábor in order to improve safety of the provided care and to reduce the risks that endenger the hospitalized patients.
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