|
|
Quantification of Basic and Special Nursing Performance on Standard Units of the Children's Department
SOROKANETS, Viktorie
Abstract Quantification of General and Special Nursing Procedures at Standard Units of Paediatric Departments The present thesis is divided into two parts, a theoretical and practical part. The theoretical part deals with the history of paediatrics, training and competencies of paediatric nurses, contemporary paediatric care and the range of provided services. There is a separate part describing general and special nursing care. Due to a limited scope of the bachelor's thesis, attention was paid to principal activities of paediatric nurses. Within the first part of the research survey two objectives and five hypotheses were established. The work aimed to inventory general and special nursing care at standard units of paediatric departments. The following hypotheses were set: H1: The most frequent general nursing procedure is patient personal hygiene care. H2: The most frequent special nursing procedure in the "Medication Administration" category is the oral (per os) administration of medication. H3: The most frequent special nursing procedure in the "Monitoring" category is the monitoring of body temperature. H4: The most frequent special nursing procedure in the category of "Special and Diagnostic and Therapeutic Procedures" is biological sampling. H5: The most frequent special nursing procedure in the category of "Other Patient Related Activities" is the reception of a patient. The research survey was carried out as a quantitative survey. The research sample consisted of 49 nurses of standard paediatric departments at five selected hospitals, namely the hospitals in České Budějovice (Nemocnice České Budějovice, a. s.), Prachatice (Nemocnice Prachatice, a. s.), Strakonice (Nemocnice Strakonice, a. s.), Písek (Nemocnice Písek, a. s.) and Český Krumlov (Nemocnice Český Krumlov, a. s.). The second part of the survey focused on assessing the selected nursing procedures. General nursing procedures included meal preparation, feeding and diapering a baby. Special nursing care included oral (per os) and rectal (per rectum) medication administration, also intravenous injection, infusion and its monitoring, assisting in examinations, blood and faeces sampling, taking part in the round and patient handover. Each procedure was measured ten times and the result was counted up and divided by their number in order to obtain the average value. The hypotheses were tested by means of the Kruskal-Wallis test where the mean rank value was set. On the basis of the test the set hypotheses were either confirmed or disconfirmed. In the area of general nursing care where three categories were compared, the highest value (463.68) was obtained for the nutrition care. The first hypothesis was therefore not confirmed. In the area of special nursing care, the "Medication Administration" category, the highest value (403.07) was obtained for medication preparation and oral administration. Again, the hypothesis was not confirmed. The hypothesis in the "Monitoring" category was confirmed since the highest value (539) was obtained for body temperature monitoring. Following, there are "Special and Diagnostic and Therapeutic Procedures" where the hypothesis was not confirmed as well since the most frequent procedure is the preparation of a child for an examination (662.21). Based on the arithmetic mean calculation in the last category of "Other Patient Related Activities" where the highest value (8.09) was obtained for filling out nursing diagnoses, the hypothesis was not confirmed as well. The results of the observation part served for creating a draft of a software application aimed at calculation of the nursing load in a monitored number of patients. This application is ready for further development.
|
|
|
Quantification of basic and special nursing care on ICV (Intensive care unit)
VEBEROVÁ, Nikola
The topic of the Bachelor Thesis is ?Quantification method of basic and special nursing care at an anaesthetic/resuscitation department?. Resuscitation and intensive care provides treatment to patients threatened or affected by failure of basic life functions and ensures their inevitable support or temporary substitution. In most cases this is a reversible state. These patients fully depend on health care staff that provides complex nursing care. The basic nursing care requires general skills and specific ability to recognize urgent clinical situations and respond to them properly. According to the Maslow?s hierarchy of needs these are physiological needs and safety needs. Specialized nursing care ensures diagnostic, therapeutic and monitoring procedures. The extent of the nursing care depends on the patient?s clinical condition. The thesis consists of a theoretical part and a research part. The theoretical part deals with development of the field of anaesthesiology and resuscitation from the very beginning in antiquity to the present, its organizational structure and the nursing care provided at an anaesthesiology/resuscitation department. The ?Therapeutic Intervention Scoring System? (TISS) method was used in the research, which is connected with the ?Nursing Care Quantification Method? elaborated by PhDr. Karla Pochylá and Ing. Otakar Pochylý. The research examination was performed by qualitative and quantitative methods. Data collection method, namely observation, was used as the qualitative method. The research sample consisted of 7 respondents whose respiration insufficiency was the main reason for resuscitation care involving artificial lung ventilation. The activities of the basic nursing care (not related to TISS scores) and the activities of special nursing care (related to TISS scores) were determined by the quantitative method. Time measurements of these activities were performed, and average values and standard deviations were determined from them. The aim of the work was to determine the average time demand of basic nursing care as well as the average time demand of special nursing care. The research shows that the basic care not related to the TISS method has a large proportion in working hours and insufficient remuneration of nurses. The contribution of the obtained results for the practice is in updating of the average time demand of the basic and special nursing care in the conditions of the present nursing care at an anaesthetic/resuscitation department. The basic care has proven to be more time consuming than special care. However we should also mention that these results were obtained from a relatively small sample of patients, which is why such measurements should be performed on a larger group of patients to gain more precise results. As the measured values depend on patient?s current condition as well as on his/her additional health problems (obesity, renal insufficiency, bronchial asthma etc) determination of the average time demand of the individual procedures on model groups of patients would be appropriate. Inspiration by the system elaborated in neighbouring Germany would also contribute to improvement of basic and special care quality. It is able to respond flexibly both, to patient?s clinical condition and to the caring staff needs, thanks to continuous everyday analysis of nursing care time demand.
|
guest ::
