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Nursing procedures as the essentials of respiratory tract in clinical praxis.
SVÁROVSKÁ, Tereza
The main goal of this bachelor thesis was a comprehensive mapping of airway care in clinical practice. Before entering practice, we must become nursing students and gain the appropriate knowledge and skills in care, so this research is focused not only on the hospital environment, but also on campus in teaching nursing procedures to teachers and students. The goals of the thesis were to map the Standards in nursing care of the respiratory tract, which can serve as a theoretical and practical basis for students and nursing staff. Another goal was to examine the theoretical teaching of students and, if necessary, to discover gaps in the teaching of respiratory care and to suggest improvements in teaching. The last stated goal of the research was to search for innovations that are used in respiratory care. The methods of semi-structured interview and non-participant observation were used in the quvalitative survey. The first research method involved a semi-structured interview has been addressing 3 groups of participants and adding subcategories to them. The first group of participants was consisted of nursing staff and the subcategory was focused on the characteristics of the research group of participants, who were selected from the internal medicine, infectious and surgical departments. The condition was to work with the AIRVO 2 device and the tracheostomy cannula. The research questions focused on the specifics of respiratory care. The introductory research question was set in such a way as to map the specific care of the nasal cavity in modern high-flow oxygen therapy using the AIRVO 2 device. This is confirmed by the results of nurses who do not know these specifics and are therefore not sufficiently trained about possible complications and their solutions. Another issue examined was the study of the Standards in the care of the oral cavity with an established tracheostomy cannula. The research has shown that most nurses motivate the self-sufficient patient to take care of themselves and contribute to the aids that the patient uses. This research with students showed that oral care in a patient with an established tracheostomy cannula is not taught at all. Means that reduce bacterial colonization in the oral cavity are little used. The third question focused on the time allocation for teaching nursing procedures focused on respiratory care. The research has shown that most participants perceive the time allowance as sufficient. Teaching is realized in 4-hour blocks. My research also included mapping the tools that students have available to teach this issue. Students and teachers presented selected aids, all aids were sufficient, except for the model of the Trachcare system at tracheostomy cannula, which lacks an outlet for airway lavage and flushing of the Trachcare system. According to research, It is perceive the AIRVO 2 medical device as an innovation, which reduces care costs, time and, most importantly, is easy to handle. The last question which was mapped the students' knowledge. All the research could serve not only as a support for students, but also for nurses in practice.
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Experience of nurses taking care of patients with a tracheostomy tube
RENGEROVÁ, Nikol
This bachelor´s thesis is divided into theoretical and practical part. The theoretical part of the thesis focuses on tracheal anatomy, types of tracheostomy cannulas with a description of individual parts and puts a big emphasis on the latest knowledge in nursing care. The purpose of the theoretical part was to describe the experience of a nurse taking care of patients in a standard and intensive care unit. A research was realized through semi-structure interview with nurses who work on follow - up intensive care, departement of Anesthesiology and Resuscitation, departement of Otorhinolaryngology. An informants were selected by the Snowball Sampling method and through a social group on Facebook. The theoretical saturation was achieved with a number of 10 informants. The obtained data showed that the metal type of cannula is a domain of a standard unit. On the other hand, plastic cannulas are used in the intensive care unit. It was further found out that the selected standard departement uses an open suctioning and other units use a closed suctioning. From the empirical part we know that the nurses taking care of peristomal skin are using different materials and substances and not everyone is doing the tracheostomy cannula sterilization. The nurses match in inhalation and humidification in the care of respiratory system, however the way of deliver differs. The method of preparation of aids and patient´s position during the tracheostomy cannula exchange differs, same as the process of decannulation. In the question of where the nurses gained the experience in taking care of patients with tracheostomy tube, we got almost an uniform answer, which was the practise in the departement. This bachelor´s thesis provides information about complex care of patient with tracheostomy tube and it compares the care on the standard and intensive departement. An output of the thesis is a brochure with a title "How to take care of a tracheostomy cannula?"
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Nursing care of respiratory system of patient with a tracheostomy cannula at the Anesthesiology-Resuscitation Department
PEŠKOVÁ, Michaela
The thesis presents nursing care of respiratory system of a patient with a tracheostomy tube at the Anaesthesiology & Resuscitation Department. The thesis is divided into two parts, theory and practice. The theoretical part concerns anatomy and physiology of airway. Then it clarifies terms such as the Anaesthesiology & Resuscitation Department and tracheostomy. It briefly mentions the history of tracheostomy, its importance and types. It also describes nursing care of respiratory system. That part introduces the topic of aspiration, air moisturizing, airway lavage and also oral and nasal cavity care. The theoretical part also concerns the importance of communication with tracheostomy patients. Two objectives have been set for the empirical part. The first objective was to check the theoretical knowledge of tracheostomy patient care nurses at the Anaesthesiology & Resuscitation Department. The second objective was to check rule compliance during the tracheostomy patient care at the Anaesthesiology & Resuscitation Department. A qualitative research was conducted at the form of a structured interview where 22 questions prepared beforehand were asked. The research applied to a group of 10 nurses carrying out their duties at the Anaesthesiology & Resuscitation Department of České Budějovice Hospital. The results have shown that the theoretical knowledge of tracheostomy patient care nurses is quite good but in a few cases that knowledge could be deepened. Based on the results however we've come to the conclusion that patients are provided with a quality care. Although tracheostomy patient care nurses meet the required standard set by the department it would be beneficial to them as well as to the patient if they completed their knowledge at least in the form of self-study.
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The care of the airways in the patients hospitalized at the unit care in view of patients
Klozová, Ivana ; Hocková, Jana (advisor) ; Hladká, Petra (referee)
Introduction:The management of patients with a tracheostomy tube is still current. It brings stress situation not only for the patients but also staff who care for them. This issue occurs across all disciplines. The aim of this study was to determine how they feel patients at the care of the tracheotomy while hospitalization of the intensive care unit. Methodology: The research was carried out during 2015 and 2016 at the surgical intensive care unit. The group of respondents consisted of patients with established tracheostomy tube. 80 pieces were distributed questionnaires, 73 patients responded return reached 91.25%. Results: The investigation showed that the comprehensive care of a tracheostomy for patients burdensome and unpleasant. Everyone clearly stated as the most annoying and most exhausting bother them forced to cough. 90,41% of patients reported that their aspiration meets at regular intervals to be able to prepare this fact. All of the respondents perform respiratory physiotherapy and 67.12% felt that they benefit. 95.89% of respondents suffer from a sense of social isolation. 82.19% would welcome the presence of a psychologist at the ICU. Group 80.82% think that it is adequately cared about their tracheostomy during hospitalization and all have the possibility of alternative communication.
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Nursing Care for Patients with Tracheostomy
Ebertová, Barbora ; Hošťálková, Monika (advisor) ; Maňasová, Taťána (referee)
The thesis is focused on nursing care of patients with tracheostomy. The work consists of two parts. The first part is theoretical. This section is devoted to anatomy and physiology of the respiratory tract, additional chapters devoted itself already the main topic and that is tracheostomy. The implementation presented here tracheostomy history, engineering design, types of procedures, types of cannulas tracheostomických, indications for the performance and possible complications. Another big part of the total nursing is where nursing care is devoted to a patient with tracheostomy and care of respiratory toilet, replacing the tracheostomy cannula and decanting. Then there is included a chapter on communication with the patient and possible alternative ways of communication and nursing diagnosis. The empirical part focuses on qualitative research, the method of data collection are two case reports of nursing. The survey was conducted at the clinic anesthesia, resuscitation and intensive care in two patients with tracheostomy. The aim of the research was to find out how the nursing care of patients with tracheostomy, method of communication with tracheostomy patients and to determine their nursing problems. Key words Tracheostomy, airway, tracheostomy tube, airway toilet, communication, nursing care
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Nursing care of the multiple trauma patient with communication barriers
Vojčíková, Žaneta ; Pražáková, Zuzana (advisor) ; Bauerová, Jana (referee)
Trauma is one of the most common causes of death in the population under the age of 40. Trauma causes irreversible and permanent disabilities and economically incalculable losses. In the Czech Republic, it ranks fifth among the most common causes of death. Trauma represents an extreme stressful situation for the human body. It burdens it and manifests itself with the disability of physical and mental functions. The man finds himself unexpectedly outside his social background and life security with an uncertain prognosis for a return to the lifestyle he had before the accident. In the theoretical part, this case study focuses on trauma and its division, specifically it deals with polytrauma and its pathophysiology and states the probability of survival. It points to the routinely used trauma protocol ATLS. The diagnostics and therapies in pre-hospital and hospital care are mentioned in the thesis as well as the most common complications of polytrauma. The conclusion of the theoretical part is devoted to communication, communication barriers and the definition of the nursing model according to V. Henderson. The practical part is represented by a specific case study of the patient. The nursing plan is created based on V. Henderson's concept and deals in detail with the main problem - communication...
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The care of the airways in the patients hospitalized at the unit care in view of patients
Klozová, Ivana ; Hocková, Jana (advisor) ; Hladká, Petra (referee)
Introduction:The management of patients with a tracheostomy tube is still current. It brings stress situation not only for the patients but also staff who care for them. This issue occurs across all disciplines. The aim of this study was to determine how they feel patients at the care of the tracheotomy while hospitalization of the intensive care unit. Methodology: The research was carried out during 2015 and 2016 at the surgical intensive care unit. The group of respondents consisted of patients with established tracheostomy tube. 80 pieces were distributed questionnaires, 73 patients responded return reached 91.25%. Results: The investigation showed that the comprehensive care of a tracheostomy for patients burdensome and unpleasant. Everyone clearly stated as the most annoying and most exhausting bother them forced to cough. 90,41% of patients reported that their aspiration meets at regular intervals to be able to prepare this fact. All of the respondents perform respiratory physiotherapy and 67.12% felt that they benefit. 95.89% of respondents suffer from a sense of social isolation. 82.19% would welcome the presence of a psychologist at the ICU. Group 80.82% think that it is adequately cared about their tracheostomy during hospitalization and all have the possibility of alternative communication.
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Nursing Care for Patients with Tracheostomy
Ebertová, Barbora ; Hošťálková, Monika (advisor) ; Maňasová, Taťána (referee)
The thesis is focused on nursing care of patients with tracheostomy. The work consists of two parts. The first part is theoretical. This section is devoted to anatomy and physiology of the respiratory tract, additional chapters devoted itself already the main topic and that is tracheostomy. The implementation presented here tracheostomy history, engineering design, types of procedures, types of cannulas tracheostomických, indications for the performance and possible complications. Another big part of the total nursing is where nursing care is devoted to a patient with tracheostomy and care of respiratory toilet, replacing the tracheostomy cannula and decanting. Then there is included a chapter on communication with the patient and possible alternative ways of communication and nursing diagnosis. The empirical part focuses on qualitative research, the method of data collection are two case reports of nursing. The survey was conducted at the clinic anesthesia, resuscitation and intensive care in two patients with tracheostomy. The aim of the research was to find out how the nursing care of patients with tracheostomy, method of communication with tracheostomy patients and to determine their nursing problems. Key words Tracheostomy, airway, tracheostomy tube, airway toilet, communication, nursing care
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Securing the airway in pediatric patients at ARO
KUBEKOVÁ, Martina
The thesis titled Securing airways in pediatric patients on ARD deals with the specifics of nursing care of airways. Care of airways of children hospitalised at the Anaesthetic Resuscitation Department is an integral part of comprehensive nursing care. Each nurse must have a sufficient theoretical and practical knowledge, as well as experience to independently perform nursing care of airways of pediatric patients. Free and patent airway is a prerequisite for ensuring one of the basic life functions. The aim of the theoretical part of the thesis was to summarise the issue of securing airway in children and to focus on nursing care for airways in pediatric patients. The aim of the research was to determine the specifics of nursing care for children hospitalised at the Anaesthetic Resuscitation Department due to impaired breathing. Based on the aim of the thesis, the author set out four research questions: 1. What nursing activities are performed by nurses when securing an airway in a child? 2. How nurses treat airways of intubated children? 3. What nursing care do nurses provide for children before, during and after extubation? 4. What nursing care do nurses provide for children with a tracheostomy? In the empirical part of the thesis the author employed qualitative research. Data collection was performed by the use of individual interviews with nurses. The survey was conducted at a pediatric ICU and a children's Anaesthetic Resuscitation Department. Based on the research questions and information obtained from literature sources the author drew up the basic points for interviews with nurses. The interviews were supplemented by an observation performed on a children's Anaesthetic Resuscitation Department. Interviews and observation were complemented with two case reports of pediatric patients. The reports were processed in accordance with Henderson's model. The thesis's results show specifics and difficulties of nursing care of pediatric patients hospitalised at an Anaesthetic Resuscitation Department. The thesis maps nursing care for pediatric patients when securing airway, it focuses on intubation, tracheostomy tube, extubation, aspiration, and care for oral and nasal cavities. The objective of the thesis is to show not only the specifics of this kind of nursing care and also to demonstrate the importance of communication and emotional support to pediatric patients before, during, and after the medical intervention. The intensive nursing care is continuously improving thanks to new methods and devices. The results will be provided to the nursing management of the pediatric ICU and the children's Anaesthetic Resuscitation Department. They will also be presented at professional seminars and in professional journals.
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A Patient with Tracheostomy at an Intensive Care Unit and a Standard Ward
HLOCHOVÁ, Denisa
Tracheostomy is a surgical operation where a permanent or temporary opening is made in the trachea to ensure passability of the air passage. The aim of tracheostomy is to provide oxygen to the lungs, to improve breathing, to reduce consciousness sedation, and to improve the tracheal toilet. The bachelor thesis mainly focuses on nursing care of a patient with tracheostomy at an intensive care unit and at a standard ward. The theoretical part explains the problem of tracheostomy, aids and types of tracheostomy cannulas. It also focuses on the nursing care of tracheostomy. It deals with mouth hygiene and care of the air passages. The care of the air passages includes humidification, lavage and tracheostomy suction. The theoretical part of the thesis also deals with rehabilitation, diet and communication with patients with tracheostomy. The subject of the thesis was to map what the nursing care of patients with tracheostomy is like and how the needs of a patient with tracheostomy are satisfied. Three goals were set to meet the goal: Goal 1: To find out the specifics of the nursing care of patients with tracheostomy at an intensive care unit and at a standard ward. Goal 2: To find out the level of satisfying the needs of patients with tracheostomy at an ICU and at a standard ward. Goal 3: To map the level of adherence to the principles of nursing care of a patient with tracheostomy at an ICU and at a standard ward. Three research questions were set in relation to the goals. 1: What are the specifics of nursing care of a patient with tracheostomy at an ICU and at a standard ward? 2: What is the level of satisfying the needs of patients with tracheostomy at an ICU and at a standard ward? 3: What is the level of adherence to the principles of nursing care of a patient with tracheostomy at an ICU and at a standard ward? Qualitative research, namely the techniques of semi-structured interview and concealed observation, was employed in the practical part of the bachelor thesis. Six nurses from the České Budějovice Hospital were invited to the interview. The first part contains identification data, the second deals with the opinions on the specifics of nursing care of patients with tracheostomy among nurses, it also focuses on the level of satisfaction of the needs of patients with tracheostomy and the last part deals with adherence to the principles in nursing care of patients with tracheostomy. At the beginning of the interviews the nurses were informed on anonymousness of the interviews and they are numbered in the thesis. The research sample consisted of nurses from intensive care units and nurses from an otorhinolaryngology department. The data obtained from the interviews were processed by means of the "paper & pencil" and "card reading" methods into three categories, which were consequently subcategorized. The obtained data were processed into graphic schemes by means of XMind 2013 software. The information obtained from the observation was processed into graphs in Microsoft Excel 2010. The results from the interviews and the observation show that patients with tracheostomy are provided with relatively quality nursing care. The nurses showed good knowledge of the nursing care of a patient with tracheostomy. The nurses consider communication with a patient with tracheostomy the most frequent problem. All the set research goals were met in the research. The subject of the bachelor thesis was to show the weak points of the nursing care provided to patients with tracheostomy. This thesis may serve for improvement of the nursing care of patients with tracheostomy and may also be helpful to student as an additional study material. Elaboration of a brochure for patients with tracheostomy was the result of the thesis.
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