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Differences in nursing care in patients with active and passive thoracic inlet
CHLEBÚCHOVÁ, Eliška
Active and passive chest suction is a treatment method used in surgery. The purpose is to suck liquid, blood or air from the pleural cavity and the restitution effect, i.e. lung unfolding. This method is very efficient in treatment of pneumothorax, hemothorax and other pathologic states in the pleural cavity. Chest suction has been used for a long time, today particularly at surgery departments. Nursing care of patients with chest suction is very important and special, in the instance of nurse's poor knowledge complications may occur, but moreover the patient may be hurt. The thesis called "Differences in Nursing Care of Patients with Active and Passive Chest Suction" is divided into two parts, a theoretical one and an empiric one. The theoretical part describes the mechanism of the active and passive suction, the development of this treatment method, and the indications leading to it. The theoretical part also deals with the nursing care about a patient with chest suction systematically from the chest drain introduction to patient's recovery. Goal was to identify the principles and find out the differences in nursing care of patients with active and passive chest sucking. Three research questions were formulated to achieve the goals. Q1: What are the principles of nursing care of a patient with active chest suction? Q2: What are the principles of nursing care of a patient with passive chest suction? Q3: In what spheres do the theoretical knowledge and practical skills in the care of a patient with active and passive chest sucking differ? Qualitative research was applied to elaboration of this bachelor thesis. The technique of semi-structured interview was used for data collection. A categorization was performed based on the interviews. To improve quality of the results the research was accompanied by the method of involved observation, which either confirmed the findings from the interviews or added facts that the nursed had not mentioned in the interviews. The research was performed at departments where patients with the chest sucking occur. The research has shown that the nurses are aware of the principles of the care of patients with active and passive chest suction. The interviews revealed the principles of the nursing care that should be followed throughout hospitalisation of a patient with chest suction. The nurses point out the differences between the active and passive chest suction in the interviews. The specifics of the system of active and passive chest sucking itself were also identified. The research has also shown that the departments where it was performed often use the active chest suction system called Medela, which gives free movement to the patients and easy handling for both the patient and the staff. Another, not as widespread active suction, compact unit has the same advantages as the Medela system. The research has however shown that the nurses were not sufficiently informed on operation of the compact system and the patient care with the compact active suction unit. The bachelor thesis has brought findings of the care of patients with passive chest suction of conventional type. The principles of the care of patients with active sucking have been found not only for the conventional system, but also those of modern active sucking techniques. The basic differences in nursing care of patients with active and passive suction have also been found out. The nurses concentrate on the differences in the care in the system tightness inspection, water column determination and the differences in handling the systems. This bachelor thesis outlines the principles and differences in the care of patients with active and passive chest suction, the adherence to which is among others a condition of timely recovery of the patient and return to normal life. It will also be written a leaflet on the principles of the nursing care of patients with active and passive chest suction.
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Nursing care for patients with a chest trauma.
HORÁKOVÁ, Magdaléna
Injuries to the chest together with damage to the chest organs are among the most frequent injuries in common life. These traumas are often combined with another injury, or they are classified as polytraumas. Care for such patients is provided mainly by trauma centres due to the necessary complex, multi-stage treatment. In the event of an injury to the chest, the chest wall or internal organs in the ribcage may also be injured. These include especially the heart, lungs, main blood vessels, bronchi and throat. A chest injury may endanger the client?s life due to an immediate or potential risk of cardiopulmonary failure. The mechanisms of injury include contusion, compression and deceleration. Injuries may be isolated, multiple or classified as polytraumas. Treatment may be conservative as well as surgical. In most cases, the injuries are non-penetrating. Injuries may be caused by direct force (for example collision with a steering wheel, collision with the ground during a fall, a received blow) or indirect force (deceleration). Chest drainage is an often applied solution. During this medical operation, the drain is inserted into the pleural sac to remove pathologic content. This diploma thesis has been elaborated using the questionnaire method. Data were collected in selected trauma centres of the Czech Republic. 182 questionnaires were processed. Results of the research are processed in the form of graphs and contingency tables. Three hypotheses were defined to achieve the objectives. Hypothesis 1: Nurses have knowledge of the principles of care for patients with active chest breathing. Hypothesis 2: Nurses have knowledge of the principles of care for patients with passive chest breathing. Hypothesis 3: Nurses cooperate with rehabilitation therapists. We have managed to confirm all the hypotheses in our research investigation and thus meet the defined objectives. The research shows that nurses have knowledge of the principles of care for patients with active and passive chest breathing, and that they cooperate with physiotherapists. A nursing standard was created for nurses who focus on patients with applied chest drainage. This thesis may also serve as study material.
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