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Saturation of patient needs during acute admission to a surgical ward
JIRÁČKOVÁ, Anna
The diploma thesis deals with the issue of satisfying the needs of a patient acutely admitted to a surgical department. The research focused on feelings and perceptions in the area of satiration of the needs of acutely admitted patients, but also on the view of the nursing staff, who saturate the needs of acutely admitted patients. We investigated whether the patient is perceived as a holistic being, and what problems the nursing staff most often faces during the saturation of the needs of an acutely admitted patient. The theoretical part of the thesis describes the structure of the patient's admission to a hospital facility, and specifies human needs and factors that affect them. In the empirical part, the methodology and results of the research methods used are presented. For the empirical part of the thesis, quantitative and qualitative research was chosen. As part of the quantitative research, a questionnaire was compiled addressing nurses working in surgical outpatient departments or nurses who perform acute admission of patients in surgical wards. The information obtained through the questionnaire survey approximated the opinion of nurses on the saturation of the needs of acutely admitted patients and partly on the working conditions of nursing staff in the surgical department. Methods of semi-structured interview and covert observation were used for qualitative research. Interviews were conducted with acutely admitted patients who were hospitalized after unplanned treatment in the surgical department. Patients were informed about the use of the information obtained and had to give their consent to conduct the interviews. The results of quantitative research have shown that nurses prioritize satisfying the basic (biological) needs of patients, and higher (psychosocial) needs are provided as secondary. The thesis also points out that in many cases nurses act through established competencies. In the interview, the nursing staff mostly said that they would like to have more time for the patient. We also found that most nurses have at least one experience with providing for an urgently admitted patient in one person, and pain relief in an acute admission comes more often from nurses than from doctors. Although nurses cited more staff as the primary factor that would help them reduce stress levels while satisfying the patient's needs. When testing hypotheses, it turned out that the impossibility of satisfying the patient's needs is not related to the working conditions of the nursing staff. The qualitative results of the research answered that patients are unable to assess the validity of the nursing interventions performed during their acute admission. However, the quality of nursing care was most often deduced from the level of communication of the staff, information, reactions to expressed concerns, calm approach, etc. We have found that patients who have previous experience with hospitalization are affected by the experience and often bring negative fears about upcoming hospitalization. Covert observation supported the results obtained from the methods already mentioned. It shows that nurses primarily provided physiological needs in all outpatient departments and surgical wards. And only then did they saturate the psychosocial needs. Nurses satiated the needs of patients both according to the doctor's office and independently, acting as an autonomous part of a multidisciplinary medical team. The results of the diploma thesis could contribute to the improvement of care in the acute admission of the patient, and serve as a possible algorithm for the admission of the patient in the form of a brochure. The thesis can be processed as a teaching material within the framework of lifelong learning for medical staff working not only in emergency departments.
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Medical Emergency from a Nurse´s Point of View.
NETRVALOVÁ, Martina
The nurse?s approach to a patient who is being admitted at the emergency ward should be in all circumstances in compliance with the holistic philosophy. In the thesis we focused on the emergency admission of a patient from the nurse?s point of view. The emergency admission of a patient requires a quick and professional approach. It is important for each nurse to realize that communication with the patient, the doctor and other members of the medical team is the part of this professional approach. Another essential part is an active search of patient?s current problems. In order to manage this, it is necessary to show the ability to cooperate with the patient, to know, how to proceed in a physical checkup, to be able to describe the deviations from the standard, and last but not least, to be able to communicate with the doctor about the findings. The theoretical part of the thesis involves chapters dealing with holism, holistic philosophy, communication and physical check-up of a patient. Further this part deals with getting the anamnesis, the agreement with the admission to hospital and other formalities that belong to the procedure of admission of a patient. At the end of the theoretical part we characterize the surgical ward and the internal ward and describe abdomen aches and chest pains as typical examples of emergency admission reasons at these two wards. The objective of this work is to find out whether nurses at these emergency wards (surgical and internal) during the process of admission provide a patient with care that is in compliance with principles of holistic philosophy and also to compare the holistic approach of nurses at the surgical and internal emergency wards. 4 questions were set before the research started. Research question No.1: How are biopsychosocial needs of a patient at the emergency admission saturated? Research question No.2: How can the communication of a nurse with a patient at the emergency admission ward, during the admission procedures, influence the following cooperation of the patient with the medical staff? Research question No.3: What does the difference between the holistic care at the surgical and internal ward lie in? Research question No.4: How can the circumstances during the emergency admission of a patient influence a nurse?s respect of patient?s needs? Half-standardized interviews with 3 nurses from the surgical ward and with 3 nurses from the internal ward were used in the research part. Then, a concerned observation of those nurses was carried out, while they were taking care of a patient at the emergency admission ward. On the grounds of the research results we can assume that the objective of the thesis was met. The objective was to describe different views and approaches of nurses to a patient who is being admitted at the emergency ward. The research results were used to compose an instruction manual called: What nurses at the Emergency Admission Ward should not forget.
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Role of a Nurse during an Acute Hospital Admission of a Patient with Trauma
KOTRČOVÁ, Ivana
Incidence of injury is currently the third leading cause of death in the Czech Republic. A good link between pre-hospital emergency care and hospital care becomes a priority. Nurses play an important role during an acute admission of patients with trauma to in-hospital care, they are the connecting link of all members of the multidisciplinary team, whose common mission is the patient and saturation of his /her needs. With the changing role of nurses in the modern concept of nursing, nurses become equal partners of physicians and other health care professionals. To be accepted by other members of the team and to be able to work with the full extent of her sphere of action in the acute phase of a trauma patient admission, she has to know perfectly her competencies under the applicable legislation. In the theoretical part the roles and responsibilities of nurses under the applicable legislation are defined. There are also chapters dealing with individual injuries and the organization of care for patients with trauma. In the final section of the theoretical part there is a chapter dealing with the holistic care for patients, including ethical care issues, the role of a patient and the importance of cooperation with the family of the trauma patient who is acutely admitted into the hospital. In the empirical part of the thesis three objectives were stated. To determine the cooperation of nurses with other members of the multidisciplinary team, as well as to find out whether the nurses involved in the admission of a trauma patient into hospital know their own competencies under the Decree No. 424/2004 Coll. The third objective was to determine how trauma patients perceive the process of admission to the hospital. Based on these objectives two hypotheses and two research questions were established. The objectives were successfully met, both hypotheses were confirmed and the questions answered. The research was conducted on the basis of a quantitative qualitative survey at departments of selected hospitals where the patients with acute trauma emergency were directed by emergency medical services. For the quantitative research the interviewing method using questionnaires was selected. Interviews with patients were conducted by the qualitative research method. The respondents were 117 nurses and 5 patients.
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