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Feeding the patients in hospital
NITA, Tatiana
The main goal of the bachelor thesis was to find out what interventions the nurses used in feeding, what communication techniques the nurses used and how they cooperated with other members of the nursing team in feeding patients in hospital facilities. Three research questions were identified, which focused on the nurse's interventions in the feeding, on communication techniques during the administration of food and on the cooperation of nurses with other members of the nursing team. The empirical part of the bachelor thesis was processed through a qualitative research survey. The data collection itself was carried out through participatory unstructured observation of nurses working in a hospital facility. Each observation was converted into written form and further processed by the method of open coding, the "pencil - paper" technique. The results of the empirical part were divided into nine categories for clarity. Among positive findings we include that the rooms had been cleaned and ventilated before the food was served. Before lunch, the nurses allowed non-self-sufficient patients to take a suitable position. The nurses also prepared bedside tables for patients at a sufficient distance and provided non-self-sufficient patients with a paper bib to prevent contamination of their clothing and bedding. No dietary changes were observed. The diet was served at a sufficient temperature and amount. During the diet, the nurses actively offered patients liquids with the help of various compensatory aids for drinking. Among the positive findings was that the nurses fed the patients in clean work uniforms, had no accessories on their hands, were properly combed, and all but one had the prescribed manicure. Furthermore, the nurses actively cooperated and communicated with both patients and nursing staff. Only minor problems were detected, but this did not have a major impact on the provision of quality nursing care to patients. Among the negative findings we can include non-compliance with the principles of barrier care for nurses. The nurses did not exchange incontinence devices for non-self-sufficient patients, they did not allow them to perform hand and oral hygiene. It was also revealed that the nurses did not wash or disinfect their hands before or after eating. This bachelor's thesis is intended for nurses and students of non-medical health disciplines and will serve as a basis for revealing problems and improving skills in the field of feeding patients. The thesis can serve as a basis for further research.
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Nursing care in a hygienic and epidemiological regime from the patient's perspective.
KŘEPELOVÁ, Lenka
Considering contemporary lifestyle and possibility of travelling imported infections accrued and some illnesses come back that have not occurred nearly at us more. Not only haemorrhagic fevers and other highly infectious illnesses but also hospital multiresistant bacterial strains that mean high risk for patients constitute a threat. The number of nosocomial infectious grows still. The patient is in the case of suspicion or already diagnosed infectious illness isolated and treated in the infectious department or in the tribal department in the room with increased hygienic-epidemiologic regime. The patient is saved in a single room, the possibility of visits is reduced and the staff uses personal protective equipment. The man is holistic being and it can come due to isolation to lack of satisfaction of his/her bio-psycho-social needs. The aim of this thesis is to identify unsatisfied bio-psycho-social needs of patients in increased hygienic-epidemiologic regime and to describe changes in needs of the patient depending on the time of hospitalisation. The theoretic part describes the problematics of infectious illnesses, system of the care for the patient with infectious illness and changes in human needs in the period of the illness. The empiric part of the thesis deals with unsatisfied bio-psycho-social needs of isolated individual through quantitative research. The research suite was made up of 10 patients who were hospitalised in the room with increased hygienic-epidemiologic regime. The survey was carried out in the Hospital Jihlava by semistructured interview and the results of the survey were processed by opened coding by method paper and pencil. It is emphasized that the most needs of the patient have biological, psychical, social and even spiritual aspects. The rate of satisfaction with caregiving depends on the health condition and personality of the patient. Not small influence has the length of the hospitalisation, too. It was found out during the survey that the patients have not enough information about specifics of the care in the infectious department and that is why there is often a misunderstanding of necessity of barrier measures. It is possible to avoid useless misunderstanding through timely and suitable education. It was created an educational material with the title "Guide for patients hospitalised in the infectious department of Hospital Jihlava" for this purpose. Employees of the infectious department of Hospital Jihlava were informed with results of the research during a workshop, too.
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The effekt of accreditation on the quality of health care providet in selected medical facilites.
SOMROVÁ, Jana
The quality of nursing care is becoming an increasingly important concept in contemporary nursing. The most effective means of achieving quality of nursing care and the means of proof is the accreditation of medical facilities. It is a significant appreciation of professionalism, the work of health professionals and an important signal for the patients. Quality of care, security of supply and preventing potential risks for health care priority. The main aim of the thesis "The influence of accreditation on quality of care in selected health facilities" was to map the set of quality management and impact monitoring and evaluation of quality indicators in hospitals accredited by the Czech Republic. To determine whether accreditation has become an instrument to ensure comparable quality, and time has changed from an unpopular instrument into an instrument for continuous quality improvement. The survey took place from November 2010 to March 2011 in the form of quantitative data collection using an anonymous questionnaire survey in selected hospitals accredited by the Czech Republic. In the research study were asked managers of nursing care, main, upper station and sisters. The thesis has been established 6 goals. The first objective was to determine what indicators of quality nursing care in accredited hospitals pursue. Interested in us as quality indicators that were studied before accreditation, and quality indicators to setting up medical facilities in preparation for accreditation. The second objective was determine how frequently watched indicator of quality is monitored in hospital. The third objective was to determine whether there was in accredited hospitals to reduce adverse events - falls. The fourth objective was to determine whether there was in accredited hospitals to reduce the incidence of nosocomial infections in complying with barrier nursing regime. The fifth objective was to identify the biggest problems arose during the implementation of audits, completeness and comprehensiveness of nursing documentation management into practice. " The sixth objective was to determine whether there was during the preparation of an increase in hospital nursing staff. The thesis then was examined six hypotheses. First hypothesis Accredited hospitals monitor the quality of care provided by at least ten quality indicators - were confirmed. Hypothesis 2 The most frequently monitored indicator of the quality of nursing care, the prevalence of pressure ulcers - was confirmed. All respondents said they monitor the prevalence of pressure ulcers as an indicator of quality nursing care. Hypothesis 3 gaining accreditation to reduce the incidence of falls - was confirmed. Hypothesis 4 obtaining accreditation decreased nosocomial infections - was confirmed. Hypothesis 5 The biggest problem in implementing the audit, management complexity and completeness of nursing documentation in practice "has been an increase in paperwork for nursing staff - were confirmed. Hypothesis 6 During the preparation for accreditation has been an increase in nursing staff - has not been confirmed. Accreditation is perceived by respondents as beneficial for the hospital. Due to accreditation standards and developing quality indicators were identified risk areas in the provision of hospital care and detail can be paid to the prevention of adverse events, nosocomial infections and other risks. The results of work will be to provide medical facilities where the research was conducted investigation, the presentation of the research will be presented at a conference, the South Bohemian nursing days "and also gives the United Accreditation Commission of the Czech Republic as a presentation at the conference to be held early next year (spring ) 2012th Nursing standards were created.
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