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Nursing physical examination in surgical nursing care.
SRBOVÁ, Klára
Current Status: The physical examination is an essential component of patient assessment, contributing to accurate diagnosis. It encompasses techniques such as inspection, palpation, percussion, auscultation, and digital rectal examination. Thesis Objectives: This study aims to delineate nursing actions in conducting physical examinations and highlight disparities in performing these assessments within surgical nursing settings. Methodology: A qualitative research method was employed, utilizing semi-structured interviews. The interview cohort comprised 8 nurses working in various surgical wards. Furthermore, a quantitative survey, comprising open, semi-open, or closed questions, was selected and included 169 respondents practicing across diverse surgical units. Data collection was conducted online, and participant selection was guided by data saturation. Thesis Findings: Interviews underscored nurses' adeptness in conducting physical examinations and their awareness of nuances that vary across departments. Most respondents (42.6%) hailed from traditional surgical units. A significant portion held a bachelor's degree (45.6%), and the prevalent experience range within surgical wards was 0-10 years (56.8%). Notably, 73.4% of patient admissions involved collaborative data collection between nurses and physicians. During physical examinations, 85.2% of nurses helped, and 97.6% performed assessments within their respective units. Inspection, olfaction, and assessment of consciousness consistently fell under nursing purview. Palpation and auscultation were infrequently conducted by nurses, with digital rectal examinations being exceedingly rare. Physical examination by a nurse varies from one surgical department to another. A relationship between the palpation and consciousness examination and the surgical ward in which she works has been demonstrated. Physical examination by a nurse varies with length of experience. There was a relationship between palpation examination and length of experience in the surgical department. Physical examination varies with the age of nurses. A relationship between percusion and consciousness examinationand and the age of the nurse has been demonstrated. Conclusion: In summary, nursing-conducted physical examinations is performed by the nurse within the scope of her competence and align with departmental needs and resources, reflecting the specific care context. The findings emphasize the collaborative nature of patient assessment and shed light on areas where nursing participation may be enhanced.
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The spectrum of surgical procedures in the conditions of pre-hospital emergency care
MONDEK, Jan
The bachelor's thesis is focused on surgical procedures in pre-hospital emergency care within solving reversible causes. The bachelor's thesis consists of a theoretical and research part. At the beginning of theoretical part, I deal with surgical procedures that belong to the environment of pre-hospital emergency care and describe their division, indications, risks and practical procedure for their application. I also describe traumatic circulatory arrest and extended cardiopulmonary resuscitation. In other chapters of the work, I deal with patient monitoring and examination, which is important for revealing reversible causes. I discuss the need for analgesia in pre-hospital care, and the last chapter focuses on the importance of maintaining an aseptic environment and risk sepsis. The research part covers qualitative research in the form of a semi-structured interview, while the research team consisted of 9 paramedics from the South Bohemian Region. The aim of the research was to map the indication and risks of surgical procedures in the conditions of pre-hospital emergency care. Another aim was to find out what awareness and experience the paramedics of the South Bohemian Region have in this issue. All research questions were answered and the aims of the thesis were fulfilled. The research found that the experience and knowledge of the paramedics at the various sites are very similar, the paramedics are sufficiently familiar with the issue, while the station in Jindřichův Hradec is objectively slightly better. This work could be used as study material in the education of paramedic students or for the self-education of paramedics.
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The nurse's role in the education of patients on surgical ward
KUBEŠOVÁ, Miroslava
The theoretical part of the bachelor thesis defines the role of a nurse-educator, the education reality consisting of the educational process, constructs, and the environment, it also concentrates on more particular introduction of the individual education topics in the pre-surgery and the post-surgery periods on a surgical ward. Four research goals were set in the empiric part of the thesis. The goals of the thesis were to find out in what ways nurses educated patients in the pre-surgery and the post-surgery periods. Further goals were to map the educational needs of patients before and after the surgery. The qualitative research form and the technique of semi-structured interviews conducted with nurses from a surgery department and patients before and after a planned surgery were chosen for the implementation of a significant part of the thesis. The criterion for the selection of respondents was that they should be patients of a surgery department with planned hospitalization longer than 2 days. The same patients were also interviewed during the post-operation period. The criterion for the selection of the nurses-respondents was that they had really worked at the standard ward of a surgery department for more than 3 months. The research sample set consisted of 9 nurses and 5 patients. Final categories and subcategories were defined based on the analyses of the carried our interviews. Educational material was prepared based on the research carried out with the patients and the nurses as the outcome from this bachelor thesis. The material was prepared in a form that enables its availability for a patient for the whole time of hospitalization. The use of the educational material can support the patient education on the surgical ward.
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Nursing care of surgical wounds on a surgical department
OCHMANOVÁ, Miroslava
The thesis deals with the care of surgical wounds in a surgical department. The aim of this thesis is to map a nursing care of surgical wounds in a standard surgical department and in an intensive care unit. Also it tries to answer what aids nurses have at their disposal in the individual surgical departments and then to compare all the parameters with each other. The following research questions were created from the aims: How do nurses treat a surgical wound in a standard surgical department? What kind of aids for nursing wounds do they have available in a standard surgical department? What are the differences in a care of surgical wound in a standard surgical ward and in an intensive care unit? What are the differences in aids for nursing wounds in a standard surgical ward and in an intensive care unit? We chose a qualitative method for the research survey. The data collection was carried out in the form of a semi-structured interview in a total of 14 addressed nurses. Seven of them work in a standard surgical department and the remaining seven nurses work in a surgical intensive care unit. From the interviews we can conclude that the process of nursing care of surgical wounds in both wards are mostly performed according to the recommended practice. The biggest difference in the care of the surgical wounds is in the care of the scar. The difference comes from different parameters of each wards. In the intensive care unit patients are hospitalized after major operations and they are then transferred to a standard surgical unit and after all this they are released to a home care. There were not found any differences in the aids which they are using for care of surgical wounds in each wards. The results of the survey can help students in preparing for future careers and to improve the awareness of nurses in the care of surgical wounds working in surgical departments.
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The need for rest and sleep of patients hospitalized in surgical wards
KOČÁRNÍKOVÁ, Kristýna
This thesis is focused on the topic of sleep and rest of hospitalised patients in surgical wards. Every patient has his own needs according to Maslow´s pyramid. His priorites of needs change during hospitalisation. In surgical wards one of the main needs is the need of enough sleep and rest. Patient needs to rest on the hospital bed and get strong enough to recover after some effort or surgery, and in the hospital, there is a lot of factors which may change his needs. To satisfy these needs every nurse should be informed about this topic and should keep the principles for keeping the patient calm and relaxed. The nurse should also inform other patients and demand them to respect the rules of hospital principles. The meaning of reseach is to map the need of rest and sleep in overall and with illness during hospitalisation and map the role of the nurse during nursing care in satisfying the patients needs of rest and sleep. In theoretical part, the thesis focus on sleep and rest characteristic, describes nursing process as it is and nursing process focused on satisfying needs of sleep and rest. Thesis continues by shortly describing characteristics of surgical wards. In practical part, the thesis shows research from surgical wards from regional hospital. Practical part of thesis starts with setting up goals and research questions. Continues with characteristic of research methods, evaluating of research data and its results in discuss part. The results show what the rest and sleep rituals are for hospitalised patients, what the results of not satisfiyng the needs of rest and sleep are and what is the difference of the need of rest and sleep while being healthy or ill.
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Use of nursing competencies in surgical department
HARAZINOVÁ, Lucie
The aim of my bachelor thesis is to map the work of nurses in the surgical department. For a comprehensive view, attention is paid to the standard inpatient department, surgical intensive care unit and surgical outpatient clinic. Determining the specifics of the work of nurses in these components was defined as the second goal. To meet the goals, 3 main research questions were set: "What is the role of a nurse in the surgical department?", "What are the specifics of work in individual departments?" and "What is the continuity of care between departments?". Due to the diversity of surgical components, the theoretical part of my work specifies their spatial arrangements and equipment, describes the expected condition of patients, the role of the nurse and other aspects. It also discusses the history of surgery as a field. The research group consists of a total of 19 informants, of which 8 informants working in the standard surgical department, 6 informants from the surgical intensive care unit and 5 informants from the surgical outpatient clinic. The results show that the addressed informants generally perceive their role as part of their job position and in the provision of nursing care. The specifics of the standard ward are described by nurses from its septic part in the more difficult state of health of patients, other informants mention the diversity of diagnoses or concern for a higher number of patients. Informants from the intensive care unit agree on the increased need for patient monitoring. The informants from the surgical outpatient clinic mainly take care of patients with acute problems, while the outpatient clinic is usually their first point of contact with a medical facility. The output of this work is a professional article providing information for medical staff and students of medical disciplines.
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THE SURGICAL TREATMENT OF UNSTABLE FRACTURES OF STERNUM AND RIBS
Šimánek, Václav ; Šebor, Jindřich (advisor) ; Čapov, Ivan (referee) ; Vyhnánek, František (referee)
The injury of chest belongs to most frequented injuries. As far as 70 per cent of injuries of thorax is connected with injury of other organs. The relevance of injury of chest increases with age. The prognosis of polytraumatized patients with injury of thorax is aggravated in combination with craniocerebral injury. 50 per cent of death caused by injuries is connected with trauma of chest. The trauma of thorax are most frequently blunt. The open injuries are heavier. The main reason of blunt injuries of chest are road traffic accidents. 80 per cent of open injuries are created by shooting weapons or by stabbing. The fractures of ribs belong to most frequent types of fractures and simultaneously to the most types of injuries of thorax. The multiple fractures of ribs are serious. From 10 to 20 per cent of fractures of ribs have the manifestation of paradox breathing. The unstable fractures of ribs are classified after Pate and Eschapasse-Gailard. The conservative and operative types of treatment are used for stabilization of chest wall. The opinion on usage of this treatment are not unified. The artificial lung ventilation with low PEEP is used during conservative treatment. Operative treatment utilizes the external or internal fixation of unstable fragments of chest wall. At the Department of Surgery,...
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Prevention thromboembolic disease in surgery
Konečná, Lenka ; Tomová, Šárka (advisor) ; Nikodemová, Hana (referee)
The bachelor thesis with the title "Prevention of Thromboembolic Disease" depicts a serious medical condition which may lead to death. Thromboembolic disease affects mostly patients after surgery. However, with proper prevention the risk of developing the disease decreases significantly. The main aim of the thesis is to find out who educates the patient and when (whether it is before or after the surgery). Furthermore, it focuses on nurses and their role in prevention of thromboembolic disease. It asks if nurses educate patients about the disease and the importance of prevention. In particular, it concentrates on the quality and quantity of patient education. It tries to find out whether nurses know what patient education in patients with this condition should include and whether they use any educational aids. In the empirical part of the thesis the author acquired data using a quantitative research method of a structured questionnaire. The survey included 128 respondents working in several intensive and non-intensive departments of the Královské Vinohrady University Hospital. A research survey showed that 83 (65.9%) nurses educate patients before surgery and there is no difference between length of practice and preoperative education on TEN prevention. Furthermore, 100 (78.7%) of the nurses check...
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Methods and consequences of some neurosurgical interventions in animal model and in human clinic. Pinealectomy and intracerebroventricular application.
Řezáčová, Lenka ; Tichý, Michal (advisor) ; Szárszoi, Ondrej (referee) ; Přibáň, Vladimír (referee)
Clinical surgical techniques of pinealectomy and intracerebroventricular (i.c.v) cannulation are still used in the clinic in indicated cases. In research, there is an effort to replace these classical surgical techniques by other means. However, these various new models often do not reflect the complexity of the functions taking place in the living organism as a whole. The thesis shows that these surgical techniques should be also a part of biomedical research in the future, as they still bring new important information. In the experiment, the pinealectomy can serve as a model of resection or depletion (removal of natural hormone secretion), while i.c.v. application of the active substance to the ventricles on the contrary as a model of addition or substitution. The practical part of the thesis is divided into 4 areas: A) pinealectomy - an animal models, B) pinealectomy - in the experiment, C) pinealectomy - in the clinical practice and D) intracerebroventricular application - in the experiment. The work describes in detail the surgical techniques and discuss possible consequences of pinealectomy in 6 animal species (and their comparison) and in humans. It also includes an experiment with pinealectomy in a rat and a clinical study in patients with pineal cyst and subsequent pinealectomy. The work...
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Returnig to Normal Life after Prolonged Period on ICU Following Major Surgical Procedures
Žánová, Libuše ; Židková, Lucie (advisor) ; Pucholtová, Romana (referee) ; Hocková, Jana (referee)
Introductin: The diploma thesis deals wits the quality of life of patients who have undergone more demanding surgery in the area of thoracic or abdominal surgery and were subsequently connected to artificial at present. This increases the need for patients to be places in an intensive care unit. Whwther i tis performance intenzity, length of anesthesia, possible complications during surgery or age of the patient. Stay in intensive care for a patient is physically and mentally very demanding, which may lead to deterioration in qaulity of life after returning to the home environment. Methodology: The research itself was carried out in the framework of qualitative research using a sem- structured interview. The interview was made up of the maim questions that could be supplemented by supplementary questions. Researchers selected patiens who had more severe surgery in the chas tor abdomen and were vented for at least 48 hours. The study also include patients who had a "minor" surgery but had complications nad had to be connected to artificial pulmonary ventilation. The research was conducted from August 2018 tu February 2019. Research Objektive: The main goal of the diploma thesis is to map the quality of life of patients who were hospitalized under intensive care and were exposed to PICS (Post...
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