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The Role of Nurse of Patient after Kidney Transplantation
ŠEVČÍKOVÁ, Tereza
The diploma thesis sets two goals: 1. To find out the role of the nurse in postoperative care of a patient after a kidney transplant. 2. To map the specifics of nursing care for patients after kidney transplantation. Therefore, in order to meet the goals, four research questions were set: 1. What is the role of the nurse in postoperative care of a patient after a kidney transplant? 2. How does the role of a nurse in the postoperative period in a patient after a kidney transplant differ from postoperative care of the patient to another abdominal operation? 3. How does the role of a nurse in the postoperative period differ in a kidney transplant patient after another abdominal surgery in the standard ward and in the ICU? 4. What are the differences in the postoperative nursing care of a patient after a kidney transplant and the postoperative care of a patient after another abdominal surgery in the first days after the operation? The theoretical part of the work is divided into individual chapters, which describe the history and development of kidney transplantation, indications and contraindications of kidney transplantation, organ donation and inclusion on the waiting list, surgical techniques of transplantation and postoperative complications, immunosuppression and specifics of postoperative care and the effect of transplantation on pregnancy. Furthermore, the theoretical part deals with the history and modern view of the roles of nurses, the relationship between nurse and patient and finally the role of nurses in surgical fields. The practical part of the diploma thesis is processed by a qualitative method in the form of a semi-structured interview. The interview was conducted on the basis of pre-prepared questions with ten general nurses working in the inpatient department and intensive care unit of Transplant Surgery at IKEM. The analysis of the interviews took place in the form of "paper-pencil" and the method of open coding. All interviewed nurses refused to record the interviews in the form of an audio recording, which was respected. The results were divided into categories. The work should provide a comprehensive view of patient care in the postoperative period after kidney transplantation, describe its complexity and the differences between patient care after normal abdominal surgery and after transplantation. It can be used as a teaching material.
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Nursing of organ donors at the Department of the Anesthesiology and Resuscitation.
KLIVANOVÁ, Zuzana
This bachelor thesis deals with nursing of organ donors at the Department of Anesthesiology and Resuscitation and mainly the work nurses perform. There are situations, when transplantation is the only way how to save one's life and the nursing of such patients is vital. Hygiene, bandaging and brain-death diagnosis are not only very important, but also time demanding. The most demanding thing is the psyche of the nurse herself, she has to be aware of the fact, that the patient she nurses is going to die, but one or more lives are saved in the process. The whole process of transplantation is very long and complicated and requires a lot of medical interventions from numerous doctors and nurses, who deserve a great deal of credit. The nurse has full responsibility for the patient, she works on her own and without supervision and she alone is responsible for the nursing quality. Nursing requires good knowledge of every aspect of the process. The nurse is a full member of the whole transplantation medical team, because it is her, who spends the most time with the patient and it is her who takes notice of every single problem which she consults with the doctor. The theoretical part deals with the process of taking off the organs from brain-dead patients. It also deals with the history of transplantation and the law and morale aspect of organ transplantation. Then the thesis deals with the process of brain-death diagnosis and the medical equipment used in this process. The last chapter is about organ donors monitoring at the department of intense care, nursing of the organ donors and nursing of deceased patients. The aim of this research was to find out how the nursing process works at the Department of Anesthesiology and Resuscitation. There were two main pre-set questions for this research. The first question was. How are the organ donors nursed at the Department of Anesthesiology and Resuscitation? The second was. What mistakes do the nurses make while nursing organ donors? The practical part of this work contains the outcomes of my qualitative research from the Department of Anesthesiology and Resuscitation at the hospital in Ceske Budejovice. A semi-structured dialogue method was used. There were sixteen questions prepared according to professional literature. The research I made was acknowledged by the head nurse and I spoke with eight previously chosen Department of Anesthesiology and Resuscitation nurses. During the dialogues I took notes which I then processed via the paper-pencil technique. After a precise analysis of the data collected I established three main categories. First one is basic nursing, second one is nursing of brain-dead patients and the last one is nursing of organ donors. Each category consists itself from various sub-categories, which are shown in a diagram. Some questions mentioned in the dialogues can't be categorised, so they are mentioned in the diagrams. The last question was of a morale nature, which is crucial in this field of nursing. The findings of this bachelor thesis show, how organ donors are nursed. The research has shown that the hygiene, bandaging and organ donor vital functions monitoring is no different from nursing of other acute patients. The nursing quality in the hospital is according to all the standards, which nurses follow precisely. Dead bodies are handled exclusively by nurses as it is a natural part of the whole process. Nurses were fully able to specify the methods of determining a brain-dead patient. They knew what tissue samples are essential and what kind of medical equipment is used for brain-death diagnosis. The communication between the hospital and the Centre of coordination for organ donors is done according to the law n. 285/2002 Sb. It is the duty of medical staff to inform the centre about every single patient. This process is the responsibility of the doctor and the nurse does as she is told.
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Nursing care for cadaverous patients and nurses views on organ donation.
PÍŠOVÁ, Barbora
This Bachelor degree work is focused on the issue of the nursing care for the cadaverous patient, on its specific features, on the knowledge of nurses and on their opinions of the transplantation program. Result of the work creates an information brochure which will serve as a guideline for all nurses of the Department of Anaesthesiology and Resuscitation in Písek Hospital and it will help them to be quickly and well informed on the nursing care for the donors. The work is divided into two parts. In the first part there are stated legal regulations which run the transplantation process in the Czech Republic, next there are mentioned duties of the doctors from the donor hospital and examinations which are necessary for pronouncing the brain dead. The first part also describes activities of the coordination centre which is in charge of the process itself. Further, there is dealt with the ethic of the organ transplantation. The description of the nursing care for the donor with the beating heart forms a major part of the work. It involves the basic nursing and intensive care, specific examinations and documentation, doctors´ assistance and patients´ monitoring. For the second research part there were set two aims, which we tried to explain by means of interviews involving several groups of questions. Respondents were only nurses who have already had experience with the care for donors. The research questions were answered by means of the qualitative research investigation using the form of the semi-structure interview. The aims were supposed to map out the nursing care for donors from nurses´ point of view and to map out the nurses´ opinion of the donorship. The groups of questions concerned the specific features of the nursing care, nurses´ knowledge in this care and their opinion of the transplantation program. The research confirmed that this care has its specific characteristics, nurses have sufficient knowledge about the issue and they have mostly positive opinion of transplantation. On the basis of the research there was compiled a brief information brochure designed not only for beginning nurses. Students of medical branches can benefit from the work too.
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