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Nursing management for patient with acute confusion
FORMÁNKOVÁ, Hana
Delirium, also known as acute confusional state, is a qualitative disorder of consciousness, that often occurs in the elderly persons, intoxicated persons and post-surgery conditions. This diploma theses deals with the issue of nurse work management for patient with delirium. The main goal of the thesis was to find out what experiences with the patients with acute confusion nurses have, as well as how the care of such a patient affects the nurse's psyche and how a nurse should proceed in the care of a patient who is experiencing acute confusion. The goals were accomplished through the qualitative research survey. The data collection technique involved covert observation of patients and nurses, as well as semi-structured interviews with nurses who have experienced the care of patients with acute confusion. Attractive results have been achieved through the research. The nurses were relatively unaware of the differences in the nomenclature of acute confusion and delirium. On the other hand, nurses were aware of the symptoms of acute confusion / delirium. They had a good knowledge of the interventions that should be performed in these patients. Most of them were able to adjust the communication to the right extend so that it was suitable for a patient who was experiencing acute confusion / delirium. Nurses were able to treat the patient kindly despite their current inappropriate behavior. When we asked the nurses about specific interventions for these patients, their awareness was not good, therefore we decided to create a brochure that could help the nurses in their care. Awareness and use of rating scales was very low, rating scales designed directly for delirium were not used anywhere. The use of restrictive measures was often abused. But some nurses were also found to be wary of unnecessary use of the these funds.
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Intensive care unit delirium from nurses perspective
Křížová, Jana ; Hocková, Jana (advisor) ; Maffei Svobodová, Ludmila (referee)
Intensive care unit delirium from nurse's perspective Introduction: Delirium is a disturbance of consciousness, one of the most frequent organ dysfunctions in the ICU. Delirium occurs in 60 - 80% patients who receive mechanical ventilation and is independently associated with increased mortality and development of post-ICU neurocognitive deficit in adult ICU patients. It is recommended to monitor delirium routinely with validated screening tools (CAM-ICU or ICDSC). Experienced and well educated nurse, armed with appropriate diagnostic tools, can actively participate in prevention, diagnosis and therapy od delirium. Objective: This Master diploma thesis objective was to get to know current knowledge of nursing staff working in Czech ICUs about delirium and their clinical praxis. Method: Quantitative research was conducted with a questionnaire filled by nursing staff of ICUs for adult patients in two university and one regional hospital in Czech Republic from August to September 2017. Results: Altogether, 110 questionnaires from 130 have returned (84% return). The outcomes showed that 63% of nurses are sufficiently informed on ICU delirium, 66% would appreciate more education on the subject. All in all, 51% of nurses don't prevent delirium in their patients and 35% don't even know what are the...
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Nursing patients suffering in delirium at ICUs (Intensive Care Units)
VANIŠOVÁ, Štěpánka
Delirium is a very common and serious health complication which mostly affects elderly patients and is associated with multiple negative effects, such as prolongation of hospitalization, increase in financial expenses, higher mortality and more frequent need for further institutional solutions. Care for patients with delirium means increased mental and physical exertion for the nursing staff and is also more time-consuming. This bachelor thesis addresses the issues of nursing care for patients affected by delirium. It has three objectives. The first objective examines the specifics of nursing care for patients with delirium on selected surgical critical care units. The second objective examines the way nurses manage communication with patients affected by delirium, and the third objective maps the knowledge nurses have of care for patients with delirium. There are four research questions assigned to the objectives and they are based on the set objectives. The empirical part of this thesis used qualitative research method. It is based on a semi-structured interview, which was conducted with nurses working in intensive care units of surgical disciplines. The answers were analysed and then categorized. The research survey was complemented by participant observation of the nursing staff who took part in the interview. The research survey has found that the majority of surveyed nurses did not have the correct approach to patients affected by delirium. Nursing care for these patients was influenced by their mood. In some cases, there was an excessive use of restraints and disregard for the Restriction of patient's movement policy. The nurses who participated in the interview had good knowledge of proper communication methods with patients affected by delirium but in some cases did not use them in practice. They had less knowledge in the fields of prevention and nursing interventions of delirium. The results show that nurses lack theoretical and practical experience required to deal with this very common and serious health complication. This bachelor thesis could serve as a basis for organizing a seminar on this issue for nurses.
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Specification of nurses work with the desorientated client
VAŇKOVÁ, Soňa
The objective of my work was to find out how the client´ s disorientation changes the attitude of the nurse regarding the saturation of his needs. Another objective was to find out if the nurses are provided with enough information in the field of the saturation of needs of the disoriented client. I have made two hypotheses. Nursing care of a disoriented client makes higher demands on nurses (H1) and nurses do not have enough information in the field of saturation of needs of the disoriented client (H2). Based on the results H1 was confirmed, while H2 was not. The results show that the disorientation makes higher demands on nurses in the field of saturation of the disoriented client´ s needs in all respects while the communication with such clients did not prove difficult for nurses. The results further show that nurses are sufficiently familiar with this issue but the observations showed that some nurses do not satisfy these needs. In particular as far as are higher needs concerned.
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The Challenges of Providing Nursing Care to Delirant Clients in Intensive Care Units
VONDRÁKOVÁ, Radka
The theme of this undergraduate thesis is The Challenges of Providing Nursing Care to Delirant Clients/Patients in Intensive Care Units. The thesis pursues three objectives and elaborates three hypotheses. The first objectives was to assess the challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital, from the nurses{\crq} perspective. The second objective was to examine the nurses{\crq} knowledge of the specific challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital. The third objective was to ascertain whether nurses were acquainted with the principles of using inhibition as a means of controlling situation, according to the nursing standards of the České Budějovice Hospital. The first hypothesis was based on the presumption that nurses taking care of delirant patients feel exhausted. The second hypothesis was based on the presumption that nurses use inhibition as a standard means of controlling situations involving delirant patients. The third hypothesis was based on the presumption that university-educated nurses have a better knowledge of patients{\crq} delirant condition than nurses with lower education. For the purposes of my research, which I conducted in January and February 2009, I applied a quantitative method using a questionnaire. The questionnaire was distributed among the nurses working at the ICU of the České Budějovice Hospital. The resulting data were recorded in the form of diagrams. The validity of all the hypotheses has been confirmed and the outlined objectives have been reached. In the closing part of my thesis, I recommend that a seminar be organized for all the nursing staff of the České Budějovice Hospital, where nurses would be presented with the complexity of delirium problems, as well as mental hygiene and relaxation techniques. Furthermore, it was suggested to perform an audit of the nursing care standard no. 37 at the České Budějovice Hospital. The hardest recommendation to meet was to ensure adequate staffing of the ICU. However, solutions for this particular problem lie beyond the limits of my undergraduate thesis, as shortage of nursing staff is a nationwide problem. My last recommendation calls for improving the theoretical preparation of non-medical students by including specific practical care of delirant patients.
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