|
|
Continuous elimination methods in intensive care - Creating Instructional Materials for Starting Nurses
ŠERIOVÁ, Martina
This dissertation deals with the issue of continuous elimination methods in intensive care, and of subsequently creating teaching materials for incoming nurses. The goal was to create teaching materials for incoming nurses. These teaching materials should help incoming nurses work with a device intended for continuous elimination methods. The dissertation is divided into a theoretical and practical part. The empirical part was implemented in the form of a qualitative research, using semi-structured interviews with respondents at the Accident and Emergency Ward of Nemocnice České Budějovice a.s. at the RES 2 station. The first stage of research was implemented by conducting interviews with the respondents. These interviews were recorded in the form of detailed notes which were later transcribed in order to prevent losses of data and inaccuracies. Subsequently, categories were established and, proceeding from these categories, schemes created using the ATLAS programme. The second stage consisted of creating an instruction video and teaching materials for incoming nurses. As a part of the third stage of research, the created video and teaching materials were presented at the Accident and Emergency Ward for evaluation. Then, interviews with the original respondents were re-conducted. During these interviews, the respondents were tasked with evaluating whether the teaching materials fulfil their needs and whether they will be usable in practice. The learned information was then arranged in corresponding schemes. Two goals were set with regards to the practical part. The first goal was to determine which form of teaching materials is suitable for incoming nurses. The second goal was to establish the benefits and usability of the created materials in practice. Based on the goals, two research questions were formulated. The first research question was: Is the form of the teaching materials suitable for incoming nurses? The second research question was: What is the benefit of the created materials in practice? Based on the research, it was discovered that most of the respondents would welcome teaching materials in the form of printed leaflets; however, opinions on the option of creating a video were also heard. Therefore, an instruction video, suitably complementing the printed leaflet, was created. The third part of research implied that most of the eight interviewed respondents were satisfied with the teaching materials. Three respondents suggested supplementing the printed leaflet with additional images. All eight respondents agreed that in their opinion, the provided teaching materials would make it easier for incoming nurses to familiarize themselves with the issues discussed. The head nurse at the Accident and Emergency Ward views the created teaching materials as beneficial. She intends to continue using these materials at her ward.
|
|
|
Continuous Elimination methods in Intesice Care from The Perspective of Nurses (Theoretical work).
HOROVÁ, Petra
The purpose of the dissertation Continuous Elimination Methods in Intensive Care in Prospective of Hospital Nurse is to inform about acute kidney injury and chronic kidney disease. These are major reason to use elimination methods at intensive care units and anesthesiological resuscitation departments. We further determine elimination issues. Continuous elimination methods in intensive care medicine are important medical treatment at acute kidney injury and chronic kidney disease. Particularly, acute kidney injury belongs to frequent complications at critically diseased patients, therefore will be properly discussed. It is afraid, because decreased renal function leads to incapability to excrete waste products of metabolism and sustain homeostasis. Mortality at acute kidney injury is higher than at chronic kidney disease so support or renal replacement therapy, in order to save life, is the only accepted method of choice at present time. The techniques of renal support or replacement therapy are integral part of instensive care medicine. The aim of this thesis is to elaborate latest accessible findings and specialized nursing care at continuous elimination methods. Ve have tried to create integrated, comprehensible summary of knowledge of this topic. We expect these findings are fundamental to high-quality nursing at patients with this disorder. The dissertation was conducted as a method of review and synthesis. As long as this part is purely theoretical-based, it gathers informations from czech and also foreign sources. The data was acquired from scientific publications, technical papers, monographs and web. The outcome of this work can be used for further research of this topic or contribute to resource information for paramedical staff. In the thesis we analyze acute kidney injury, briefly chronic kidney disease, then we proceed through the history of dialysis and its specifications. These are closely explained. We focus on technical aspect of various elimination methods, the division, indication to initation, advantage and disadvantage, vascular access will also be described. The possibilities of anticoagulation have been defined, the types of membrane hemofiltrates and dialysators, substitutional and dialysing solutions have been characterized, the need of dietary measures has been emphasized. The complications that can happen during the use of elimination method have not been left out of consideration. We describe the intensive care units, nurse competencies, their work, monitoration, patients' and elimination unit preparation and vascular access care.
|
|
|
Nutrition of dialysis patient
ŠIKOLOVÁ, Nela
My Bachelor's thesis ,,Nutrition of dialyzed patient" is divided into two parts, the theoretical and practical one. The theoretical one consists of eight chapters. The first chapter deals with kidney anatomy. I briefly describe the shape, size, position and vascular supply to kidneys. I also mention the basic functional unit - nephron, as well as primary and final urine creation which is connected with it. The second chapter is focused on three main kidney functions. The first one is excretory which means elimination of waste and extraneous substances. The second function is metabolic when kidneys participate in managing ions and water in the body and thus they keep homeostasis of internal environment. The third function is endocrine; in the course of this function, kidneys secrete renin, kallikrein, prostaglandins, and erythropoetin and they participate in vitamin D metabolism and degradation of insulin. In the third chapter I characterize kidney diseases and I try to reveal the main causes of their formation. I specifically deal with primary and secondary glomerulopathy, acute, sub-acute and chronic glomerulonephritis. The conclusion of this chapter is devoted to acute and chronic tubulointerstitial nephritis; moreover I mention the most frequent hereditary kidney diseases. In the fourth chapter, I describe renal insufficiency and renal failure which is divided into acute and chronic. Acute renal failure is divided according to its main cause into pre-renal (functional), renal (impairment of renal parenchyma) and post-renal (urological). Chronic renal failure is divided according to KDOQI classification into five stages. The fifth chapter is devoted to metabolic effects (consequences) of renal diseases when the impairment of excretory, metabolic and endocrine renal function occurs (endocrine renal function influences all our body). I aim at acid-base disturbances, water and electrolyte metabolism, calcium-phosphate metabolism, hormonal function, metabolism of proteins, fats, carbohydrates, vitamins and trace elements. In the sixth chapter, I illustrate the diversity of hemodialysis, hemofiltration, hemodiafiltration and peritoneal dialysis. In the seventh chapter, I mention a kidney transplant, which is possible from a living donor or cadaver program. The eight chapter is the core of my Bachelor?s work. I deal with dietary and lifestyle changes in patients before a dialysis therapy, during dialysis therapy, and after a kidney transplant. For the practical part, I have chosen some methods of quantitative research. The purpose of the research part was to investigate awareness of dietary regime and how the respondents (patients in chronic dialysis programme in the Hospital in České Budějovice, a.s.) comply with it. I have stated the research question as follows ,,How do dialysed patients comply with dietary regime?". I have applied a method of data gathering which was carried out by means of an anonymous questionnaire. The questionnaire consists of 28 questions, out of which 12 questions are close and 16 are open. The starting point for the evaluation of results of following dialysis regime was questions number 6 to 27. Out of 22 questions, the respondent who follows the diet should have replied 12 and more questions correctly. The results based on a sample population have shown that 25 respondents on dialysis do not follow the dietary regime, while only 15 respondents do follow it. If the dialysis diet is not kept, not only the prognosis of treatment is negatively affected, but first of all medical condition of the patient is being aggravated. To address this problem, I recommend a consultation with a nutrition therapist who would thoroughly educate the patient, especially in terms of main principles in dialysis treatment. The therapist would also compile a diet individually for each patient based on their actual medical condition.
|
guest ::
