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A design of the system for continous evaluation of analytical samples quality in a clinical biochemistry laboratory
SVATOŠOVÁ, Kristýna
The aim of my work is to provide information about the process of evaluating analytic quality of samples. This kind of process is recommended in clinic biochemistry laboratory at present. Serum indexes are measured always, in any required sample test whose result can be influenced by sample quality. It is possible to evaluate the degree of haemolysis, icterus and lipemia in patients´ blood samples by the photometric method. The sample haemolysis is mostly caused by bad technic of blood samples taking or their inappropriate transport so that in the end of this process, in regular intervals there is a possibility to find out the level of results changes in connection with concrete laboratory services users. In theoretical part of my work I describe reasons of sample quality decreasing in vivo that´s something people can´t influence because they originate in a patient´s body and in vitro that are caused by wasteful manipulation. In this part there are also principles of the photometrical methods mostly used. The practical part contains the model example that shows how the analyts can be influenced by artificial adding of interfering substances. I could see increasing of some element concentration after making evaluation: Concentration of K increased by 24%, Fe by 10%, bilirubin by 13% and enzymatic activity ALT by 23%, AST by 179%, GMT by 26% and ALP was reduced by 25% in haemolytic serum. In icteric and lipemic serum there isn´t interference on such high level. Icterus causes decreasing of urea by 17%, creatinine by 27%, enzymatic activity ALT by 10% and activity GMT is increased by 11%. Lipemia decreases concentration of creatinine by 8%, enzymatic activity ALT by 6% and bilirubin is higher by 21%. In the end of my work I introduce statistic conclusion laboratory informatics system that gives laboratory management possibility to find out samples of bad quality in connection with concrete applicants and help to make some reparation.
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Nursing process in newborn with hyperbilirubinemia
SEKALOVÁ, Monika
The thesis deals with Nursing process with neonates diagnosed with hyperbilirubinemia. The theoretical part focuses on the physiological and premature new-born babies, anatomy and physiology of blood, neonatal hyperbilirubinemia problems, nursing process and NANDA and NIC classification systems. The practical part contains research results. Qualitative method was used for the research and it was carried out at the neonatal department in Nemocnice Ceske Budejovice, a.s. (Ceske Budejovice Hospital). The first objective was to determine the specifics of nursing care for full-term new-borns and premature new-borns diagnosed with hyperbilirubinemia. It was found that the specifics were mainly in monitoring of the physiological functions, measurement frequency of transcutaneous bilirubinometry, in positioning the new-born during phototherapy, in the prescribed temperature inside the incubator and in children's diets. All information necessary was collected through interviews with nurses, from documentation content analysis and by observation. Based on the information, case studies were developed. The research sample consisted of two new-born babies diagnosed with hyperbilirubinemia. The second objective of the thesis was to determine nurses´ position when using NANDA classification systems to diagnose Neonatal jaundice and NIC Phototherapy: new-born. It was found that nurses would change some defining characteristics and related factors to diagnose Neonatal jaundice (00194) as well asinterventions from NIC Phototherapy: new-born (6924). Most of them agreed that they would not like to use these classifications during care of the new-borns. Information was collected using structured interviews with three neonatal nurses and two midwives. The results could be used to improve nursing care for neonates diagnosed with hyperbilirubinemia.
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