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Keeping preventive measures of patients with total joint replacement as prevention of infectious complications development
DRATNÁLOVÁ, Dominika
Total joint replacement is already considered routine elective operation in orthopaedics. With the growing number of these operations, there are higher requirements for medical personnel, but also for patients. One of the complications that can occur with total joint replacement is infection. The objective of this research was to find out; how are patients involved in the prevention of infectious complications, to detect whether general nurses adhere to the standards of application of antibiotic prophylaxis and, last but not least, to determine which interventions performed by general nurses within the frame work of preventive measurements of infectious complications in patients before and after total joint replacement. Qualitative and quantitative research methods were used in the empirical part of the research. The first quantitative questionnaire was focused on orthopaedic patients and their involvement in prevention of infectious complication. The second questionnaire (record arch) monitored the patient's conditions before the operation and proper use of antimicrobial prophylaxis. General nurses from the anaesthesiology-resuscitation ward and from the orthopedic (orthopedic-traumatology) ward contributed to the completion of this record sheet. The focus group method was used in the qualitative part of research and it paid attention to the work of nurses from the orthopedic-traumatology ward. Outcomes of this research showed that orthopaedic patients are not involved enough in prevention of infectious complications and they could be engaged in the support of their health more. Both questionnaires showed that the biggest issue in the patients is overweight or some degree of obesity. From the results of the record sheet completed by the nurses, we can see there is an effort to follow recommended practice of antimicrobial prophylaxis. There was a significant improvement in this aspect of prevention of infectious complications compared to the audit of Ceske Budejovice Hospital from 2008. Results of the focus group method showed that general nurses know the interventions carried out to prevent infection well. But the investigation also revealed that for nurses, barrier care is routine procedure, therefore, they dont pay enough attention to this care. Based on the obtained results, a procedure was proposed to involve patients more in preoperative preparations and to inspire an interest in their health. Management of the orthopaedic ward and management of the antibiotic center of Ceske Budejovice Hospital were both informed about the result of the evaluation of the administration of antimicrobial prophylaxis. Active control system within the preoperative preparations was created for the general nurses from the Jihlava hospital's orthopaedic-traumatology ward.
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The incidence of postoperative infectious complications in neurosurgical ICU
Brindová, Jana ; Mrákava, Vlastimil (advisor) ; Hocková, Jana (referee)
This thesis examines in detail the nature of postoperative infectious complications in patients who underwent brain tumor surgery. It deals with the incidence of these complications and their severity, depending on various factors and suggests the most appropriate nursing procedures used in the care of a patient in whom these complications occurred. For the structure of the work is divided into two parts - theoretical and empirical. The theoretical part deals with the issues examined in terms of the medical field Neurosurgery (closer diagnoses, conditions, operations and other procedures, and complications to occur after these operations or expected performance), analyzes a nursing practice and patient care on neurosurgical ICU, and finally closely examines infections and nosocomial diseases, including a description of the most common types, their agents, diagnosis and treatment. The second, empirical part focuses on the problems from a practical point of view. With the help of set of case studies it closer which specific complications are most commonly found on the neurosurgical ICU in patients after surgery of brain tumors, what are the most common methods of treatment and nursing procedures which are most used in the care of patients with these complications. In conclusion summarizes the...
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The incidence of postoperative infectious complications in neurosurgical ICU
Brindová, Jana ; Mrákava, Vlastimil (advisor) ; Hocková, Jana (referee)
This thesis examines in detail the nature of postoperative infectious complications in patients who underwent brain tumor surgery. It deals with the incidence of these complications and their severity, depending on various factors and suggests the most appropriate nursing procedures used in the care of a patient in whom these complications occurred. For the structure of the work is divided into two parts - theoretical and empirical. The theoretical part deals with the issues examined in terms of the medical field Neurosurgery (closer diagnoses, conditions, operations and other procedures, and complications to occur after these operations or expected performance), analyzes a nursing practice and patient care on neurosurgical ICU, and finally closely examines infections and nosocomial diseases, including a description of the most common types, their agents, diagnosis and treatment. The second, empirical part focuses on the problems from a practical point of view. With the help of set of case studies it closer which specific complications are most commonly found on the neurosurgical ICU in patients after surgery of brain tumors, what are the most common methods of treatment and nursing procedures which are most used in the care of patients with these complications. In conclusion summarizes the...
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Nursing Care of Patients with Infectious Complications after Total Hip or Knee Endoprosthetic Replacement Nursing Care of Patients with Infectious Complications after Total Hip or Knee Endoprosthetic Replacement
BREJŠKOVÁ, Soňa
Infectious complications belong to the most serious problems after endoprosthesis implantation. Their solution is very demanding for its surgical and psychological aspects with regard to its devastating effects and uncertain prognosis. The percentage of infections complications fluctuates between 0.5 and 2 % nowadays. From nurse?s point of view the care about these patients is very demanding and has its exactly defined specifics. The aim of the thesis was 1: To map the knowledge of the causes of occurrence of infectious complications after TEP of hip or knee joint among nurses. 2: To map the knowledge on nursing care of patients with infectious complications after TEP of hip or knee joint among nurses. 3: To examine adherence to aseptic procedures in caring about patients with infectious complications after TEP of hip or knee joint. Three research questions were set to reach the goals: 1. What is the extent of knowledge of the causes of occurrence of infectious complications after TEP of hip or knee joint among nurses? 2. What is the knowledge of specific care of patients with infectious complications after TEP of hip or knee joint among nurses? 3. What is the extent of knowledge of specific needs of patients with infectious complications after TEP of hip or knee joint among nurses? 4. To what extent nurses adhere to aseptic procedures in caring about patients with infectious complications after TEP of hip or knee joint? Qualitative research was applied to elaboration of the thesis. Semi-structured interviews and involved observation were the data collection methods and techniques. The research was performed at the infectious disease department of the České Budějovice Hospital. The survey was anonymous, the interviews and observation were conducted from 1 to 25 February 2013 . The research has shown that nurses know the causes of infectious complications occurrence after TEP. It is also obvious that nurses are aware of the specifics of nursing care about these patients and they also have theoretical knowledge of the needs. However the analysis of the replies has revealed that nurses have problems with applying some nursing procedures, namely becauseof partial ignorance, uncertainty and impossibility to try some procedures. The results have also shown that all the nurses try to saturate physical needs of patients but not all of them are able to saturate patients? physical needs as they mentioned in their replies and as we could observe. These are particularly drawbacks in communication in the field of motivation, mental support and self care support. We have also found that most of the nurses adhere to aseptic procedures in nursing care of patients with infectious complications after TEP, but the results have also revealed weak points. More than a half of the nurses of the monitored sample fail to perform hygienic disinfection in compliance with the standardized technique and a third of them do not disinfect their hands even before the act. We have found further drawbacks particularly in handling sterile and biological material. The research results have shown that despite lack of information and experience the nurses proved their general knowledge of care about these patients in their replies. However there is still a lot to learn, both theoretically and practically. This thesis was written to bring basic outline of the issue of infectious complications after total endoprosthetic replacement so as it can be used as information material for both, experienced or starting nurses that are in contact with patients with infectious complications after TEP. A multidisciplinary seminar aimed at the issues of infectious complications after total hip or knee endoprosthetic replacement (see Annex 12) is the practical output of the bachelor thesis
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