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Nursing perioperative care on the gynekological section.
WOLFOVÁ, Petra
The bachelor thesis focuses on nursing care before, during and after a gynaecological surgery. Gynaecological surgeries are divided into small and big. Small gynaecological surgeries require only one surgeon and the hospitalization of the patient is shorter than 24 hours. Big surgeries require more surgeons, the patient is under anaesthesia for a longer time and the hospitalization is longer than 24 hours. In this bachelor thesis, we focused on perioperative care in women after a big gynaecological surgery. Care during the preoperative period is an integral part of the work of a birth assistant, as gynaecology is largely a surgical specialisation. With advancing technical progress and development of new surgical methods, various types of surgeries appear with specific requirements for nursing care. Effective perioperative care is important for trouble-free convalescence of women after surgeries. Perioperative care includes both nursing procedures and informing the patient about the hospitalization and care course. Perioperative care is very demanding for the woman herself and for the whole team participating in the care. Interaction of all the medical staff is necessary in perioperative care to provide specialised care according to the standards. The aim of this bachelor thesis was to determine the needs of patients that are affected in the highest extent during perioperative period. The research focused on the way women perceive perioperative period and the approach of health care professionals and the extent these items meet their expectation. The research was performed at a gynaecology-obstetrics department of a hospital, using qualitative assessment in deep interviews. The interviews included 13 open questions. The research group consisted of 8 women after a big gynaecological surgery. The participation in the interview was voluntary. The results of this research were carefully transcribed and analysed using the "pen-paper" method. These results were divided into four categories and further subcategories.
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Management of Risk in an Intraoperative Care
KUDRLIČKOVÁ, Dagmar
Current Status: The management of risks is a strategy directed to the good reputation of the medical facilities, to protect assets, patiens and employees from any harm to health. Risk management consists of four interrelated phases: identification, assessment, mitigation and monitoring.Risk prevention and safety of patient and medical personnel requires the involvement of all members of the multidisciplinary team (Pokojová, 2011; Škrla and Škrlová, 2003).Subjekt: The main aim of the research was to identify the risks in the provision of nursing care during the intraoperative period and map installation of preventive mechanisms in the risk processes in providing nursing care during this period.Methods: The method of qualitative research was selected for survey research. Techniques of data collection was carried out using nonstandarized (depth) interview with the sisters (nurses). Participation in the interviews was voluntary and anymous. Interviews were recorded on the tape recorder and subsequently transcribed word for word. At the beginning of the talks were chased up objektive data on the age, length of experience in the health service and educational attainment of nurses. The first part of the discussion focused on issues related to risk identification of nursing care in the intraoperative period.Followed by a section with questions related to the mapping preventive mechanisms to risk processes in the intraoperative period.Participants: The research sample was studied with regard to the research problem. The group consisted of disters of Hospitál Písek, a.s. Six sisters were addressed. Three sisters worked as perioperative nurses and the other three as anesthetist nurses. Interviews and research questions were focused on the risk of nursing care in the intraoperative period from the perspektive of anesthesia and perioperative nurses. The venue of talks were sister facilities of central operating theaters. The selection criteria of sisters were: different period of practice, different education and different ages of sisters. All the sisters (nurses) met a criterion in providing nursing care in the intraoperative period.Results: Anesthetist and perioperative nurses providing nursing care in the intraoperative period are put at risks that are associated with their work in the operating theaters. These include physical occupational risks (ionizing radiation), chemical (risk of anesthetics inhalation), biological (risk of infection) and psychological stress factors. The Patient is in the intraoperative period is endargered by risks that are associated with the administration of anesthesia (difficult intubation), with surgery (risk of burns) and a total stay of patient in the operating theater (air-conditioned enviroment). As possible means of preventing and managing risks in the working environment of nurses can mention an adequate communication within a multidisciplinary team, the use of disposable protective equipment, ample off after intensive services and keeping on instructions, standards and relevant legislation. In the prevention of chosen risks that threaten the patient in the intraoperative period can recommended these possible eventualities of prevention: during administration of anesthesia(anesthesia techniques monitoring medications and device monitoring), during surgery (adherence to aseptic procedures) and during the whole stay of a patient in the operating room (theatre) we can recommend(regular audits of intraoperative care and medical records with keeping on instructions and standards of nursing care.Conclusions: Intraoperative nursing care is one of the most high-risk part of hospitalization in the medical facilities. During this period is very important a substantial monitoring and prevention of risks that threaten the patient immediately.
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