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The issue of invasive accesses in intensive care
ŠILHÁN, Daniel
In intensive care, invasive procedures represent an essential condition in the care of critically ill patients. In particular, the knowledge and skills in providing and taking care of them are crucial. The main objectives were to map the knowledge of non-physician medical staff in the intensive care environment regarding selected invasive procedures. Further, to identify the differences in adherence to recommended procedures in intensive care across different types of nursing education, and eventually, to determine the effect of the length of work experience on compliance with recommended procedures. The set objectives were achieved by means of a quantitative research survey using online questionnaires distributed among fellow healthcare professionals who had worked in intensive care for longer or shorter periods. The respondents were general nurses, with or without specialization in intensive care, and paramedics. Based on the results of the conducted research, several conclusions can be drawn. It was found that the research sample did not demonstrate adequate knowledge regarding the selected invasive procedures. The median value of the provided questionnaire was 60.6%, which is significantly less than the intended 70%. Furthermore, it has been shown that there were differences across different types of nursing educational attainment. Respondents with a high school diploma achieved the worst results on average (56.1%). People with a master's degree performed best on average (64.7%). Therefore, it can be concluded that adherence to recommended invasive procedures in intensive care depends on the education of the staff. Finally, the length of work experience of healthcare professionals did not prove to be a significant factor influencing adherence to recommended invasive procedures in intensive care.
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Prevention of catheter infections in patients in the need of critical care
SVOBODOVÁ, Alžběta
Current status: The term sepsis refers to a systemic inflammatory response to the presence of an infection. The highest mortality rate associated with bloodstream infection is linked to severe septic shock. The most commonly used invasive bloodstream inputs include peripheral and central venous catheter, arterial catheter also included are PICC and Midline catheter an alternative method of securing the venous system in intraosseous entry. The aim of this study was to describe the spectrum of nursing practices that minimize the risk of catheter infections related catheter infections and to evaluate the skills of nurses in the area of vascular access care. Methodics: Qualitative research methods using semi-structured interviews and participant observation were employed for data collection. The research was conducted in selected hospitals of the Vysočina Region and the South Bohemia Region. It was a deliberate selection. Nurses working in intensive care units (i.e. anesthesiology and resuscitation departmen and unit critical care) were approached. Covert observation was conducted to ascertain compliance with nursing standards and uncover errors in the care of invasive vascular access. The size of the research sample was determined by theoretical data saturation. Results: The survey shows that the interviewed general nurses have sufficient knowledge in the field of catheter infections to reduce their incidence. Participant observation, specifically peripheral venous cannula insertion, revealed that nurses do not check the expiration of the necessary equipment for this procedure. Furthermore, there was a lack of hygiene and epidemiological precautions and disposal of the needle from the cannula in the sharps box. There was evidence of not using a sterile table but only sterile instruments, improper hand hygiene and use of personal protective equipment when treating a central venous catheter. Conclusion: The outcome of this diploma thesis is a set of recommendations for non medical healthcare personnel.
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