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The use of TIME management in nursing practice
RATHOVÁ, Lenka
The bachelor thesis deals with the use of the TIME management concept in the practice of nursing. The theoretical part presents knowledge related to wound management, with the primary focus on the concept of TIME management and its use in nursing. In the empirical part, the first objective was to compare the knowledge of the TIME management concept in terms of the education of the nursing staff. The study's second objective was to find out the kind of experience nurses have in TIME management. The third and last objective was to map whether, an000d to what extent, TIME management is being used in selected wards. To meet the objectives, three hypotheses were formulated. The objectives were achieved through quantitative research using a non-standardized questionnaire. The research population included general nurses working in selected wards in the Klatovy hospital. The total number of respondents was 140. The results obtained verified that respondents with higher education more often declared knowledge of the rating scales (p = 0.006), reflecting the importance of educational background when preparing to provide effective care to non-healing wounds. When assessing the level of experience with TIME management, there were no significant changes in wound parameter scores, which related to respondents' length of experience. It was also found that the use of therapeutic methods in TIME management varied by type and specialization of the ward, which is primarily related to the frequency of the occurrence of non-healing wounds in a given workplace.
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Quality of care in the treatment of non-healing wounds (in wound management)
HOLUBOVÁ, Adéla
Introduction: Quality care for patients with non-healing wounds requires a systematic approach that should include a complete wound assessment and an objective description of the wound assessment. Goals: The goal was to assess how non-healing wounds were evaluated and documented in clinical practice at selected health care facilities and social care providers in the Czech Republic. To verify whether a clinical algorithm for evaluating non-healing wounds is available in clinical practice for selected providers and whether it is used. Methods: A mixed research design was used. The first research method was a cross-sectional retrospective study - content analysis of documentation for non healing wounds in clinical practice at selected health care and social care providers in the Czech Republic. Statistical methods of one-stage and two-stage sorting were used to evaluate the information obtained through content analysis of the data, and absolute and relative frequencies were determined through disaggregation. Identification of potential groups was performed by calculating a similarity matrix based on Gower metric followed by application of a hierarchical agglomerative clustering algorithm. One-stage and two-stage data classification was used to evaluate the information obtained from the questionnaire survey. Two-stage sorting was performed to assess the independence between the selected pairs of questions using appropriate tests according to the nature of the data obtained (chi-square test, Fisher's exact test, Kruskal-Walli's test followed by pairwise comparison) at a significance level of ? = 0.05. Results: The research was carried out in selected health care facilities and social care providers in the Czech Republic (3 faculty health service providers, 5 non-faculty health service providers, 4 social care providers and 4 ambulatory health service providers). 331 health documentations of patients with non-healing wounds were analyzed. The total number of questionnaires analyzed was 565. The resulting data of the cross-sectional retrospective study conducted in 14 selected health care and social care providers can be separated into three separate groups, with the highest quality of wound assessment being the nursing documentation of wound healing consultants, in which the most frequent use of objective scales and the highest number of assessment parameters were verified. Use of the Clinical algorithm was only confirmed in non-faculty healthcare providers. More frequent use of the Clinical algorithm was verified when a wound healing consultant was present (p <0.001; chi-square test). From the outcome data of the questionnaire study carried out in 11 selected health care facilities and social care providers, it was validated that statistically significant differences in the wound documentation process were most frequently demonstrated between faculty and non-faculty health care providers (p <0.05; chi-square test). Respondents working at health care faculty-based facilities rated the following items as more significant: type, etiology, wound location and size, wound bed, wound infection continuum, granulation quality assessment, wound odor, and comorbidities. Conclusion: It was verified that the process of assessment of non-healing wound parameters was very inconsistent. The recommended procedure for assessment of non-healing wounds was not properly followed and accepted in the clinical practice by the assessed care providers. We verified that the presence of a wound healing consultant was associated with the more frequent use of objective wound assessment scales to document wound care and condition. This study is educational, informative and pragmatic in character.
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The role of a nurse specialist in wound care in a hospital
VIDLÁKOVÁ, Nikola
The diploma thesis is focused on the current topic "The role of a nurse specialist in wound care in a hospital". Nurses specialists in care of non-healing wounds have an irreplaceable role in planning nursing interventions like an evaluation of a chronical wound, a selection of a suitable covering material, or an education of patients and their family members. In the given issue we deal with the theoretical part, where we characterize wounds, division of non-healing wounds, individual phases and continuum of wound healing. We also distinguish between treatment options for non-healing wounds and risk factors affecting wound healing. Part of the theoretical part is the characteristics of nursing care in wound healing and specialist nurse, her education, competencies, roles and cooperation in the nursing team. In the empirical part we use qualitative research, where the aim of the study research the way of cooperate nurses specialist with general nurses and the way nurses specialize with general nurses in the care of non-healing wounds.
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