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Increasing the efficiency of hazardous waste sorting at the hospital Česky Krumlov a.s.
SELINGEROVÁ, Šárka
This thesis deals with the handling of waste and linen. It is divided into a theoretical and practical part.The theoretical part describes the history of Česky Krumlov hospital and is followed by an in-depth look at the history and development of the handling of waste and linen in a medical facility etc. In the practical part of the research qualitative-quantitative methods were used in the form of observation, interview, questionnaire and secondary data analysis. In Česky Krumlov Hospital I observed the ongoing activities and gathered data. The research sample for the interview consisted of 10 respondents. The questionnaires consisted of 21 questions. A secondary analysis of operating rules, guidelines and waste management legislation was used. The main objectives of the research were to compare the system of waste and linen handling in Česky Krumlov hospital with applicable legislation and rules of operation. In so doing, to determine whether there are shortcomings in the separation of waste and the handling of laundry and in which department(s). In addition, to compare the production of waste in amount and time with regards to the use of disposable devices and instruments. Finally, to monitor the way employees separate waste in the hospital and compare the approach to it between smokers and non-smokers.For the purpose of this research five research questions and four hypotheses were put forward: V1: Does the procedure for handling waste meet legislative requirements and the current operating system? V2: Does the system of separation and disposal of waste differ in individual departments and if so why? V3: Can a more effective system for waste management be found? V4: Does the procedure for handling linen meet legislative requirements and the current operating system? V5: Can a more effective way of handling laundry be found? H1: The attitude to the separation of waste is different in smokers and non-smokers. H2: The sorting method depends on education. H3: The sorting method depends on the job position. H4: The sorting method depends on the amount of work experience of employees. Interviews were transcribed using MS Word 2007, and then processed using XMind 6. The hypotheses were statistically analyzed.In addition, information from my observations, interviews and the operating rules and directives for hospital staff helped me to answer the research questions. On the basis of the statistical findings all the hypotheses, with exception to H1, were confirmed. Hypothesis H1 was refuted. During the work all the objectives were met with exception to the fifth objective where problems relating to the quality of services provided by the laundry in České Budějovice Hospital, a.s. were identified. A comparison of the waste management system in Česky Krumlov Hospital a.s. with its operating rules, guidelines and legislation shows that overall the procedures correspond. There were just a few exceptions in the form of unlocked containers for infectious waste and a lack of signatures on labels of some of the staff responsible. During my observation no errors occurred in the separation of waste. The hospital has established a uniform system, whereby the procedures only vary according to the type of waste. The established system of waste separation in Česky Krumlov Hospital a.s. is very good, fully compliant with legislative requirements and is efficient. When comparing the production of general waste over time, the amount is decreasing. However, the amount of hazardous waste being produced is increasing. It was found that the attitude to waste separation does not differ in smokers and non-smokers and that university-educated workers separate less waste at work than others due to the type of job within the organization. Nurses recycle more and more responsibly. The same can be observed for employees with more work experience. I found minor discrepancies in the handling of laundry and the current operating rules.
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The Culture of Hand Hygiene
PAVLÍČKOVÁ, Eva
Basic theoretical premises:Nursing personnel presents the most numerous professional group in the health care sector. They spend 24 hours a day and seven days a week with patients. The nursing personnel's inadequate hand hygiene may result in hospital-acquired infection with all its negative consequences. The knowledge and application of proper hand hygiene techniques as well as aseptic procedures play a key role in the prevention of nosocomial infection theoretical part of the thesis consists of two sections. The former section focuses on a detailed definition of hospital-acquired infection, its categorization, origin, and prevention. The latter section discusses hand hygiene, including its development since 1847. Particular attention is paid to WHO's "Five Moments for Hand Hygiene," the various techniques, obstacles, and improvement strategies.Goals of the thesis, research questions and hypotheses:The primary aim of the research was to establish whether the measures recommended in the "Five Moments for Hand Hygiene" were followed in selected hospitals in the Czech Republic. To reach this objective, three sub-goals were defined: Sub-goal no. 1: To establish, by means of the direct observation technique, whether proper hand hygiene was performed. Sub-goal no. 2: To map the application of proper hand hygiene in particular situations. Sub-goal no. 3: To test the proper hand disinfection by means of a fluorescent lotion and a UV lamp. Five hypotheses were postulated to reach the objectives. Hypothesis no. 1: The recommended hand hygiene techniques are adopted to the same degree in all hospitals under investigation. Hypothesis no. 2: The recommended hand hygiene measures are applied to the same degree in the five particular situations. Hypothesis no. 3: The hospital provider influences the attitude toward proper hand hygiene. Hypothesis no. 4: The level of education impacts the attitude toward proper hand hygiene. Hypothesis no. 5: The number of years of personnel's work experience affects proper hand hygiene compliance. Methodology:The practice-based research section of the present thesis contains quantitative results gathered from the field research in selected hospitals in the Capital City of Prague and the Central Bohemian Region. The direct observation involved a test of the actual application of hand hygiene measures by means of a fluorescent lotion and a UV lamp. The results of the direct observation were recorded in the observation notes and subsequently processed by means of the Excel application from the Microsoft Office software suite. The Anova method was employed to test the set hypotheses. Graphics was used to interpret the outcome of the direct observation.Research batch: The research batch was presented by 104 non-physician staff members working in 7 hospitals administrated by 3 different providers and involving 3 different types of wards, all located in the Capital City of Prague and the Central Bohemian Region.Results:.As based on the results, the initial hypotheses were assessed as follows: Hypothesis no. 1: The recommended hand hygiene techniques are adopted to the same degree in all hospitals under investigation. The hypothesis was not confirmed. Hypothesis no. 2: The recommended hand-hygiene measures are applied to the same degree in the five particular situations/diagnoses. The hypothesis was not confirmed. Hypothesis no. 3: The hospital provider influences the attitude toward proper hand hygiene. The hypothesis was confirmed. Hypothesis no. 4: The level of education impacts the attitude toward proper hand hygiene. The hypothesis was not confirmed. Hypothesis no. 5: The number of years of personnel's work experience affects proper hand hygiene compliance. The hypothesis was not confirmed..Conclusion:The present thesis offers an insight into the issue of proper hand hygiene of non-physician health care workers..
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Identification and risk assesment in nurcing care
LUDÁNYIOVÁ, Sabina
Theoretical base: Safety of the Healthcare personnel is one of the key aspects in the good and safe care of patients. There are many risks threatening nurses while doing their daily job. It's necessary to perform a detailed identification, analysis and assessment of these risks. These processes lead to improved work life of general nurses and clients' stay in the healthcare facility. Important s of the theoretical part are chapters concerning the accreditation and certification of the healthcare facilities helping to achieve safe environment. Objective: The objective of this study is to identify risks for nurses while performing their medical profession, to analyze the problem of their physical workload, nosocomial infections and the risk of sharps injuries. Another objective is to describe preventive mechanisms of compliance with work safety standards and how they are perceived by nurses. The main objective is to analyze the overall standpoint of nurses towards risks in a way to show their individual perception. Methods: Form of qualitative research was chosen with in-depth interviews in order to fully understand risk perception of nurses. Thanks to using the pre-prepared thoughtful open questions, a number of extensive answers could be collected that illustrate various themes of work. After processing the interviews a subsequent coding and categorization of data took place. These categories have also been used for a survey of the results in the discussion. Participants: Intentionally ten nurses of different ages, length of service, department, and finally, opinions and standpoints have been chosen. Interviewed nurses are working in one of the hospitals in Central Bohemia. Size of the study sample was determined by theoretical saturation of data. Results: The results of the research are divided into seven categories, according to the data. Nurses are aware of the risks they face. They are able to name, describe risky behavior and prevention mechanisms that prevent the onset of these risks. Nurses demonstrated basic knowledge regarding nosocomial infections, but in the barrier care there is still room for a deeper understanding of the mechanisms and approaches that can help to reduce the frequency of nosocomial infections. Nurses are also aware of the risks that arise from excessive physical workload and they tend to eliminate them through sports. Another risk that nurses realized and considered as the most threatening, is the risk of sharp objects injuries. Although aware of this fact, the research shows that nurses do not comply with the preventive measures, despite they know them. Nurses have a rather negative attitude towards training regarding health and safety at work. This is due to poor quality in processing of such trainings. They have a positive attitude towards education, but they realize that trainings for general nurses which might be interesting are not for free and they take place usually during their free time. Conclusions and recommendations for practice: This work highlights the weak points in this topic and tries to look into the attitudes, feelings and concerns of nurses, which are related to the riskiness of such profession. Nurses should be aware of their importance to society and should take responsibility not only for performed procedures, but also for their own safety. Among the recommendations, which could minimize the risks associated with the performance of nursing profession, is the implementation of rigorous training of health and safety at work and quality of training provided by healthcare facilities.
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Sticking to the principles of berrier nursing care as a prevention of infectious diseases transmitted by blood in selected wards.
CANDROVÁ, Eliška
The topic of this bachelor's thesis is "Compliance with the principles of barrier nursing care as a prevention of infectious diseases transmissible by blood in selected wards". The important part of nurses' work includes complying with the principles of barrier nursing care. By following these principles we prevent the transmission of nosocomial infections as well as professional infections transmitted by blood. The theoretical part of the thesis describes infectious diseases transmitted by blood, especially viral hepatitis B, viral hepatitis C and AIDS. Another important chapter describes barrier nursing care. The aim of this thesis was to conduct a survey of nurses' compliance with the barrier nursing care principles in relation to the prevention of infectious diseases transmissible by blood in selected wards. The survey was carried out quantitatively, by the method of involved, hidden, direct observation. The observations were conducted from November 2013 to March 2015 and continuously recorded into a recording sheet. The survey was carried out in a selected hospital, where a total of 121 nurses in twelve wards were observed. Based on the results it is evident that the nurses do not fully respect the principles of barrier nursing care in all areas surveyed. The results of this thesis will be given to the head nurse of the hospital where the observations were made, and will serve as a basis for detecting weaknesses in compliance with the principles of barrier nursing care related to the prevention of infectious diseases transmissible by blood.
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Nosocomial infections and their causes.
KROUPOVÁ, Lucie
The present thesis focuses on nosocomial infections and their causes. The theoretical part summarizes information on especially the sources of these infections, the way of their transfer and the most frequent infection agents. Clostridium difficile is studied in more detail. The illness caused by this pathogen leads to the complications especially with in-patients with a previous antibiotic therapy and immuno-compromised individuals. And this is the problem the present thesis is also concerned with. The thesis also divides nosocomial infections by their clinical manifestations and contains basic anti-epidemic measures and surveillance methods. Its empirical part focuses on the description of an occurrence of select nosocomial infections in Strakonice Hospital, a.s., especially an occurrence of the Clostridium difficile pathogen and methicillin-resistant Staphylococcus aureus (MRSA).
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Nursing barrier care in the ICU
DUŠKOVÁ, Ludmila
Barrier nursing care is one of the important methods falling under the area of prevention of nosocomial infections which should be known and adhered to by nurses during the execution of their work. The theoretical part of the thesis deals with nosocomial infections and the characteristics of intensive care and it explains the principles of barrier nursing care. The practical part of the thesis inquires into the nurses´ knowledge of the principles of barrier nursing care, the adherence to these principles and the aids needed for caretaking using the barrier nursing technique. The research inquiry was carried out using quantitative research method. Data collection was realised by a questionnaire. Three goals had been set. Goal 1: Finding out what knowledge the nurses working in intensive care departments have about the principles of barrier nursing care. Goal 2: Finding out what principles of barrier nursing care are adhered to by nurses working in intensive care departments. Goal 3: Finding out what problems nurses working in intensive care departments identify in terms of the adherence to the principles of barrier nursing care. To specify the goals, four hypotheses were laid out. Hypothesis 1 stating that nurses in intensive care departments know the principles of barrier nursing care wasn´t affirmed. As the nurses do not adhere to the principles of barrier care during the execution of their work, we suppose they do not know them. Hypothesis 2 stating that nurses in intensive care departments research information concerning the principles of barrier nursing care wasn´t affirmed. Only 58.5 % of nurses are interested in educational events dealing with the principles of barrier nursing care. The remaining nurses (41.5 %) would not attend training events. Hypothesis 3 stating that nurses in intensive care departments work in adherence to the principles of barrier care was not affirmed. Out of seven questions testing work habits of nurses during caretaking according to the principles of barrier care, only one was answered correctly by more than 70 % of the nurses. Hypothesis 4 stating that nurses in the departments of intensive care do not identify the problem with caretaking according to the principles of barrier nursing care in the lack of aids was affirmed. Most nurses (89.6 %) think they have enough aids for caretaking according to the principles of barrier nursing care at their disposal in their workplace. The result of the research inquiry also point to the principles the nurses adhere to. These include using aids necessary for caretaking by the barrier nursing technique and isolating the patient in a separate room or a closable box. The nurses state that acute states of health related to intensive care represent a problem which sometimes leads to breaking the principles of barrier care while taking care of the patient. The research revealed the need to motivate nurses to acquire more profound information in this area of problems and to adhere to the principles of barrier nursing care. Furthermore, it is necessary to monitor nurses more during the execution of their work and point out their malpractice to them in time. The result will be submitted to the management of the hospital where the research inquiry took place. Our recommendations, which should contribute to raising more interest in the area of problems of nosocomial infections and barrier nursing care on the part of the nurses, can be proposed to the management. The cause of the low level of awareness and low interest in acquiring more knowledge about barrier nursing care on the part of the nurses could be a further research issue.
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Prevention of Nosocomial diseases in dental surgery
TESAŘOVÁ, Petra
The degree work is concentrated on basic characterization of nosocomial infections, on the prevention thereof and on the observance of antiepidemical measures in the sphere of stomatology. Although these infections were largely related to the mortality and morbidity in health service establishments in the past, their occurrence goes down significantly these days. The adoption and observance of fundamental hygienic principles and rules was of decisive importance in this sphare. The neglect of these principles can endanger the health and life of the patient seriously end bring about the increase of costs for further therapy of the patient. It is therefore necessary even at present time ot pay great attention to these diseases and to the prevention thereof. The research part of the work is devoted to the evaluation of preventive measures connected with nosocomial infections in stomatological practice. The literature search in the theoretical part follows therefore this orientation too. The theoretical part deals at first with the most frequent agents of nosocomial infections, that can be encountered. The attention is concentrated on brief characterization of these diseases, their sources and on the process of spreading. Then, the basic classification of these diseases and the concrete methods of prevention are mentioned. In the sphere of stomatology, the work resumes the basic historical relations and identifies particular sectors of this discipline. In conneciton with nosocomial infections, their impact upon the stomatology as well as the need of protection against these infections are discussed. It means epidemiological measures, importance of hand hygiene, necessity of sterilization, desinfection and of cleaning. The aim of the work is to point out the importance of prevention as to the origin and spreading of these infections and the necessity to observe the epidemical principles at the work in dental surgeries. The performed investigation resumes established facts about the observance of hygienic and epidemiological regimen and that not only as to the general judgement on problems, but in consideration of local differences, of differences in the duration of practice carried out by individual stomatologists and in relation to the frequency of conducted hygienic inspections as well. Problematic areas as to the nosocomial infections and as to the observance of decreed provisions by stomatologists are defined here. It refers also to the influence of the locality and to the frequency of inspections directed to the observance of these hygienic rules by physicians.
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The realization of the barrier care by students from Health-Social Faculty
STEHLÍKOVÁ, Jaroslava
The term barrier care is possible to define like a set of different working processes, whose aim is to destroy pathogenic organisms and to prevent them in repeated extantion. It is in principle about prevention of the hospital (in-patient) infections. Every student from Faculty of Health and Social Studies is during the studies notified of the principles of proper washing and desinfection of hands, of safe handling with laundry and biological material, but also of basic fundamentals personal safeness, to which come under e.g. the utilization of the personal protective aids, safe liquidation of the hospital waste et al. The work with title The realization of the barrier care by students from University of South, Faculty of Health and Social Studies is splitted into two parts. The theoretic part of the bachelor work tries to include the complex theme of barrier care, with a view to way of transfer of hospital infections, types of hand washing and hand desinfection, methods of sterilizing, the use of personal protective aids and some principles of safety. The results of nursing research are compiled in the experimental part of work. In the course of the research was used the quantitative method of collecting data with the technique of hidden observation. The students, which were observed, were from Faculty of Health and Social Studies, University of South, from 2nd and 3rd classes of present study called General nurse. The research was provided in Hospital Ceske Budejovice, Inc. The chosen wards for research were neurological, internal and surgical ward. In connection with the task of the bachelor work three targets were set together with six hypotheses to pertinent confirmation or negation. The authoress tryed to find out whether the students from Faculty of Health and Social Studies, University of South adhere a correct process of hand washing and hand desinfection, to what extent the students use personal protective aids and to what extent the students adhere to some fundamentals of their safety work. In conclusion there are the most important facts, which were ascertained and proposals on possible solutions. The authoress thinks that the bachelor work could serve as an informative material for another students and at the same time it could help teachers to aim the problematic parts of lessons or at training of practical skills, in which the students were slipped.
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Nursing care of a patient with multi-resistant strains
ZAJÍCOVÁ, Lucie
Occurrence of bacterial resistance appeared already five years after the antibiotics had been introduced in practice. Currently the occurrence of resistant or multiresistant strains is increasing. It is therefore highly important to adhere to barrier nursing techniques for clients colonized or infected with multiresistant strains. The risk of transmission of infection between patients and also between the medical staff is thus minimized. However, many of the nursing staff have not fully realized the importance of adhering to the barrier nursing care. A quantitative research by means of anonymous questionnaires was applied to collect the data. The research survey was carried out in the specialized departments of Nemocnice České Budějovice a.s. (The Hospital of České Budějovice). The following information was checked: identification data, the awareness of the nursing staff concerning the barrier care and the possibilities of the nursing staff to adhere to this care in practice when nursing clients suffering from multiresistant strains. 139 questionnaires have been distributed from which 110 (100%) have been included in the research. In the bachelor thesis the awareness of the nursing staff concerning the barrier nursing care and the possibility to adhere effectively to this kind of care for nursing clients suffering from multiresistant strains has been investigated, which was also stated in the aims of the paper (there were three of them), which were confirmed by the results of the research. Three hypotheses were set. The first one was to prove that the nursing staff adhere to the barrier nursing care for patients suffering from multiresistant strains, which was confirmed. The second one was to prove, that the nursing staff have enough aids to adhere to barrier care for patients suffering from multiresistant strains. This hypothesis was also confirmed. The third one was to prove that the nursing staff are acquainted with principles of barrier nursing technique as prevention of transmission of multiresistant strains, which was also confirmed. In general it can be stated that although the nursing staff are over strained in their work physically and psychically due to evident lack of nursing staff in all departments, the awareness and adherence to barrier nursing care and thus the minimizing the risk of transmission of resistant or multiresistant strains is evident. The research has shown that in spite of problems the nursing staff is to handle daily, the adherence to barrier nursing technique is important for them. The awareness in this field is on a very satisfactory level, as well as material equipment and aids necessary to adherence to barrier care. There is also a tendency from the part of the superiors to inform on topical subjects in nursing care for clients suffering from multiresitant strains in regular seminars organized within the hospital. The adherence to barrier nursing care is an essential part of care for clients suffering from multiresistant strains. The results of the paper shall be used to inform medical staff on this issue to make a positive impact on opinions of medical staff on adhering to barrier nursing care to prevent transmission of multiresistant strains.
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Setting up a unified methodology for hygiene, disinfection, and sterilization at UZ, RTG, CT, MR and AG departments.
HLOUŠEK, Jan
The presented bachelor´s thesis {\clq}qSetting up a unified methodology for hygiene, disinfection, and sterilization at UZ, RTG, CT, MR and AG departments`` focuses on an area closely relatedto the field of radiology. The hygiene of the radiology ward, disinfection, and sterilization are an inseparable part of the work of the radiological assistant. In my thesis I wanted to set up guidelines for newly established wards specializingin imaging methods in order to easily tackle this issue. Some of the findings of this work may be applied also at established wards, for instance for the broadening of the range of their action. The risk of contamination by nosocomial infections in medical facilities is very high, especially in radiology wards where various people with different infectious diseases come into contact with hospitalised patients and people treated at outpatient wards. Each imafing method has its specific requirements and various hygienic demands. The evolution of diagnostic methods, new technologies and materials prompts the growing of the quantity of invasive and diapeutic operations, which leads to substantially increased risks. Medical facilities are not safe places for patients. Approximately each eighth to ten patient is infected with a nosocomial infection during hospitalisation. This is why every radiological assistant should maximise the elimination of all hygienic and epidemiological risks related to the performance of his profession by strict adherence to hygienic standards. The motto of every medical professional at work should be {\clq}qPrimam non nocere`` {--} First, do no harm.
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