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Patient satisfaction with nursing care at Surgical Intensive Care Units
KRAMAŘÍKOVÁ, Lucie
This diploma paper aims at defining and mapping out patient satisfaction in intensive care units for surgery patients and comparing results in dependence on length of hospitalization and facility. Diploma paper consists of theory and research. Theory is divided into 5 chapters. Empirical part of this diploma paper was carried out using the method of combined research. The first part is created by qualitative research using semi-structured interview, second part comprises quantitative research using non-standardized, structured questionnaire face to face survey. Processed results were arranged into Excel tables and graphs. All research was based on eight dimensions of patient-centered care delineated by the Picker Institute. Qualitative research sample consists of 11 respondents, quantitative research sample comprises 142 respondents. Data collection took place in surgical ward. This diploma paper defines four aims with two related research questions. The first aim is to determine the level of patient satisfaction with postoperative care. The second aim focuses on patient satisfaction with nursing care, the third aim is to define positive and negative factors influencing patient satisfaction in intensive care units and the last aim points at patient satisfaction with nursing care in intensive care units in relation to the type of facility and length of hospitalization. These two quantitative research questions were posed: 1. What are the possibilities to improve patient satisfaction in nursing care? The research survey showed that an area of concern is patient awareness. It is necessary to improve patient awareness after admission to an intensive care unit and during transfer to a standard ward. Pain and insufficient pain relief often occurred. Nurses should cooperate more with doctors in this respect and, above all, monitor patients more and offer alternative ways of pain relief. Other problems were mentioned in relation to bed adjustment possibilities. Despite the fact that nurses were trying to do their best, not all the circumstances could be influenced that way, for example mattress hardness. The last concern area, mentioned by patients, was perceived loneliness. Nurses should conduct considerate and sensitive conversation, create feeling of trust and support patients. The second question: What factors influence patient satisfaction? The results show that it is, above all, nursing staff attitude, followed by patient awareness, pain and sufficient pain relief, intensive unit environment and last but not least bed adaptation. Quantitative part set six presumptions using statistical methods independence test, chi-square test, Yates correction, t-test, and correlation-regression analysis. Questions from the first part of this paper were processed (in percentage) into clearly arranged graphs. Research survey shows that respondents were satisfied with nursing care and nursing staff. Patient awareness during admission to intensive care unit and staff anonymity proved to be the biggest areas of concern. Pain and insufficient pain relief turned out the clear reason for dissatisfaction as well as absence of information about performed surgeries. Conclusion of quantitative research survey showed that there is no statistically significant difference in patient satisfaction according to health-care facility or length of hospitalization.
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Contribution of sisters and ward sisters to the nursing care quality
NEKLOVÁ, Lenka
This degree work concerns the role of sisters and ward sisters and their share in the nursing care quality. The theoretical part of the work is divided into three sections. Section one presents sisters and ward sisters as active members of the nursing management. Section two deals with the managements functions of the sister staff and their impact on the nursing care quality. Section three reviews the basic issues of the nursing care quality. The purpose of section one was to review the scope of activities of sisters and ward sisters with respect to the nursing care quality. The purpose of section two was to identify the key difficulties preventing sisters and wards sisters from increasing the nursing care quality. The purpose of section three was to analyse the working relationships between sisters and ward sisters with respect to the nursing care quality. While mapping out the situation in the selected hospital (the Faculty Hospital in Plzeň), we asked the following six research questions: 1. What are the areas where the hospital sisters may affect the nursing care quality? 2. What obstacles the sisters can see preventing them from taking part in continuous improvements in the nursing care quality? 3. How do the hospital sisters co-operate with the respective ward sisters concerning the nursing care quality? 4. What are the areas where the ward sisters may affect the nursing care quality? 5. Are there any obstacles preventing the ward sisters from taking part in continuous improvements in the nursing care quality? 5. How do the ward sisters co-operate with the respective sisters concerning the nursing care quality? The questions were asked during informal discussions with ten sisters and ten wards sisters at the Faculty Hospital in Plzeň. The information and data collected were processed using the framework analysis method whereby the answers to the research questions were derived. The research identified the following main problems preventing the hospital sisters and ward sisters from increasing the nursing care quality: inefficient time management on the side of ward sisters, insufficient competencies of ward sisters regarding staff remuneration, insufficient application of the existing nursing-care quality improvement tools by both sisters and ward sisters, limited engagement of the hospital sisters and ward sisters in creation of internal standard procedures, and reluctant attitudes of the hospital staff to changes. Based on the shortcomings identified through our research we have worked out proposals on practical improvements.
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