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The administration of risky drugs as a nursing problem
KOUKALOVÁ, Kristýna
This bachelor thesis deals with an issue of hazardous medication administration and with risks in their storage, ordering and disposal. The aim of the thesis was to find out a quality of experience and knowledge of nurses in the field of hazardous medication as well as their knowledge of the specifics connected with administration of this medication. To fulfil the aim, two research questions and two hypotheses were set. What is the nurses´ experience in the field of hazardous medication administration? What is the nurses´ knowledge of the specifics of hazardous medication administration? Hypothesis no.1: General nurses´ knowledge of specific administration of hazardous medication is influenced by the length of their practical work. Hypothesis no.2: General nurses´ knowledge of specific administration of hazardous medication is sufficient. The research survey was performed through a combination of qualitative and quantitative research methods. In the framework of the qualitative technique, a half-structured interview with individual general nurses was performed (11 respondents) and in the framework of the quantitative research, a non-standardised questionnaire for general nurses (100 respondents) was used. From results of the quantitative research survey is obvious that the general nurses (87%) have knowledge in the field of hazardous medication and they are sufficiently informed about the specifics connected with hazardous medication administration. They know the whereabouts of internal directives of their hospital in the case of emergency, which instruct them how to react in a particular moment or situation. Only one respondent stated that she had been informed only perfunctorily and signing the directive had been the most important. Results of the qualitative research survey revealed that most of the respondents know the hazardous medication, where and how they are stored and what is the right way of their disposal. Four respondents admitted no knowledge of LASA medication. This fact was surprising because the respondents were general nurses with a long practical experience. It was presumed that they would know this field after so many years. In the conclusion, it is possible to state that most of the respondents have very good knowledge of an issue of administration, storage and disposal of hazardous medication. It is possible to state that those respondents who have no sufficient knowledge of hazardous medication issue, have insufficient or missing training in this field. Following this, the thesis was supplied with an information leaflet with a clear outlook of principles of dealing with medication, its storage and disposal, which is inserted as a supplement in the bachelor thesis.
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Nursing care for a client suffering from Parkinson's disease
SVOBODOVÁ, Pavlína
Current state of the research field: Parkinson's disease is a neurodegenerative disease affecting basal ganglion. Brains of patients suffering from Parkinson's disease are damaged by death of dopamin producing cells in substantia nigra. Cause of this cell death is still unknown. Symptoms of Parkinson's disease include tremor, rigidity, aknesia and bradykinesia, disturbances to posture and gait, hypophonia, dysarthria, micrographia, eye movement abnormalities and decreased blink rate, hypomimia and mental, vegetative, sensoric and sensitive dysfunctions. In diagnosis of Parkinson's disease a medical history collected by a physician in collaboration with a nurse is used. Nurse assists a client with filling a questionnaire regarding nonmotoric symptoms. Furthermore, she carries out a L-dopa test. If symptoms are mitigated after drug administration, the test is considered being positive. Other examinations requiring nurse's assistance are DaTscan and histology. Pharmacological treatment relies on substitution of missing dopamin and hence restoring dopaminergic transfer. Nurse administers Levodopa, dopamin agonists or COMT inhibitors according to physician's decision. In neurosurgical treatment, where deep brain stimulation is used, nurse conducts preoperative and postoperative care. Pharmacological and neurosurgical treatment could be also combined with supportive treatment, about which should a nurse inform a client. Major nursing care complications in Parkinson's disease which are monitored by a nurse includes limited mobility, walking problems, tremor, impaired self-management, stress overload, anxiety, speech disturbances and voice disorders, constipation, urinary incontinence, impaired balance and frequent falls, inappetance and swallowing difficulties. Aims: To map problems in nursing care for a client suffering form Parkinson's disease from client's and nurse's points of view. To map nursing interventions in Parkinson's disease therapy from client's and nurse's points of view. Methods: Qualitative research in form of an in-depth interviews with nurses and clients was carried out. All interviews were recorded as a verbatim copy and coded using pencil and paper open coding method. Created codes were grouped into categories and subcategories. Interviews were carried out in March 2014. Participants: First set of participants comprised of ten nurses caring for Parkinson's disease suffering clients, four of them working at a department of neurology, four at a department of long-term care and aftercare, and two nurses providing a home care. Other set of participants comprised of six clients suffering from Parkinson's disease, five of them were members of Parkinson club České Budějovice, and the last was living in a village near Náměšť nad Oslavou. Results: Using the open coding method three categories, focused on particular topic, each containing several subcategories, were picked from interviews with both participant groups. Categories Nursing care problems, Nursing care and Specific interventions are identified in the first part. In the category nursing care problems nurses mostly agreed on a self-management deficit, movement difficulties, increased fall risk and communication problems. Aktivisation, motivation, rehabilitation, self-management training, regular drug administration and family participation were most frequently mentioned in the category nursing care. In the category specific interventions nurses focused on interventions directly related to particular problems. In the second part of the research categories Every day tasks management, Nursing care and Specific interventions are identified. In the every day tasks management category clients mentioned necessity of other parsons assistance in self-management, and movement difficulty and stiffness are considered being most annoying.
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Urinary tract infections in children from the perspective of nursing care.
BUDÍNOVÁ, Eliška
The bachelor thesis is focused on urinary tract infection in children from the perspective of nursing care. Despite the fact that the quality of prevention and nursing care are constantly improving, urinary tract infection continues to rank among one of the most common childhood diseases. For this reason, it is very important to introduce the problems of this disease, familiarization with nursing care of a child and all of its specifics regarding the work of a nurse. The theoretical part deals with the actual disease, urinary tract infection in children, from the anatomy and symptoms to diagnosis and treatment. It also focuses on the work of nurses taking care of a child with a urinary tract infection. In the survey there were two main objectives. The first objective was to map the nursing problems of children with urinary tract infections. The second goal was to determine the principles of nursing care of a child with IMC, both goals were set from the point of view of nurses and parents. The empirical part of the thesis was determined by qualitative research. The used method was non-standardized semi-structured interview. The research sample consisted of 10 respondents. The first half of the respondents consisted of nurses working at a children's hospital and the other half of parents of children with urinary tract infections. During the interviews a method of open coding was used, especially method of pencil and paper. The survey was based on 4 research questions. Research question 1: What are the principles in the context of nursing care of children with urinary tract infections? Research Question 2: What basic knowledge have parents about urinary tract infection? Research Question 3: What nursing problems have children with urinary tract infection? Research Question 4: What knowledge have parents about the nursing care of children? Results of the research showed the most common nursing problems which were further subdivided according to respondents' answers. From the results of interviews of nurses emerged the 3 most common nursing problems. It was an issue of hyperthermia, acute pain and a risk of infection. In relation to this issue the solutions were similar. This mainly involved the administration of analgesics and antipyretics, according to the doctor and compliance with barrier nursing care for prevention of infection.From the interviews with parents emerged the most common problems related to the child. These were mainly pain and hyperthermia. Furthermore, there also appeared a trouble-free urinary tract infection. With this topic were also connected ways of solving the problem, the most frequent response was targeted antibiotic therapy for urinary tract infection. From the research came out principles of nursing care provided to a child with a urinary tract infection. These results are also divided according to respondents' answers. Nurses consistently stated that for a child with a urinary tract infection are not specific policies for nursing care. The care is performed in the same manner as for children with other diseases. The interviews also showed specific procedures in nursing care such as hygiene, medication administration, measurement of body temperature, urine and blood collection, drinking regime and patient enrollment in the documentation, etc. An interesting part is a part about the education of patients and parents. Nurses stated that they don´t educate patient´s parents. Only a doctor does that kind of care. According to the survey majority satisfaction regarding care, education, etc., is obvious from both the nursing staff and the family. However, these results could serve to a partial change especially in improving nursing education. In the future this change could cause even greater satisfaction for patients and their families and reduce the incidence of this disease in children.
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Burns as a Nursing Problem
KROPÍKOVÁ, Eva
The name of the bachelor work is "Burns as a Nursing Problem", which is divided into the theoretical and the practical part. The theoretical part of the work deals with the general description of skin and its functions, the causes of burns, its extent and depth, principles of the first aid, rehabilitation and medical treatment of burns, the infection connected with burns, nursing care, nursing problems, nursing procedures, the principles of barrier care, education and psychological issues.In the practical part of the work are compiled three objectives, which were determined in advance. The aim was to chart the procedures used by nurses while treating burnt surface. The second aim was to ascertain the problems nurses see during the care about the patients with burns. The third aim was to ascertain whether nurses educate patients with burns.In the practical part the method of quantitative survey was used for the data collection, which was realized by the research form of questionnaires, all of them were completely anonymous and were consisted of 34questions. The questionnaires were handed in the hospitals in South Bohemia. Pisek´s hospital plc, Prachatice´s hospital plc, Tabor´s hospital plc and Ceske Budejovice´s hopital plc participated in the research survey. The respondents were nurses working in the surgical wards. For the achievements of aids were created four hypotheses. H1: Nurses use modern methods with healing wounds of burns. H2: Nurses perceive like a nursing problem to communicate with patients who have burns. H3: Nurses see a problem with the observance of nursing barrier care when patients have burn trauma. H4: Nurses educate patiens with burns.
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