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The principles of the safe administration of medication and it's impact on the quality of care.
Sedláková, Dana ; Vaculíková, Barbora (advisor) ; Slanina, Petr (referee)
8 ABSTRACT This thesis discusses the theme: "The principles of the safe administration of medication and it's impact on the quality of care". This work is divided into two sections - theoretical and practical. The main purpose of the theroretical part is to focus on recapping the theories of quality in healthcare, especially in terms of safety for patients during medication administration. The drugs are the most frequently used therapeutic means of the modern medicine and therefore the topic of safe administration is so often the matter of discussion. Theoretical part of my thesis defines quality in healthcare and also includes chapters about methods for improving the quality and standardization of health care. This work presents an effective tools for dealing with misconducts and describes possible reasons and causes of patient's harm during the administration processes. The practical part of the thesis is dedicated to the content analysis of the selected nursing standards from hospitals within the Czech Republic. The main objective of this thesis is to compare the formal and practical aspects of nursing standards (injection administration) in three different health care facilities with regards to the structural, procedural and results criteria. The results of the content analysis are compared with respect...
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The principles of the safe administration of medication and it's impact on the quality of care.
Sedláková, Dana ; Vaculíková, Barbora (advisor) ; Slanina, Petr (referee)
8 ABSTRACT This thesis discusses the theme: "The principles of the safe administration of medication and it's impact on the quality of care". This work is divided into two sections - theoretical and practical. The main purpose of the theroretical part is to focus on recapping the theories of quality in healthcare, especially in terms of safety for patients during medication administration. The drugs are the most frequently used therapeutic means of the modern medicine and therefore the topic of safe administration is so often the matter of discussion. Theoretical part of my thesis defines quality in healthcare and also includes chapters about methods for improving the quality and standardization of health care. This work presents an effective tools for dealing with misconducts and describes possible reasons and causes of patient's harm during the administration processes. The practical part of the thesis is dedicated to the content analysis of the selected nursing standards from hospitals within the Czech Republic. The main objective of this thesis is to compare the formal and practical aspects of nursing standards (injection administration) in three different health care facilities with regards to the structural, procedural and results criteria. The results of the content analysis are compared with respect...
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The Giger and Davidhizar transcultural assessment model
SOUKUPOVÁ, Jaroslava
Abstract The Giger and Davidhizar Transcultural Assessment Model. Because of the globalization we live in the world where {\clqq}the borders are getting closer`` which also means to live our lives in more multicultural society. That is why a nurse must react to modern nursing care and must be well prepared to cope with specific problems of various communities in their health and illnesses. In my diploma work we deal with transcultural evaluation of nursing care according to the J. N. Giger and R. Davidhizar Nursing Care Models. These models are about regardful and tailored care which we apply to members of Vietnamese community living in the Czech Republic. The theoretic part contains problems of the globalization, migration of foreign people, transcultural nursing, the Giger and Davidhizar nursing care models, information about Vietnam and the model application to members of Vietnamese community living in the Czech Republic. In the practical part we created standard of nursing care named Nursing of Vietnamese patient/client in health care institutions and we are interested in its using in the working practice. Then we found out opinions of people working in health care institutions who work with this standard and found out expectation of Vietnamese patients/clients hospitalized in health care institutions whose findings could help with prevention of hospitalization problems. The goals of the work: 1. Using of modification the Giger and Davidhizar nursing care models with giving care to Vietnamese people in health care institutions 2. To find out cultural changes in nursing process and their influence on behaviour of Vietnamese people in an illness 3. To identify problems and expecting of hospitalized Vietnamese people The research was conducted with the help of quasiexperiment and interview in the Regional Hospital Příbram. We addressed 10 nurses and 6 Vietnamese patients/clients. We must point out that in the year 2007 only 6 Vietnamese people were hospitalized there. The goals of the work were achieved. We hope that our work may help to increase quality and efectivity of the nursing care given to Vietnamese people.
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Application of the Kathryn Barnard nursing care model to the physically handicapped child
STRNADOVÁ, Eva
Physical disability/physical handicap is an affection that is manifested by either temporary or permanent problems in motor diathesis of children. Physically disabled children may suffer from physical disability either from their birth or may acquire physical disability in the course of their lives. These problems may act in a negative manner on children perception and feeling and the same holds good for their near relatives. Problems come into existence in parent-physically handicapped child interrelation. The nursing model of Ms. Kathryn Barnard focuses on mutual interaction between parents and their children. In her model Ms. Kathryn Barnard points out the importance of the aforementioned parent-physically handicapped child interrelationship. On the basis of evaluation of the parent-child interactions based on three main factors: a child, mother, environment, a general child development is determined. The parent-child interaction affects a child development, child{\crq}s health, growth and development of a child. The aim of nursing care is to assist in finding a proper way of parent- physically disabled child interaction so that the nursing care may act on general development of a child in a positive manner. In this diploma work the following goal has been set: to find out and identify the most important problems existing in the parent-physically disabled child relation, and to evaluate possibilities of nursing care in solving problems arising at the parent-physically disabled child interaction. For the purpose of meeting these goals the following research questions has been established: What are the most important problems in the parent-physically handicapped child interaction? How can nursing care help in the parent-physically handicapped child interaction? What is the proper procedure for the nursing care of a physically disabled child and his/her close relatives? After carrying out research examinations the answers to the above-specified questions are as follows: 1. The most important problems lying in the parent-physically disabled child interaction are as follows: parent to reconcile himself/herself with his/her child's diagnosis, more frequent occurrence of stress situations, excessive emotional ties of the physically handicapped child with his/her nursing personnel. 2. The nurse can help by means of nursing process in an active manner solve the above-specified problems in interrelation between parent-physically handicapped children. On the basis of information having been gained by the study of professional literature and pieces of information obtained from the answers of the parents of physically disabled children a nursing documentation has been made in accordance with the Kathryn Barnard interaction model as well as nursing care standard of physically handicapped children. By finishing it both the third and fourth aims have been accomplished. Nurses providing care for physically disabled children have used the nursing documentation and it has proved useful and nursing personnel declared it satisfactory. The nursing documentation and the standard should help nurses in providing quality nursing care of physically handicapped children.
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Qualitative investigation of nursing practice for blood donations
NEUMANNOVÁ, Jana
Venous blood sampling poses one of the basic professional skills of a nurse. As in other fields of medical professions, new techniques, standards, instruments and auxiliary instruments are steadily developed here. Their use in practice should facilitate the work of nurses, increase the comfort of patients and, last but not least, increase the costs of health centres and hospitals resulting from repeated samplings and consequently repeated analyses of blood samples. The obtained blood test results facilitate the diagnosis as well as the monitoring process of the individual treatment effectiveness. When taking blood samples, nurses should comply with the current nursing standards ensuring that the result of the given venous blood sampling is correct and non-distorted by an incorrect venepuncture. A violation of the nursing standard may endanger the health safety of both the patient and the nurse. This baccalaureate work monitors the compliance of stipulated nursing standards related to blood sampling. The research was carried out within the surgical ward of the Klatovy Hospital. The monitoring method of disguised participating observation and consequent interviews with monitored nurses was selected. Thus, the research questions could be sufficiently answered. The first question was focussed on the rate of compliance with the principles of correct venous blood sampling. The observations showed that nurses not always proceed in compliance with the appropriate venous blood sampling standards. The second research question dealt with the sampling safety standards both in terms of the patient and the nurse. The research results suggest that nurses are not always fully aware of their own or patient's safety issues. The nurses are not yet sufficiently skilled in the application of protective equipment. The third research question was focussed on the individual preferences of the available sampling techniques. The results of the interviews with nurses suggest that nurses tend to prefer the closed technique. The ward sister of the surgical ward as well as the deputy executive manager for nursing issues of the Klatovy Hospital shall be made acquainted with the results of my research. I plan to propose to hold a seminar in the co-operation with the staff of the clinical biochemistry ward of the Klatovy Hospital.
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Caesarea section- perioperative nursing care during regional and total anesthesia
MAŠKOVÁ, Šárka
In my thesis I focused on perioperative nursing care for women with a caesarean section in regional and general anesthesia. The thesis is divided into a theoretical and research part. In the theoretical part of my thesis history, conditions, indications and contraindications, and also complications during a caesarean section performance are described. Information about anesthesia which is used for a caesarean section is also given. Conditions for general, epidural and spinal anesthesia administration are described. Advantages, disadvantages, indications, contraindications and complications of different types of anesthesia are also mentioned. A substantial part of the theoretical part is devoted to perioperative nursing care. The preoperative nursing care is described, the preparation for it is divided according to the type of anesthesia. Nursing care during the intraoperative and mainly postoperative phases is mentioned in detail. The aim of my thesis was to identify differences in perioperative nursing care for women with a cesarean section in regional and general anesthesia. My work was also focused on women's level of awareness about possibilities of anesthesia for caesarean section. Another goal of my work was to make up standards of perioperative nursing care for women during a caesarean section delivery in regional and general anesthesia, which is administered in the delivery room. Two hypotheses were stated. The first hypothesis is the supposition that women after a caesarean section need a different nursing care, which depends on the type of anesthesia administered. The second hypothesis is the supposition that women are adequately informed about the possibilities of anesthesia for a caesarean section. Quantitative research conducted through questionnaires was chosen to conduct the survey. Questionnaires were distributed to women after a caesarean section at the confinement department. Research results are shown in graphs .The both hypotheses were confirmed by the research investigation. The research has revealed a new finding that women need different nursing care not only after a caesarean section, but also during the intraoperative phase. I used this finding to develop a standard of perioperative nursing care for women during a caesarean section delivery in regional and general anesthesia. The standard is designed for midwives and is intended to improve nursing care for women in the course of a caesarean section delivery during the intraoperative phase. The research has proved that women with a cesarean section need a different perioperative nursing care, which depends on the type of anesthesia administered. It is therefore necessary to differentiate between the two groups and provide them with a different nursing care. The research has also shown that women feel sufficiently informed about anesthesia for a caesarean section. Women´s awareness is a prerequisite for a good cooperation with the patient and successful nursing and medical care. The nursing care provision according to the perioperative care standard will ensure a quality professional nursing care for women before, during and after a caesarean section.
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Problems of Nursing the Patients Self-intoxicated in Suicidal Intention.
DRÁBKOVÁ, Iveta
Suicide as an individual event as well as a social phenomenon attracts great interest and attention in various spheres, both in the immediate environment of the self-murderer and in broader public. The definition of suicide differs according to authors and changes in the course of historical development. Most definitions are identical in two essential aspects of suicidal behavior. These are a voluntary individual's intention to terminate his life and a purposeful behaviour leading to death. Suicide is the conscious and intentional killing of oneself. About 95% of suicidal attempts are just acute intoxications by any amount or kind of a poisonous substance. Acute intoxication belongs to a group of serious conditions threatening human health and life. Acute poisoning is one of the frequent admission diagnoses in the Departments of anesthesiology and resuscitation and Intensive care units. 80% of poisonings are caused by drugs. Damage to the organism by ingesting a poisonous substance is the more significant the longer is the interval between the exposure to noxae and the professional medical assistance provision. For the future fate of the patient the medical equipment and the competence of health professionals who provide intensive care for these patients is crucial. After stabilization of all physiological functions, balancing inner environment of the patient and after the time that may have led to late complications of intoxication, the following phase of treatment is provided by psychological and psychiatric interventions. Determination of suicidal risk among the most common challenge in urgent psychiatry is suicide risk assessment. The aim is to prevent further suicide attempts. The objective of the thesis was to determine, with regard to the competence of nurses, the predominant character of patients´ experience after intoxication, and also the reasons for aggressive behavior of intoxicated patients towards the nursing staff. The third objective was to establish a standard of nursing care of intoxicated patients. The research was designed as explorative with the goal to map the nursing process in intoxicated patients and to provide information for the establishment of the standard of nursing care, which should include both somatic and psychological aspects. Quantitative and qualitative methods were combined. The outcomes of the thesis should lead to detection of the most frequent problems in nursing care for patients with intentional intoxication with suicidal tendency and the establishment of nursing standards to help improve the care of these patients.
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Changes of the attitude of a nurse towards the nursing care after his/her ranging to a higher position.
PROCHÁZKOVÁ, Marie
The Thesis deals with a change of an approach of a nurse to nursing care provision after her promotion to a managerial position. A nurse appointed to the position of charge or head nurse has different responsibilities, she becomes a manager, her colleagues have suddenly become her subordinates, whose work she has to organize, lead and control. A wide range of new responsibilities might change her approach to provision of nursing care. The aim of the Thesis was to discover whether and how the approach of a nurse to nursing care changes when she is appointed to a managerial position and how a nurse promoted to a managerial position achieves authority among her subordinates. The following hypotheses were chosen in relation to the aims of the Thesis. Hypothesis 1: The approach of a nurse to nursing care changes after being promoted to a managerial position. Hypothesis 2: A nurse promoted to a managerial position requires provision of nursing care in line with nursing standards. Hypothesis 3: A nurse promoted to a managerial position is responsible for nursing care quality. Further research questions were put: 1. Is it difficult for a nurse promoted to a managerial position to achieve authority among senior nurses? 2. Is it difficult for a nurse promoted to a managerial position to control nursing care provided by shift nurses? 3. Is it easier for a nurse promoted to a managerial position to organize work for shift nurses she did not work with before? Quantitative research in the form of questionnaires was applied to confirmation or refutation of the hypotheses. The research sample consisted of head and charge nurses from South Bohemian hospitals and from hospitals in Příbram and Pelhřimov. Qualitative research was organized in the form of unstructured interviews with head nurses from Hospital České Budějovice. After evaluation of the results all the three hypotheses showed confirmed. The research results confirm that an approach of a nurse changes after their promotion to a managerial position. They are much more responsible for quality work among her subordinates. The results of the work will be presented at all-house seminars and conferences and published in a specialized journal. The results will also be provided to the hospital management {--} to the Nursing Care Manager {--} and finally to the respondents involved in the research.
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Nurses knowledge of The quality evaluation of provided nursing care
KLIMEŠOVÁ, Jana
The name and the topic of my thesis is evaluation of the quality of given nursing care. The quality of nursing care as integral part of quality of medical care is gaining ground not only in medics but also in public. Words like quality, standard, audit are commonly used by every nurse but do they know meaning of separate words? Do they know how to ensure high-quality care and how to evaluate it? These and other questions must be answered in order to retrieve possible insufficiencies and thus, to ensure high-quality nursing care. That´s why I chose this topic for my thesis. Theoretical part first characterizes nursing, its aims and organization of nursing care. Extensive part is devoted to quality of nursing care, systems and models to ensure and evaluate the quality. Practical part is focused on research and its interpretation. There were two research units and were created by nurses from surgical wards of Hospital in České Budějovice and Hospital in Jihlava. In order to collect needed data I chose quantitative method, when the way of data collecting was questionnaire. The aim of the thesis was to chart nurses´ knowledge on evaluation of quality of given nursing care through two hypotheses. The hypothesis supposing that nurses working in Hospital České Budějovice know more about evaluation of quality of given nursing care than nurses working in Hospital Jihlava was confirmed. But it is evident from the results that both investigated units have certain reserves. The other hypothesis supposing that more than 80% nurses consider the audits helpful for improving the quality of nursing care was not confirmed. According to the results, for more than half of addressed nurses audit is only stressing matter when hospital management looks for faults in their work. I mean, this opinion results from insufficient knowledge or incorrect understanding of the audit sense. I would like to use the thesis and its results as a base for creating scientific lectures and subsequent presentation. The head nurse asked me to present my thesis and the results at the meeting of head nurses in autumn 2008. I was asked for the results by Jihlava Hospital management as well.
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