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Blood collecting yesterday and today
STOLARIKOVÁ, Pavlína
Blood collection is nowadays a common procedure, especially nurse's. The nurses encounter blood donations almost every day of their service. This procedure is especially important for physicians, who, based on laboratory results, can diagnose pathological conditions and subsequently indicate appropriate treatment. This bachelor thesis called Blood collection in the past and today is processed as a theoretical work. According to the title of the thesis, it is clear that it is focused on blood collection and other problems related to it. The aim of this thesis is to analyze the development and related changes in blood collection performance using available sources. Specifically, the aim is to analyze how the procedure itself and the tools used for blood collection have changed. The thesis is processed by an analysis of available primary and secondary sources of historical and current data. Blood collection is of course related to blood, whose physiology is described in the work. The procedure of blood collection is related to laboratory examination, which is also mentioned in this thesis. The aim is to analyze the sources describing the development of blood collection and tools used for it. The paper also mentions the topic of transfusion medicine and nursing education, which is closely related to the performance of blood collection within the competence of nurses, whose form has changed over the years. The thesis has been elaborated using available Czech and foreign literary sources, databases and articles from professional periodicals. A comprehensive theoretical basis has been developed, which can be used in practice especially as a study and information material for professional and general society. Based on an analysis of sources, it has been found that blood collection has changed both during the development of nursing and medicine itself, and due to many industrial, technical and political influences.
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Elements of the Preanalytical Phase of Blood Taking Influenced by Nurse and their Adherence in Practice.
Remešová, Andrea ; Eislerová, Iva (advisor) ; Eckelová, Ivana (referee)
The bachelor thesis is divided in theoretical and empirical part. The theoretical part deals with preanalytical variability influencing blood test results with a closer view of elements that can be affected by a nurse. The empirical part consists in quantitative research using questionnaires which determine the nurses's awareness about this issue. Qualitative research focuses on the use of this knowledge in nursing practice by methods of observation. The aim of this research was to investigate the knowledge level of nurses in the issue of preanalytical phase of blood sampling and to confront theory with practice. Subsequent comparison of the results of both methods showed that the commonly usedpractice is not always consistent with theoretical knowledge. The most important discrepancy between theory and practice has been established in connection with the preparation of the patient, the duration of application of a tourniquet, the flexion-extension arm exercise prior to sampling and shaking of test tubes containing blood. Powered by TCPDF (www.tcpdf.org)
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Network Optimization of Transfusion Sites in the Czech Republic
Konderlová, Nicolle ; Lešetický, Ondřej (advisor) ; Svěráková, Veronika (referee)
This thesis is about medical transfusion sphere, which has nowadays many deficits - as the other spheres in medical industry. Target of this thesis is a proposal of new equipment structure in transfusion service in the Czech Republic, which will be more effective then the existing one and which occurs a reduction of blood processing department. It includes not only calculation of basic expenses needed for installation new system and ensure operations for 5 years and comparison of both variants, but it includes also proposal of centralized managing and changes of staff secure of production process.
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Influence of parameters of blood count in dependence on the amount of blood collected into tubes
MOUDRÁ, Pavla
Haematology is the branch of science engaged in the study of blood and its components - especially blood cells - red blood cells, white blood cells and blood platelets. In the core haematology examination - the blood count - not only their amount is evaluated but also the morphology. When blood taking, the right ratio of blood and anticoagulant must be kept, otherwise changes in blood count may occur. Laboratorians are bound to reject examination of incorrectly taken samples. Since it is difficult to take blood from some patient groups (children, elderly, obese patients, etc.), there is often put a pressure on laboratories from the staff to process also the incorrectly taken samples. The aim of this study is to state the level of impact of the incorrect blood taking, within the meaning of the blood - anticoagulant ratio, on the particular parameters of the blood count. The sample consisted of one hundred patients who were invited by their physician for blood tests to the Synlab Czech., s.r.o. company, U Tří lvů 4, České Budějovice in the period from December 2011 to June 2012. There were healthy and sick patients aged 10-77 years in the sample. All one hundred patients were taken within the same examination two test tubes with anticoagulant K2EDTA made by Becton Dickinson - BD Vacutainer. According to instructions, 2 ml of blood were taken into the first tube. Into the second tube, from the fifty patients only 0.5 ml of blood were taken, from the another fifty patients 3.5 ml. These samples were measured in the laboratory of Synlab Czech, s.r.o. company, U Tří lvů 10, České Budějovice using the Advia 120 analyzer made by Bayern HealthCare LLC, serial number IR28850224, installed in 2011. All 13 parameters issued by Synlab Czech, s.r.o. company on the result sheet as a blood count were analysed. The results from correctly and incorrectly taken samples were compared using a paired t-test. Hypothesis assumed that deviations will occur at both sampling errors for all thirteen blood count parameters at the significance level of 95%. This hypothesis was not confirmed, there were no deviations of statistical significance in all of thirteen parameters in any incorrectly taken samples. In the case of test tube where more blood than required was taken, there were no deviations of statistical significance in any of thirteen parameters. In the case of test tube where less blood than required was taken, there were deviations of statistical significance in six of eight measured parameters. A statistically significant increase occurred in the number of red blood cells (by 0.85%), haemoglobin amount (by 0.97%), haematocrit values (by 2.19%) and MCV (by 1.41%). The decrease occurred in MCHC values (by 1.23%) and platelet count (4.96%). The differential white blood cell count was statistically significantly different only in the monocyte value (reduction of 6.35%). Within examination of samples from tube where more blood than required was taken, there were no statistically significant deviations. Therefore, we may assume that such incorrectly taken samples could be used for blood count examination. When taking less blood than required, statistically significant deviations occur in almost half of the blood count parameters. The platelet reduction of 4.96% is clinically the most important. Nevertheless, we can say that even this value is probably not significant enough to not use the incorrectly taken sample in acute cases. If the conclusions of this study are confirmed by other studies, it could be possible to make health care more effective in cases where deviation is considered to be neither statistically nor clinically significant.
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Venous blood taking - routine issue for nurses?
JELÍNKOVÁ, Petra
Venous blood taking belongs to frequent nursing procedures of a nurse. Venous blood is easily accessible biological material, whose valid result enables to specify the diagnosis of a disease and to begin appropriate treatment in an inpatient. At present the Health Service emphasises quality improvement of nursing care. There are executed standards of nursing procedures in hospitals and nurses are obliged to follow them. Venous blood taking is one of those procedures. There are two objectives of the thesis - to examine knowledge of nurses in the hospital of Tabor, Ltd. concerning the issue of venous blood taking and to research nurses? workplace and procedures during venous blood taking at sampling points. Quantitative and qualitative research was applied to achieve the above mentioned objectives. The questionnaires were distributed to nurses at standard hospital wards. Five respondents, working at sampling points in South Bohemian Region, took part in the interviews. The first hypothesis, whether nurses follow the standard nursing procedure when taking the venous blood, was proved. The second hypothesis, whether nurses are aware of the fact that they can influence the final analysis of the blood sample by the procedure itself, was proved. The third hypothesis, whether nurses are aware of the negative factors of pre-analytic variability, was also proved by the research. The last hypothesis, number four, whether nurses have the knowledge of the proper sequence of the sampling tubes, as the answers demonstrated, was not proved. Three research questions could be answered as follows. Nurses at sampling points do have adequate work background that provides calm and safe procedure of venous blood taking. Blood taking nurses follow the right procedure that guarantees a valid sample of blood taken. The respondents at sampling points know and follow elaborated standard nursing procedures. I find this procedure correct, safe and the only one that ensures quality samples taken. The research revealed that for nurses in hospitals, unlike nurses at sampling points, venous blood taking is a routine matter and that they have their own trained process to do that. On the grounds of both, the literature on this subject and the results of the research, I would like to suggest particular adjustments of the standard nursing procedure to the management of the hospital of Tabor. The nurses will have a manual drawn up by me available. The manual might serve as a proper routine procedure of venous blood taking.
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The role of pediatric nurse and midwife in the laboratory screening of newborns
CHVÁTALOVÁ, Lenka
Newborn laboratory screening represents a pro-active blanket search for diseases in their early, pre-clinical stages. It uses an analysis of a dried blood drop on filtration paper. The blood is taken under specific conditions from all newborns born on the territory of the Czech Republic. The blood samples are collected by midwives and pediatric nurses, who are responsible for correct execution of the test. In 2009 the number of screened diseases increased from nine to thirteen. The samples are accompanied with double NCR cards to record all data about the newborn and the conditions of blood collection, including an NCR copy of demographical data. The midwife or pediatric nurse shall instruct the mother who should be present during the blood collection. In the theoretical part the author deals with the history of newborn screening, characteristics of the newborn screening and its principles, tested diseases, preparation, procedure and care after the test. The practical part used a combination of quantitative and qualitative research survey. The quantitative survey used inquiring with a questionnaire technique. The objective number 1 of the survey was to map the knowledge of pediatric nurses/midwifes about laboratory screening of newborns. The objective 1 was fulfilled. The hypothesis formulated in connection with the objective was: Pediatric nurses and midwives are familiar with the principles of laboratory screening. The hypothesis was confirmed. The research technique used for the qualitative survey was an in-depth interview. The objective number 2 was to map obstacles to the laboratory screening of newborns from the viewpoint of pediatric nurses and midwives. The objective 2 was fulfilled. The research question formulated in connection with the objective was: What are the obstacles to the collection of samples for laboratory screening of newborns? The research question was answered. The most frequent obstacles are poor blood flow, necessity to make more than one puncture and the fact that one prescribed drop of blood may not be sufficient for the testing. This bachelor degree thesis may serve as a source of information and study material for students of midwifery. The results of the research may be used as a teaching material at the University of South Bohemia.
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Professional injuries of health workers
KRÁTKÁ, Hana
I chose the topic of my thesis, professional injuries of health workers, because I wished to know how such problems are evaluated, as each of us has been or will be in a health facility some day and will see health workers performing their work. From my experience regarding health facilities, I knew that not all acts of health workers are appropriate, but I did not know whether they violate legislation or rules of operation, or whether their procedures are correct. Therefore I chose the topic in order to learn the facts about professional injuries and procedures followed by health workers when executing their jobs. Health workers are exposed to the risk of injury by a sharp object and to the associated risk of infection every day. In the Czech Republic, both non-professional and professional injuries are monitored. Health workers are also exposed to the risk of infections in consequence of professional injuries, such as hepatitis viruses A, B, C, D, E, HIV/AIDS, cytomegalovirus infection, infectious mononucleosis and syphilis. The aim of my thesis is to evaluate the monitored numbers of injuries of health workers in Ústí nad Labem according to determined criteria, and to focus on the observance of valid legal regulations when handling medical materials, medical means and dangerous waste. Further, the aim was to make health workers familiar with the research results and to participate in training on work safety in health facilities. The hypothesis of my thesis is that valid legislation is observed when handling medical materials, medical means and dangerous waste. As the research method, I used questionnaires, which were distributed in five hospital wards, and secondary data collection from health records of the years 2003, 2004, 2005, 2006 and 2007, which were available at the anti-epidemic department of the Regional Hygienic Station in Ústí nad Labem. I think that the hypothesis as provided in my thesis was not confirmed as health workers do not observe the valid legislation in the Czech Republic. The aim of my work was fulfilled, because I processed the questionnaires in tables and graphs, and the secondary data collection was evaluated in tables and the obtained results were compared with other available resources regarding the problems. The findings of the thesis will be interpreted to the head nurse of Krajská zdravotní a.s. {--} Masarykova nemocnice (Masaryk Hospital) in Ústí nad Labem who will subsequently organize training of head nurses. Further, the findings will be used for the preparation of an educational program for health workers and will be interpreted to concerned persons.
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