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Nursing care management for orthopedic outpatient clients from the nurse's point of view.
VOPÁLKOVÁ, Milena
In view of the fact that clients with locomotor system difficulties (who often have impaired mobility, are in pain and have difficulties finding their way in a new environment and situation) come to the orthopaedic outpatient department, we consider it worthwhile to look at the comprehensive nursing care of these clients. The task of the healthcare personnel at this moment is to provide support, assurance and safety to the client and his family, and to allow him to gain sufficient information, skills and habits to restore and maintain his health. A total of three goals were laid out in this thesis. Our first goal was to map out the features specific to the management of nursing care for clients of the orthopaedic outpatient department from the nurse's aspect. The other two designated goals concerned elucidation of the means for detecting and dealing with nursing care problems and needs of clients of the orthopaedic outpatient department. Qualitative and quantitative research methods were used in order to meet the goals of this thesis. In the qualitative research investigation there was a semi-structured interview with five informants who work in selected orthopaedic outpatient departments of the South Bohemian Region as paramedical staff. The interviews with the informants were recorded on a recording device, and this was followed by transposition and data analysis using coding. The results were summarised in structured categories and sub-categories. Two orthopaedic outpatient departments were intentionally selected. One site was a private orthopaedic outpatient department, and the other was an outpatient department that was part of a medical facility. We used a quantitative research investigation to gain feedback for the provided nursing care in the orthopaedic outpatient departments. Using surveys with respondents who attended the selected orthopaedic outpatient departments. We were interested in their perspective and satisfaction with the provided nursing care and instruction. A total of 160 respondents, exactly one half from each orthopaedic outpatient department, were asked to fill in a questionnaire. Based on the results of the qualitative investigation it is clear that the greatest burden faced by nurses of the orthopaedic outpatient departments is the lack of time to provide comprehensive nursing care. It was discovered that nurses spend most time on specific professional tasks, assisting doctors, satisfying the most immediate needs of clients and, in particular, administration. However, they spend the least time on prevention and instruction. It was discovered that nurses most often note a lack of self-care, movement and activity in clients of the orthopaedic outpatient departments, along with pain, fear and lack of information. The quantitative investigation showed that there were no statistically significant differences between the selected outpatient departments in the resolution of current needs and approach of nurses. In the matter of time for answering questions, instruction and subsequent satisfaction of respondents of the selected orthopaedic outpatient departments, we can say that there exist statistically significant differences between the private orthopaedic outpatient department and outpatient department that is part of the healthcare facility. A summary of the findings from the research survey allows us to state that it is unavoidable to focus more on the comprehensive nature of the provided nursing care, including instruction, in nursing care management for clients of orthopaedic outpatient departments. The output of this work is a draft concept for functional orthopaedic instruction nurses which will be submitted to nurses of the orthopaedic outpatient departments as a suggestion for expansion of instruction centres for patients.
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Multidimensional view on the work of children's nurse in the emergency room of children's ward
PŘÍPLATOVÁ, Iveta
The work of nurses in the outpatient department belongs between discussed topics. The interplay and cooperation of all members of the medical team are especially important. Correct communication between all team members and communication with children and their accompaniment are also a matter of course. The aim of this diploma thesis is to map the work of a nurse in a comprehensive view in the outpatient area of the children's ward, the satisfaction of children and parents in the outpatient area of the children's ward and to suggest possible improvements for the outpatient sphere of the children's ward of České Budějovice a.s. The diploma thesis is processed by qualitatively quantitative investigation using semi-structured interviews, questionnaires and observations. The research group consisted of nurses, doctors, paediatric patients and their accompaniment at the children's ward, paramedics and the general public as well. The interviews were categorized and processed by the method of pencil and paper. Questionnaires were processed statistically. The hidden participating observation was focused on the collaboration and communication of nurses from outpatient department with other nurses, doctors, paramedics, children and their accompaniment; and it was also focused on the satisfaction of the children or their accompaniment at the outpatient department. The results of the work showed that the view of the work of the paediatric nurse is distorted both from the health care professionals and the general public, which means that the nurse is seen mainly as a nursing care provider. The results also showed the necessity of proper communication and knowledge of foreign languages. At the same time, the thesis was used to identify shortcomings or suggestions for changes in the paediatric outpatient department of the České Budějovice Hospital, including the satisfaction of patients and their accompaniment during visiting the department that depends on the time spent in the waiting room. Suggestions for improvement were drawn up, drafted and handed over to the children's ward management.
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Educational Activity of a Nurse in an Outpatient Department
HANOUSKOVÁ, Radka
This thesis focuses on educational activity of a nurse in an outpatient department. The introduction to the theoretical part identified educational activities, their types, phases, methods and forms.The aim of the thesis and the research question: The aim of the thesis was to find differences between educational activity of a nurse working in outpatient departments existing in hospitals and those out of hospitals. Methodology: The results of this thesis were obtained by a qualitative research method, namely semi structured interviews. One anonymous South Bohemian hospital was involved in the research, from which three nurses working at specialized outpatient departments were chosen. One anonymous South Bohemian outpatient clinic was another research subject. Three nurses working at specialized outpatient departments were chosen there as well. Results: Four categories, each consisting of several subcategories were based on the obtained data. In the first category called educational activity in an outpatient department we found that the educational activity for nurses in outpatient departments is based on education of a patient in health maintenance and restoration and education in prevention and treatment. In the first established subcategory called the applied educational methods we found that the nurses in the hospital as well as those in the outpatient clinic mostly apply dialogue and demonstration to education. In the second subcategory called the number of educated patients the empiric research showed that in average the number of educated patients is twice as high in the hospital as in the outpatient clinic. We were surprised that nurses in the hospital used an education record sheet to record their educational activity, while the nurses from the outpatient clinic did not keep any records. The second category identifies in what nurses can see the importance of patient education. Upon analyses of the result we can say that they can see it in the information source. This category consists of three subcategories. A subcategory dealing with attracting patient's attention to education showed that nurses gain patients with a smile, a kind word, motivation and commendation. The second subcategory was feedback, which showed that nurses get it orally. And the education topic the nurses meet is always specific for each particular type of department. The finding that various topics are educated in all the departments, but one topic is common, namely diet, where all the nurses educate patients in nourishment, was the result. The third category, education method choice was also established. There was a positive finding that nurses use various education methods, which they choose with regard to patient's state and needs. This category consists of two subcategories. The first subcategory was called the most effective educational method. All the nurses uniformly considered interview to be the most effective method. In subcategory educational material we found that nurses use leaflets or aids for injection application as educational material. The last chapter called influence on education was aimed at things that influence nurses' educational activity. A subcategory time for education was established here. One thing the nurses working in the hospital agreed on was that they did not have enough time for education. On the other hand the finding that the nurses from the outpatient clinic mentioned that they had enough time for education was a surprising result. Another subcategory searched for the proper environment. The answers here differed according to the place the nurses worked at. The nurses working in the hospital replied that they did not have suitable environment for education, while those from the outpatient clinic considered their environment acceptable. The last subcategory examined the obstacles to educational activities. The research showed that the nurses see obstacles in age and in lack of confidence in new technologies. T
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Simulation of the operation of the hospital department
Olejár, Filip ; Dlouhý, Martin (advisor) ; Kuncová, Martina (referee)
This diploma thesis deals with the solution to a real situation that occurred at Nemocnice Na Františku in Prague. The problem is solved by using a computer simulation in SIMUL8 simulation program. At the beginning I describe the theoretical foundations that are afterwards used as a basis for the main practical part. The main subject of the work is a simulation of an operation of the hospital outpatient department. The hospital management decided to change the system for handling patients operations. I have created simulation models for particular workday and weekend means of patients serving operations. The created simulation models and their outputs are evaluated in the final part of the thesis and will serve as a basis for making reorganization decisions in the hospital. The provided advice for hospital management fulfills the goal of this thesis.
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