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Comparison of the Vascular Access Care in the Intensive Care Unit and Standart Departement
Vašková, Marcela ; Tomanová, Alena (advisor) ; Petrášková, Hana (referee)
Abstaract(thesis) In my thesis, I decided to take the issue of treatment of vascular input in surgical department and surgical intensive care units. This nursing problem can be found practically on every inpatient department and each nurse meets with vascular access dutiny her career. The work is divided into theoretical part and empirical part. The first theoretical part deals with the history of vascular input, a list of basic vascular entries and the educational process. Of the vascular inputs, the work focuses especially on central venous catheter and peripheral venous catheter. The second empirical part focuses on the evaluation of collected data and their statistical analysis. Before the research 4 hypotheses were provided. These hypothesis were confirmed by statistical evaluation of questionnaires. The questionnaires were filled in by sisters from the surgical department and intensive care units. At the end of the thesis is work evaluation. Keywords Vascular access, peripheral venous cannula, central venous cannula, nursing, dressing, asepsis, infections, nurse, patient
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Ensuring patient´s privacy during re-bandaging
BELLOVÁ, Daniela
This bachelor thesis investigates the way nurses ensure patient´s privacy in surgery departments during re-bandage. Beginning of the thesis´ theoretical part is focused on theoretical knowledge necessary for wounded patients care, the basic knowledge of anatomy and skin physiology. Next, what are a wound and what the healing process itself looks like. Which factors, either local or general, can negatively affect healing and how the care of particular nurse can contribute to it. Further, the process of wound treatment followed by post-surgery care and theoretical procedure of the bandaging itself, focusing on ensuring patient´s intimacy during the procedure. The entire knowledge of aseptic bandage procedures and good general patient care allows fast and uncomplicated healing. The number of re-bandages is decreased as well as the risk of violating the patients´ intimacy. Therefore, following chapters are focused on patient´s needs, his/her dignity and holistic approach of man. Patient´s needs are centered around self-concept and self-respect. Dignity and an emphasis on its compliance is the core of this thesis. The perception of intimacy, shame and nudity brings us to this issue. It is the reason this thesis was written and why it is so important to ensure such things as intimacy. Theoretical part of the thesis then brings information about legislative protection of privacy and highlights Patient´s rights and Code of Ethics for Nurses that should be remembered and followed by every nurse. Research in this thesis was conducted by the method of quantitative investigation in surgery departments in České Budějovice hospital, specifically in its surgical, orthopedic, traumatology, gynecology, urology, neurosurgery and cardiac surgery departments. Two kinds of survey were held. First was intended for patients hospitalized in surgery departments who underwent re-bandage and second one was given to the nurses working there. The aim of the thesis was to find out the way patient´s intimacy is ensured during re-bandaging. According to the highest number of positive answers from both clients and nurses, it was shown that nurses, when preparing to bandage patients, always ensure that the door is closed. When exposing a client, they make sure not to uncover his body more and longer than necessary. Despite this finding, we didn´t confirm the hypothesis number one: Surgery department nurses ensure patients intimacy during bandaging. The cause of the low number of achieved points was the failure to ensure patients intimacy in front of the other patients in the room, where majority of the bandaging were held. This finding contributed in the confirmation of the second hypothesis: Surgery department nurses do not use the equipment for ensuring patient´s intimacy during bandaging. Results from patient´s answers positively showed that nurses do not use either the curtain or the bandaging room. Therefore, clients are bandaged in front of other patients in the room. The kind of bandaging wasn´t taken into account in the survey. However, the intimacy is perceived differently by each individual and even its slightest disruption might be taken negatively. The third hypothesis: Intimacy violation occurs more frequently among long-term hospitalized patients, was confirmed. The results was not contributed by the majority of answers as with the previous hypothesis, but even small number of respondents confirming the decrease in quality during their hospitalization, could not be left unnoticed and was considered sufficient for confirming the hypothesis. The results of this bachelor thesis will serve as feedback for nurses and if it increases their interest in ensuring patients´ intimacy, then this work has fulfilled its purpose.
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Use of modern methods in treatment of chronic wounds
LEPIČOVÁ, Zuzana
Healing and treatment for chronic wounds are big problems and they affect overall states and fate of patients who are immobile after heavy injuries in consequence of some diseases or because of penetrating wounds. Prevention and treatment flowing from profound knowledge of anatomy, skin physiology, pathology and patho-physiology of defects origins and of healing process is currently taking a big step forward in treatment for refractory wounds. The thesis is divided into two parts. The theoretical part deals with skin anatomy and physiology, pathology and patho-physiology of origins of defects, healing processes and proper treatments of wounds, especially chronic wounds such as ``diabetic foot syndrome{\crqq}, venous and arterial ulcerations and decubital ulcers. Preventative measures against decubital ulcers are described. Documentation of refractory wounds, 3 phases of healing and continuum of healing are described in detail. Re-bandages, the local wound care, are the most significant factor of treatment. Re-bandages follow standard procedures, which involve make-ready of patients, preparations of wounds for re-bandages, preparations of instruments and make-ready of attending staff. Good re-bandage assistance is crucial. Modern treatment methods include various new types of wound cleanup (from the mechanical one, chemical one and autolysis to the enzymatic one, with the use of larva therapy, for example) as well as the usage of very effective ``moist healing{\crqq} methods. Various contact - not adhesive bandages, foams, alginates, hydro gels, antiseptic bandages, dressings with active Carbon, hydrocolloids, hydro adherent dressings, hydro fibres, bandages with active AG ions, chitosin, dressings with hyaluronic acid, collagen bandages, dressings with iodine, mupirocin, or honey. The practical part is dedicated to qualitative research, in a way of non standardised interview. There were two thesis objectives: To map the usage of modern treatments for refractory wounds and to enlighten general nurses in this field. 15 nurses, who deal with chronic wounds, from various emergency wards and hospital wards took part in the interviews. Information was collected from February 2010 to April 2010 and it was elaborated into 15 casuistries. The result of analysed answers was digested into a table. In the Discussion I analysed the particular answers and set 3 hypotheses for each domain. Domain 1: H1: Modern treatments for healing of wounds are not systematically used at most units. H2: Monolithic systems for usage and indication of modern methods do not exist at most units. H3: Statistics of chronic wounds existence is not kept at many units. Domain 2: H1: Trainings are organised by medical facilities in collaboration with distributing companies but their capacities do not satisfy the interest of applicants. H2: Most nurses declare good knowledge of chronic wound healing phases and of continuum of healing. H3: Neither managers of medical facilities nor health insurance companies have sufficient knowledge regarding the ``cost {--} benefit{\crqq} of chronic wound treatments. The Conclusion summarise the whole thesis. The importance of follow up treatment and rehabilitation for subsequent fate of afflicted patients and their families is underlined in this part.
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