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Children's wards nurses knowledge of taking care of intermediate-term vascular access devices
Müllerová, Julie ; Hromádková, Jaroslava (advisor) ; Průšová, Kateřina (referee)
The bachelor's thesis is focused on mapping and researching the nurses knowledge of taking care of intermediate-term vascular access devices inserted to pediatric patients. The aim of the work was to find out, based on a questionnaire, the level of nurses knowledge of individual types of intermediate-term catheters and nursing procedures related to catheters. The theoretical part of the bachelor's thesis includes pediatric anatomical specifics, general characteristics of vascular access devices, specifically described types of intermediate-term vascular access devices and nursing care of these catheters. The empirical part presents classified data in the form of overviews of tables and sectional charts, which are then compared with hypotheses based on age, length of practice, type of workplace and specialized competence of the respondent in the field of intensive care. The research methodology consisted in distributing a self-designed structured questionnaire in the form of a didactic test to nurses working in the children's wards of The University Hospital in Motol Faculty Hospital. The examined sample consisted of 76 respondents. Based on the questionnaire survey statistically significant difference was found in three particular items depending on the type of workplace of respondents in favor of...
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Scale assessment in nursing process for children
BENEDIKTOVÁ, Anna
Introduction The nursing process is an integral part of quality nursing care in paediatrics. This process contains many individual components that can work together to create a whole that not only assists nurses, but also makes patients' hospital stays more enjoyable. One of the components is assessment and measurement scales. These can be focused on pain, consciousness, nutrition or fall risk. Objectives of the work The aim was to become familiar with assessment and measurement scales in paediatrics and to find out their application in the nursing process in selected paediatric wards. First, we investigated which assessment scales can be applied in the nursing process in children. This was followed by interviews in which we focused on the assessment scales used in the selected wards and how nurses view the use of assessment scales. Methodology The research was conducted in two phases. In the first phase, we searched the literature for assessment and measurement scales in paediatrics. In the second phase, we conducted closely interviews, which were conducted with nurses working in standard wards or in the ICU. The research investigation was developed by searching information from the literature and also using closely interviews with nurses in our selected wards. Data collection was conducted from January to June 2023. All interviews were recorded on a dictaphone and then transcribed into MS Word. The "pencil paper" method was used to analyse and code the data. Subsequently, the data was broken down into units, which were assigned appropriate codes and these were grouped into categories. These categories and subcategories were then worked into clear diagrams and described in detail. Results From the research we found that there are many scales for assessing pain, and not all can be applied to the same age. In addition, for each of the scales the correct tally or technique needs to be found and each is rated differently in the result. Nurses are familiar with the assessment scales they use on the wards and know what they are used for, but do not know their exact names, but rather a general one for the assessment issue. Most nurses spoke in general terms such as 'pain assessment', 'fall risk assessment', 'consciousness assessment'. Not all units use the same assessment techniques, nor do they all use the same assessment domains. Conclusion The results show that rating scales are an essential part of nursing documentation. So many assessment scales have been used that most wards are able to choose one that suits their particular issue and the department we selected did so. However, it is important to choose the right one with respect to the age and psychomotor development of the child. This bachelor's thesis can be used in the theoretical and practical part of teaching in Paediatric Nursing. The assessment techniques can be used in professional practice in the respective departments or we can offer a pain assessment scale that we have devised. It could assist nurses in diagnosing and determining the degree of pain in all ages.
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The role of paediatric nurse in prevention of the CAN syndrome
KROUŽKOVÁ, Aneta
Abstract Current state: CAN (Child Abuse and Neglect) syndrome can be characterized as physical and psychological abuse, sexual abuse and neglect of a child. The most common perpetrators of such treatment are parents or family members. Domestic violence and bullying are also part of CAN syndrome. The aim of the thesis was to evaluate trends in the number of reported cases of violence against children in the Czech Republic within the observed period of 2012-2021, to describe parents' knowledge of the abused and neglected child syndrome, to describe parents' knowledge of the Shaken Baby Syndrome, to describe the role of paediatric nurses in the prevention of the abused and neglected child syndrome and to describe the role of paediatric nurses in the prevention of the Shaken Baby Syndrome. Methodology: A combination of a qualitative-quantitative research strategy was chosen for the empirical part of the thesis. For the quantitative data collection, the method chosen was secondary analysis of documents from the Ministry of Labour and Social Affairs from the period 2012-2021. For the second part of the quantitative research, a questionnaire survey method was used using a non-standardized structured questionnaire. The data collection was partly carried out in the practitioners' offices for children and adolescents, and partly collected on the internet through forums for parents. A total of 212 questionnaires were collected. The method of semi-structured interviews was chosen for qualitative data collection. The research file consisted of six nurses working at practitioners' offices for children and adolescents. Results: In the period of 2012-2021, a total of 84 897 cases of abused and neglected children were reported to the register of the Ministry of Labour and Social Affairs (100%). Neglect was the most frequent form of CAN syndrome (72%). 11.2% children suffering from CAN syndrome were mentally abused, 10.2% were sexually abused including children in prostitution and children used for pornography, 7.6% were physically abused. The representation of girls and boys was almost equal, with 51.5% of girls and 48.5 % of boys. The most abused and neglected age group of children were children aged 6-15 (55%). Statistical testing did not confirm the hypothesis that the number of reported cases of violence against children increased significantly in the period of 2015-2021 (p<0.830). A total of 212 parents participated in the survey and 43.9% of the respondents had experienced some form of CAN syndrome. According to the parents surveyed, the most at-risk groups of people who are at higher risk of child abuse, neglect or exploitation include: alcohol addicts; substance abusers; or sexual deviants. According to the respondents, the most frequent perpetrators of sexual abuse were stepfathers (87.7%) or uncles (66.0%). According to the respondents, symptoms of physical abuse include: bruises of different ages, change in the child's behaviour , burns, fractures or stab wounds. According to respondents, symptoms of child sexual abuse include: anal injuries, genital bleeding, behavioural changes, increased anxiety or aggression. Parents were most likely to agree with the statement that shaking their infant resulted in brain injury (4.4 ? 0.9), brain haemorrhage, death of the infant, or retinal haemorrhage. Parents' knowledge of Abused, Abused and Neglected Child Syndrome and Shaken Baby Syndrome did not vary significantly with their education (p<277) or age (p<406). Based on the interviews with primary care nurses, it can be concluded that the role of nurses in the prevention of CAN syndrome is to seek out children at risk for CAN syndrome and educate parents about Shaken Baby Syndrome. On the basis of the theoretical and empirical part, an informative material was designed CAN "syndrome" for parents and nurses in general practitioners' offices for children and adolescents.
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Procedural Pain Relief in Premature Neonates
DUDARCOVÁ, Terezie
This Bachelor's thesis deals with the topic of procedural pain management in preterm newborns. Procedural pain is caused during medical procedures. Long-term exposure to pain has a variety of consequences, which is why it is very important to pay attention to the procedural pain prevention management. The first aim of the thesis was to explore the possibilities of assessing procedural pain in premature neonates. The second aim was to map the available methods of procedural pain management, followed by the final goal to identify the possibilities of involving mothers of premature neonates in the procedural pain prevention management. The research part of the paper was based on a qualitative investigation by means of questioning and observation. Data collection was carried out using in-depth interviews with paediatric nurses and mothers of premature neonates. Next part of the research involved observation of paediatric nurses during painful procedures. The information obtained was logged in observation sheets. Research has shown that there is currently a great effort to reduce the number of painful procedures that preterm newborns have to undergo. It was found that when evaluating procedural pain, all circumstances must be taken into account and not evaluated only according to a given scale. According to the research, the most effective of the non-pharmacological methods of pain relief is direct contact between mother and child. Pharmacological methods of pain relief are used in rare cases. It was also confirmed that there is currently a great effort to involve parents in the care of preterm newborns, but this needs to be further intensified and fathers need to be engaged more, for example. The results obtained from the research can be used in the education of paediatric nurses. An educational leaflet for mothers has also been developed.
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Educational needs of mothers with newborn twins
ŠIMEČKOVÁ, Tereza
Introduction: Despite the declining trend of multiple pregnancies, twins are encountered quite frequently. Caring for two children at once can be very challenging, and for this reason support from both partner and family, as well as from health care professionals, is important. Nurses responsibilities include educating mothers about newborn care, with safety and breastfeeding playing a major role with newborn twins. Objectives of the work: The first goal was to determine the specifics of nursing care in newborn twins. The second goal was to discover the educational needs of mothers of newborn twins. The third goal was to reveal the most important areas in which the mother needs to be educated and the fourth goal was to find out if there is a difference in educational needs from the perspective of mothers and nurses working in the newborn unit. Methodology: The research part of this work was done in the form of qualitative analysis and semi- structured interview with nurses of neonatology unit and mothers of newborn twins was used for data collection. The interviews were conducted from December 2022 to March 2023. All interviews were recorded on a recording device after consent and then transcribed into Microsoft Word. The analytical software ATLAS.ti was used to analyse, code and generate individual charts. Subsequently, the data were broken down into units, which were assigned appropriate codes, which were further grouped into categories that captured contexts with a direct link to the research questions. Subsequently, the categories and subcategories were processed into clear diagrams. Results: The research showed that the specifics of nursing care for newborn twins clearly include breastfeeding, which has countless benefits for both the newborn and the mother. The areas in which the mother needs to be educated include the aforementioned breastfeeding, but most importantly safety. Among the educational needs of mothers, we can again include breastfeeding and a supportive, empathetic approach from nurses. Differences in educational needs from the perspective of the nurses include practical education with practice and subsequent observation of the mother to see if she is doing the activity well and subsequent re-education. Mothers, on the other hand, would appreciate if another family member participated in the education. Conclusion: The results show that mothers of newborn twins are educated in the same way as mothers with a single newborn. The emphasis is mainly on safety, so that the mother does not leave the children unattended or leave one unattended while she takes care of the other. Breastfeeding is also an important area, with mothers of twins preferring tandem breastfeeding, which means that the mother breastfeeds both babies at the same time. This bachelor thesis can be used in improving the care of mothers with newborn twins and in the teaching of future paediatric nurses.
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Nursing care for paediatric patient after orthopaedical surgeries
WEISSOVÁ, Eva
Abstract Current situation Current range of orthopaedics is not only surgery of musculoskeletal system, but it also deals with diagnostics of congenital defects, injuries, illnesses, metabolism disorders and their after-effects on musculoskeletal system. A paediatric nurse plays a key role in taking care of a paediatric patient after an orthopaedical surgery. She helps children to overcome an unpleasant situation and tries to minimize physical and psychological complications. Cooperation with child's family is essential. Child's pain, suffering and fear can be moderated by proper nursing care. Aim of the work We determined three aims in this diploma thesis. The first aim was to map children awareness before orthopaedical surgeries and during hospitalization. The second aim was to analyse satisfaction of parents during hospitalization. The third aim was to assess the importance of psychological pre-surgery preparation of children and hospitalization of parents in overall perception of child's hospitalization. Methodology A quantitative research by means of a paper and electronical survey was used for the empirical part. The research group was made up of 104 respondents, it means 52 parents and 52 children. Those were parents and children from two selected hospitals and from general public. The surveys were processed statistically afterwards. A descriptive analysis of all the questions was used and four determined hypotheses were tested. Results It was found out that most of the children felt sufficiently informed before and during the hospitalization. It could be claimed that better awareness of a nurse means better feeling of child's sufficient awareness. Furthermore, we found out from the results that most of the parents were sufficiently informed by the nurse and that their overall satisfaction depends on children awareness provided by the nurse. Based on results, nurse education in the area of children care and manipulation with children during hospitalization is very important and leads to satisfaction of both children and parents. Based on other results, a child's hospitalization with a parent is very important because 97% of children said that they were calmer because of the presence of a parent. We can claim this about parents as well, because the presence of a parent is perceived by parents themselves as a very important factor improving the perception of a stay at a hospital. Hospitalization of a parent with a child depends on the age of the child, in which case a child at the age of 5 and less was always hospitalized with a parent. Moreover, it was found that compared to the presence of a parent, parents claim the psychological preparation (talking in form of play or with the help of a therapist) has slightly more important point. That was confirmed by the children as well. We can obviously see from the response that they stand the hospitalization better if they are prepared for the surgery. Conclusion The research has shown that most of the children felt informed enough during the hospitalization and before the surgery. I find the psychological preparation of children for a surgery very important. That was also confirmed both by the children and parents, who consider the psychological preparation to be one of the most important factors. The hospitalization of a parent with a child depends on the age of the children. We trust that this work could serve as a study material for paediatric nurses working at corresponding postoperative departments, besides other things as a study material for students of medical subjects. This diploma thesis can describe given illness or the care of a child after an orthopaedic surgery to both parents and children.
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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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The roles of nurse in nursing care for a child with congenital cataracts
MEDVECOVÁ, Vladimíra
Current state: Congenital cataract is an ophthalmic disorder where the clouding of the lens causes defect in its transparency and light dispersion. The child experiences a visual impairment that can be examinated depending on the age and mental state of the child. The treatment is removal of the clouded lens, subsequent correction of dioptric defects and subsequent training and monitoring of amblyopia. Purpose: of this study was to describe the roles of paediatric nurse in nursing care of children with congenital cataract and the specifics in nursing care in this condition, based on reviewed material. The following research problems were explored: What are the roles of paediatric nurse in nursing care of children with congenital cataract? What are the specifics in nursing care of children with congenital cataract? Methods: In order to reach the goal set by this study we used qualitative data and study analysis. This study implements data sources from National Medical Library in Prague, the Academic Library of University of South Bohemia in České Budějovice, the library of 2. LF UK and FN Motol in Prague and the library of National center of nursing and non-medical health providers in Brno. Moreover the study reviewed the material from bibliographic databases (Cochrane Library, Ebscohost, Medscape, ProQuest, PubMed, ScienceDirect, Scopus) and online databases of medical associations of ophthalmology (The American Academy of Ophthalmology, The Royal College of Ophthalmologists). Results: The goal of this study is to provide a comprehensive view on nursing care of children with congenital cataract. Conclusion: Even though the role of paediatric nurse in nursing care of children with congenital cataract is rather neglected in current literature, it is crucial in all forms of healthcare. In conclusion we define the role of paediatric nurse in nursing care of children with congenital cataract and description of the specifics of this care.
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Parents and Peadiatric Nurses Awareness of Infant Sleep
ŠIPANOVÁ, Renáta
One of the most common complaints of mothers at the paediatrician's is complaint about the night sleep disorder, especially in older infants and toddlers. Long-term insomnia of a child negatively affects well-being of parents and disrupts peaceful atmosphere of home. We often encounter sleep disorders in babies; mostly they are frequent nocturnal awakenings and difficulty falling asleep. Parents should be therefore informed about sleep issues already at neonatal units, as they are informed about breastfeeding. The target group of this research was mothers of infants and nurses working at neonatal units and in primary paediatric care. The aim of the study was to determine the level of awareness of paediatric nurses and parents about infant sleep and create educational material for nurses. The survey was carried out using a snow ball technique, in-depth interviews with mothers and a questionnaire with open questions for nurses. Collected data were then transcribed, coded, and processed using frame analysis by. Then, using the snow ball method, we gradually extended the sample to 7 mothers of unsleepy infants and 7 mothers of sleepy infants, i.e. to cases that were supposed to strongly manifest the problem. Also, paediatric nurses were selected intentionally according to their place of work at neonatal departments and in primary paediatric care. Parents receive information about infant sleep most often on the Internet, from specialized books and from their own mothers and friends; and they usually do not ask nurses for information on infant sleep. Parent only find out at home that there is a problem with their child's sleep. They tend to try various interventions to lull their baby to sleep. Research has shown that the most common source of knowledge for nurses is their personal experience with their own children. Nurses also use their rich experience gained during long years of practice. Furthermore, they educate themselves in this issue using specialized books, visiting seminars, and they also use the internet. Nurses' advice to mothers regarding infant insomnia is shown in two perspectives in our research. The first is the perspective of mothers and the second one is the perspective of nurses. Surprisingly, there are discrepancies, especially regarding the nurses in primary care. Interventions that were reported by nurses coincide with working techniques of lulling a baby to sleep. In contrast, some interventions which were described by mothers as advice from a nurse rather indicate ignorance or indifference of some nurses. The research showed that the quality of infant sleep may be to some extent influenced by the information given to parents already at neonatal unit by medical staff, because they are in the best position to provide such information. However, mothers often choose different sources. The research has shown that mothers usually instinctively select proper techniques to lull restless infants to sleep without consulting a paediatric nurse. These results have prompted the development of an educational leaflet for nurses which informs about proper practices and appropriate techniques to lull restless unsleepy infants to sleep.
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Past and present of education of paediatric nurses and their attitudes towards their own profession
ZMEŠKALOVÁ, Stanislava
This thesis deals with the history and present state of the education of paediatric nurses and their attitudes towards their own profession. The first objective was to find out information regarding the education in the nursing profession in Bohemia, with a focus on child care, and to create an overview of the education in the profession Paediatric Nurse. The second objective was to find out about the attitudes of paediatric nurses towards their profession. Interviewed were sisters who chose the profession after finishing elementary school and underwent qualifying studies as well as nurses who chose the profession after graduating from a secondary school or university education and achieved their education through specialization studies. The last objective was to compare these two groups and to assess whether there are any differences between them. The theoretical background of the thesis defined basic concepts such as the definition of education, education in nursing, a profession, and attitude towards a profession. Documents related to education since the foundation of nursing education to the present were also used and studied. The chapters on the status of nursing staff and its employment chances focus on the development of the relationship to the profession and shaping attitudes towards it. In the research part of the thesis, the collected information related to education and derived from archival documents, literature, laws and regulations is presented. The results can be used as a basis for creating educational material focused on the history of the field and intended for the education of paediatric nurses to strengthen their identification with the profession. The thesis also presents interviews with in-service paediatric nurses where they express their views on the work in the field and their attitudes towards their profession. The results of the interviews are documented and organized so that it is possible to assess whether there are any differences between these groups. The anticipated differences can be used for further investigation focused on attitudes to the profession. Verified knowledge could then be used for training paediatric nurses aimed at creating desired attitudes towards the profession.
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