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The issues of patient´s self-sufficient after cerebrovascular accident at ward of subsequent care
MACHKOVÁ, Marcela
Cerebrovascular accident is a serious destructive condition with suddenly formed infliciton of cerebral blood vessel. There might appear obstruction and taper of them or defect on wholeness of vascular wall which result into hemorrhage to brain tissue. Sings of this condition might be termporary with physical and psychical changes or fatal which end up with serious paralysis, unconsciousness or even death of individual. Cerebrovascular accident problematics is currently a big challenge for the entire society, because progressiveness of European society´s aging is likely to bring increase in total amount of this disease´s causes. The first important step in problematics of the disease is to reduce the risk of stroke by consistent prevention; general lifestyle changes; blood pressure controls and treatment; lipid, coagulation factor and heart disease observation and compensation. The second step, when speaking about already formed disease, is to start well-timed and complex therapy which provides the patient with distinctly higher chance of better final clinical status without permanent harm. After overcoming the acute phase in neurology department the patient carries on with another therapy acorrding to seriousness of his/her condition in rehabilitation or aftercare department. Therapeutic, nursing and rehabilitation care should be set to contain all aspects of lost self-sufficiency encouragement and should be oriented mainly on person who has, even after stroke, his/her own needs, motivations, leisure time activities and skills. The bachelor thesis starts with medical part which describes brain anatomy, deals with epidemiology and stroke history. More detailted stroke characteristics and disease itself are defined by etiology, clinical picture, diagnostics and treatment. This part is then ended up with stroke consequences, factors influecing patient´s recovery, patient´s needs and self-sufficiency after stroke. Multidisciplinary team and aftercare deparment create an independent chapter and after this starts a new chapter interested in the role of nurse and needed nursing interventions, evaluation techniques during basic needs saturation of patients after stroke. Therapeutic rehabilitation creates almost the last important part of the bachelor thesis, on which depend gradual recovery and patient´s future life quality after this desease. The recovery part includes physiotherapy, occupational therapy, speech-language pathology, neuropsychology, spa treatment and prosthetic security of patient. Then, the whole thesis is ended up with patient´s preparation on release into home environment. The first set aim is to find out patient´s needs to reach the maximal functional independence and self-sufficiency after stroke according to previously studied sources. The second aim is to find out the nurse´s role in the encouragement of patient´s self-sufficiency and the third aim is to find out nursing interventions in the encouragement of patient´s self-sufficiency after stroke according to previously studied sources. The whole bachelor thesis is mainly taken as theoretical. It tries to insight into problematics of all needs, self-sufficiency encouragement and patient´s maximal functional independence after stroke according to previsously studied sources and information obtained from consultants, physiotherapists and general nurses. Then, the thesis deals with the role of nurse and nursing interventions in patient´s self- sufficiency encouragement on aftercare department to satisfy his/her essential needs of life without someone else´s help after the disease. After a gradual improvement of functional disability, the whole life quality and the independence of patient, it is necessary to follow all nursing, medical and rehabilitation procedures very carefully without their neglect with a sufficient amount of medical staff and specialized doctors.
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Medical Emergency from a Nurse´s Point of View.
NETRVALOVÁ, Martina
The nurse?s approach to a patient who is being admitted at the emergency ward should be in all circumstances in compliance with the holistic philosophy. In the thesis we focused on the emergency admission of a patient from the nurse?s point of view. The emergency admission of a patient requires a quick and professional approach. It is important for each nurse to realize that communication with the patient, the doctor and other members of the medical team is the part of this professional approach. Another essential part is an active search of patient?s current problems. In order to manage this, it is necessary to show the ability to cooperate with the patient, to know, how to proceed in a physical checkup, to be able to describe the deviations from the standard, and last but not least, to be able to communicate with the doctor about the findings. The theoretical part of the thesis involves chapters dealing with holism, holistic philosophy, communication and physical check-up of a patient. Further this part deals with getting the anamnesis, the agreement with the admission to hospital and other formalities that belong to the procedure of admission of a patient. At the end of the theoretical part we characterize the surgical ward and the internal ward and describe abdomen aches and chest pains as typical examples of emergency admission reasons at these two wards. The objective of this work is to find out whether nurses at these emergency wards (surgical and internal) during the process of admission provide a patient with care that is in compliance with principles of holistic philosophy and also to compare the holistic approach of nurses at the surgical and internal emergency wards. 4 questions were set before the research started. Research question No.1: How are biopsychosocial needs of a patient at the emergency admission saturated? Research question No.2: How can the communication of a nurse with a patient at the emergency admission ward, during the admission procedures, influence the following cooperation of the patient with the medical staff? Research question No.3: What does the difference between the holistic care at the surgical and internal ward lie in? Research question No.4: How can the circumstances during the emergency admission of a patient influence a nurse?s respect of patient?s needs? Half-standardized interviews with 3 nurses from the surgical ward and with 3 nurses from the internal ward were used in the research part. Then, a concerned observation of those nurses was carried out, while they were taking care of a patient at the emergency admission ward. On the grounds of the research results we can assume that the objective of the thesis was met. The objective was to describe different views and approaches of nurses to a patient who is being admitted at the emergency ward. The research results were used to compose an instruction manual called: What nurses at the Emergency Admission Ward should not forget.
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Care for the oral cavity in a hospitalized patient
CINCIALOVÁ, Kateřina
The term oral hygiene includes a set of measures to prevent the origination of parodont and hard tissues and their progression. These ailments belong to the most common and frequent ones despite the fact they may be prevented by appropriate care and by the proper choice of oral hygiene aids. The most frequent problems are dental decay, dental plaque, gum disease. For each of us, good oral hygiene practicing daily is essential for preventing troubles mentioned above. During hospitalization patients often alter their habits and modes because of the disease and the stay out of home. In patients who are not self-administering and patients with limited capabilities it is the nurse who is in charge of providing the oral hygiene. Each nurse´s priority should be to meet all the patient´s needs and the proper oral hygiene is one the basic ones. I set four aims in my thesis. The first was to find out patients´view of the oral hygiene level at hospitalization. The second aim was to describe the standards of oral hygiene the particular ward offers the patients. The third aim was to compare opinions of self-administering and non self-administering patients. The fourth aim was to compare the role of a nurse in providing oral hygiene for self-administering and non self-administerin patients. The results of my research confirm the first hypothesis {--} hospitalization brings about changes in oral hygiene. Also the second hypothesis proved to be right {--} during hospitalization oral hygiene worsens in patients because they do not have enough possibilities to carry out all the procedures they are used to. The third hypothesis was confirmed, too. Nurses are familiar with oral hygiene aids and know how to use them. The fourth hypothesis that nurses do not ask patients to tell them what their oral hygiene habits are was true. I conducted the research by the questionnaire method and the method of a stuctured interview. The research samples were nurses and patients in following units - neurological, internal, surgical and orthopaedic - in the České Budějovice hospital, Inc. and in the Tábor hospital. Inc. The results of this research could be used as a feedback for hospital management to help improve patients´oral hygiene. It is necessary to take some measures in this respect. Nurses should be more active in getting information about patients´ oral hygiene aids and their hygienic habits. They should ensure the highest patients´comfort possible. Then their efforts will be rewarding.
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