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Importance of nurse´s work providing nurishment to senior patients
KOPAČKOVÁ, Lucie
Theoretical Foundations Ageing and old age are natural parts of every individual during their lives. Most of the population wants to live an active life of the best quality possible. Nutrition is a factor that influences healthy aging most significantly. Adequate nutrition plays an important role in maintaining the quality of life and good physical condition. Nutritional needs of the elderly are highly specific. The nutritional needs of the elderly are defined mainly by changes in the organism and a wide range of influencing factors resulting from a person's lifestyle. An important role is played especially by eating habits, social and cultural environment, education, social status, economic standards and, ultimately, health and psychological condition of a person. Proper nutrition of the elderly contributes to their health and wellbeing; it is also important for recovery from the illnesses to which the elderly are more vulnerable. When providing nutrition to the elderly in hospitals, the role of nurses is important. Objective of the Thesis Four objectives were specified for the thesis: 1 To find out whether nurses follow the principles of providing nutrition to the elderly. 2 To identify the most common factors that affect nutrition of the elderly in hospitals. 3 To map the most common nutritional disorders in the elderly occurring in hospitals. 4 To find out what diet is the most common in the elderly staying in hospitals. Methodology The research qualitative inquiry was conducted in the form of covert observation. The objects of observation were the nurses working at a department of aftercare, which were observed in serving food to the elderly. The covert observations were complemented with depth interviews, also with the observed nurses working at the department aftercare. The observations were processed in Microsoft Excel in the form of tables and the interviews were processed in the Atlas.ti programme. Results The observations of the nurses in serving of food to the elderly showed that all the observed nurses failed to comply with the principles of providing nutrition to the elderly in the hospital. More or less each of the observed nurses made some mistakes. The most frequently occurring mistakes were as follows: While serving food, the nurses did not use aprons or serving overalls; the nurses did not prevent direct hand contact with the food. Almost half of the observed nurses did not provide the patients with sufficient time and the support to the patients while serving the food by the observed nurses was also inadequate. Further, nearly half of the observed nurses did not wish a Bon appetite to the patients. Also noteworthy is the latest most frequent mistake: nearly half of the nurses did not put away their aids after serving food. In the interviews, the nurses surveyed identified the most frequent factors influencing nutrition of the elderly in hospitals as follows: biological changes in old age, various types of dementia, psychological condition of the individual, co-morbidities, medication use, eating habits of the individual, the state of dentition (dental prosthesis), and the influence of the family. The most common nutritional disorders identified were as follows: absence of appetite, dehydration, excess weight, obesity and malnutrition. The most common diets eaten by the elderly in hospitals were identified as follows: diets no. 3, 9, 4, 0 and also diets in ground form, puree form and food served through an NGS (nasogastric tube). Conclusion Based on the research survey and the review of expert literature, a standard of nursing care, called "Serving food to patients with deficient self-care in nutrition", was designed for nursing staff. Nursing staff will have the opportunity to use the manual that will serve them as good practice when serving food to patients with deficient self-care in nutrition, and nurses will not consider the activity as a routine procedure.
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Benefits and barriers to the transfer of information nurses at the bedside of patients.
MERUNKOVÁ, Michaela
The nursing handover report belongs to everyday activities of nurses. In the work of a nurse it is important to know exactly who, when, where, what and how. This is what the following activity and responsibilities of the duty period are derived from. This diploma thesis, focused on the Nursing Handover Report at a Patient´s Bedside, has a theoretical and practical part. The first, theoretical part, is composed of three chapters, the modern trend of nursing, the nursing report and legislation. The second, practical part, is based on quantitative and qualitative surveys with three defined objectives and four hypotheses. The first objective was to determine what nurses regard as a major contribution of the nursing handover report at a patient´s bedside. The second objective was to define the greatest obstacle in the nursing handover report at a patient´s bedside. The third objective was assessing the patients´ attitude towards the nursing handover report at their bedside. All three objectives were met by the research. The qualitative part of this diploma work was based on a conducted kvasiexperiment and subsequent questions for patients and nurses. The research sample was 5 nurses and 5 patients from the intermediate care unit (IMCU) and 5 nurses and 5 patients from the resuscitation station (RES) of the České Budějovice hospital, PLC. The semi-structured interview consisted of six to eight questions, surveying the feelings, contents, visualization, integration, advantages, disadvantages, departments, nursing handover at the bedside and the quality. The data collection was carried out by means of an anonymous questionnaire designed for nurses to find out how nurses hand the report over or how they would like to hand it over. 303 nurses from the České Budějovice Hospital, PLC, and the Příbram Hospital, PLC, took part in the research. The results were used to confirm or to reject the hypotheses. The first hypothesis: Nurses do not consider an oral handover report as a quality one when done without a visual completion, this has not been confirmed by the investigation. The second hypothesis: In terms of the risk of the patient's damage, the quality of the handover report done by the nurses in the IMCU and the RES is better than that done by the nurses in a standard unit, this has been confirmed. The third hypothesis: Nurses consider the time consuming nature of the handover report at the patient´s bedside as the greatest difficulty, this has not been confirmed. The fourth and last hypothesis: Patients have a positive attitude towards the nursing handover report at the bedside, this has been confirmed by the research. The output of this thesis is to suggest a standard for the nursing handover report at a patient´s bedside. The results can be used for nursing managers, deputy directors of nursing, medical students and nursing professionals.
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