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Nursing care of children with cleft lip and palate
PRÁŠKOVÁ, Kateřina
This bachelor thesis deals with the nursing care of children witch cleft lip defects and palate. The prevalence of cleft defects has decreased thanks to modern prenatal diagnosis, but cleft palate and cleft lip are still at the top of the ranking among the most common congenital developmental defects. The thesis is divided into two parts, a theoretical part and an empirical part. The theoretical part describes the anatomy and physiology of the oronasal region, prenatal care, classification of cleft lip and palate, history of treatment and current surgical treatment, nursing process and multidisciplinary care. In this bachelor thesis three objectives were set. The first objective was to determine the nutritional nursing care of children with cleft lip and palate defects. The second objective was to determine the nursing care after surgery for a child with cleft lip and palate defect. The third and final objective was to determine parental awareness of cleft lip and palate defect in their children. The research investigation of the bachelor thesis was conducted through qualitative research in the form of a case study. The case study includes a description of the situation, a description of the factors that caused the situation, a description of the procedures used and their impact on the resolution of the situation, and in particular an evaluation of the resolution of the situation and, where appropriate, suggestions for further action. The content structure became case studies: the characteristics of the client and his/her initial situation. To obtain this information, an analysis of medical records, nursing documentation, child observation and the nursing process was carried out to create a detailed nursing case history of children with the problem using the Nanda Taxonomy II. Based on the information obtained, we developer a nursing plan for two children with surgical correction of this defect. Categorization of the case study was done. According to the detailed analysis of the nursing case studies, we have created categories and subcategories, which are discussed and described in detail under each scheme. The research investigation was conducted in a specialized unit dedicated to the treatment of developmental defects of the lip and palate in pediatric patients. The research was conducted from February to mid-April 2023. Parents of children with cleft defects were interviewed to supplement the information. All of this information that was found is completely anonymous. The interview included a total of 23 pre-designed questions. Individual interviews were recorded on a mobile phone and then transcribed verbatim into Microsoft Word. Then, the parents´ interviews were analyzed and categorized using the pencil-paper method. Based on the research investigation, it was found that care is provided individually, according to the congenital defect in the lip and palate and the extent of its damage. This determines the timeliness of surgical treatment and associated nutrition. A detailed analysis of the nursing process and the creation of nursing diagnoses related to the specific patient with a congenital defect in the lip and palate region was performed. The research revealed that careful professional awareness of the parents was taken care of. Despite the fact that mothers reported sufficient awareness, some sought further information on the internet and/or in leaflets from the doctor. In terms of nursing care for children after surgery, these children are hospitalized as soon as possible after birth. These early surgeries are done for faster healing and from a psychological point of view. This bachelor thesis can be used in theoretical teaching in nursing process focused on surgical issues. In my opinion, this thesis could also be used to expand the awareness of cleft defects among health care professionals in practice.
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The role of the pediatric nurse in providing laboratory newborn screening
STEINBAUEROVÁ, Julie
This bachelor thesis focuses on the role of the pediatric nurse in newborn laboratory screening. The pediatric nurse has an indispensable role in the entire process, educating parents prior to collection, obtaining informed consent from parents prior to testing, preparing supplies, performing the actual collection, checking and preparing the collected specimens for shipment to the screening laboratory. Although the thesis is primarily focused on maternal education prior to collection and possible errors during collection that may negatively affect the results of the examination, the theoretical and practical part of the thesis also covers other topics related to newborn laboratory screening, not least the description of the methodology of the correct collection procedure and subsequent verification of knowledge of its principles in a research investigation with nurses. The first objective was to describe the process of maternal education by the pediatric nurse prior to collection. The second objective was to determine the knowledge of pediatric nurses about the negative impact of substandard blood collection on screening outcome. The research part of the study was based on qualitative research, using the interview method. Data collection was carried out using the technique of in-depth semi-structured interviews with nurses from neonatology departments of selected Prague hospitals. Data analysis was done by pencil paper method, then the results were divided into three categories and described in diagrams. The survey found that nurses perceive the language barrier as the biggest difficulty in educating mothers before delivery, but they have resources available to help them overcome this barrier in practice. It was also found that nurses are well informed and have sufficient knowledge about the principles of dry drop blood collection. The most common errors in collection were described by nurses as insufficient or incorrectly filled in targets on the filter paper and illegible data on the screening card. This work can be used to educate pediatric nurses, and recommendations for practice include focusing on non-pharmacological methods of procedural pain relief for newborns during collection and checking specimens before sending them to screening laboratories to avoid unnecessary repeat collections.
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Ensuring comfort and safety for newborns and infants
JELÍNKOVÁ, Karolína
The bachelor thesis focuses on a specific issue concerning comfort and safety establishment for newborns and infants. Comfort and safety is the key component of newborn and infant care. This bachelor thesis focuses on paediatric nurses´ and mothers´ perspective on the comfort and the safety ensurement of the newborn and the infant, furthermore focuses on the education of mothers provided in this field by the paediatric nurse and on the way by which comfort and safety of the newborn and the infant is ensured by the mother in the home environment. Four objectives were set in the bachelor thesis. The first objective was to describe the perspective of pediatric nurses on ensuring comfort and safety in newborns and infants. The second objective was to determine the way how to educate mothers in the field of providing comfort and safety to newborns and infants. The third objective was to describe the mothers' perspective on ensuring comfort and safety of newborns and infants and the last objective chosen was to find out the method of ensuring comfort and safety of newborns and infants by mothers in the home environment. The theoretical part of the bachelor thesis defines the concepts of the neonatal and the infant period, and follows up basic human needs, particularly the need of security and safety and the need of love and together belonging. The theoretical part also describes possibilities of comfort and safety ensurement of newborns and infants, such as skin to skin contact, bonding, newborn bathing including skin care, proper handling, safe sleep, and finally the use of baby massage, aromatherapy and swaddling. The research part of the thesis was based on qualitative survey, using an interview method. The data collection was done using in-depth interview technique with pediatric nurses and mothers of newborns and infants. Data analysis was done using pencil paper method. Subsequently, categories of in-depth interviews were created separately for paediatric nurses and mothers. Five categories were created for the baby nurses: Providing the Need for Security and Safety from the Baby Nurses' Perspective, The way of the Baby Nurse Education Conduct, Content of the Education, Use of Alternative Methods in the Child Care from the Baby Nurses' Perspective and Preparation for the Child Care. For mothers, five categories were also created, which include: Providing the Need of Security and Safety from the Mothers' Perspective, The Education, The Sleep, Use of Alternative Methods in the Child Care from the Mothers' Perspective, and The Layette Set. Corresponding sub-categories were then created for the categories. The research revealed that paediatric nurses just as mothers had the same perspective on providing comfort and security for the newborn and infant. They agreed that it is necessary that mother and baby are to be in constant contact, including cuddling, caressing and talking to the baby, generally speaking to be the loving mother. The research survey also showed us that mothers are not sufficiently educated in the area of handling the newborn and infant and in safe sleeping. Based on the results of the research, two educational leaflets were developed containing the principles of proper handling and safe sleep for newborn and infant.
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Specifics of nursing care in children hospitalized with infectious disease
KŮSOVÁ, Marie
The bachelor thesis deals with the specifics of nursing care for children hospitalized with infectious disease. The bachelor thesis is divided into theoretical and research parts. The theoretical part deals with infectious diseases in childhood, specifically infectious diseases of the digestive and respiratory tract, infectious exanthematous disease and infections affecting the CNS. It also deals with the specifics of nursing care for children with these diseases and their needs during hospitalization. It describes the transmission and agents of infectious diseases, as well as the prevention of infectious diseases in children, specifically the barrier regimen. The research section focuses on the specifics of nursing care and the most common nursing problems in children with infectious disease. The aim of this part was to identify and describe the specifics of nursing care in children hospitalized with infectious disease. A qualitative form of research inquiry was used to conduct the research through semi-structured interviews with ten participants. Nurses from the children's ward were deliberately selected for the research investigation. The questions were directed at specific systems that are discussed in the theoretical part of this thesis. The research investigation was completed after theoretical data saturation. Further, it was then categorized using the open coding method, specifically the pencil and paper method. Based on this coding, several categories and sub-categories were constructed. From the research, it was found that nurses know the specifics of nursing care for children with infectious disease. Nurses can describe the barrier nursing care procedure, but not all nurses follow this procedure. Nurses are able to list and describe the most commonly encountered nursing problems in infectious diseases.
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Competences of nurses caring for pediatric patients in the surgery of practitioner for children and adolescents
TATEROVÁ, Kateřina
The work of a nurse in a general practitioner's office for children and adolescents is very diverse. The nurse is primarily involved in primary care, which is a set of activities related to health promotion, prevention, investigation, treatment, rehabilitation and, last but not least, nursing. Her other responsibilities include monitoring and evaluating the child's psychomotor development, thus creating a stimulating environment for healthy development. In the course of her work, the nurse takes on the role of administrator, care coordinator, educator, nurse, team player, organizer and above all communicator. The first objective of this study was to determine the competencies of nurses working in a general practitioner's office for children and adolescents. The second aim was to find out the attitude of nurses towards increasing their competencies in caring for paediatric patients in a general practitioner's office for children and adolescents. The third aim was to find out what barriers nurses perceive in the application of their competencies in the paediatric and adolescent practice. The practical part of the bachelor's thesis was prepared using a qualitative research method. We used the questionnaire method and the semi-structured interview technique to collect data. The research population consisted of ten nurses working in general practitioner's offices for children and adolescents from the South Bohemia region with different lengths of experience. After transcribing the interviews with the respondents verbatim, we analyzed the results using the open coding method of pencil and paper, where we established seven categories: Workload of nurses, Professional competencies, Increasing nurses' competencies, Adding competencies, Barriers to the application of new competencies, Performing tasks not falling within competencies, Education. The results are summarized in the individual tables and diagrams in the empirical part of this thesis. The survey shows that the most frequently used professional competences of nurses in the general practitioner's office for children and adolescents are vaccinations, checking physiological functions and taking biological material. Nurses' attitudes towards increasing their competencies were predominantly positive. Only two respondents indicated that they would not add any new competencies. The new competencies that the respondents would welcome are sampling and swabs without a doctor's office, administration, basic physical examination, prescribing chronic medications, diabetes education, and wound healing education. The barriers perceived by nurses to exercising their competencies with the pediatric and adolescent general practitioner included limited office hours, overflow patients, and the physician. The remaining seven respondents answered that they did not perceive any barriers. We believe that this bachelor thesis could serve as an overview of the interest of nurses to increase their competencies and as a study material for health professionals and the general public for orientation in the given issue, as well as an overview of the workload of nurses working in the general practitioner's office for children and adolescents.
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Primary care from the point of view of a pediatric nurse working at a general practitioner for children and adolescents
TLAČILOVÁ, Tereza
This bachelor's thesis deals with primary care from the perspective of a pediatric nurse working in a general practitioner for children and adolescents. Our aim was to find out the specifics of the work of primary care nurses and their collaboration with parents of children during preventive checkups.The theoretical part focuses on the definition of the term primary care in pediatrics, regular preventive checkups, the job description of the primary care nurse, and educational and communication skills. Our aim was to find out the specifics of the work of primary care nurses and their collaboration with parents of children during preventive checkups. The practical part was developed in the form of a qualitative investigation using a semi-structured interview technique with non-medical staff in a general practitioner's office for children and adolescents
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Food intolerances and allergies in children from the perspective of nursing staff
KREJSOVÁ, Lucie
Food intolerance is a condition where there is an absence of a substance or a group of substances that under physiological conditions help to process food. Food intolerances are manifested by a wide range of symptoms and can be caused by a number of factors. If a child develops a food intolerance, his organism is unable to digest and process the given food due to the absence of a certain substance, and thus a number of clinical symptoms arise, which in most cases concern several organ systems. In contrast to food allergy, food intolerance is directly dependent on the amount of the inciting substance ingested and the onset of clinical symptoms. For food intolerances in less sensitive individuals, even a trace amount of the problematic food may not cause any clinical symptoms. It is even recommended that a child patient who suffers from food intolerance does not follow an elimination diet, but should include a small amount of the problem food in the diet. This is to prevent the maintenance of unwanted sensitization. Among the well-known symptoms of food intolerance are diarrhea, abdominal pain, but less well-known symptoms include fatigue, headaches, migraines or musculoskeletal problems. For the treatment of lactose intolerance are dietary supplements currently available on the market, which are taken with food and contain lactase, an enzyme that helps break down lactose (milk sugar), so the patient can also consume foods that contain lactose. Currently, it is still difficult to understand the pathophysiology of some food intolerances, and for that reason they can be dangerous in children. On the other hand, food allergy is a condition where an inappropriate and unwanted reaction of the child patient's immune system occurs. The development of food allergy is influenced by the genetic predisposition of the child patient, but also by his environment. Food allergies can cause mild, but also very serious body reactions. Therefore, unlike food intolerance, it is recommended to follow an elimination diet and avoid even trace amounts of the allergen. Food allergies can cause a life-threatening condition called anaphylactic shock, which can lead to the subsequent death of a child patient. Therefore, it is important that such patients follow a strict diet and that their surroundings, including parents and nursing staff, know the typical symptoms of anaphylactic shock. Clinical symptoms of food allergy include problems with the gastrointestinal tract, respiratory problems or skin symptoms, which include atopic dermatitis. Breastfeeding and the nutrition of a lactating mother play an important role in the prevention of food allergy, because important microbial colonization of the child's intestines occurs during breastfeeding. For children, it is important to know that food allergies disappear spontaneously in most of them over time, most often around school age. The aim of this bachelor's thesis was to find out how nurses care for a child patient who suffers from a food allergy or intolerance and to find out what knowledge nurses have about food allergies and intolerances. Qualitative research was conducted using a semi-structured interview method. For better processing, the interviews were anonymously recorded on a dictaphone and then transcribed into written form. The results of the qualitative investigation were analyzed using the pencil and paper method. Furthermore, the results were categorized into five categories. Categorization: Symptoms, Food allergies, Knowledge, Anaphylactic shock, Specifics of nursing care. The categories are further divided systematically according to the resulting answers of the female respondents into another eleven subcategories. The results are clearly divided into tables and schemas. The research showed that nurses know the specifics of nursing care for children with food allergies or intolerances, but the mapped knowledge of nurses about food allergies and intolerances is insufficient.
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Nursing care of children hospitalized with respiratory diseases from the point of view of parents.
ŠÁTAVOVÁ, Iva
Current state: Respiratory diseases are commonly encountered during our lifetime. A very common group affected by this disease are most often children. Many authors state that this is because children do not have a sufficiently mature immune system and are also frequent participants in larger groups. In this paper, we focused on parents who experience hospitalization with their child, just because of respiratory illness. Objectives of the work: Two objectives were set for this thesis. The first objective focused on how nursing care is provided to their children with respiratory illness from the parents' perspective. The second objective was to map the parents' attitudes towards this nursing care for their hospitalized child. Methodology: Qualitative research method was chosen for the research investigation of this bachelor thesis. The technique of semi-structured interviews with parents of children hospitalized in the pediatric ward with respiratory disease was used for data collection. The dialogues were recorded using the "Dictate" function and then analysed using the open coding technique "pencil and paper". The size of research sample was determined based on the theoretical saturation of the collected data. Results: The results of the survey showed that parents of children hospitalized with respiratory disease are satisfied with the nursing care provided to their children. Parents are informed and educated on the children's wards about the provision of nursing care and are also actively involved in nursing care. In nursing care, each parent takes a supportive stance for their hospitalized child. Parents also strive to establish a calmer environment and conditions for their child while performing nursing activities.
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The specifics of care for a newborn baby of a drug-addicted mother
PEKÁRKOVÁ, Barbora
The neonatal abstinence syndrom occures in newborns of addicted mothers to any kind of drug. The drugs may be soft (legal) or hard (illegal). The manifestation of neonatal abstinence syndrom is mostly of neurological symptoms, such as seizures, restlessness and tremble. The neonatal abstinence syndrom can also be manifested by gastrointestinal, respiratory and termoregulation problems. Neonatal abstinence syndrom begins to manifest within 24 to 72 hours after birth and the most conclusive examination drug testing is from newborn's meconium. The newborns are assesed by the Finnegan score and if the result is higher than eight points, the neonatal abstinence syndrome can be diagnosed. The first goal was to reveal and describe the differences in care between a newborn of a drug-addicted mother and a physiological newborn, second goal was to specify nursing problems of a newborn of a drug-addicted mother and the third goal was to concretize the role of the nurse in a care of a newborn of a drug-addicted mother. The research part of this work was processed by the qualitative research method, using semi-structured interviews. The interviews took place in june 2022. Five interviews were recorded on a recording device and three interviews were written down on a paper due to dissapproval of said nurses to record the interviews. All interviews were transcribed into Microsoft Word programme. The ATLAS.ti programme was used to analyse, code and create schemes. The data was split into parts and codes were added to the said parts. The codes were put into categories related to the research questions. Afterwards, the schemes were made from said categories and subcategories. Based on data collected from the research we can say that the most common nursing problem in a newborn with neonatal abstinence syndrom is restlessness, crying, tremor, scream, sleep deprivation, instability of temperature, gulping and vomiting. Futhermore, the analysed data showed that the role of a nurse in taking care of a newborn with NAS are mainly "nurse as a provider of nursing care" and "nurse as a educator". The main differences in care between the newborn of a drug-addicted mother and a physiological newborn are in nutrition, contact with mother, when it also depends on her presence and the condition of the baby, in participation of other profesionals. There are hardly any differences in education, but it also depends on the condition of a baby and its needs. In conclusion, the most common nursing problems in a baby with neonatal abstinence syndrom are neurological problems, following the problems with sleep, temperature and nutrition. The nurse is mainly in a role of a nurse educator and provider of a nursing care. The differences in care between the baby with NAS and the physiological baby depend on the presence of its mother, the condition of the baby and its gestational age. The differences are mostly in nutrition and the participation of profesionals, for example the child protect services. The results of this research can be used in improving the quality of care for newborns with NAS, in an education of the future pediatric nurses in Pediatric nursing study programme and in further education of pediatric nurses in NAS in hospital through lectures.
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The importance of LATCH score in promoting effective breastfeeding
MATĚJKOVÁ, Radka
The LATCH score is a breastfeeding mapping system that supports effective breastfeeding, and it is used to predict the duration of exclusive breastfeeding at six weeks after delivery. Assessments, which begin in the delivery room and continue until the mother and newborn are discharged, are essential. The LATCH system serves as a systematic collection of information about breastfeeding. The rating scale assigns 0, 1 or 2 points to five key areas of breastfeeding. Every letter of the LATCH acronym indicates an area of assessment. With the LATCH scoring system the pediatric nurse can assess maternal and newborn variables, and can easily define areas for intervention and prioritize nursing care at maternity hospital. Our first goal was to reveal the importance of the LATCH score in promoting effective breastfeeding. The second goal was to reveal in which areas of breastfeeding techniques mothers most often make mistakes. The third aim was to describe in which areas of LATCH mothers need more education. And the last goal was to find out what are the specifics of nursing care for mothers and newborns with a low LATCH score.The practical part of the bachelor's thesis was processed using the method of qualitative research using direct observation and the method of questioning through a semi-structured interview. The research group consisted of ten mothers who, during the research period, were hospitalized after delivery in the department for physiological newborns. Mothers were directly observed during breastfeeding on the day after delivery and upon discharge from the hospital. LATCH scores were evaluated during observation. For mothers with a low LATCH score on the first day after delivery, the interventions provided to the mothers were further qualitatively evaluated and their effectiveness verified by the LATCH value at discharge. These mothers were contacted again in sixth week of the child's age, and through a short interview we verified, whether the mothers were still breastfeeding, what problems they had and what was the reason for stopping breastfeeding. The obtained data were qualitatively analyzed with the ATLAS.ti program. Based on the research investigation and the obtained analyzed data, it follows that the LATCH score is important in promoting effective breastfeeding. Nowadays, more and more women want to breastfeed as long as possible. During the analysis of the obtained data, we established three categories. The first category deals with the evaluation of the LATCH score at the first feeding after birth, here it is captured what affects breastfeeding in the first hours after birth by the mother, the newborn and the child's nurse. In the second category, we deal with the most common problems during breastfeeding and their solution by a pediatric nurse. The most common obstacle was the mutual position of the mother and the newborn and the correct latching and sucking of the newborn. The psychological and physical comfort of the mother is also closely related to breastfeeding. Nursing staff, i.e. children's nurses, educate the mother more in LATCH areas, where points are removed, and their goal is for the newborn to leave the maternity ward fully breastfed and for the mother to know everything about breastfeeding in the home environment. The last category is the progress of breastfeeding after six weeks after giving birth. We are interested in whether the mothers are still fully breastfeeding and whether they have had any complications.The results show that the LATCH score is a quick and simple tool for assessing breastfeeding after delivery, during hospitalization and before discharge. This breastfeeding assessment method serves pediatric nurses to effectively evaluate mother and newborn variables, define areas where intervention is needed and determine priorities in the provision of nursing care for the mother and newborn. The results of the research investigation can be used to improve the quality of nursing care...
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