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The effect of dialysis on activities of daily live
Kolaříková, Jaroslava ; Nikodemová, Hana (advisor) ; Jirkovský, Daniel (referee)
The aim of this bachelor's thesis entitled "The effect of dialysis on activities of daily life" is to provide a brief overview of relevant basic knowledge of hemodialysis and peritoneal dialysis using existing and already published litarature and try to determine the influence of the dialysis on activities of daily life. The thesis is devided into theoretical and empirical part. The theoretical part is focused on kidney disease, hemodialysis and peritoneal dialysis, principles of dialysis therapy, their differences, complications, dietary measures and approaches to dialysis. Further attention is paid to the comparison of the advantages and disadvantages of both methods of dialysis among themselves. Part of the work deals with human needs and activities of daily life. The empirical part consists of an exploratory survey, which was given to patients in dialysis centers Fresenius Medical Care Prague 5 - Motol, Prague 10 - Vinohrady, Prague 4 - Krc, Prague 9 - Vysočany, Slaný, Louny, Chomutov, Most and dialysis center department of Internal Medicine Strahov Všeobecná fakultní nemocnice in Prague. The obtained data are presented in tabular and in graphic reports. Keywords hemodialysis, peritoneal dialysis, renal failure, activities of daily life, disease impact
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Infectious complications in chronic renal failure
Kielberger, Lukáš ; Eiselt, Jaromír (advisor) ; Dusilová Sulková, Sylvie (referee) ; Matoušovic, Karel (referee)
INFECTIOUS COMPLICATIONS IN CHRONIC RENAL FAILURE Infections represent a serious problem in chronic kidney disease (cohort and they are) associated with signifficant morbidity and mortality. The thesis originated in the nephrology division of the Department of Internal Medicine I., Charles University Teaching Hospital and Medical Faculty in Pilsen, an institution with a long standing research activity in the field. In the theoretical part of this work, a general summary of infectious complications in chronic kidney disease population is presented. The other part of this work presents results of our research dealing with pharmacoeconomical aspects of cytomegalovirus infection and finally our results in the field of influenza vaccination. The Aim of the first presented work was to evaluate the cost impact of four different strategies for prevention of cytomegalovirus infection after renal transplantation. We provide post hoc analysis of 2 randomized studies performed in our department and calculating direct CMV-related expenses using valacyclovir prophylaxis, ganciclovir prophylaxis, preemptive vlaganciclovir treatment and deferred therapy. To simulate ihe impact of varying prices of prharmacotherapy or diagnostic procedures, a sensitivity analysis was performed. With respect to our results, valacyclovir...
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Improvement of risk adjustment for health insurance companies in the Czech Republic - compensation of costs of patients with renal failure
Škodová, Magdalena ; Votápková, Jana (advisor) ; Bryndová, Lucie (referee)
Risk adjustment models are used to predict health care costs of insurees and represent an important part of mechanisms for redistribution of funds among insurance companies. In the Czech Republic, pharmacy-based cost groups (PCGs) were introduced into the risk adjustment model in 2018, reflecting the costs of chronic diseases in addition to age and gender. The thesis reviews the model for the most expensive chronic disease - renal failure. Using the sample of General Health Insurance fund (GHI) insurees reported with typical health care consumption for kidney disease in years 2015-2018, we tested the current model and subsequently modified the classification criteria for PCG "renal failure". The classification based on the number of dialysis procedures proved to be much better indicator of costs than the currently used consumption of typical drugs. The incorporation of dialysis-based approach into the PCG model improved the explained variation from 26 % to 49 %, and the predictive power increased substantially. The study suggests improvements of the Czech risk adjustment model and proposes a fairer fund redistribution among insurance companies, while no additional data collection is needed.
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Nursing process hemodialysed patient
Šmajda, Dávid ; Kordulová, Pavla (advisor) ; Maffei Svobodová, Ludmila (referee)
Chronic renal failure is often asymptomatic and painless. Many sick people realize too late that something is happening with their body or kidney function. In renal failure, a complex metabolic disorder arises and water and electrolyte imbalances occur. Unfortunately, this phenomenon is irreversible and a large number of patients must subsequently undergo hemodialysis treatment, which only substitutes kidney work, but does not heal the kidneys themselves. Hemodialysis is currently one of the most widespread methods of renal replacement. Thanks to continuous technological development, it extends the life of patients by several decades and thus improves their lives with chronic kidney disease. The bachelor thesis describes the issue of nursing care of patients included in the hemodialysis program. In the theoretical part of the thesis I describe the issue of chronic renal insufficiency. Furthermore, I focus on the elimination methods of this disease and the necessary vascular approaches for hemodialysis for these patients. In my work I also describe the specifics of nursing care for patients in the hemodialysis program. I have elaborated the thesis on the basis of searching for relevant sources for the given issue. I drew on resources from the National Medical Library, where literature searches were...
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Living donor kidney transplantation
Stöcklová, Lucie ; Heczková, Jana (advisor) ; Nejdlová, Tereza (referee)
Kidney transplantation is still the most succesful method of kidney failure treatment. Transplantations from living donors get ahead of transplantations from cadaveric donors due to better results. Transplantations from living donor can be planned and have less complications. Indisputable advantage is the possibility to perform transplantation before the onset of dialysis-premptively, which provides up to twice better patient survival compared to survival on dialysis. The empirical part is elaborated using the case study describing hospital stay of living kidney donors which describes the postoperative and specific nursing care of kidney transplant recipient. The aim of this thesis is to get to know nursing algorithms in the care of patients after kidney transplantation in intensive care unit and to give comprehensive review of kidney transplantation. keywords: Kidney transplantation - predialysis - living donor - nursing procedures - intensive care - care of kidney transplant recipient
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The effect of dialysis on activities of daily live
Kolaříková, Jaroslava ; Nikodemová, Hana (advisor) ; Jirkovský, Daniel (referee)
The aim of this bachelor's thesis entitled "The effect of dialysis on activities of daily life" is to provide a brief overview of relevant basic knowledge of hemodialysis and peritoneal dialysis using existing and already published litarature and try to determine the influence of the dialysis on activities of daily life. The thesis is devided into theoretical and empirical part. The theoretical part is focused on kidney disease, hemodialysis and peritoneal dialysis, principles of dialysis therapy, their differences, complications, dietary measures and approaches to dialysis. Further attention is paid to the comparison of the advantages and disadvantages of both methods of dialysis among themselves. Part of the work deals with human needs and activities of daily life. The empirical part consists of an exploratory survey, which was given to patients in dialysis centers Fresenius Medical Care Prague 5 - Motol, Prague 10 - Vinohrady, Prague 4 - Krc, Prague 9 - Vysočany, Slaný, Louny, Chomutov, Most and dialysis center department of Internal Medicine Strahov Všeobecná fakultní nemocnice in Prague. The obtained data are presented in tabular and in graphic reports. Keywords hemodialysis, peritoneal dialysis, renal failure, activities of daily life, disease impact
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Infectious complications in chronic renal failure
Kielberger, Lukáš ; Eiselt, Jaromír (advisor) ; Dusilová Sulková, Sylvie (referee) ; Matoušovic, Karel (referee)
INFECTIOUS COMPLICATIONS IN CHRONIC RENAL FAILURE Infections represent a serious problem in chronic kidney disease (cohort and they are) associated with signifficant morbidity and mortality. The thesis originated in the nephrology division of the Department of Internal Medicine I., Charles University Teaching Hospital and Medical Faculty in Pilsen, an institution with a long standing research activity in the field. In the theoretical part of this work, a general summary of infectious complications in chronic kidney disease population is presented. The other part of this work presents results of our research dealing with pharmacoeconomical aspects of cytomegalovirus infection and finally our results in the field of influenza vaccination. The Aim of the first presented work was to evaluate the cost impact of four different strategies for prevention of cytomegalovirus infection after renal transplantation. We provide post hoc analysis of 2 randomized studies performed in our department and calculating direct CMV-related expenses using valacyclovir prophylaxis, ganciclovir prophylaxis, preemptive vlaganciclovir treatment and deferred therapy. To simulate ihe impact of varying prices of prharmacotherapy or diagnostic procedures, a sensitivity analysis was performed. With respect to our results, valacyclovir...
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Specifics of the nursing care of patients with arteriovenous fistulas in a standard departement
NIEDERMEIEROVÁ, Michaela
Theoretical basis: My bachelor thesis briefly explains the reason for establishing this vascular access, describes the types of dialysis and discusses different types of vascular accesses. It analyses the process of haemodialysis including the role of the nurse during this procedure. Finally, it provides an outline of the life of a patient, who needs to attend dialysis regularly as well as to manage to take care of the fistula at home. This shunt is the only patient's connection to the dialysis during the renal failure and therefore it requires a specific nursing care. In order to preserve the function of the fistula the longest time possible, the patient himself also needs to follow the principles of a good care. The aim of the thesis: One aimsare set in the empirical part. Aim 1 should check whether nurses know the specifics of care of patients with arteriovenous fistula. In order to acquire these aims one research question were set: what nurses know the specifics of care of patients with arteriovenous fistula. Methodology: In the empirical part of the thesis, the qualitative research method with the help of semi-structured interview was used for the research. Respondents consisted of general nurses from surgical and medical ward of selected hospital in the South Bohemian Region. The data collection took place after consultation with the senior nurse and ward sisters during March this year. Before starting the empirical investigation, the reason and intention of interviews, which took place on a voluntary basis and were electronically recorded, was explained to the respondents. The questions in the interview were prepared in advance. Obtained data were processed into categorization groups, which were further analysed. The interview was divided into 5 areas: identifying issues, preoperative preparation, postoperative care, nursing care for fistula, patients' awareness. The research part of the thesis was also consulted with the ward sister of the hemodialysis center of the selected hospital of the South Bohemian Region. Results: The results of the empirical survey shows what specifics of nursing care of patients with arteriovenous fistulas nurses know. After analysing the research, we found that nurses know the basic nursing care of the vascular access. Nurses know that this vascular access is used only for purposes of hemodialysis. They do not measure the pressure on a limb with fistula, draw blood from it or insert a permanent venous catheter into it. They know that the skin around the fistula should be observed carefully and each day. They monitor the limb with fistula mainly for signs of infection and ischemia. In case of necessity of the provision of information for the patient about the care of an arteriovenous fistula, nurses are able to complete the missing information or arrange for a consultation with a specialist. However, the research also revealed weaknesses. Nurses are not sure how long fistula matures, do not really prepare patients for hemodialysis and don't know exactly when to remove the bandage from a patient after dialysis. In case of bleeding from the fistula, they do not know whether to use a pressure bandage.
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The Satisfaction of Patients with Peritoneal Dialysis in the Provision of Nursing Process
JANSOVÁ, Miroslava
Peritoneal dialysis is a method of treatment of chronic renal failure. The principle of this method is the exchange of substances between blood and dialysis solution soaked into the abdominal cavity. The absolute indication for the dialysis is the impossibility to establish vascular access for hemodialysis. It is primarily indicated for patients as a treatment for cardiovascular diseases which may cause hemodynamic instability during extracorporeal circulation. Individual preferences of the patient also play an important role. The contraindications are extensive adhesions in the abdominal cavity and inflammatory bowel diseases. This method has recently become common practice at most dialysis centers. It provides patients with more freedom as well as more independence from a medical center and its staff. The qualitative data collection technique was used for the research survey. The qualitative research took the form of non-standardized interview. The research group consisted of six patients from dialysis centers and hospitals in Tábor and České Budějovice. Objective 1 was to find out whether peritoneal nurses provide patients with sufficient information. The research has shown that the patients had been informed about the method before as well as during the treatment. Objective 2 was to find out how nurses support the patients´ self-care. The research has shown that the nurse had supported patients´ self-care by providing them with information regularly, checking during the exchange of dialysis solution and by reeducating them. Objective 3 was to find out whether a nurse helps to reduce social isolation of patients with peritoneal dialysis by providing a health visiting service. The research has shown that patients had highly praised this service, feeling encouraged to become more active thanks to the health visiting service. The work of nurses caring for these patients is rather independent and individualized. The success of treatment largely depends on high quality work of a nurse, on her educational and communication skills. We hope that the results obtained will be an example for other health professionals caring for these patients. The brochure could help patients with renal failure to decide when selecting a method of treatment.
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