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The offer of health and social services for seniors in relation to their needs
HADAČOVÁ, Jana
Abstract The society has become increasingly interested in the issue of seniors at present. Considering the increasing age of seniors, a situation when they are not able to take care of themselves and need help of another person may occur. The assistance secured by health and social services may be provided to seniors in their homes or in housing facilities. Human needs are changing and developing with age and form an integral part of the personality of an individual. The theoretical part of the thesis addressed the terms of aging, old age, needs and health and social services. The data were collected using the qualitative research strategy, the method of questioning and the technique of interviews, involved observation and technical literature analysing. While interviewing the respondents, their anonymity was respected. The objective of the thesis was to ascertain whether needs of seniors are satisfied in relation with the offered health and social services. In the research, the main research question was set out. In order to answer the question, five research sub-questions associated with the interview structure were used. The research was conducted in retirement home Hvízdal České Budějovice, p.o. (organization co-funded by the state budget). The main research question led to confirmation of the thesis objective. The obtained information may be used for improvement of quality of the services provided in the facility where the research was conducted.
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Řízení IS/ICT se zaměřením na sourcing služeb informačního systému
Šebesta, Michal ; Voříšek, Jiří (advisor) ; Havlíček, Zdeněk (referee) ; Příklenk, Oldřich (referee) ; Král, Jaroslav (referee)
Research on outsourcing has been around for several decades, while recent evolution in the information systems discipline towards ICT service commoditization significantly changes the context of decision-making. Services that are available on-demand via the Internet allow organizations implementing functions they demand in a fraction of time. This trend represents a chance for organizations seeking to use advanced ICT services without a need of major investments. Problem is the current lack of guidelines and tools for managing ICT services and their outsourcing. Given the trends on the ICT service market, it is expected that much of the IT management in the future will encompass the ICT services and utilize service-level structures. Methods currently available are either too broad or encompass only small part of the whole problem. Ad-hoc or unsound decisions in this area might cause major complications in terms of quality, usability, integration, and consequently influence total cost of organizational IT. Organizations need to either revise existing models or propose and implement completely new models to manage their IS/ICT. This thesis deals with the management of IS/ICT with focus on the ICT services outsourcing. It discusses available sourcing models in the literature and links them to the various interconnected areas. Based on these areas, it presents an integrated view on IT outsourcing strategies. Most importantly the thesis proposes an original concept for decision-making about outsourcing of ICT services named the SOURCER framework. This approach utilizes the presented outsourcing strategies, and introduces a complex methodology and decision-making criteria that will assist organizations with selection of ICT services in order to maintain and manage a most suitable ICT service portfolio. The decision-making is based on four essential viewpoints: function, costs, time, and quality. These viewpoints are discussed, individually analyzed, and serve as a basis for further research. The whole framework is developed and validated according to Design Science Research Methodology (DSRM). Individual components are evaluated using a survey among a group of selected IT managers. Proof of concept is then established by a case study on framework use in a real organization. This case study covers strategy specification, business--IT alignment, specifying service architecture and its interconnections, outsourcing, and management of the ICT service portfolio.
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Customer Relationship Management in B2B
VRCHOTA, Tomáš
This thesis is focused on CRM systems for small and medium-sized enterprises operating in the B2B market. The main goal was to identify the needs and possibilities of the use of CRM systems in small and medium-sized enterprises operating in the B2B market and propose the appropriate CRM systems for this target group. Needs of small and medium-sized enterprises were explored by qualitative research by individual structured interviews. In the next part of the thesis I selected 33 CRM systems which I analyzed for the required functionality. In the last part of the thesis I evaluated the selected CRM systems for small and medium-sized enterprise according to criterions: price, customer service and user-friendliness.
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Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
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Standardization of nursing care as an integral part of preparation for the accreditation survey
ŠIMÁČKOVÁ, Alexandra
The Diploma thesis deals with standardisation of nursing care in the context of preparatory work for accreditation survey, i.e. a mutual harmony between standards developed in health care institutions and those developed by the SAK ČR accreditation commission. Standardisation is a process of setting essential rules which should guarantee providing a high quality nursing care. These rules (standards) enable to evaluate the quality of all nursing activities. Nurses should be aware of standardisation process and be actively engaged in it. The theoretical part describes the part of Czech nursing system concept focused on the quality of nursing care, defines the quality itself, maps the systems which help improve the quality of nursing care in health care institutions and refers to the formation of nursing standards. Practical part deals with five aims stated at the beginning: To map the quality of standardisation in nursing care as a preparatory part of accreditation survey. To find out if nursing care in hospitals is carried out through the method of nursing process. To find out if nursing care is supported by properly kept documentation. To find out if the needs of education were considered for all patients. To find out if nurses are aware of the importance of nursing care standardisation. We chose a quantitative research method. To collect the research data we used anonymous questionnaires. Each of the hospitals was given 50 questionnaires, i.e. 250 in total as the research group was made by respondents from the hospitals in Jindřichův Hradec, Pelhřimov, Tábor, Písek a Havlíčkův Brod. 230 completed questionnaires were returned and 204 of them represented then the research group. Within the research, we accomplished the aims stated, and proved these hypotheses: Hypothesis 1 (H1): The hospitals meet all requirements of accreditation survey of nursing care standardisation. H2: Nursing care in the hospitals is carried out through the method of nursing process. H3: Nursing care in the hospitals is supported by properly kept documentation. H4: The needs of education were considered for all patients and recorded in the nursing documentation. H5: The nurses are aware of the importance of nursing care standardisation. The quantitative research resulted into the statement that all hospitals meet the requirements of accreditation survey of nursing care standardisation. Nursing care in the hospitals is carried out through the method of nursing process which is properly recorded in nursing documentation. It was also found out that the needs of education were considered for all patients and properly recorded in the nursing documentation. The nurses are aware of the importance of nursing care standardisation. The facts resulted from the research prove that the quality of nursing care in the chosen hospitals is very high and meets the requirements of accreditation standards. The research findings will be offered to the hospital managements as an educational material for nurses and midwives.
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Manager's role in nursing staff in the intensive car unit.
ŠKULINOVÁ, Iveta
The theoretical part of the thesis introduces the current state of the issue. The fundamentals of management, the three basic lines of health managers and their functions and roles are described first. Another section is devoted to the specifics of nursing care in the intensive care unit. The second part is focused on qualified nurses, their qualification, duties and the role, factors of satisfaction and difficulties of the care for patients in the intensive care unit. The last part deals with problems occurring in exercise of the nursing profession and with the assistance of a manager in dealing with these problems. Five objectives were established. Objective 1: To identify what nurses working in intensive care units need to be satisfied in their work. Objective 2: To map the form of support to the nursing team in the ICU from the perspective of managers. Objective 3: To point out possibilities of increase in job satisfaction of nurses working in intensive care units. Objective 4: To identify motivational factors for nurses working in intensive care units. Objective 5: To determine if there are obstacles preventing managers from supporting the nursing team. Qualitative research was selected to collect the data and 6 research questions were established. Research question No.1: What do nurses working in ICU need to be satisfied in their profession? Research question No.2: Do nurses working in ICU perceive any difference in position of a nurse working in an ICU and a nurse working in a standard unit? Another question No.3: What are the means used by the management to support the nursing team in ICU? Question No. 4: What are the possibilities of increasing work satisfaction of nurses working in ICU? Question No. 5: Which specific motivational factors are involved in satisfaction of nurses working in ICU? Research question No. 6: Which obstacles prevent managers from supporting the nursing team? Non-standardized interviews were conducted with 8 ward nurses and 12 nurses working in shifts who were employed in intensive care units of surgical or internal departments. Answers to the established research questions were formed based on analysis of the results. Results can be provided to managers in health care facilities and to nurses working in intensive care units.
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Cardiac Surgical Patient in the RES Room and the Approach of a Nurse to Nursing Care
KAFKOVÁ, Zuzana
In the past years, the cardiac surgery performance was very demanding. The limited range of medical performances, imperfect procedures and techniques resulted in frequent postoperative complications and high postoperative mortality. Over time, surgical techniques, heart replacements, extracorporeal circulation and postoperative care have improved. This makes it possible today to operate on much older patients, where surgeries previously were nor feasible. The diploma thesis on the topic Cardiac surgical patient in the RES room and the approach of a nurse to nursing care is dedicated to the patient after heart surgery. It deals with meeting the patient's needs in the RES room and what the patient perceives while staying in the resuscitation unit and what he /she needs from a nurse. In the empirical part of this thesis two objectives were stated. To determine what a cardiac surgical patient perceives and what he /she needs in the RES room, and to find out whether it is possible to improve the quality of patient-oriented care. Based on these objectives, hypotheses and research questions were established. The objectives were successfully achieved, the hypothesis was confirmed and the questions answered. The research was conducted using qualitative quantitative research methods in the RES units of the cardiac surgery department, where the patients with heart disease are operated on. For the quantitative research the questionnaire interview method was selected. The qualitative research method was used to carry out semi-conducted interviews with the patients.
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