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Nursing process and its significance to seniors according the perspective of retirement home nurses
FRÜHAUFOVÁ, Hana
Modern nursing care is characterized by seeking, planning and satisfying needs of a healthy or an ill person. All this is performed by means of the nursing care process. The nursing care process is considered the basic scientific method of advanced nursing care leading to solution of problems. It has already become an inherent form of individual care planning. Thanks to the nursing care process a nurse has a holistic view of a patient and is able to provide quality care. Nursing care is provided in compliance with the nursing care process principles with regard to the specifics of geriatric care in senior homes. A senior home nurse takes into consideration the specifics of the individual phases of nursing care process in seniors. Senior homes provide residential services to people with lower self-sufficiency particularly caused by higher age and to those who need regular care in the field of self-sufficiency and personal care. Unfavourable social situation does not allow these people to live in their domestic environment. Complex care provided in senior homes substitutes for domestic environment. Seniors are also given health care provided by general nurses. The aim of the thesis was to examine nursing care process application in a senior home and the importance of the nursing care process from the point of view of senior home nurses. The following research questions were set: Which nursing care process phases are applied by nurses taking care about seniors in the senior home? How do senior home nurses feel the importance of nursing care process? Qualitative research by means of in-depth interview and questioning of nurses in a selected senior home in South Bohemia was chosen for collection of necessary information. The interviews were recorded and subsequently literally transcribed. The transcribed interviews were deeply analyzed by means of paper and pencil method by open coding. Four categories were created from the data analysis: Nursing care process, Nursing care process in practice, Nursing care process phases and Compilation of nursing care diagnosis and maintenance of nursing care documentation. Subcategories, where the core data are coded, are assigned to the individual categories, everything is illustrated by clear diagrams of the individual categories. The research shows that nurses have general knowledge of nursing care process. They were able to define nursing care process, to name its phases and to express their attitude to this method. They actively apply the process, but they say it is demanding for them from time and administration point of view. The fact that the knowledge of nursing care diagnosis is very poor among nurses is surprising. With regard to the limited awareness of nursing care diagnoses I propose a seminar explaining this issue.
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Fulfilling the criteria for saturation of the patient's needs
ŠTOKROVÁ, Veronika
The thesis deals with the realization of the criteria for saturation of the patient's needs. In the current system of nursing care, the principles of modern nursing are failing to realize and therefore we want to find out the main obstacles of this situation and the possibilities of their removal. For the purpose of the thesis there were set three objectives. The first of them has set the objective of finding out the most common problems in meeting the criteria for saturation of the patient's needs. The research showed that the nurses see the problem in a lack of staff at the wards, a lack of time, excess of documentation, excessive demands for nurses. The purpose of the second objective was to find out what supports the realization of the criteria for saturation of the patient's needs. Results have shown that what helps nurses is a positive work environment, motivation, nurse´s personality, own scale of values, salary, good leadership, organization, nursing care. The third objective was to find out the opinion of nurses on meeting the criteria for saturation of the patient's needs. It turned out that the majority of respondents think that nurses do not effectively satisfy all the needs of patients for a number of reasons: there are few nurses and they are overloaded, the nurses do their best but still cannot satisfy all the patients´ needs. We also found out that the higher patients´ needs are omitted. Less than a third of the nurses indicated that nurses effectively meet all the patients´ needs. For the qualitative part of the research, we set two research questions in advance. Which criteria nurses use in patients´ needs saturation? The research showed that time, which is very valuable for nurses and very often is in short supply, is an important criteria for the saturation of the patient's needs. Furthermore, it is knowledge and manual dexterity when nurses additionally reported a lack of education of some nurses especially within the nursing process. As the next criteria, it was mentioned the cooperation with the patient as it is necessary to engage patient himself in care planning. The next criteria is monitoring of the patient´s response, which is included in every phase of the nursing process. Furthermore, the nurses agreed on criteria, which include communication as a key skill of every nurse, then individual care, a suitable environment and utilities, education, critical thinking, effective nursing process and empathy. The second research question tried to find out which obstacles prevent nurses in effective saturation of the patients´ needs. We found out that nurses are concerned about a lack of staff at wards and the excess of administrative load, which is related to a lack of time for patients. These three factors are also obstacles for nurses and prevent them from effective satisfying of the patients´ needs. The next obstacles in satisfying the needs are burnout, reluctance of nurses to work, excessive demands for nurses, poor workplace relationships, a lack of evaluation both in a form of praise and appreciation, and finance. We also found a lack of information, which is related to a lack of time, as nurses do not have a chance to collect all the information concerning the patient. As another possible obstacle, nurses also mentioned personal problems. The results of the thesis can be used as a small contribution to currently ongoing effort of the Czech Association of Nurses.
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Ethics of clinical research provided in intensive care by nurses.
Lerchová, Martina ; Haškovcová, Helena (advisor) ; Tošnarová, Hana (referee)
This presented gradual thesis deal with problems connected with research projects provided by nurses in cooperation with doctors on Coronary Intensive Unit in the IKEM hospital Praha. The exact name of this thesis is - Ethics of clinical research provided in intensive care by nurses. This thesis is composed from two parts - theoretical and practical. Theoretical part is divided into the seven parts. The first chapter descripe a develop of relationship between the doctor and patient whitch is very important especially during the research studies. The second chapter is focus on problems of informed consent area. Describe its historical development and process its standardization in big hospitals. The third chapter contain an information about ethicall comitte and its role in medical researchs. Fourth chapter contain some information about development and changes in documents important in research area. Nursing as a area for research is mentioned and discuss in five part of this thesis together with supervision which is very important in research too. Part six try to solve a problems connected with competention of nurses in the Czech republic in research area. The last seven part try to explain the meaning of some research studies, which are actualy running on Coronary Department in the IKEM Praha hospital....
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A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
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Role of the nurse in screening for depression in the elderly.
VRZALOVÁ, Monika
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
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Pick´s disease and the specifics of the nursing care of a patient with this disease
KOPKAŠOVÁ, Lenka
Pick's disease is a degenerative-atrophic process that primarily affects the frontal and temporal lobes of the brain. Besides Alzheimer's disease, it is a lesser known form of dementia which affects people of younger age. Although the exact range of Pick's disease occurrence varies in the literature, the average reported age is between 50-60 years. The disease can change eating habits, cause emotional swings, inappropriate behaviour and sloppy appearance of the patients. The behaviour to others is often selfish, the patients are unable to listen to others and ignore their surroundings. Pick's disease is also characterized by inappropriate sexual behaviour. Globally, the number of dementia patients is still growing and according to expert guesses the increase will continue. Nursing care for patients with dementia is therefore becoming a very actual topic as dementia is called a quiet epidemic of our century. Nurses in their departments quite frequently encounter patients suffering from dementia of various origins at different stages of disability and the staff at healthcare facilities often regard these people as a burden. The aim of this thesis, which is called Pick's Disease and Specifics of Nursing Care for Patients with this Disease, is, based on the theoretical knowledge, to map definitions and diagnosis of Pick's disease, to define the needs of such a patient, and to list the most common problems in the nursing care. It focuses on people with dementia within medical facilities. For proper understanding of the problem, the thesis starts with the anatomy and physiology of the brain and the description of cognitive functions which are affected by the dementia syndrome and the definition of dementia. Based on the studied literature, dementia is divided according to various criteria. It has been found out that dividing dementia is not entirely uniform, but the essential facts and overall opinions of the authors do not diverge. Pick's disease belongs to a group of frontotemporal dementia and its position in this group has changed over time, as it is recorded in the literature. The thesis includes recommendations resulting from the studied literature in the approach to patients with dementia and emphasizes personal communication with the patients and empathetic and humane approach. Although medicine cannot prevent dementia, an early diagnosis of a specific type of dementia and correctly targeted treatment can increase the quality of life not only of the patients but also of their families. I have chosen this topic because I find it very current and interesting. During my nursing practice at the Surgery Department and Aftercare Department, I have met patients suffering from dementia and I did not know how to properly and efficiently communicate with them. For the theoretical part of my work, the methods of explanation, synthesis and induction on the basis of Czech and foreign information sources have been used. The most frequently quoted Czech authors in my thesis are doc. MD. Roman Jirák, PhD., the head of the center for diagnosis and therapy of Alzheimer's disease at the psychiatric clinic of the General University Hospital in Prague, the 1st Medical Faculty of Charles University. This thesis can serve as an informational and educational source both for nurses and the general public who may experience the disease within their families. It would be considered a great success if it helped nurses or family members to diagnose Pick's disease or other dementia at an early stage.
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Qualitative investigation of nursing practice for blood donations
NEUMANNOVÁ, Jana
Venous blood sampling poses one of the basic professional skills of a nurse. As in other fields of medical professions, new techniques, standards, instruments and auxiliary instruments are steadily developed here. Their use in practice should facilitate the work of nurses, increase the comfort of patients and, last but not least, increase the costs of health centres and hospitals resulting from repeated samplings and consequently repeated analyses of blood samples. The obtained blood test results facilitate the diagnosis as well as the monitoring process of the individual treatment effectiveness. When taking blood samples, nurses should comply with the current nursing standards ensuring that the result of the given venous blood sampling is correct and non-distorted by an incorrect venepuncture. A violation of the nursing standard may endanger the health safety of both the patient and the nurse. This baccalaureate work monitors the compliance of stipulated nursing standards related to blood sampling. The research was carried out within the surgical ward of the Klatovy Hospital. The monitoring method of disguised participating observation and consequent interviews with monitored nurses was selected. Thus, the research questions could be sufficiently answered. The first question was focussed on the rate of compliance with the principles of correct venous blood sampling. The observations showed that nurses not always proceed in compliance with the appropriate venous blood sampling standards. The second research question dealt with the sampling safety standards both in terms of the patient and the nurse. The research results suggest that nurses are not always fully aware of their own or patient's safety issues. The nurses are not yet sufficiently skilled in the application of protective equipment. The third research question was focussed on the individual preferences of the available sampling techniques. The results of the interviews with nurses suggest that nurses tend to prefer the closed technique. The ward sister of the surgical ward as well as the deputy executive manager for nursing issues of the Klatovy Hospital shall be made acquainted with the results of my research. I plan to propose to hold a seminar in the co-operation with the staff of the clinical biochemistry ward of the Klatovy Hospital.
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