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Organization of the neonatal transport servis from the view of nurses
SCHWARZOVÁ, Lucie
Even though it has been managed to concentrate deliveries of premature infants to the perinatal centres thanks to the ?in utero? (before-delivery) transports in recent years, there are still a certain number of newborn infants who are born outside the centres and, thus, it is required to transport them to the specialized departments. The transport of a newborn infant is characterized with special therapeutic procedures and it requires different equipment for providing intensive or resuscitation care and it is provided by transport service for newborn infants that is an integral part of the regional system of the differentiated care of newborn infants. The objective of the diploma thesis is: Objective 1: To characterize current provision of neonatal transport services. Objective 2: To map the role of nursing staff when providing neonatal transport service. Objective 3: To find out if nurses deliver care by nursing process when providing neonatal transport service. A hypothesis and research questions were defined on the basis of these results. Hypothesis 1: Presence of a nurse when providing neonatal transport service is important. Research question 1: What is the role of a nurse when providing neonatal transport service? Research question 2: How is the nursing process applied when providing neonatal transport service? The investigation proved the hypothesis and the research questions were answered. The goal of the thesis was met. The standard ?Nursing Care of Newborn Infants during Transport? is the result of the diploma thesis.
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Level of knowledge of midwives and pediatric nurses for oxygen therapy in neonates and infants
JIRÁKOVÁ, Nikol
Abstract The theoretical part of the thesis focuses on oxygen therapy of mature and premature newborns, particularly as a part of resuscitation. The thesis summarizes general findings about postpartum adaptation of individual groups of newborns and about immediate care provided in the delivery room. The theoretical part also deals with a nursing care of newborns and young babies requiring ventilation support in the hospital neonatology ward. The practical part surveyed both theoretical knowledge and practical skills of pediatric nurses and midwives. The survey used quantitative inquiry and observation. Anonymous questionnaires were distributed to midwives and pediatric nurses working at the gynecology-obstetrics and neonatology wards in the hospitals in České Budějovice (Nemocnice České Budějovice, a. s.) and in Benešov (Nemocnice Rudolfa a Stefanie Benešov, a.s.) The observation was conducted during my practice at the neonatology ward in the hospital in České Budějovice. The thesis had one formulated objective and two related hypotheses. The objective was to determine the level of knowledge of midwives and pediatric nurses about the principles of treatment of newborns and young babies with oxygen. The objective has been met. Hypothesis 1: ?I believe that the level of knowledge of midwives and pediatric nurses about the oxygen treatment of newborns and young babies is sufficient? has been confirmed. Hypothesis 2: ?The nursing team in the delivery room is familiar with the current recommendations for application of oxygen during resuscitation of newborns in the delivery room? has been confirmed. This bachelor degree thesis may serve to future students of midwife profession as a study material and source of information. Moreover, the thesis might be used as an educational material for midwives and pediatric nurses working in delivery rooms and at neonatology in-patient wards.
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Feeding strategies for premature infants (24th-34th gestational week) on discharge from the hospital.
GAZDOVÁ, Zdenka
According to the experts, the breastfeeding support and education of mothers in the Czech Republic is insuficient. There is declining number of children who are brestfed exclusively to six months of life, premature babies posing even greater problem in this matter. Much of this problematic trend resides in the lack of support for mothers. A major problem in the Czech Republic is the fact that there are still a few maternity hospitals which are arranged so that mothers can be with their babies immediately after birth, especially if we talk about preterm newborns. Breastfeeding is the most important way to ensure the healthiest nutritional needs of an infant. It allows not only nutrition, but also feeling of safety and security, which is very important in proper development of the child. Furthermore, the breastfeeding contributes to the creation of solid emotional relationship between mother and child. Among other things, breastfeeding is undoubtedly the cheapest possible child nutrition. Goal of this thesis is to draw attention to a small number of premature babies, who are fully breastfed at discharge from the hospital leading to many negative consequences such as reduced immunity, psychosocial issues, et cetera. In our opinion, the problem is caused by lack of time, excessive workload of nurses and doctors' little initiative. Through this thesis we would like to draw attention to current knowledge and information about the breastfeeding preterm infants in perinatal centers. We also mapped the number of premature babies fully breastfed at discharge from hospital and identified through research the causes of low prevalence of breastfeeding these children. Another objective was to map the knowledge and skills of nurses in practice, to determine the connection between these skills and the difference in diet between compared hospitals. Finally, we propose solutions to the identifed shortcomings. The theoretical part processed characteristics of a premature baby, anatomy and physiology of breastfeeding and its benefits for the child, proper breastfeeding technique, the importance of nurses in the management of breastfeeding and activities to promote breastfeeding in the Czech Republic and in the world. In the empirical part we used qualitative and quantitative research. We collected data in three randomly selected perinatal centers in the Czech Republic during the fourth quarter of 2012. The stated objectives of the study were processed using a questionnaire, content analysis of documents and methodology and regression trees. The research showed that all of the top centers have similar level of child care. However, there are significant differences in nutrition and ways of feeding the children and nursing care. The study showed that child nutrition at discharge from hospital is different, and this may have an impact on the later development of the child, as evidenced by other studies. Differences in nursing care most relevant to the proper and effective education of the mothers, which both can be observed from the investigation, have the greatest impact on the type of diet at the end of the hospitalization of the infant.
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Nursing care of a newborn with oesophageal atresia
Chlumová, Hana ; Sedlářová, Petra (advisor) ; Rygl, Michal (referee)
The bachelor thesis deals with diagnostic procedure, treatment and nursing process in a newborn diagnosed with esophageal atresia without fistula. The work consists of clinical part, in which anatomy of esophagus, prenatal evolution of esophagus, types of esophageal atresia, options of surgery, prediction and complications of this disease are briefly described and at the end there is a description of the course of hospitalization. Nursing part consists of a theoretical section describing the nursing process and the nursing model of Virginia Henderson. In the next part of work is the needs of the patient are assessed according to this model. Nursing diagnoses are described both for the period before surgery and immediately after the first operation. Due to the lenght of stay the long-term plan of nursing care is intertwined with information, instructions and guidance of the parents The work also contains a list of used drugs with their brief characteristics. In supplement scoring tables, X-ray documentaion, and information for the parents are presented.
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The role of nurses in community care for newborn.
BROŽÍKOVÁ, Radka
This diploma thesis examines the role of paediatric nurses caring for newborns in the community. It aims to determine if and how newborn care in the home environment takes place and the role of the paediatric nurse. The research is based on one of the primary objectives set out by the member states of the WHO to improve the health of the entire population in the twenty-first century with the focus on community care and its development. The theoretical part is dedicated to the definition of community care and its history in the Czech Republic. We initially focus on how childcare at home was provided in the past. This is followed by a description of the current situation regarding care of a newborn and the mother during the first weeks following birth, both here and abroad. We evaluate the role of the paediatric nurse in terms of nursing care for newborns and research the duties that the nurse carries out within the clinic, family, and community.We have set out two objectives and five research questions. The first objective was to identify nursing care problems encountered by mothers at home and how they solve these problems. The second objective was set out in order to explore how nurses become involved in the community care of a newborn. We have chosen a qualitative method for the research part of the thesis. Data was collected through semi-structured interviews. Subsequently, a qualitative analysis and categorization of collected data was conducted. Two research sample groups were created in the first phase. The first consisted of mothers with newborns, i.e. children from birth to 28 days. The second group consisted of paediatric nurses who work in outpatient care with children and adolescents. The second phase of the research addressed paediatric nurses working in the neonatal clinic, which is run by the hospital's paediatric department. The result of our thesis is the finding that community care provided by the paediatric nurse in the field, in a natural environment and with the cooperation of the entire family and community, as defined, is almost nonexistent. The long-established system of primary care directs all nursing work into the surgeries of the paediatric practitioner, and only the first visit to the newborn, but not in all cases, is conducted at home. This system is insufficient to cover all the specifics of childcare. The needs of the newborns and their parents are becoming more urgent and in the first weeks following the birth the mothers only very slowly begin to gain healthy self-esteem and confidence in their maternal abilities, hence the need for an individual approach and help in the proper care of their baby. They feel there is a lack of information and they do not know how to deal with the needs of their newborn. The most problematic issue described is breastfeeding. The addressed nurses are of the same opinion and also consider breastfeeding as the most common focus of their intervention, and therefore, the most important part of their work.We have discovered that the skills and competencies of the paediatric nurses are sufficient to enable them to become a relevant element in the comprehensive care of newborns within the community. The interventions delivered by the nurse are fully integrated into paediatric nursing.The parents of newborns would, according to our survey, prefer a home visit from health professionals, particularly if it concerns the first contact with the baby and family. The out-patient care does not provide enough time and space to pursue common nursing issues, therefore, home visits are an essential part of the care that should be offered to the mother and baby. Community nurses would help to coordinate the services provided to families as well as help solve the nursing issues that mothers encounter in the first weeks of their child's life. A paediatric nurse would, therefore, become a partner to the parents in a joint effort to ensure the healthy development of their child.
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Nursing process in newborn with hyperbilirubinemia
SEKALOVÁ, Monika
The thesis deals with Nursing process with neonates diagnosed with hyperbilirubinemia. The theoretical part focuses on the physiological and premature new-born babies, anatomy and physiology of blood, neonatal hyperbilirubinemia problems, nursing process and NANDA and NIC classification systems. The practical part contains research results. Qualitative method was used for the research and it was carried out at the neonatal department in Nemocnice Ceske Budejovice, a.s. (Ceske Budejovice Hospital). The first objective was to determine the specifics of nursing care for full-term new-borns and premature new-borns diagnosed with hyperbilirubinemia. It was found that the specifics were mainly in monitoring of the physiological functions, measurement frequency of transcutaneous bilirubinometry, in positioning the new-born during phototherapy, in the prescribed temperature inside the incubator and in children's diets. All information necessary was collected through interviews with nurses, from documentation content analysis and by observation. Based on the information, case studies were developed. The research sample consisted of two new-born babies diagnosed with hyperbilirubinemia. The second objective of the thesis was to determine nurses´ position when using NANDA classification systems to diagnose Neonatal jaundice and NIC Phototherapy: new-born. It was found that nurses would change some defining characteristics and related factors to diagnose Neonatal jaundice (00194) as well asinterventions from NIC Phototherapy: new-born (6924). Most of them agreed that they would not like to use these classifications during care of the new-borns. Information was collected using structured interviews with three neonatal nurses and two midwives. The results could be used to improve nursing care for neonates diagnosed with hyperbilirubinemia.
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The role of a midwife and a pediatric nurse in ensuring termomanagement by a physiological newborn
BARTŮŠKOVÁ, Lucie
The theoretical part is focused in ensuring thermal management for a physiological new-born baby. To ensure the optimum thermal management for a new-born baby is very assential in order he/she can adapt to the external environment after the birth as a new-born baby is prone to loss of heat in the first moments after the birth. Body temperature regulation after childbirth is not sufficient and stable and therefore a new-born baby can get quickly cold when the surrounding temperature is low or, on contrary, he/she can get overheated when the temperature is high. That is why the nursing staff should minimize heat losses of a new-born baby and prevent his/her overheating. The first goal was to map out the knowledge of the nursing staff at the Department of Neonatology of ensuring thermal management of a physiological new-born baby at the labour ward. The other goal was to map out the way of ensuring thermal management of a physiological new-born baby at the labour ward. The research investigation was conducted by means of a qualitative survey using in-depth interviews and hidden observations of paediatric nurses at the Department of Neonatology at the Hospital in České Budějovice. All interviewed nurses have proved they know the way of ensuring thermal management of a physiological new-born baby at the labour ward correctly and at the same time all nurses observed have followed the Nursing Care Standard in Neonatology No. 513 Thermal management of a new-born baby when ensuring thermal management. This bachelor thesis could be used as a study material for students of the following years of midwifery studies. Further, it could be used as information material for the already experienced or fresh midwives and paediatric nurses. The outcome of the bachelor thesis is a leaflet providing information on ensuring thermal management of a physiological new-born baby.
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Nursing care of physiological newborns nowadays ane future trends
LÍZALOVÁ, Karolína
This bachelor thesis has two parts: the theoretical and practical ones. The theoretical part describes the care of physiological newborn infants from the moment of their birth until discharge from hospital. It also includes the physiology of newborn infants and a summing up the history of this subject. In the practical part, investigations focused on the opinions and the common practice of nurses taking care of physiological newborn infants were conducted. Investigation reveals that nurses working in departments of physiological newborn infants mostly work according to present-day trends of care of physiological newborn infants.
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Nursing Procedures of Oxygen Administration to Newborns
STUDÍKOVÁ, Monika
Nursing Procedures of Oxygen Administration to Newborns The diploma thesis is to outline the current perspective of oxygen therapy of newborns who need highly specialized care as early as in the delivery room and subsequently in intensive and resuscitation care units of perinatologic centres. The research in the diploma thesis is focused on the assessment of the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The theoretical part addresses the first treatment and evaluation of a newborn. Then the reasons leading to oxygen administration are discussed as well as the methods of oxygen application in the delivery room and intensive and resuscitation care units. Being at the forefront, oxygen is one of the most often administered medicines. Inadequate use of oxygen as a medicine increases the risk of complications for the newborn. The delivery and the first weeks after the birth rank among the crucial periods of every child. Adherence to the recommended procedures improves the outlooks of premature newborns for leading quality life. The objective of the thesis is to ascertain the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The research was quantitative and used the questionnaire technique. The author created one kind of the questionnaire for the selected research set. The set consisted of nurses working in neonatal wards of selected hospitals. A total of 65 questions were created to ascertain the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The research set consisted of 184 respondents. In order to attain the objective, the following hypotheses were raised: H1: Nurses know the current recommendations for oxygen administration to newborns. H2: Delivery rooms have sufficient technical equipment for oxygen administration to newborns. H3: Nurses are theoretically and practically trained for situations requiring oxygen administration to newborns. H4: Clearly formulated rules of oxygen therapy are available for nurses in a written form in a well visible place in the delivery room. Based on the statistically processed results, the first three hypotheses have been confirmed. The fourth hypothesis was disconfirmed. The objective of the thesis has been attained. The research results may be used for better understanding of the issue of oxygen administration to newborns in a hypoxic condition with regard to the findings of its toxicity. In order to secure adherence to the recommendations for oxygen administration to newborns, it is appropriate to create a nursing procedure and standard and secure its availability in every delivery room and station.
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