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Influence of early antibiotic treatment on lower airway microbial colonisation in patients receiving mechanical ventilation
Kroupová, Alžběta ; Duška, František (advisor) ; Kukol, Václav (referee)
AJ Introduction: Ventilator-associated pneumonia (VAP) is a significant source of morbidity and mortality among patients undergoing mechanical ventilation. Its development is preceded by colonization of the lower respiratory tract with pathogenic bacteria. The purpose of this study was to investigate how antibiotic therapy administered for non-pulmonary infections affects the colonization of the lower respiratory tract compared to patients not receiving antibiotics. The hypothesis is that antibiotic treatment reduces colonization of the lower respiratory tract but increases the occurrence of multidrug-resistant bacteria. Methods: This was a retrospective observational cohort study conducted on critically ill patients hospitalized at the Department of Anesthesiology and Resuscitation, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady. This study is part of an ongoing project aimed at improving the quality of care and preventing VAP in intensive care unit patients. Patients had to meet certain criteria: they had to be on mechanical ventilation for more than 48 hours, have no pre-existing pulmonary diseases upon hospital admission, and not be immunocompromised. The primary outcome was the difference in the proportion of patients with positive microbiological...
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Oral hygiene care for ventilated patients. What is the influence on microbiome of respiratory tract?
Lišková, Marie ; Rambousková, Kateřina (advisor) ; Kukol, Václav (referee)
This diploma thesis deals with the influence of oral hygiene care on the microbial colonization of respiratory tract of the patients with secured airways. The aim was to find out whether the microbial population of the respiratory tract will change after the introduction of a new procedure in oral hygiene care. The assessment was based on the examination of aspirates taken from hospitalized patients in intensive care. In these patients, the incidence of ventilator-associated pneumonia was also assessed in connection with oral hygiene. Research has shown that there has been a reduction in the occurrence of potentially pathogenic microorganisms in the respiratory tract following the introduction of the new procedure. There was no reduction in the incidence of ventilator-associated pneumonia.
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Intra Aortic Balloon Counterpulsation from the Perspektive of Nurse in the Intensive Care Unit of Cardiac Surgery
Ebertová, Barbora ; Sojková, Monika (advisor) ; Kukol, Václav (referee)
The thesis is focused on the intra-aortic balloon counterpulsation (IABP) from the perspective of nurses in the cardiac intensive care. It consists of two parts. Theoretical and empirical. The theoretical part will deal with the intra-aortic balloon counterpulsation, including basic anatomy of the heart and blood vessels, the principle of IABC, its indications, contraindications, technology IABC and specific nursing care of patients with established IABC. The empirical part is treated as quantitative research, which is used for the data collection method anonymous questionnaire. The aim of the thesis is to determine nurses' knowledge of IABC in the cardiac intensive care and subsequent drafting of guidance for postoperative cardiac surgery department KARIM University, Prague. In this section are also included important questions and answers from the perspective of the specified variables obtained from the questionnaire and subsequent actions arising in practice. Key words Counterpulsation, Cardiac cycle, Aorta, Heart, Nursing care
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Attitudes of health care professionals in intensive care to patients after suicide attempt
Kukelková, Petra ; Kukol, Václav (advisor) ; Di Cara, Veronika (referee)
The thesis focuses on the attitudes of health care professionals in intensive care to patients after a suicide attempt. First chapter deals with suicide issues in detail, outlines sources of emotional problems and stress which can health care professionals encounter. The next chapter talks about burnout syndrome. The research part surveys the attitudes of healthcare professionals to suicidal patients, investigates the level and effectiveness of the awareness of health care professionals in the psychiatric and psychological issues and its impact on their attitudes, assesses awareness of burnout syndrome and eventual respondent's own experiences with this condition and evaluates the degree of mental and emotional demands of care of suicidal patients. On the qualitative research in the form of semi-structured interviews participated 20 respondents. We found that the attitudes of health care professionals to patients after a suicide attempt are rather positive. A surprising finding was that 70 % of respondents didn't receive any seminar or course focused on topics mentioned above, and that none of them are actively interested in the specific issue of psychiatric intensive care of patients with somatic disease and neither the issue of suicides. A disturbing finding was that 85 % of respondents observed...
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Nursing Care in Patient with Acute Myocardial Infarction
Němec, Pavel ; Hošťálková, Monika (advisor) ; Kukol, Václav (referee)
This thesis deals with the issue of acute myocardial infarction in context of prehospital, and hospital care. Specific clinical symptoms, diagnostic procedures, and treatment of acute myocardial infarction are described in the theoretical part. The part is also devoted to nursing care. Emphasis is put especially on prevention of cardiovascular diseases development. The goal is to evaluate nursing care of patients with acute myocardial infarction in prehospital, and later on, hospital care. The empirical part is divided into two sections. First contains a quantitative research, based on 2012 - 2014 statistics of Emergency Medical Service of the Pilsen Region. This statistics deals with myocardial acute infarction rate at prehospital care patients. The second section contains a qualitative research. Two case studies with different progress of patients suffering with acute myocardial infarction are studied. The result of this thesis is a description of nursing care in prehospital and hospital care of patients with acute myocardial infarction. Separate results of the thesis are summarized and compared in a discussion in the closing part of the thesis. Key words: acute myocardial infarction, interventional treatment, nursing care, nursing diagnose, interventional treatment, patient.
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Nursing care measures in the prevention of ventilator-associated pneumonia
Kukol, Václav ; Heczková, Jana (advisor) ; Feixová, Dagmar (referee)
The thesis is focused on ventilator-associated pneumonia and its possible preventive measures during nursing care. In the theoretical part of the work we have included chapters on nosocomial infections emphasizing on the etiology and epidemiology of ventilator-associated pneumonia and its clinical manifestations. We have analyzed the issues of artificial airway management with a detailed focus on the peculiarities of nursing care of the ventilated patients. There, we focus primarily on the care of the patients oral cavity, respiratory tract and the ventilation circuit. A big chapter is dedicated to preventive measures and to the possibilities of prevention in the nursing practice. The empirical part includes research on preventive measures that are implemented in practice and comparative analysis of the measures between different facilities as well as their compliance to the guidelines. We have also determined the level of VAP awareness and its prevention among the nurses. KEYWORDS nosocomials infections, nursing care, prevention, ventilator-associated pneumonia
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Intra Aortic Balloon Counterpulsation from the Perspektive of Nurse in the Intensive Care Unit of Cardiac Surgery
Ebertová, Barbora ; Sojková, Monika (advisor) ; Kukol, Václav (referee)
The thesis is focused on the intra-aortic balloon counterpulsation (IABP) from the perspective of nurses in the cardiac intensive care. It consists of two parts. Theoretical and empirical. The theoretical part will deal with the intra-aortic balloon counterpulsation, including basic anatomy of the heart and blood vessels, the principle of IABC, its indications, contraindications, technology IABC and specific nursing care of patients with established IABC. The empirical part is treated as quantitative research, which is used for the data collection method anonymous questionnaire. The aim of the thesis is to determine nurses' knowledge of IABC in the cardiac intensive care and subsequent drafting of guidance for postoperative cardiac surgery department KARIM University, Prague. In this section are also included important questions and answers from the perspective of the specified variables obtained from the questionnaire and subsequent actions arising in practice. Key words Counterpulsation, Cardiac cycle, Aorta, Heart, Nursing care
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NURSING CARE OF PATIENTS WITH HEMATOLOGICAL MALIGNANCIES IN THE INTESIVE CARE UNIT
Dolinská, Michaela ; Hošťálková, Monika (advisor) ; Kukol, Václav (referee)
NURSING CARE OF PATIENTS WITH HEMATOLOGICAL MALIGNANCIES IN THE INTENSIVE CARE UNIT Michaela Dolinská, DiS. ABSTRACT Overall survival and quality of life of the patients with malignant diseases, especially with hematological malignancies, have improved significantly in the last years. Early diagnosis and aggressive treatment, including the hematopoietic stem cell (bone marrow) transplantation modality, have led to the increase survival rate of such patients. Simultaneously, these opportunities generate increasing number of individuals requiring the intensive care due to various complications of malignant disease and/or its treatment. This bachelor thesis is designed as theoretical-empirical study. The theoretical part provides the review and analysis of current literature and discusses particular specifics of nursing care of patients with hematological malignancies in the intensive care setting. Pancytopenia- associated immunosuppression and infection risk, the need of barrier-approach principles of nursing care will be described. Next, bleeding conditions and restricted transfusion politics, telling unfavorable information to the patients and their families and last but not least the palliative care principles are reviewed too. The empirical part of the thesis is processed as the qualitative research in...
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