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Nursing care about woman with diagnosis fetus mortuus in delivery room.
Rus, Alice ; Endlicherová, Jana (advisor) ; Kulhavá, Miluše (referee)
This bachelor thesis deals with the issue of dead fetus. The thesis has a theoretical and practical part. In the theoretical part, the terminology distinguishing birth and abortion, delivery of a dead fetus including the appropriate use of epidural analgesia are analyzed in individual chapters. I also deal with psychological issues that occur during childbirth. The last chapter of the theoretical part is devoted to social and legal support. The practical part is devoted to cases from the birth hall, where I analyze a particular case from the delivery room. The main emphasis is placed on the importance of the nursing process in the care of a woman with a suitable determination of nursing diagnoses and their complete realization. The output of my bachelor thesis is a recommendation for a practice devoted. The work as a whole is intended for midwives and midwifery students. The bachelor thesis is supplemented by annexes for clarity. keywords: Nursing proces, stillbirth, delivery room, perinatal death
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Nursing care of the patient with ischemic heart disease
Šedová, Lenka ; Heřmanová, Jana (advisor) ; Jirásek, Vít (referee)
Autor práce: Lenka Šedová Vedoucí práce: Mgr. Jana Heřmanová Odborný konzultant: MUDr. Vít Jirásek Téma práce: A Nursing Care of the Patient with Diagnosis Coronary Artery Disease after Surgery Abstract: The aim of the work is to report on the case of a 79-year-old patient after cardiac surgical intervention. The surgery was indicated for coronary artery disease. The clinical part deals with the characteristics and stages of ACD. It also deals with the diagnosis and treatments of UP (unstable angina). The next part describes the patient's hospitalization. The last part describes the palliative care of this patient, his psychological rehabilitation and his return to daily life. The nursing history is formulated according to the theory of Virginie Henderson. An important role in the reduction of complications is the education of patient. Key words: ACD, UA, nursing proces, Henderson's theory, aortocoronary bypass, Warfarin, methods of invstigation, self-sufficiency, self-care
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The use of rateing scales in the department of subsequent care
JINDRLOVÁ, Lenka
Current Situation: Rating scales help nurses judge the patient´s health condition objectively. Via rating scales it is possible to state the areas of a patient´s needs and plan interventions leading to solutions of his or her problems. In after-care departments, patients who have already had their basic diagnosis set and their health-condition stabilized, are hospitalized. In this department, nursing care as well as rehabilitation nursing, physical and mental activization, nutrition care, rehabilitation, and professional ergotherapy, are provided (Doležalová, 2011). The aim of this research was to determine the range of use of rating scales in after-care departments, to describe the content of individual rating scales, to find out about the nurses´ perspectives on the advantages of rating scales for practical use, and to evaluate the complexity of nurses´ work with rating scales. Methodology and Research File: The research was implemented via the method of a qualitative survey using in-depth interview, rating scale content analysis, and nursing documentation content analysis. Interviews were carried out with five nurses working in the after-care department. Content analysis was focused on 5 rating scales used by the nurses when planning nursing care, and 10 chosen complex pieces of nursing documentation. The results prove clearly that the nurses use Bartel´s test of basic every-day activities to evaluate the patient´s self-sufficiency when carrying out everyday activities. Norton´s redesigned scale serves the determination of decubitus formation, risky factors of a fall to identify the risk of the fall, evaluation of nutritional status to determine malnutrition risk, and pain evaluation and monitoring. Screening is carried out in all patients accepted at the department up to 24h after having been accepted, at a change of health- situation in a patient, and in regular intervals once a week. Pain is evaluated daily. The nurses´ point of view is positive towards the first screening, but rescreening is evaluated negatively by the participants, especially in self-sufficient patients. The results also prove that nurses´ work with rating scales is incomplete and not complex. It was found out that formal recording requirements were not followed, concerning corrections of record errors, marking all points in rating scales and a correct point sum. Re-screening is not always done in regular intervals, nursing intervention planning in relation to the observed risks and re-screening are insufficient. Conclusion and Practical Use: The results of the submitted qualitative research may not be generalized. To verify our conclusions it would be suitable to implement a quantitative study the aim of which would be to evaluate the complexity of rating scales, based on a wider file of closed or open pieces of nursing documentation. With regard to findings of an incorrect evaluation of rating scales, there was an expert seminar held in the after-care department, through which the nurses were introduced to rating scales, their use and working with them. Survey result presentation was a part of the educating programme.
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Nursing Documentation in Selected Countries
ČERNÁ, Simona
This thesis deals with nursing documentation in the Czech Republic and Germany. Nursing documentation is an inseparable but also independent part of medical documentation and the specifications of its keeping is both in the Czech Republic and Germany based on law. Nursing documentation should reflect the level of provided nursing care and serve to promote its quality. In the introduction of the theoretical part the term of nursing documentation based on the law of the Czech Republic and Germany is defined. Due to the fact that nursing documentation is a part of medical documentation itself the term is explained, too. The following part is concentrated on a detailed analysis of single steps of nursing process because it should serve as a basis for the further control work with it. The law defines the minimal requirements for the nursing documentation which is each medical facility due to fulfill. In order to complete the idea of this thesis, two objectives have been set. The first one is concentrated on nurses´ opinion collection about work with documentation in the selected medical facilities in the two selected countries. The next aim is to compare nursing documentation in the selected medical facilities in the two previously mentioned countries. Furthermore, two research questions have been formulated: What is the view of nurses in the Czech Rebublic and Germany in selected hospital departments on work with the documentation? What is the difference in the documentation in the selected departments between the Czech Republic and Germany? The practical part summarizes the results of qualitative research, which have been obtained by a semistructured interview and by the anylysis of the documentation. The first part of the research consists of the interviews with nurses, which have been recorded by indirect transcription and further processed through the open coding method. Additionally, pencil and paper method was used to unify the answers which were followingly organized into categories and subcategories through the technique of opened coding. The second part represents the anylysis of Czech and German nursing documentation. Both research questions have been answered through the proceeding of the research. The research of the first research question shows that Czech nurses see the documentation as neccessary evil, they do not use it an active way. Furthermore, they have answered that recording of all procedures related to the patient is done additionally. However, the German nurses have stated a steady presence of the documentation during the errands. The main reason for that is a possibility of immediate recording after a procedure which allows not only to make the documentation more effective but also provides the safety for the patient. Next, they state they have all the neccessary information with them. In addition, they share the idea that a high-quality nursing care cannot lack high-quality nursing documentation. The main difference between the two hospitals is that the German one performs open nursing documentation audit. This means that the management controls mainly if what has been written has been done, specifically nursing interventions carried out in patients who are still hospitalized. Nevertheless, the Czech hospitals conduct closed nursing documentation audit, which does not force them to use the documentation in a more active way. Next, the majority of the nurses have agreed on rising amount of paperwork.The second research questions have been answered through the analysis of the documentation. This meant a comparison of the documentation in the selected countries. The subject of the analysis was the nursing anamnesis, nursing care plan, its realization and nursing discharge summary. The German documentation for the nurse contains more points they must go through than the Czech one.
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Tick-borne encephalitis - life with the consequences
ŠTIBINGEROVÁ, Jana
This thesis charts the course of the tick-borne encephalitis since the beginning to the eventual consequences that the illness had left and that the patient must live with. Ixodes ricinus, tiny parasites carrying the disease called encephalitis, is no longer present only in the wild, but also in city parks or in our gardens. Every year, many cases of this disease occur across groups of all ages. It is an inflammatory disease of the central nervous system caused by viruses. Disease is usually divided into two phases, where the first stage is similar to spring-summer influenza with different length of quiescent phase, in the second stage exacerbation occurs. At this stage, the patient is struggling with high temperatures, headaches, severe pain in muscles and joints, vomiting and disorders of consciousness. Correct diagnosis is specified after sampling of cerebrospinal fluid through a lumbar puncture. Patients with confirmed tick-borne encephalitis are hospitalized in isolation wards, not because of the spread of the disease, but for the experience of doctors. Here they are isolated in the rooms, which can have a detrimental effect on their psyche. Treatment follows after discharge from the hospital, and often takes several months. The aim of this study was to map the progression of the disease from its beginning, through time spent in a hospital bed, followed by home recovery up to the present. A very important part in the return-to-health process has the nurse, and therefore this paper tries to describe her role in treatment of patients with tick-borne encephalitis. Given that there exists a specific prevention in form of vaccination, the next objective was to verify the vaccination on samples of the population in the Česke Budějovice and Gmünd, Austria, and to compare these two groups of respondents. The survey of the thesis was carried out from August 2015 to April 2016 using a combination of qualitative and quantitative methods. Qualitative data were collected through semi-standardized interviews with nine respondents, who were recruited through social networks with the help of gatekeepers. Quantitative data was collected via short survey distributed in Česke Budějovice and Gmünd, Austria. The results of the qualitative part were processed through coding and compiling of diagrams, from which the answers of individual respondents can be deducted. Evident is the whole course of the disease from the beginning up to the present. Data from the quantitative section were arranged into tables and then statistically evaluated. Based on the results, the frequency of vaccination of specific groups can be compared and therefore campaigns on health protection against tick-borne encephalitis can be targeted effectively.
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Values of live in nursing process
KRISLOVÁ, Anna
This work is aimed at the life priorities of a patient within the context of nursing. The research is focused on the ideas of general nurses of the preferred life priorities of a patient, if there are differences in the ideas of general nurses and the preferred life priorities of a patient, if general nurses take interest in the life priorities of a patient and if they include the work with life priorities within the nursing process. In order to do the research, the method of quantitative collection of data was used, with the aid of the questionnaire technique. Two questionnaires were formed. The first questionnaire, of my own making, for general nurses was distributed among nurses working in hospitals in the area of the city of Plzeň. The other questionnaire, of my own making, for patients was distributed among patients hospitalized or visiting particular departments in hospitals in the area of the city of Plzeň. The research was carried out with the approval of the head nurse. Four aims of this Bachelor's Thesis were stated. The first one aims at assessment of nurses' ideas of the life priorities of a patient and if they consider these an important part of the nursing process. The second aim deals with the question if general nurses are willing to include the work with the patient's life priorities within the nursing process. The third one focuses on the conditions that general nurses have in order to include the life priorities of a patient within the nursing process. The fourth aim deals with the differences between the life priorities preferred by patients and ideas of general nurses of patients' life priorities. General nurses mostly consider life priorities of a patient an important part of the nursing process and most of them are willing to include the work with life priorities of a patient in the nursing process. Patients mostly perceive the care of their life priorities from nurses' side as insufficient. Although illnesses have changed patients' life priorities, some of them could have become unaccomplished, not all general nurses are interested in each patient's life priorities. There have been differences between life priorities preferred by patients and ideas of general nurses of life priorities of patients. The specific theories have been affirmed: T1: General nurses consider working with life priorities of patients as important. T2: General nurses are willing to include the work with life priorities of patients into the nursing process, if certain conditions are granted. T3: Work with patients' life priorities within the nursing process is more frequently influenced by working conditions of general nurses than life priorities preferred by patients. This Bachelor's Thesis may be used when teaching students preparing for the a non-physician medical profession. It may be recommended to general nurses as well as management workers as a tool of increasing the quality of nursing care within psychosocial care.
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Hormonal treatment in women, prejudice and awareness
BUDÍNOVÁ, Eva
Hormonal treatment is an essential component in treatment of a modern woman. But yet it is disputed and perceived negatively in women owing to prejudice and poor awareness of the issue. The lack of information or information obtained from non-professional sources cause prejudice and the negative perception that is difficult to refute. The data were collected using a quantitative as well as qualitative examination. The quantitative research was made through an anonymous questionnaire in the gynecologist{\crq}s office of MUDr. Koubková in Tábor. The questionnaire gathered identification data and general knowledge on hormone therapy. 110 questionnaires were handed out and 95 were included in the questionnaire. The qualitative examination was carried out in the form of an interview with the nurses from the gynecologists´ offices in Tábor. The thesis gives a survey of the awareness of treatment and the reasons for its refusing, which was its main target. The five single goals that had been set were accomplished by the research results. Five hypotheses were stated. The first, second and third hypotheses were to confirm the premise that women tend to have a negative attitude towards hormonal treatment and they refuse hormonal treatment on account of prejudice. These hypotheses were confirmed. The negative attitudes and hormonal treatment refusal stem from the lack of information or the information obtained from wrong sources. Prejudice is caused by inaccurate information obtained from non-professionals. The fourth and fifth hypotheses were to confirm the presumption that highly educated women have a more positive approach to hormonal treatment than those with basic education, and that the education level has an influence on the attitude towards hormonal treatment, and that women of a lower age are more open to hormonal treatment than middle-aged or elderly women. These hypotheses were not confirmed. Four hypotheses were determined. Questions 1 and 2 examined the women{\crq}s problem taking hormone therapy. Questions 3 and 4 investigated the way a nurse participates in giving information on hormone therapy in the gynecologist{\crq}s office and the way this shortage of information can be made up. All of the questions were answered by the results of the research. The results of the research show that women, while seeking information, address their questions to physicians, but also to their friends, or check the Internet for information. Those who influence their decision making in the respect of hormonal treatment are their partners, friends, media and others. Women confirmed that they have lack of information and are interested in obtaining more information about hormonal treatment. Prejudice and the negative attitude to hormonal treatment originate from lack of information. Hormonal treatment is an indispensable part of the care for a modern healthy woman. It is necessary for women to have access to all the information available to prevent them from the influence of incorrect information and prejudice. The results of the research will be used to make health care personnel familiar with the questions of unawareness and the influence of prejudice on women so that the situation could improve in this respect.
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The aplication of transfusion in a nursing proces
VĚTROVCOVÁ, Hana
Blood transfusion treatment can safe life of many patients and yet it may cause justified anxiety. A qualified and educated nurse taking care within the treatment not only for biological needs but also the psycho-social ones may by means of the right manner of communication moderate this anxiety. When applying blood transfusion it is necessary to adhere to standard procedure, to presume possible complications, to prevent them and thus protect the client. In case the undesirable reaction occurs, it is necessary to commence timely the right treatment, to clarify the cause of the occurrence of the reaction and prevent its re-occurrence. Maintaining maximum safety the rightly indicated transfusion is the most effective treatment for the patient. One of the goals of the paper was to determine particulars of transfusion application in adults and in children in practice and to show possible risk factors that might complicate transfusion therapy. The other goal aimed at determining the recent years changes in the process of transfusion application. The third goal aimed at describing competences of nurses applying transfusion in practice. The quantitative data collection method by means of anonymous questionnaires was applied for the research. The questionnaires were distributed to nurses in South Bohemian hospitals, Nemocnice (hospital) České Budějovice a.s., Nemocnice (hospital) Písek a.s., Nemocnice Prachatice a.s. The nurses' responses were analyzed and compared with standards of the corresponding hospitals. Based on the research results it can be stated that H1: Application of transfusion in children and adults has its particulars. H2: In recent years no changes in transfusion application have been confirmed. H3: The nurses' competences in applying transfusion are sufficient. In connection with the research particular processes in application of transfusion were determined in children and adults, such as the procedure of the biological test, the amount of transfusion preparation and psychological preparation. At the same time some weak points in the nurses have been discovered. The paper may be used for the nurses as a comprehensive information material on transfusion therapy. Based on the results suggestions for nurses in hospitals have been formulated concerning seminars and lectures to deepen knowledge of nurses in order to increase quality of nursing care and thus protection of the client.
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