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Patient as a partner in the hygienic hand desinfection program
FRISCHOVÁ, Kristýna
The bachelor thesis deals with the issue of hygienic hand disinfection, its development, importance in healthcare, prescribed principles and techniques. The theoretical part also includes knowledge of prescribed disinfectants, their types, properties, requirements for them and placement in facilities providing health care. The second part deals with improving the quality of nursing care through the involvement of the patient and family members in the hygienic hand disinfection program. The information contained in this work was obtained exclusively from domestic or foreign literature. The practical part of the bachelor thesis is quantitative research, which also consists of two parts. In the first part, a survey using a non-standardized questionnaire was used as a data collection technique. In the second part, structured observations were used to collect data. The aim of the research was to analyze the current situation in the field of hygienic hand disinfection in patients in a selected hospital. Theoretical knowledge and practical skills were examined. The research was carried out in the surgical department and rehabilitation department of a regional hospital. The results of the research showed that the success rate of the questionnaire survey and observation is below 50 % in both cases. It was found that 44.0 % of respondents are sufficiently informed about the issue of hygienic hand disinfection and the process of hygienic hand disinfection was performer adequately by 33,0 % of respondents.
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Use of barrier nursing care techniques in outpatient services
ŠAFÁŘOVÁ, Marie
This bachelor's thesis is about using barrier nursing care techniques in outpatient services. The first part describes the present situation, which includes single techniques of barrier nursing care, namely mechanical washing of hands, using personal protective equipment, disinfection, sterilization, and manipulation with used medical materials. The next part of the thesis is about applicable legal norms which are related to these issues. The thesis also has a part about the role of the nurse in outpatient services and the nursing process. The separate chapter is also devoted to nosocomial infections. In the second part are definitions of three targets. The first is to find out which types of protective equipment are used by nurses in outpatient services. The second target is to find out how nurses use hand hygiene techniques and the third is to find out which way nurses are manipulating used medical materials. The third part describes research methods. For qualitative research, the investigation was by deliberately selecting seven outpatient services in the territory of the capital city of Prague. The data collection technique is a semi-structured interview and participatory observation of a nurse working in outpatient services. The research was focused on the use of protective equipment, hand hygiene by nurses, and manipulation of used medical supplies. The fourth part contains the results of the research investigation, which are analyzed in the subsequent discussion, which provides a comparison of current legislation, literature, and results from practice. The conclusion of this thesis is that some techniques of barrier nursing care, namely proper hand hygiene, use of protective equipment, and compliance with some legislative standards in the field of prevention of the risk of infection, are not yet so included in the automatism of nurses working in outpatient services. The output of this thesis is a draft of a workshop on the topic of the thesis, especially hand hygiene and prevention of infection transmission.
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Problematic of nursing care for the covid of a positive patient
MARKOVÁ, Monika
The Bachelor thesis deals with the problematic of nursing care for the covid positive pacient. Covid-19 is a highly infectious respiratory disease transferred from human-to-human by airborne droplets with SARS-CoV-2 coronavirus. The first symptoms may appear as a common cold in the form of coughs and runny nose. In case of dyspnea and difficulty with breathing, hospitalization is necessary. The aim of the bachelor thesis was to map the problems in the care of a covid-19 positive patient. The practical part was processed using qualitative research. The research group consisted of seven nurses who care for the covid-19 positive patients. Data were collected using a semi-structured interview. Questions were created for the nurses with focus on the chalanges that the nurses perceived in the area of biological, psychological and social needs of covid positive patients. Based on the conducted interviews and the collected data, the results were processed by open coding into seven categories. The results of the research survey found that the biggest obstacle in the care of a Covid positive patient is the lack of communication between staff and patients in the area of psychological needs. In the area of social needs, the need for social contact between positive patients and their loved ones and the complete lack of it is the biggest problem. Nursing care itself is very specific. Strict principles of barrier nursing care must be followed in covid-positive patient environment. According to the research results, in the area of biological needs, the respiratory care and the patient's airway care are the most crucial. According to the informants, it is possible to use positioning, where the patient changes his position at regular intervals and consequently relieves himself from shortness of breath. Based on these results is created seminar material for medical staff caring for patients with covid-19. The seminar is focused on caring for the needs of covid positive patinents.
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Problematics in Nursing Care of Venous Catheters
CHMELÍČKOVÁ, Anna
The aim of this thesis, Problematics in Nursring Care of Venous Catheters, is to map and create a material for informational and studying purposes in caring of venous catheter. The first goal was to focus on venous catheters. The chosen ones were central venous catheters and peripheral bloodstrem catheters and in both cases were chosen its representatives and were described. More detailed were described nursing care of venous catheters and then single aspects in nursering care of specific catheters. Important to mention is sharing information and new ways of applying venous catheters like Peripherally inserted central catheter (PICC) and intravenous port, both inserted into central venous and Midline catheter, which is in the group of peripherally inserted ones. The rest of the thesis was focused on the main aim of this paper - Problematics in Nursering Care of Venous Catheters where the first part was concerned with describing the biggest problems, like for instance, catheter infection including infectious flebidities and catheter related bloodsterm infections. These complications were described thoroughly with corresponding impacts for both the patient and health service provider. Catheter infection is a complication which nurses can easily prevent, because the prevention of this problem is to hold up to the standard of barrier nursing care, strict aseptic rules and/or awareness of nursing staff and patients about this problematic. The amount of risk of inserted venous catheters is always present. Therefore, the intend and main focus of this thesis is to take in consideration potential risks and complications while not using the mentioned preventive measures and moreover discussion on the importance of prevention associated with nursing care of venous catheters. Information about venous catheters, their attendance and nursing intravenous catheters were found in academic papers, database PUBMED, academic reviews, Bulletin Ministry of Healthcare, nursing standards, Clinical Practice Guidelines and on website of Association for intravenous ports and permanent catheters.
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Selected infectious illnesses - procedures of emergency medical service
SVOBODOVÁ, Adéla
This bachelor thesis is dealing with problems of selected infectious illnesses and procedures of emergency medical servise during dealing with infectious patients. We want to achieve the summary review about selected infectious diseases with the context of the laws in the Czech republic. An important part of this thesis is charting of possibilities of prevention of infectious diseases in conditions of emergency medical service. The thesis is aimed on 4th biological agens of the highest biological safety level against which do not exist any effective treatment. These includes viral hemorrhagic fevers, variola and equine morbilli virus. The selection was decided of division according to valid notice in the Czech republic, which these illnesses graded among the most dangerous. The first part of the thesis contains to complex spreading and transmission of infectious diseases. This part can be use for better understanding and orientation in the following chapters of thesis. The next chapters deal with the aforementioned selected infectious illnesses, barrier nursing care ( focused on emergency medical servise). There are also described primary protective equipment of paramedic and the basic role of the Biohazard team of Jihočeský kraj, which is an important part of the system solution for infectious illnesses. The issue of the thesis id the so-calles The ten proceeding againts infectious illnesses. The effort includes supplemental photographs, which are gained during visits of emergency medical servise and some hospital departments. In the attachement there is a recommendation of Regional Hygiene Station for safer and easier dealing with infectious patients.
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The quality of nursing care at selected department subsequent care
KRATOCHVÍLOVÁ, Eva
Current state: The goal of nursing is a quality of nursing healthcare. Each department has its own specific features and therefore has its own quality indicator. This work focuses on two quality indicators related to healthcare, specifically on patients with MRSA infection and their falls. Methodology: In the research were applied three methods of data collection: 1) statistical data from the hospital system; 2) intentional structured observation; 3) structured interviews. Research file: In order to evaluate the incidence of falls and cause of falls, were examined a total of 85 patients and a total of 98 patients for evaluation of decolonized patients with MRSA infection. The investigated group of people for observation and in-depth interviews were ONP nurses from the 6th floor of České Budějovice Hospital, plc. Results: The hypothesis that the most common cause of the fall is leaving the bed without any accompaniment has not been confirmed and the incidence of falls at the patients throughtout the observation period of the year 2015 dropped down significantly in comparison with the year 2014. The most common source of MRSA infection was a wound. Also, has not been confirmed the hypothesis that the number of decolonized patients with MRSA infection who were observing in the year 2015 will be statistically higher than in the year 2014. Most nurses know the cause of MRSA infection, but the problems they have are the precise definitions. By observing the practical activities and skills of nurses during the treatment of patients with MRSA infection were revealed certain shortages, especially the improper use of protective equipment and the improper disinfection of aids after their use. Conclusion: The results of the research show the need for more nursing education in this subject. Adverse events are a serious complication of the nursing process. The number of falls as well as the number of decolonized patients with MRSA infection is not successful significantly decrease in comparison year-on-year. The research also found inadequate theoretical preparedness of the nurses in the area of infectious diseases and a certain discrepancy between verbally presented experiences and the results of observation real activities.
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The issue of nursing care in patients with Clostridium difficile
ŠEDIVÁ, Ilona
Nosocomial infections, which do not often relate to the diseases are increasing nowadays. Clostridium difficile belongs to the frequent nosocomial infections and it is known as post-antibiotic colitis. The main reason of colitis is the usage of antibiotics, especially broad-spectrum antibiotics. The thesis is divided into the theoretical part and practical, as well. Theoretical part describes the division of the nosocomial infections, infection of the intestinal tract, anatomy, physiology of the intestines and infectious diarrhoeal diseases. The thesis is subsequently aimed to the clostridial infections and precautions against the spread of the disease. Practical part is aimed to the knowledge of the nurses, skills and attitude towards this issue.The thesis uses quantitative investigation and technique of the questionnaires, hidden observation of the nurses working on the selected wards and additional interviews with head nurses. The research was conducted in hospital in Tábor, a.s. The questionnaires were distributed on the surgery, orthopaedics, surgical JIP, ARO, ONP, infective ward, rehabilitative ward, TRN, cardio JIP, internal ward-cardio, internal ward-gastro. The thesis was formed from 143 questionnaires and 171 questionnaires were distributed. Hidden observation was made by head nurses from individual wards and it was logged to the relevant observation sheets.From existing findings we can say that there exist specifics of nursing care at the patient with the clostridium difficile. Among to these specifics we can cite the barrier nursing care where we can include the isolation of the patient, disinfection and hygiene of hands,using protectors, appropriate usage of laundries and infectious waste, location of the patient according to the epidemiological perpective and individualization of the tools for the patients. From another investigation ensue that the nurses keep barrier nursing care, superficial disinfecion, decontamination of the tools. From the results is evident that the nurses do not know the methods of the transmission of the clostridial infection. On the base of another investigations we have found out that the nurses do not know principles of the barrier nursing care. In conclusion is it possible to say that the nurses do not have so extensive information, that are essential for care for the patiens with clotridium difficile. In order to care for these patients in right way is neccessary to know principles of the barrier nursing care and keep them all. Keeping the principles of the barrier nursing care is crucial step in preventing the transmission nosocomial infections. The results will be provided to the officials of the individual hospital´s wards as an option of improvement in caring for the patiens with clostridial infection. The results were partially presented at a conference in Tabor´s hospital in May 2014. We recommend to re-train the staff of the hospital, which would be specifically aimed towards the principles of the barrier nursing care and towards the disinfection and decontamination in related to the nosocomial infections. On the base of these findings was made a proposal of the nursing care standard, which would specify and unite the care for the patiens with clostride infection. Subsequently, it would be apropriate to repeat the research in 1 2 years and than both researches compare together.
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Barrier nursing care for surgical operating theaters
BOŠKOVÁ, Marie
This work is focused on the principles and implementation of barrier nursing care in operating theaters. The theoretical part describes the principles of hygienic and aseptic principles during perioperative care, as well as the organization and coordination of work in the operating rooms, legislation, management, quality monitoring of perioperative care, a single barrier methods, in which there may be the most common errors made by nurses. In the second, empirical part of the work the compliance with the principles of hygiene regime for surgical operating theaters with perioperative nurses to determine their knowledge of the principles of barrier nursing care, and look for the most common causes of violations was verified. For the research portion the following objectives were provided: 1st to identify the knowledge and awareness of perioperative nurses in the principles of barrier nursing care in operating rooms 2nd at the selected sites to verify compliance with the principles of barrier nursing by perioperative nurses 3rd identifying potential problems in the principles of barrier nursing care from the perspective of perioperative nurses What conditions medical facilities are making for perioperative nurses to the principles of barrier nursing care and what is the impact of sociological data of individual nurses, especially the length of practice, qualifying and specialized education of errors in the observance of hygienic mode, we examined using qualitative research using participant, covert observation and semi-standardized interviews with nurses, which also formed the research group for covert observation. Using interviews we learned from individual nurses, how they perceive using of the principles of barrier nursing care, and how it may be affect by themselves. The results of the research point to the origin and the most common causes of errors in the principles of barrier nursing of perioperative nurses. The combination of both research methods allowed us a comparison between theoretical knowledge claims of individual nurses and their actual behavior while respecting the principles of barrier nursing care at work in the operating theater.
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Sticking to the principles of berrier nursing care as a prevention of infectious diseases transmitted by blood in selected wards.
CANDROVÁ, Eliška
The topic of this bachelor's thesis is "Compliance with the principles of barrier nursing care as a prevention of infectious diseases transmissible by blood in selected wards". The important part of nurses' work includes complying with the principles of barrier nursing care. By following these principles we prevent the transmission of nosocomial infections as well as professional infections transmitted by blood. The theoretical part of the thesis describes infectious diseases transmitted by blood, especially viral hepatitis B, viral hepatitis C and AIDS. Another important chapter describes barrier nursing care. The aim of this thesis was to conduct a survey of nurses' compliance with the barrier nursing care principles in relation to the prevention of infectious diseases transmissible by blood in selected wards. The survey was carried out quantitatively, by the method of involved, hidden, direct observation. The observations were conducted from November 2013 to March 2015 and continuously recorded into a recording sheet. The survey was carried out in a selected hospital, where a total of 121 nurses in twelve wards were observed. Based on the results it is evident that the nurses do not fully respect the principles of barrier nursing care in all areas surveyed. The results of this thesis will be given to the head nurse of the hospital where the observations were made, and will serve as a basis for detecting weaknesses in compliance with the principles of barrier nursing care related to the prevention of infectious diseases transmissible by blood.
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The comparison of nursing care for clients with MRSA at the ICU and standard unit
AMBROŽOVÁ, Martina
This thesis deals with one of the most important multidrug-resistant infection ?MRSA. Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen that has the ability to spread very fast. Infections caused by MRSA are always associated with high mortality. An antibiotic resistance is a reason for twice increased morbidity, it prolongs hospitalization of patients, thus significantly increases the costs of health care (European Antibiotic Awareness Day, 2012). The costs spent for the prevention of multidrug-resistant infections represents less than 20% of the cost needed to treat patients suffering this infection. Among the risk factors associated with the emergence of MRSA infection or its carriage include a long stay in the hospital, especially the ICN, invasive procedures, antibiotic treatment, diabetes mellitus, chronic renal failure associated with dialysis, and skin disease. There is a usual transfer by hands of nursing staff, but the transfer via the air can not be excluded (Maďar et al., 2006).There were set four objectives for the study. The first goal was to determine whether there are differences in the principles of barrier nursing care for patients with MRSA in hygiene, eating, emptying and the re-bandaging at intensive care units (?ARO? and ?JIP? departments) and standard units. The second objective was to map the availability of protective equipment for staff in particular departments. The third goal was to find out differences in knowledge of the nursing staff on the issue of MRSA at various departments. The fourth objective was to determine how the various departments involve families of the patients with MRSA in the treatment process.Study conclusions show differences between particular intensive care departments. There is the best provision of barrier nursing care at the ICN ? ARO in all explored parts. The research found there is the possibility of isolating patients with MRSA on a separate stall or room in all departments. There were deficiencies in barrier nursing care related to ICN ? JIP and standard units. Than survey found out there are some standard units and ICN ? JIP, where there are used decolonization neither in health care and nor in re-bandaging of patients with MRSA. In the case of specific nutrition of a patient with MRSA there are not properly distinguished and disinfected used tools in these departments. Regarding the specifics of emptying of patient with MRSA there are usual mistakes made by respondents from ICN ? JIP and standard units in the procedure of handling infectious biological waste. A positive result is unlimited availability of protective equipment for particular departments. However, there are the standard units where the use of protective equipment involves gloves only. Startling finding is the washing of hands before entering the room and after leaving disinfectant respondents from ICN ? ARO only. The knowledge of respondents on the issue of MRSA were at a very good level except one respondent from the standard department. There is an effort to involve the family in the treatment process in all departments. According to all respondents there is a great irreplaceable importance of the family during hospitalization of the patient.
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