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Work management of nurse in the ordinary of praktitioners
VAŇHOVÁ, Romana
Primary health care is an intrinsic part of health care system in all developed countries. The purpose of primary care is to provide preventive, diagnostic and therapeutic care. Primary care requires a very high level of cooperation, especially between the doctor and the nurse. The activities of a nurse in a general practitioner's office can be divided into several basic areas. The first corresponds to tasks for which the nurse has work competence, however, other areas include managerial, social and societal responsibilities. A nurse in primary care is the most professional person responsible for implementation of health education. and contributes thus to reducing the incidence of the disease and mortality from chronic diseases. The aim of this diploma thesis was to map the management of nurse working in the general practitioner's office, to map the visiting care for patients in the home environment and to find out the needs of patients in the home environment. The empirical part of the research was conducted using qualitative research survey, using the technique of in-depth semi-structured interview. The research group consisted of nurses working in general practitioners' surgeries, patients who are visited by general practitioner nurses and carers who take care of their loved ones in their natural environment. The research survey showed that nurses in general practitioners' surgeries do not have enough information about the current legislation needed to ensure the operation of the surgery. They lack suitable professional courses, such as resuscitation course, computer course, communication or management course. They would also welcome education on social issues. Research on a group of patients confirmed the benefits of staying in the home environment with the emphasis on meeting their needs. A research survey of a group of carers revealed high burden for carers who care for their loved ones in their home environment. A nurse practitioner plays a key role for both groups. He/she is often the first person the patient or his family talks to. Often, patients and families communicate their feelings and pleas to nurses rather than doctors. Given that patients and their families currently prefer home, it is important that the responsible nurse has highly versatile capabilities. The results of the research survey showed that nurses in general practitioners' surgeries would welcome the possibility of further comprehensive education. Therefore, a proposal for courses in lifelong learning for nurses was created within the diploma thesis.
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Nursing management for patient with acute confusion
FORMÁNKOVÁ, Hana
Delirium, also known as acute confusional state, is a qualitative disorder of consciousness, that often occurs in the elderly persons, intoxicated persons and post-surgery conditions. This diploma theses deals with the issue of nurse work management for patient with delirium. The main goal of the thesis was to find out what experiences with the patients with acute confusion nurses have, as well as how the care of such a patient affects the nurse's psyche and how a nurse should proceed in the care of a patient who is experiencing acute confusion. The goals were accomplished through the qualitative research survey. The data collection technique involved covert observation of patients and nurses, as well as semi-structured interviews with nurses who have experienced the care of patients with acute confusion. Attractive results have been achieved through the research. The nurses were relatively unaware of the differences in the nomenclature of acute confusion and delirium. On the other hand, nurses were aware of the symptoms of acute confusion / delirium. They had a good knowledge of the interventions that should be performed in these patients. Most of them were able to adjust the communication to the right extend so that it was suitable for a patient who was experiencing acute confusion / delirium. Nurses were able to treat the patient kindly despite their current inappropriate behavior. When we asked the nurses about specific interventions for these patients, their awareness was not good, therefore we decided to create a brochure that could help the nurses in their care. Awareness and use of rating scales was very low, rating scales designed directly for delirium were not used anywhere. The use of restrictive measures was often abused. But some nurses were also found to be wary of unnecessary use of the these funds.
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Social support of nurses
Němcová, Naďa ; Štefančíková, Mariana (advisor) ; Mareš, Jiří (referee)
Author: Naďa Němcová Institution: Charles Univerzity in Prague, Faculty of Medicine in Hradec Králové, Department of Social Medicine, Department of Nursing Title: Social support of nursing Supervisor: PhDr. Mariana Štefančíková, Ph.D. et Ph.D. Number of pages: 227 Number of encloures: 13 Year of defense: 2017 Keywords: social support, nurse, adaptation process, supervision, psychosocial intervention care, peer support, nursing management The bachelor thesis deals with the issue of social support nurses. The theoretical part describes the concept of social support and possible sources of social support. Further, it highlights the positive and negative aspects of social support human life. The second chapter deals with the professional social support that general nurses in the exercise of his profession. The concept of professional social support related to external conditions that have nurses available, ie., they are given in the work environment. In the empirical part, a combination of qualitative and quantitative surveys. Research on social support, and how to support nurses perceive, evaluate and use is made by semi- structured interviews, these are complemented by a questionnaire surfy. The obtained data is processed using the phenomenological description, open coding and triangulation.
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Selected risks in nursing practice
HLADÍKOVÁ, Šárka
Current state: High percentage of risk is associated with providing medical care and therefore it may harm both the patient and the nursing staff (Drahoš, 2007). Objectives: To assess the most frequent risks in nursing care that may harm patients during their hospitalization. Furthermore, the aim is to find out whether the occurrence of these risks changes depending on the type of care provided and also whether the nurses' understanding of the principles of administration of oral medication is affected by the length of their work experience. Methods: The empirical part of this thesis was based on the quantitative research study - data collection method via structured questionnaires. The study was then supplemented by observation of nurses using the audit technique. The research group-participants: The questionnaire was designed for general nurses working in selected wards of Ceske Budejovice Hospital, plc. During the Semester-in-Practice Externship, six nurses in 'The administration of oral medication'audit. Results: The result of the aritmetic mean, results in the nurses stating the risk of fall in patients as the highest risk (3,56), risk of medication error (3.01). According to the addressed nurses from the internal department, the following risks belong to the group of the most significant risks to the patients of the internal department- risk of injury to the patient during hospitalization, risk of nosocomial infection, risk of falls in patient and risk of immobilization syndrome. According to the questionnaire research results, some differences were shown in the knowledge of principles of safe administration of oral medication in connection with the length of work experience of the addressed nurses. Nurses with the longest practise (over 11years) most frequently chose the correct answer in the following parts: expired drug usage and checks, medical refrigeration temperature, preparation and disposal of left-over medication, how to care for tablet splitter, correct action taken when a patient refuses to take medication and filling in the daily medication report. On the other hand, nurses with practise of 5-10 years more often correctly answered questions regarding drug administration system, safe usage of medical trolley cart and optimum storage conditions in medicine fridge. Nurses with the shortest work experience (under 5 years) proved to have the weakest knowledge of administration of oral medication. A conclusion that can be drawn from the audit results is as follows: the most common errors committed by the nurses are usage of generic drugs, lack of hand disinfection, touching medication with bare hands, preparation of meds in corridors instead of at the patient's hospital bed and incorrect drug disposal when the left-over tablets were put back in the packet. Conclusion: From the statistically significant connection between the probability of the risk and the department (type of care), it came to light that risk of injury to patients during their hospitalization, risk of nosocomial infection, risk of falls in patient, risk of immobilization syndrome and risk of aggressive behaviour are more common risks in internal wards rather than in surgical wards. Nurses with work experience over 11 years proved to have the best knowledge of principles of safe administration of oral medication. The audit proved that despite their good knowledge of safe drug administration procedures, the nurses do not always follow these in the workplace. My thesis is a proposal for standard care procedure 'administration of oral medication'.
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Utilization of the role of a nurse as a decision-maker in practice in connection with provision of quality nursing care
STEHLÍKOVÁ, Jaroslava
The thesis attempts to outline the extent to which the decision-making role of nurses is utilized, and the main factors that affect decision-making of nurses within the scope of provision of nursing care. The research has found out that nurses utilize their decision-making role to an insufficient extent hence the sense and purpose of decision-making must be emphasised again. This task may be assumed by managing nurses. Managing nurses may also contribute by more effective defending of competences of nurses. From the factors needed by nurses for effective decision-making, attention should be paid particularly to education. It is necessary to make possible for nurses to extend their knowledge and thus to obtain theoretical insight (e.g. in respect of decision-making) to be used by them while providing care to a patient/client.
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Requirements for changes in nursing care on the part of top management
PŘIBYLOVÁ, Kateřina
Requirements for changes in nursing care on the part of top management Abstract At present, nursing care has been experiencing a great progress. Implementation of the nursing process as a working method has been striven for. The educational system for non-medical workers has been changing. Nurses holding top managerial posts should have competence to lead and manage people effectively in the ever changing nursing environment. To acquire information necessary for achievement of the set goals, a quantitative research was employed. Within the framework of the quantitative research, the questioning method using a questionnaire was selected. The questionnaires concerned were sent to top managers among nurses and doctors working in medical centres all over the Czech Republic. The thesis had three objectives defined. First, to discover what prerequisites top managers miss to be able to implement the changes concerned in the area of nursing care. Second, to discover top managers´ opinions on the system of nursing care provision. Third, to identify differences between requirements for the nursing process method on the part of top managers {--} nurses and top managers {--} doctors. Based on these objectives, four hypotheses were formulated. The hypothesis no. I: The current situation does not allow top managers operating in health service to implement changes in nursing care in practice. This hypothesis has been confirmed. The hypothesis no. 2: Top managers do not require group nursing care as a prerequisite for the implementation of nursing care changes. This hypothesis has not been confirmed. The hypothesis no. III: Representatives of nurses in managerial posts promote the nursing process application as a prerequisite for changes concerning nursing care. This hypothesis has been confirmed. The hypothesis no. IV: Representatives of medicine doctors in managerial posts do not promote the nursing process application as a method of nurses´ work. This hypothesis has not been confirmed. As far as the results of this diploma thesis are concerned, we were trying to outline possible solutions of the issues concerning changes in nursing care. Top managers are recommended to stimulate critical thinking in their employees in the course of work in the nursing process. It is beneficial to improve communication on the managerial level in hospitals, and in addition, to obtain feedback from subordinates with respect to continuing education, to identify effectiveness and needs relating to education on the part of employees and to enable them to participate in the process of the respective changes implementation. To train function nurses in such changes management. To implement a programme aiming at continual quality improvement.
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Position of the head sister viewed by a medical sttaf member
LUKÁŠOVÁ, Věra
The position of the head sister viewed by a medical staff member My thesis examines the position of the head sister from the viewpoint of staff nurses both in state-run and private health care facilities. It gives insight into contacts between the head sister and staff nurses, especially if staff nurses are informed enough about the head sister´s duties. The results obtained in state-run and private health care facilites are compared. The following hypotheses were set: H I - staff nurses get into a personal contact with the head sister at least twice a year; H II {--} staff nurses are informed about the duties of the head sister ; H III {--} staff nurses working in hospitals, Inc., get into personal contacts with the head sister more often than staff nurses working in teaching hospitals. I set up thirty questions to address the issues of the position of the head sister in the hospital management and her duties. To obtain as much as possible information and to involve as many as possible respondents, the quantitative method of a questionnaire was used. The questionnaire consisted mainly of closed and semi-closed questions .One open question was also included to enable the respondents to express their own opinions. Respondents from the teaching hospital in Plzen and several other hospitals in the Plzen region ( the hospital Primaved, the Mulac hospital, the hospital in Stod, the hospital in Domazlice) took part in the investigation. The results of the investigation were processed in two phases: first the overall summary of all the replies was made and in the second phase the replies of the particular groups of respondents were evaluated separately. The investigation shows that staff nurses come into contact with the head sister and are familiar with her duties. The same conclusion was reached by comparing the replies obtained from staff nurses working in both kinds of hospitals, state-run and private. The results suggest that stuff nurses in both kinds of hospitals are thus well informed about the position of thehead sister. The objective of the investigation was achieved. The hypotheses I and II were confirmed, the hypohtesis III was not confirmed. The conclusions of the investigation will be presented at a workshop in the teaching hospital in Plzen with the approval of the head sister.. If the medical periodical is interested the conclusions will also be published there.
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