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Nursing care of surgical wounds on a surgical department
OCHMANOVÁ, Miroslava
The thesis deals with the care of surgical wounds in a surgical department. The aim of this thesis is to map a nursing care of surgical wounds in a standard surgical department and in an intensive care unit. Also it tries to answer what aids nurses have at their disposal in the individual surgical departments and then to compare all the parameters with each other. The following research questions were created from the aims: How do nurses treat a surgical wound in a standard surgical department? What kind of aids for nursing wounds do they have available in a standard surgical department? What are the differences in a care of surgical wound in a standard surgical ward and in an intensive care unit? What are the differences in aids for nursing wounds in a standard surgical ward and in an intensive care unit? We chose a qualitative method for the research survey. The data collection was carried out in the form of a semi-structured interview in a total of 14 addressed nurses. Seven of them work in a standard surgical department and the remaining seven nurses work in a surgical intensive care unit. From the interviews we can conclude that the process of nursing care of surgical wounds in both wards are mostly performed according to the recommended practice. The biggest difference in the care of the surgical wounds is in the care of the scar. The difference comes from different parameters of each wards. In the intensive care unit patients are hospitalized after major operations and they are then transferred to a standard surgical unit and after all this they are released to a home care. There were not found any differences in the aids which they are using for care of surgical wounds in each wards. The results of the survey can help students in preparing for future careers and to improve the awareness of nurses in the care of surgical wounds working in surgical departments.
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The quality of nursing care in aseptic treatment of operative wounds
KARŠULÍNOVÁ, Pavla
The present diploma thesis deals with the quality of nursing care in aseptic treatment of surgical wounds. High quality nursing care is desired in order to satisfy patients' needs. Equally high level of quality is required from the healthcare organizations where patients are treated. The diploma thesis is divided into two sections: a theoretical section and an empirical section. The theoretical section focuses on surgical wound, its healing, aseptic care, complications of wound healing, nosocomial infections, quality of nursing care, nursing care indicators, and quality of health care from the patient's point of view. The empirical section's aim is to evaluate the quality of nursing care in selected surgical departments. The thesis aims to answer two research questions: 1) How do nurses employ the aseptic technique when changing a surgical wound's dressing? 2) Nurses must enhance their expertise in surgical wound care. How do head nurses at selected surgical wards secure the aforementioned training? A qualitative research survey was used to process the empirical part of the thesis. Semi-structured interviews with ward managers and head nurses were conducted for data collection. The nurses answered 20 questions each. During the interview, valuable answers were provided by 17 nurses. The results indicate high quality of nursing care in aseptic treatment of surgical wounds, as nurses employ modern trends and techniques in surgical wound care; the high quality of nursing care is reflected in the minimally occurring complications that affect surgical wounds. Aseptic approach is a priority for the nurses working in the wards where the research was conducted. Nurses follow standardized procedures for aseptic dressing of surgical wounds. The head nurses and ward managers consider education of nurses in the issue of aseptic treatment of surgical wounds to be of the utmost importance, and they supervise or arrange education in aseptic care of surgical wounds for nurses on a regular basis. The information obtained in the research can serve as a basis for seminars on aseptic treatment of surgical wounds.
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Nursing care for clients with surgical wound healing using vacuum therapy in gyneacological and obstetric practice.
VOPÁLKOVÁ, Natálie
This thesis deals with nursing care for clients with healing of operation wounds using negative-pressure wound therapy in gynaecology-obstetrics practice. Negative-pressure wound therapy is a modern wound-healing method that has spread to other areas of medicine. One of them is the field of gynaecology and obstetrics. The thesis is divided into two parts, theoretical and empirical. The theoretical part contains a description of the history of wound healing and negative-pressure wound therapy, skin anatomy, classification and phases of wound healing and current trends in wound healing. The theoretical part also offers a description of the use of negative-pressure wound therapy in wound healing in gynaecology and obstetrics and the role of the midwife in care for a client using negative-pressure wound therapy. Two goals were selected in the empirical part - to outline the experience of midwives with the use of negative-pressure wound therapy in gynaecology-obstetrics practice and to discover the features specific to nursing care for clients with applied negative-pressure wound therapy. We wanted to find out whether midwives had experience with negative-pressure wound therapy and whether they knew the concrete features specific to nursing care for these clients. Based on these two goals we designated two research questions. What experience midwives have with the use of negative-pressure wound therapy in gynaecology-obstetrics practice, and what features specific to nursing care for clients with applied negative-pressure wound therapy they mention. The research investigation was conducted in a qualitative form using a semi-structured interview. The research cohort consisted of 10 informants working in gynaecology-obstetrics departments. The first research question considered what experience midwives have with the use of negative-pressure wound therapy in gynaecology-obstetrics practice. The research investigation showed that all the informants asked had experience with the use of negative-pressure wound therapy in gynaecology-obstetrics practice, most often for abdominal laparotomies, specifically for operation wounds following abdominal hysterectomies, caesarian sections, wound dehiscenses, and poorly healing wounds in the abdominal area. The second research question was to find out what specific features midwives mention for nursing care of clients with applied negative-pressure wound therapy. The research investigation showed that mobility, hygiene, diet and care for operation wound have specific features for the nursing process for clients with applied negative-pressure wound therapy. So the research investigation showed that all the informants asked were familiar with negative-pressure wound therapy, and they had experience with nursing care for these clients. But only some could describe the preparation of all the necessary aids for first application and dressing of an operating wound with negative-pressure wound therapy. Some informants could not describe the actual process for dressing of an operating wound with negative-pressure wound therapy. They also struggled to name the restrictions that clients have with this therapy and explain their solutions. The reason for this may be the fact that this method for healing non-healing operation wounds is not used routinely and on a day-to-day basis in gynaecology-obstetrics practice.This thesis resulted in two information maps for midwives working at gynaecology-obstetrics departments. The first information map shows the preparation of aids for the first application and redressing of negative-pressure wound therapy, and the second information map shows comprehensive nursing care for clients with applied negative-pressure wound therapy, including instruction. The results of this thesis may also be used as the basis for expert lectures, conferences and seminars for midwives.
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Importance of enzymatic solutions (Enzymel) in postoperative treatment of upper respiratory tract wounds
Šimurdová, Marcela ; Tomová, Šárka (advisor) ; Nikodemová, Hana (referee)
Bakalářská práce Význam Enzymelu v pooperačním ošetřování ran v horních cestách dýchacích 1 Abstract Healing surgical wounds in upper respiratory tract is often difficult and painful due to constant presence of food (contamination), movements during talking and continuous presence of aggressive saliva. Most of the surgery clinics use natural solutions especially chamomile to accelerate healing and to remove patient's postoperative problems. Gel Enzymel parodont, which contains proteolytic enzymes and its application limits bacteria production and accelerates healing of the surgical wounds, hasn't been used in a clinical treatment in surgical ORL yet and its effects on healing haven't been studied. The theoretical part of this study is focused on a brief introduction of selected surgical procedures in upper respiratory tract and the corresponding nursing process including a summary of possible complications in the postoperative period. The empirical part of the thesis contains a summary of the results of non-standardized questionnaire survey, which was conducted on selected patients of the ORL (ENT) Clinic of Motol University Hospital. Using a surrogate survey of a selected group of patients (80 in total), data were obtained to compare the effectiveness of the investigated agents, especially in the area of...
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Nursing care of the operation area before and after the operation
KRATOCHVÍLOVÁ, Michaela
Theoretical outcomes The preparation of the operating field is an important part of all preoperative preparation. Preoperative preparation, before surgical intervention, cannot be neglected. In most cases, the doctor will not perform an operation without proper preoperative preparation. The only exception is urgent surgical intervention for which only the most basic preoperative preparation is provided. Preoperative preparation can be categorized as long-term, short-term, or immediate. A thorough and proper preparation of the operating field reduces any development of postoperative wound complications. The aim of thorough preoperative preparation of the operating field is to reduce any risk of developing postoperative wound complications. Postoperative care prevents postoperative complications. It is aimed at controlling the state of a patient's current health after surgical intervention, but also the surgical wound and its dressing. Both nurses and doctors are obliged to perform these controls. In the early postoperative period, the client stays in the ward or in the postoperative room. In the case of arising complications during surgical intervention, the client is moved to the ICU/ARO. The Aims of the Thesis The aim of the thesis is to map the differences in preoperative preparation of the operating field among surgery departments, and to find the differences between preparation in the operating field before a scheduled and an urgent surgical intervention. Furthermore, the aim is to find out if nurses perform preoperative and postoperative care properly. The following questions were chosen: What are the differences in preoperative preparation of the operating field among surgery departments? How do nurses perform preoperative and postoperative care of the operating field? Implemented methods In order to gain the desired information, a qualitative form of research was chosen, namely an in-depth interview method, a method of questioning, and an observational method. Observation was implemented using the hidden observation method. The respondents in the research were the nurses from the urology and the surgery departments at a hospital in Vysočina. Data collection was conducted from February to March, 2014. The acquired data was then analyzed through an open coding method. Results The subsequently transcribed interviews and observations were carefully analyzed using the 'pencil & paper' method and open coding. Eventually, five categories were created: preoperative preparation before a scheduled surgical intervention, preoperative preparation before an acute or urgent surgical intervention, preparation of the operating field, postoperative wound care, medical documentation. Conclusion The research suggests that nurses are well aware of the complete preoperative and postoperative care. What is, however, surprising is how adherence to the principles of barrier care and the client's intimity vary in the course of providing this care.The conclusions in this thesis should aim at an improvement of preoperative and postoperative care of a client and to eliminate any discovered shortcomings in the provided nursing care. The practical outcome of this thesis will be an article in a professional magazine for nurses.
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Nursing Care of Patients with Infectious Complications after Total Hip or Knee Endoprosthetic Replacement Nursing Care of Patients with Infectious Complications after Total Hip or Knee Endoprosthetic Replacement
BREJŠKOVÁ, Soňa
Infectious complications belong to the most serious problems after endoprosthesis implantation. Their solution is very demanding for its surgical and psychological aspects with regard to its devastating effects and uncertain prognosis. The percentage of infections complications fluctuates between 0.5 and 2 % nowadays. From nurse?s point of view the care about these patients is very demanding and has its exactly defined specifics. The aim of the thesis was 1: To map the knowledge of the causes of occurrence of infectious complications after TEP of hip or knee joint among nurses. 2: To map the knowledge on nursing care of patients with infectious complications after TEP of hip or knee joint among nurses. 3: To examine adherence to aseptic procedures in caring about patients with infectious complications after TEP of hip or knee joint. Three research questions were set to reach the goals: 1. What is the extent of knowledge of the causes of occurrence of infectious complications after TEP of hip or knee joint among nurses? 2. What is the knowledge of specific care of patients with infectious complications after TEP of hip or knee joint among nurses? 3. What is the extent of knowledge of specific needs of patients with infectious complications after TEP of hip or knee joint among nurses? 4. To what extent nurses adhere to aseptic procedures in caring about patients with infectious complications after TEP of hip or knee joint? Qualitative research was applied to elaboration of the thesis. Semi-structured interviews and involved observation were the data collection methods and techniques. The research was performed at the infectious disease department of the České Budějovice Hospital. The survey was anonymous, the interviews and observation were conducted from 1 to 25 February 2013 . The research has shown that nurses know the causes of infectious complications occurrence after TEP. It is also obvious that nurses are aware of the specifics of nursing care about these patients and they also have theoretical knowledge of the needs. However the analysis of the replies has revealed that nurses have problems with applying some nursing procedures, namely becauseof partial ignorance, uncertainty and impossibility to try some procedures. The results have also shown that all the nurses try to saturate physical needs of patients but not all of them are able to saturate patients? physical needs as they mentioned in their replies and as we could observe. These are particularly drawbacks in communication in the field of motivation, mental support and self care support. We have also found that most of the nurses adhere to aseptic procedures in nursing care of patients with infectious complications after TEP, but the results have also revealed weak points. More than a half of the nurses of the monitored sample fail to perform hygienic disinfection in compliance with the standardized technique and a third of them do not disinfect their hands even before the act. We have found further drawbacks particularly in handling sterile and biological material. The research results have shown that despite lack of information and experience the nurses proved their general knowledge of care about these patients in their replies. However there is still a lot to learn, both theoretically and practically. This thesis was written to bring basic outline of the issue of infectious complications after total endoprosthetic replacement so as it can be used as information material for both, experienced or starting nurses that are in contact with patients with infectious complications after TEP. A multidisciplinary seminar aimed at the issues of infectious complications after total hip or knee endoprosthetic replacement (see Annex 12) is the practical output of the bachelor thesis
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