|
|
Fall risk assessment in the senior population.
Kovařčíková, Iveta ; Machač, Stanislav (advisor) ; Demeková, Júlia (referee)
The bachelor thesis focuses on a pilot assessment of selected tests for the prediction of fall risk in the elderly. The theoretical part deals with falls and their risk factors, the possibilities of assessing the risk of falls by means of functional tests and instrumental methods, as well as the possibilities of fall prevention. A total of 81 seniors (mean age 78.5±8.5 years) were included in the actual study, 78 of whom completed the entire follow-up. All probands completed The Timed Up and Go (TUG) test and subsequent gait and standing stability measurements via Oculus' Meta Quest 2 virtual reality (VR) headset using piloted apps designed by VR Medical. Incidence of falls was collected by telephone and email correspondence over the following 6 months. There was no statistically or substantively significant difference in the duration of the TUG test between the control group and the group of probands who suffered a fall during the follow-up period (12.9±6.9 vs. 11.5±5.0 s; p=0.99; Cohen's d=0.02). The probands in the control group who did not suffer a fall showed a higher step cycle time variability compared to the probands who suffered a fall (SD=0.54±0.40 vs. 0.38±0.55 s). However, the difference between the groups with and without a fall in step cycle variability was far from statistically...
|
|
|
Tools for identification and analyze risks in nursing practice.
PUCHNAROVÁ, Jana
Current state: Using tools to identify and analyse risks is presently very important in nursing to minimise the risk of harm to patients that can be prevented. The FMEA (Failure Mode and Effect Analysis) is a very efficient tool to address the failure issue. It is an important preventive method determining possible failures and proposing preventive measures to minimise the risk of errors. The RCA (Root Cause Analysis) is another important tool to handle failures. Objectives of the work: The objective of the research was to determine processes with the highest risks in nursing and to find out the most common risks associated with the nurse profession. Another objective is to describe the undesirable events reporting methods and to find out the utilisation of all risk analysis methods by nurses. And the final objective was to describe the intervention fall prevention programmes.Methodology: A qualitative research method was used to prepare the empirical part of the thesis. Data were collected using in-depth interviews. Qualitative data were coded using the pencil and paper technique; data were then categorised and respective subcategories were determined and shown in the SmartArt application. Research participants: Interviews were conducted with the head nurse, quality manager, senior nursing officer and departmental sister from the department of internal medicine, department of neurology and aftercare department. The first research was conducted in Nemocnice Jindřichův Hradec, a.s., the second in Nemocnice Tábor, a.s. and the final one in Nemocnice Písek, a.s. Results: It was found out from the results of the qualitative research that the most risky processes included medication in form of pills when, for example, generics drugs are given incorrectly or drugs of wrong strength are administered. The second risk process is the preparation of drugs from concentrated solutions of kalium, heparin or insulin. Administering intravenous drugs and infusion solutions is the third risky process. Too many activities of a nurse at one time is often the cause. Non-cooperation, poor communication of the patient and his/her family also lead to risky situations.Another serious group of risky processes includes patient transfer, moving the patient from a stretcher to a bed or going to the toilet. Further, it was found out that the most common risks are nosocomial infections, falls and decubital ulcers. Too much workload of nurses and new staff undergoing training are also mentioned as a risk. They include in particular medical assistants. Prescribing drugs through a computer system where the doctor relies on the nurse that she will alert when wrong drugs are prescribed although it is not her obligation to do so is also considered a common risk. Closing the infectious department in a hospital is the next risk. Patients who have a suspicion for certain diseases are then examined in a department. Nurses working there are afraid of getting infected from the ill person. And quite often, a disease is really found in the patients. Respondents gave different answers to the procedure of reporting undesirable events. The answers were different from one hospital to another. Nevertheless, all the reporting go to the hospital management that evaluates it. Nurses in the inquired hospitals do not use any risk analysis method. Not even nurses in management positions do not work with the methods and do not know the FMEA method. A direct analysis is addressed by the quality manager who most often uses the RCA analysis. Its results are discussed at meetings of nurses in the department, meetings of senior nursing officers or meetings of chief physicians. As for preventive programmes reducing the risk of falls it was found out that in all hospitals the screening of the risk of falls is standardly performed in all patients upon admission, except hospitalisations shorter than 3 days.
|
|
|
The influence of pregnancy on static and dynamic postural stability
Palanová, Alžběta ; Stupková, Michaela (advisor) ; Malá, Jitka (referee)
Title: Influence of pregnancy on static and dynamic postural stability Objectives: The aim of this thesis is to evaluate the influence of pregnancy on the static and dynamic postural stability using the dynamic computerized posturography. Another objective of this thesis is to determine which one of sensory inputs (visual, somatosensory, vestibular) plays the most important role in the control of postural stability during pregnancy with the help of various posturographic tests. Based on literature search to characterize changes in the organism of pregnant woman, which are responsible for postural instability in gravidity. Methods: One healthy pregnant woman was enrolled in this longitudinal study. She was evaluated in terms of static and dynamic postural stability using the dynamic computerized posturograph NeuroCom®. Posturographic tests were performed once every two or three weeks in the period from the 16th week of pregnancy until the 37th week of pregnancy and consisted of a battery of diagnostic tests of the module Smart EquiTest System. The data were processed in the program NeuroCom Data Analyzer. Results: The results demonstrate that there is an increased reliance on sensory inputs to maintain balance during pregnancy. Limitation of visual and proprioceptive components of stability...
|
|
|
The issue of nursing care about patients with geriatric fragility.
ŠINDELÁŘOVÁ, Renata
Bachelor thesis titled The issue of nursing care about patients with geriatric fragility is a theoretical work, that tries to catch and describe the most information about geriatric frailty and specifics of nursing care for geriatric patients, who are withering away. Geriatric frailty has significant influence on quality of seniors life who currently live longer. Because the population is getting older and number of geriatric patients is increasing and it will be stil in the future, the geriatrics and the gerontology began to focus on geritraic frailty in their research. The geriatric frailty is called "The Holy Grail" of this medicine that tries first to maintain the longest possible psychical and physical senior activity and to turn away institutionalization of geriatric patient mainly by appropriate interventions in the provision of comprehensive nursing care. The aim of great effort in this work was to map and find out all details not only about geriatric frailty, but also about areas with influence on the emergence and development of the geriatric frailty and also on quality of senior life. Geriatric frailty does not have set definition yet and it is not now known if it is a syndrome, a symptome or a medical diagnosis. Involution, that goes along and has significant influence on men's life, causes natural biological aging process of organism, which is manifested by decrease or loss of functional human reserves. If these reserves are also influenced by inner factors for example multimorbidity or undesirable effects of medicaments or external factors, where we put malnutrition, sarcopenia, cognitive deficit, inactivity, instability but also loneliness, excessive load, inappropriate housing and insufficient financial income, than the "spiral of deteriorating" is developing and heading towards disability, immobility and danger of senior life. It is necessary to add that senior with geriatric frailty may not be always ill but he wither away. So effort of my thesis is to bring meaning and impact of "geriatric frailty" and "spiral of deteriorating" in the seniors life, that are not in the awareness of medical staff who provide nursing care to seniors (Kalvach, 2008). Geriatric frailty is getting worse by its progressivity and causes emergence of other syndromes, of which the most serious are immobilization syndrome and terminal geriatric deterioration followed by death. We need the presence of three basic characteristic of five to diagnose geriatric frailty in the eldery. It is malnutrition, sarcopenia, self-reported exhaustion, reduced level of mobility and weakness. As already said geriatric frailty is now the main theme of geriatric medicine, gerontologists and geriatrists, and because it can meaningfully contribute to providing of nursing care with propriate interventions, I tried in my thesis to determine specifics of nursing care focusing on areas, which have significant influence on emergence and development of geriatric frailty. It is primarily nutrition, rehabilitation nursing and motivation of frailty seniors, but also decubitus, falls and injuries of patients, inappropriate communication with elements of ageism or sleep disturbances can affect the emergence of frailty. The result from acquired information is that the main goals of nursing care for patients with geriatric frailty are to make eat, get to go and motivate patient. Effort this thesis is not to disparage present nursing care for geriatric patients, but to explain and give information about the necessity of greater focus of nursing care on risks mentioned above. Nursing care will have to make certain changes, as well as the geriatric medicine is adapting to the population aging and geriatric frailty. If this bachelor thesis will enrich awareness of nurses and other members of multidisciplinary team with problem of geriatric frailty, specifics of nursing care of patients with geriatric frailty, attitude and motivation of these risk patients, then the.
|
guest ::
