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Selected nursing services in the context of Evidence Based Nursing
KRATOCHVÍLOVÁ, Gabriela
The thesis deals with the issue of selected nursing processes in the context of Evidence Based Nursing. The process in question is the care of central venous entry and peripherally placed central entry in relation to the incidence and prevention of central line associated infections. One of the aims of this paper is to map and analyse information on central line entry care. Other objectives are to determine which central line entry care is most effective in relation to infection incidence and to provide an overview of the interventions provided in central line care that are absolutely necessary and essential. The thesis is divided into several chapters which are structured around Evidence Based Nursing. The chapter describing the current state of the art outlines Evidence Based Nursing, invasive admissions and catheter infection. Chapters dealing with the education of general nurses in relation to central line nursing competency are presented, the area of infection and its prevention, the site and method of central line insertion, the type and characteristics of the central line catheter, dressing and draping techniques, disinfection, and the issue of flushing and needleless entry are discussed. The last chapter reviews education, care training and training in the care of central venous accesses. The information sources were searched from all over the Word in scientific databases. Several recommendations for practice have been established based on the development of this thesis. The thesis can be used as educational material and be an inspiration in the issues of different practices and education in this field.
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Problems of dosing during aplication gravity infusion.
PAVLOVÁ, Šárka
This bachelor thesis deals with the issues of gravity infusion dosage. The thesis is divided into a theoretical part, which describes the infusion therapy, techniques of infusion and invasive inputs. Two research goals were set - to map the differences in the incidence of errors in the dosing of gravity infusions in relation to the focus of the field of nursing (surgical and internal medicine) and to find out the specifics of the work of a nurse in the application of gravity infusions. In terms of the first goal, the hypothesis was set: H1: There are differences in the incidence of errors in the dosing of gravity infusions in relation to the focus of the field of nursing (surgical and internal medicine). The second goal is related to two research questions, RQ1: What are the principles of gravity infusion? And RQ2: What are the major problems with gravitational infusions? The research survey of the quantitative part took the form of a questionnaire on the social aspects, with a total of 105 respondents. The results were graphically processed and supplemented with verbal commentary. The hypothesis was verified using a chi-square test. For the H1 hypothesis, the chi-square test result was p = 1.70 %, which was compared with a significance level of 5 %. The result therefore shows that HA is right: There is no difference in the incidence of errors in the area of gravity infusion dosing in the surgical and internal medicine departments. The qualitative part of the research took the form of a non-standardized structured interviews with four nurses working in the internal medicine or surgery department. This part was used to get acquainted with the principles of application of gravity infusions and fundamental problems in the field of infusion therapy. Research has shown that nurses do not have enough information about the possibilities of calculating the rate of gravitational infusion, or do not use it due to its length or complexity. This bachelor thesis can serve as an inspiration for nurses to provide quality nursing care for patients.
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Problem of sepsis in the intensive care unit
Škrabánková, Hana ; Marková, Eva (advisor) ; Jankovcová, Kateřina (referee)
The aim of the thesis was to determine the microbial colonization at the injection site of central venous catheter and its possible influence to maintain the lowest incidence of catheter sepsis. The culture results of skin swabs and taken blood cultures from two groups of patients were compared with each other using qualitative analysis methods. Those were Intensive Care Unit patients with established central venous catheter. The result was the discovery of microbial colonization of the skin and the representation of different pathogenic strains at the site of a central venous catheter for both established groups. Further showed that the higher the risk of microbial colonization with symptoms of catheter sepsis was seen where patients have central venous catheter established for longer period of time and have been treated under home parental nutrition program with stoma. The recommendation is the continuous education of health professionals to act in accordance with the latest preventive treatment recommendations, and the emphasis is mainly placed on hands cleaning and disinfecting as the hands of health professionals are one of the most common and risky way of transmission of pathogenic strains with potential nosocomial infection formation. Aseptic principles must be repeatedly communicated to all...
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Nursing care of vascular access focused to prevention of catheter sepsis
Prošková, Michaela ; Heczková, Jana (advisor) ; Chvojková, Kateřina (referee)
Ensuring the bloodstream is one of the most frequently indicated invasive procedures, especially in the pre-hospital emergency and intensive care. All invasive inputs are nowadays an integral part of intensive care. Despite careful daily care, vascular accesses are at risk of complications, which annually effects many patients institutionalized at intensive care units. Catheter sepsis is undoubtedly one of the most serious. Although a significant proportion of these infections are considered highly preventable, they still contribute to high morbidity and mortality among these patients. The aim of this diploma thesis is to analyse nursing care for vascular inputs. One of the partial goals is to evaluate and compare the relevance of the nursing standard of a medical facility with scientific knowledge and current recommendations of professional societies. The research method is a quantitative questionnaire survey focused on nursing staff working in the Department of Anesthesiology and Reanimation. The analysis of the vascular inputs re-dressings was performed in patients hospitalized in the same ward, where the research itself took place. The results of the research survey show a discrepancy between the given procedure in the nursing standard and common practice in the ward. In view of the...
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Complications of central venous catheters applications 2011 CDC guedelines
Šťastná, Monika ; Michálek, Pavel (advisor) ; Hocková, Jana (referee)
In the presented diploma thesis I deal with the issue of proper insertion of short-term central venous catheters, adherence to procedures by medical and non-medical staff according to CDC guidelines 2011 during insertion and subsequent treatment in intensive care in a faculty-type medical facility. The aim of the diploma thesis is to determine the occurrence of complications, especially infectious, the level of adherence to recommended procedures in practice according to 2011 CDC guidelines, central venous catheter manipulation, comparison of real activities with recommendations and mapping the level of knowledge of non-medical staff about short-term central venous catheters. The theoretical part deals with the importance of clinical guidelines, central venous catheter in general, complications associated with the central venous catheter and prevention of infectious complications of invasive inputs. For the empirical part of the diploma thesis, a prospective non- randomized observational study of cannulation and possible complications associated with a short- term central venous catheter according to CDC 2011 guidelines was chosen to determine real procedures for insertion, treatment and removal of a short-term central venous catheter. This was supplemented by an exploratory questionnaire survey of...
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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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