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Systematic evaluation of quality of palliative care in the Czech Republic
Žáčková, Lucie ; Loučka, Martin (advisor) ; Vosečková, Alena (referee) ; Dobríková, Patricia (referee)
In both the social work and health sector, there is an increasing emphasis on monitoring and improving the quality of care and services provided. In both areas, quality standards are already established in wider practice and attention is therefore focused on monitoring the quality of services and care at a system level. However, this requires the availability of appropriate tools. This also applies to palliative care, which is developing rapidly in the Czech Republic and whose need will continue to increase as a result of the prolongation of life expectancy. The theoretical part of this dissertation shows, through the example of palliative care, the deeper interconnection of the social and health spheres. It occurs thanks to its holistic approach to the patient and the irreplaceable role of social workers in a multidisciplinary team. There is also a growing demand in palliative care for systematic quality monitoring and improvement of care and services. The theoretical part summarizes knowledge regarding the development and use of quality indicators, presents examples of systematic quality measurement in palliative care abroad and compares their strengths and weaknesses. The empirical part deals with the creation and subsequent pilot implementation of a methodology for assessing the quality of...
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The role of preventive colonoscopy in the detection of colorectal neoplasia.
Vojtěchová, Gabriela ; Zavoral, Miroslav (advisor) ; Rejchrt, Stanislav (referee) ; Falt, Přemysl (referee)
Colonoscopy is used in colorectal cancer (CRC) screening either as an independent screening method (screening colonoscopy) or following a positive result of a primary screening test (eg. fecal occult blood test, FOBT). Preventive colonoscopy is the collective name for screening and FOBT+ colonoscopy. Due to the considerable variability in the detection of colorectal neoplasia between individual endoscopists, colonoscopy quality indicators were introduced. Adenoma detection rate (ADR) and polyp detection rate (PDR) are defined as the proportion of colonoscopies in which at least one adenoma (for ADR) or polyp (for PDR) was detected to the total number of colonoscopies performed. ADR is considered a key indicator of the quality of colonoscopy. Adenoma per colonoscopy (APC), defined as the total number of adenomas detected relative to the total number of colonoscopies performed, is the most accurate indicator currently available. However, APC limit values have not yet been set. Both ADR and APC are validated indicators, but their evaluation is time-consuming and personnel-intensive, which limits their use in clinical practice. The main purpose of the presented work is to simplify the monitoring of colonoscopy quality by introducing a more user-friendly indicator, which does not require histological...
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Monitoring quality indikators of anesthesilogy care
Šimonová, Petra ; Jeřábková, Lenka (advisor) ; Dynáková, Šárka (referee)
Safety and quality of care are considered to be one of the main priorities in anaesthesia and their management and monitoring should be continuous and systematic. Quality indicators in anaesthesia must be frequently evaluated. Their evidence and evaluation create not only safe environment for patients but also continuously improve quality of anaesthesiologic care. The main objective of this diploma thesis was to evaluate patient's satisfaction with provided anaesthesiologic care, one of the main quality indicators in anaesthesia. Other objectives were research of quality indicators recommended in the Czech Republic and quality indicators recommended by foreign medical societies. The last partial objective was to create quality indicators checklist tailored for specific department of anaesthesiology based on collected data. Quantitative method research was conducted, using unstandardised questionnaire for patients, hospitalized and anaesthetised. 140 questionnaires were distributed of which 117 questionnaires returned. Based on objective the author of diploma thesis found out that Czech society of anaesthesia, resuscitation and intensive care determines quality indicators monitored in the Czech Republic. Quality indicators in foreign countries are in form of criteria that are necessary to adhere to....
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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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One instead of six: does the centralization of Emergency Medical Dispatch affect the quality of care?
Bradna, Jan ; Vrzáček, Petr (advisor) ; Franěk, Ondřej (referee)
This thesis engages in its theoretical part description of the process of pursuance and assurance of quality in emergency medical dispatch centre. There is also a comprehensive description of key quality parameters used in this environment in this part. The content of the empiric section is an organizational case study, which aim was to evaluate an extensive organizational change in emergency medical dispatch centre of the Emergency Medical Service of the Central Bohemian region and its impacts on the quality of care. The first phase of centralization of emergency medical dispatch centres in the Central Bohemian region went through during the first half of 2011. Four local emergency medical dispatch centres were gradually brought together into one entity. The aim of the research was to evaluate impacts of the organizational change on key quality parameters. The observational retrospective study consists of two groups of data, collected from identical area during two equivalent periods. Group A contains data from the period of six months before and group B contains data from the period of six months after the centralization. Key quality indicators were compared in both groups: response time; call processing times; safety of classification and indication of calls; use of dispatch life support and...
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Quality in Practice of Czech Music Therapists
Fajfrová, Jitka ; Vrzáček, Petr (advisor) ; Šimanovský, Zdeněk (referee)
Master thesis Quality in Practice of Czech Music Therapists deals with the theoretical and empirical research of the quality-in-practice-of-Czech-music-therapists phenomenon. This is realized both in the national and the European context. It develops the previous thesis Recent directions in Czech Music Therapy and focuses on monitoring the process of professionalization. Theoretical part of the thesis is divided into four sections. First section discusses the quality in general. It introduces systems of quality management and methods of detection. It gives an overview of the quality in the sectors of the economy where music therapy is implemented. Second section deals with the music therapy and especially the Czech music therapy. It replies the following questions: Who is music therapist? What are the recent directions of the music therapy? And the key personalities? It introduces current development stage in field: the stage of institutialization. Third section deals with the European music therapy and its relationship to quality. Fourth section monitors quality in the field of Czech music therapy and related expressive therapies. At the end there is a summary of some important questions and challenges for the future development of the profession. Empirical part is dedicated to qualitative...
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Patients satisfaction with the provided services. An important indicator of the quality of health care facilities.
MALANÍKOVÁ, Jana
My master's thesis which topic is "Satisfaction of patients with the services provided. An important indicator of quality of medical equipment " is mainly focused on satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. Furthermore, the mapping focused on overall satisfaction with care in the already mentioned Hospital České Budějovice and on exploring whether patients evaluate the quality of information provided by a medical doctor in this hospital affirmatively and whether they are satisfied with care of local nurses. The satisfaction of patients is an important indicator of the quality of care provided, which has an impact on their status of basic human needs. One main purpose was determined: Monitoring the satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. and this purpose was fulfilled. Quantitative research was executed, to its realization the interview method was used. By means of the technique of standardized anonymous questionnaires on the basis of the above-mentioned purpose,the 3 following hypothesis were verified: 1) Patients are satisfied with the overall care in the Hospital České Budějovice, a.s. 2) Interviewed patients evaluate the quality of information provided by a medical doctor in the Hospital České Budějovice, a.s. affirmatively 3) Interviewed patients are satisfied with the care of nurses in the Hospital České Budějovice, a.s. I processed the data to confirm or refute the pre-established hypotheses. The evaluation of the data was carried out using statistical nonparametric methods, Chi-square test and the chosen level of significance of p=0.05. The results of the research have been clearly processed into the tables and graphs. The program Microsoft Office Excel 2010 was used to process the results.
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The Swedish health care financing and quality analysis
Štrossová, Denisa ; Maaytová, Alena (advisor) ; Kubátová, Květa (referee)
This diploma thesis explains how the Swedish health care system is financed. First, the health care system in Sweden is introduced. Next part of the thesis analyses the health care foundation of Sweden. The important part of the thesis is the analysis of health care quality. This part includes the cost effectiveness analysis, which is compared with selected OECD countries. Finally few changes are recommended.
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