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The physical handling of the patient with self-sufficiency impairment in home care.
ZAVADILOVÁ, Leona
The Bachelor thesis deals with the physical handling of a patient with a self-sufficiency disorder in home care. It defines physical handling as part of everyday nursing care. It presents the care of patients with self-sufficiency impairment in rehabilitation treatment using the kinaesthetic concept and handling aids. Unskilled handling carries risks that can negatively influence the physical and psychological well-being of all involved. The aim of the study was to investigate the use of handling aids in home care when physically handling a patient with impaired self-sufficiency. The research questions focused on the handling aids available to home caregivers and the complications of physical handling. The implementation of qualitative research using a semi-structured interview method with eight home care nurses provided information on the handling aids used as well as complications of physical handling in the home care setting. Five categories were created by categorizing the data using the pencil-paper method. Research shows that information for safe handling is provided to the patient's family by the nurse. Caregivers use a positioning mat for care. Very important, but sometimes unavailable, in home care is the reclining bed. Physical handling then becomes risky. Nurses do not use a slide sheet. Two of them do not know the aid at all. Complications of physical handling that occur to nurses and patients include musculoskeletal or skin injuries. The results of the research show the need to popularize the topic of safe physical handling. A leaflet has been produced for agencies involved in physical handling research. Another way to prevent the risk factors of physical handling in home care and to make it safe for the patient and the caregiver are courses and conferences with theoretical and practical content on safe physical handling for professionals and lay people.
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Manipulation with patient as a nursing problem
BLÁHOVÁ, Kateřina
Current status Patient handling is a comprehensive process. A nurse handles patients many times a day throughout the entire time of hospitalization. The range of processes that require patient handling is very broad. Patient handling takes up a relatively big part of time and efforts in the course of positioning. While handling patients the nurse´s motoric system is loaded and this may result in musculoskeletal diseases and subsequent incapacity to work. Incorrect handling also increases the risk of damaging the patient. The risk may be eliminated to a certain extent by the use of handling aids and by observation of barrier nursing care and occupational health and safety rules. An important role is also played by education of nurses and healthcare workers in the area of motoric communication concepts. Objective of the work and research questions Three objectives were set for the research survey. The first objective was to identify the issues faced by nurses in the process of patient handling. The second objective was to map aids most frequently used by nurses for patient handling. The third objective focused on education of nurses about patient handling. Six research questions were formulated to achieve the objectives: 1. Which undesired events may occur in the process of patient handling? 2. Which problems do nurses see in the process of patient handling? 3. Do nurses have aids available to ensure safe handling of patients? 4. Are nurses able to use aids for patient handling? 5. Which methods do nurses use to facilitate patient handling? 6. Do nurses have opportunities for /are they willing to get education about patient handling? Method The method of qualitative research was used for the empirical part of the bachelor thesis. The data were collected by means of two techniques: semi-structured interview and covert participant observation. The interviews were conducted, using a previously prepared set of questions, with nine nurses who work in three in-patient wards in a hospital in the South Bohemian region. Observations were conducted in the same wards as the interviews. The resulting data were categorized and evaluated. A precondition for the research survey was to keep all the respondents and the healthcare facility anonymous. Results The results of the survey indicate that the most frequent undesired events which may occur during patient handling are injuries of the patients or personnel. The principal issues seen by the nurses are the weight of patients and limiting conditions of the environment. Despite the fact that the nurses reported sufficient quantity of aids for safe handling of patients they would appreciate a different structure of the aids. Moreover, the observations have shown that they are not always able to use the aids correctly. The nurses use simple non-technical aids to facilitate patient handling and they also use methods of handling by several persons. Conclusion The empirical survey has shown that patient handling is the activity performed on everyday basis by nurses performing their jobs and providing nursing care. Such activities expose nurses to physical load and they also need to deal with a number of problems. They approach patient handling in a quite conservative manner and they only use a few basic handling aids. They do not have more sophisticated aids available at their workplaces and by now they have not shown any interest in getting them. The nurses fail to use any motoric communication concept in the handling process, such as kinaesthetics. An overwhelming majority of the nurses have never heard about kinaesthetics or their notion about it was totally incorrect. We can conclude from the obtained results that most of the nurses are interested in education about correct patient handling techniques.
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Safety when handling and positioning of the patient
HŘEBEJKOVÁ, Blanka
This thesis focuses mainly on threats to the safety of nursing personnel. These include a high risk of injury when positioning and the risk of developing musculoskeletal disorders,which can lead to a long-term sickness of the member of the medical staff. The theoretical part is divided into four parts. The first part describes in particular the need for safety and security, as well as factors that have an influence on this human need.Attention is focused also on ensuring safety while providing nursing care, especially when positioning patients. In connection with safety during this activity, a section in this thesis is devoted to the kinaesthetic mobilization, which offers a slightly different view of the positioning and patient handling. In the last chapter of the theoretical part, findings concerning the prevention of damage to health nurses in providing nursing care are summarized. The thesis has three objectives that were formulated as follows. Objective 1: Determine whether nurses use kinaesthetic principles during a patient handling. Objective 2: Determine whether nurses, in their opinion, have enough equipment to ensure safety during patient handling and positioning. Objective 3: Map the causes of the use of inconsiderate patient positioning techniques. Based on these objectives, the research question and three hypotheses were set. Research question: What are the possibilities for improving patient handling and positioning within the nursing process? Hypothesis 1: The use of kinaesthetic depends on the type of department. Hypothesis 2: Nurses use bad positioning techniques despite their knowledge that they can harm their health and also patient's. Hypothesis 3: Lack of time is the most common cause of the use of the inconsiderate method of positioning. In order to fulfil the objectives, a quantitative research, for which we choose the questionnaire method of data collection, was conducted. The questionnaires were designed for nurses working in the department of surgery, internal medicine and the department of aftercare. The survey was carried out in 7 hospitals of South Bohemia. In total, 340 questionnaires were distributed into these hospitals.The final research sample, therefore, consisted of 209 completed questionnaires. The rate of return was 61%. The obtained data were processed and analysed using Microsoft Excel 2013, then analysed statistically using the chi-square test. The results were processed into graphs. Based on the results, we can conclude that the hypothesis 1 is confirmed. We found that kinaesthetic is used most in aftercare departments. On the contrary, surgery departments use it the least. This is probably due to a different composition of patients on these wards.Hypothesis 2 was, for testing purposes, divided into two working hypotheses. H2a: 60 % nurses know that classical principles of positioning can damage their health. This hypothesis has been disproved. A corollary is HA: Knowledge of nurses about the risk of an injury is not 60%. The research has also revealed that almost three quarters (74 %) of the nurses know that positioning can damage their health. The second part of the hypothesis 2, i.e. H2b: 60 % nurses know that the classical principles of positioning can damage the health of the patient, has also been refuted, and thus applies HA: Knowledge of nurses about the risk of an injury to the patient is not 60%. The results of the survey showed that only 24 % nurses consider the classic method of positioning a risk to patient's health. Hypothesis 3 was, through our research survey, refuted. Sisters see the most frequent reason for using the inconsiderate positioning procedure in the lack of staff.We managed to answer the research question by analysing literature in the theoretical part and performing the survey in the practical part of this thesis.An output of this thesis will be an expert article published in a professional journal and a presentation at a professional conference
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Basal stimulation and kinaesthetics and their integration into the the care of seniors with specific problems
POLICHRONOVOVÁ, Lenka
Summary In my bachelor's thesis I focus on an integration of a stimulatory care into daily activities of seniors with heavy motoric, cognitive or perceptional changes by the means of the concept Basal stimulation and by the means of the concept Kinaesthetic mobilisation. In a theoretical part I describe an old age with manifestations of involution, I marginally mention a neurorehabilitation, nursing in order to point out a penetration of rehabilitation into the care which is directed to therapeutic aim in a nursing way. Subsequently I deal with both concepts, with individual stimulations and with kinaesthetic principles of mobilization. In a practical part there was a qualitative research applied. A data sampling was implemented by the way of a secondary analysis of documents and by a method of observation. An observation was implemented both as involved and neutral one. There was an instrumental method of casuistics applied to describe an integration of concepts into the care. The diversity of sample was the main criterion at choice. There were 4 males and 2 females in the age range 53{--}95 years old in a set. The objective of work no. 1 was to create an integrated image of the possibilities of integration and of utilization of elements from a concept of basal stimulation and kinaesthetic mobilisation in the care of seniors with specific problems. The objective no. 2 was to support a theory that an interconnection of a concept of basal stimulation and kinaesthetics leads to the development of perceptiveness and to improvement of skills and capabilities. The objective no. 3 presupposes that concepts of basal stimulation and kinaesthetics contribute to a support of overall perception and to improvement of the quality of life of seniors with a somatic, sensoric and mental affection. The objective no. 4 was to find out whether the concepts are a suitable communicational and educational form in a fundamental nursing care in order to achieve a higher level of self-service and mobility. All the objectives were achieved in my opinion. An importance of rehabilitation and psychosocial educational care even in old age ensued from an elaboration of a theoretical part. By the way of evaluation of a practical part I came to my personal opinion that a stimulation care has a positive effect even in a developmental stage of an old age. The thesis could become a source of information at introduction of concepts into practice; it could be conducive for family members when taking care of their close relatives or eventually as a basis for the purposes of study of these problems.
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Methods of handling of rather less self-sufficient and non-self-sufficient clients in residential houses for elderly persons in the Region of South Bohemia
ČÁPOVÁ, Pavlína
Handling of clients is an integral part of everyday work of most of nurses. It constitutes also the largest physical load for nurses. Correctly conducted handling of a client and usage of handling aids reduces both the physical load for nurses and the risks of nurses{\crq} injuries sustained in relation with handling. As far as clients are concerned, the risks connected with handling are reduced and the comfort of the nursing care is increased then. Handling includes positioning, shifting, lifting to chairs and verticalisation. Correct handling of a client allows prevention of the complications resulting from immobility and thus also maintenance and even renewal of a client{\crq}s self-sufficiency. The bachelor thesis themed ``Methods of handling of rather less self-sufficient and non-self-sufficient clients in residential houses for elderly persons in the Region of South Bohemia{\crqq} has a research character. It is divided into two parts {--} a theoretical and a practical one. The theoretical part is focused on old-age, self-sufficiency, immobility and handling of clients. The practical part consists of a quantitative research conducted by a questionnaire method, in which we attempt to confirm the raised hypotheses. H1: Nursing staff has no practical experience in the area of handling of clients. H2: Residential houses for elderly persons are not sufficiently equipped with handling aids. H3: Nursing staff in residential houses for elderly persons does not require changes in the established manner of handling of clients. Nurses in residential houses for elderly persons in the Region of South Bohemia obtained 150 questionnaires, of which 126 were returned, i.e. 84 %. The final set of regularly filled out questionnaires for the research consisted of 108 questionnaires. The objective of the thesis is to ascertain the level of knowledge and practical experience of nurses in the area of handling of clients, and to ascertain and compare the manners of utilization of technical aids and equipment facilitating handling in residential houses for elderly persons in the Region of South Bohemia. The results of the thesis should redound to more regardful, comfortable and considerate handling of rather less and non-self-sufficient clients in residential houses for elderly persons, and facilitate the work of nursing staff in terms of their own health.
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