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Use of barrier nursing care techniques in outpatient services
ŠAFÁŘOVÁ, Marie
This bachelor's thesis is about using barrier nursing care techniques in outpatient services. The first part describes the present situation, which includes single techniques of barrier nursing care, namely mechanical washing of hands, using personal protective equipment, disinfection, sterilization, and manipulation with used medical materials. The next part of the thesis is about applicable legal norms which are related to these issues. The thesis also has a part about the role of the nurse in outpatient services and the nursing process. The separate chapter is also devoted to nosocomial infections. In the second part are definitions of three targets. The first is to find out which types of protective equipment are used by nurses in outpatient services. The second target is to find out how nurses use hand hygiene techniques and the third is to find out which way nurses are manipulating used medical materials. The third part describes research methods. For qualitative research, the investigation was by deliberately selecting seven outpatient services in the territory of the capital city of Prague. The data collection technique is a semi-structured interview and participatory observation of a nurse working in outpatient services. The research was focused on the use of protective equipment, hand hygiene by nurses, and manipulation of used medical supplies. The fourth part contains the results of the research investigation, which are analyzed in the subsequent discussion, which provides a comparison of current legislation, literature, and results from practice. The conclusion of this thesis is that some techniques of barrier nursing care, namely proper hand hygiene, use of protective equipment, and compliance with some legislative standards in the field of prevention of the risk of infection, are not yet so included in the automatism of nurses working in outpatient services. The output of this thesis is a draft of a workshop on the topic of the thesis, especially hand hygiene and prevention of infection transmission.
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Feeding the patients in hospital
NITA, Tatiana
The main goal of the bachelor thesis was to find out what interventions the nurses used in feeding, what communication techniques the nurses used and how they cooperated with other members of the nursing team in feeding patients in hospital facilities. Three research questions were identified, which focused on the nurse's interventions in the feeding, on communication techniques during the administration of food and on the cooperation of nurses with other members of the nursing team. The empirical part of the bachelor thesis was processed through a qualitative research survey. The data collection itself was carried out through participatory unstructured observation of nurses working in a hospital facility. Each observation was converted into written form and further processed by the method of open coding, the "pencil - paper" technique. The results of the empirical part were divided into nine categories for clarity. Among positive findings we include that the rooms had been cleaned and ventilated before the food was served. Before lunch, the nurses allowed non-self-sufficient patients to take a suitable position. The nurses also prepared bedside tables for patients at a sufficient distance and provided non-self-sufficient patients with a paper bib to prevent contamination of their clothing and bedding. No dietary changes were observed. The diet was served at a sufficient temperature and amount. During the diet, the nurses actively offered patients liquids with the help of various compensatory aids for drinking. Among the positive findings was that the nurses fed the patients in clean work uniforms, had no accessories on their hands, were properly combed, and all but one had the prescribed manicure. Furthermore, the nurses actively cooperated and communicated with both patients and nursing staff. Only minor problems were detected, but this did not have a major impact on the provision of quality nursing care to patients. Among the negative findings we can include non-compliance with the principles of barrier care for nurses. The nurses did not exchange incontinence devices for non-self-sufficient patients, they did not allow them to perform hand and oral hygiene. It was also revealed that the nurses did not wash or disinfect their hands before or after eating. This bachelor's thesis is intended for nurses and students of non-medical health disciplines and will serve as a basis for revealing problems and improving skills in the field of feeding patients. The thesis can serve as a basis for further research.
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Prevention of nosocomial infections origin and spreading in Český Krumlov a.s. hospital
KOCOURKOVÁ, Lenka
The present Bachelor thesis focuses primarily on the prevention of occurrence of hospital-acquired infections and the causes of spread of these infections across healthcare facilities. The thesis relies on active communication with the coordinator for management of quality and safety of nursing care, who helpfully provided me with valid information and documents relating to the system of hospital-acquired infection prevention, and arranged for sampling for microbiological examinations in postoperative care departments (ONP) - ONP II and ONP - C III, the hospital Nemocnice Český Krumlov a.s. The Bachelor thesis consists of a theoretical part and a practical part. The theoretical part summarizes knowledge related to nosocomial infections as such, the division and manner of transmission, with an emphasis of prevention of occurrence of these infections and spread of the same among "healthy hospitalized persons." The practical part explores the hospital's approved internal documents aimed at prevention of nosocomial infections and training of staff in the healthcare facility. Moreover, the practical part also verifies the prevention of nosocomial infections by means of microbiological tests. The entire research was carried out in cooperation with two hospitals: Nemocnice Český Krumlov a.s., i.e. the location of sampling, and Nemocnice a.s. Prachatice, the location of microbiological processing. The laboratory-based research part was solved in a microbiology laboratory in the hospital Nemocnice Prachatice a.s., with the aim of identifying the individual microorganisms from the smears taken in the postoperative care department in the hospital in Český Krumlov. These smears reflect the quality of the performed hygiene in connection with the risk of occurrence of nosocomial infections. In addition to laboratory-based research activities, the present thesis also examines the current quality and processing of the hospital's internal documents relating to the prevention of nosocomial infections and the training schedule for the hospital's staff in this respect - trainings are conducted on an annual basis. The thesis is concluded by a summary of isolated microorganisms and comparison of these microorganisms in the framework of the two hospital departments. Last but not least, the presence of highly infectious agents for occurrence of nosocomial infections is excluded on the basis of valid legislation. The thesis also provides a result of qualitative processing in a form of recommendations e.g. for improvement of purpose-directed cleaning. The thesis may therefore be used as a tool for improving awareness of this problem area.
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The incidence of postoperative infectious complications in neurosurgical ICU
Brindová, Jana ; Mrákava, Vlastimil (advisor) ; Hocková, Jana (referee)
This thesis examines in detail the nature of postoperative infectious complications in patients who underwent brain tumor surgery. It deals with the incidence of these complications and their severity, depending on various factors and suggests the most appropriate nursing procedures used in the care of a patient in whom these complications occurred. For the structure of the work is divided into two parts - theoretical and empirical. The theoretical part deals with the issues examined in terms of the medical field Neurosurgery (closer diagnoses, conditions, operations and other procedures, and complications to occur after these operations or expected performance), analyzes a nursing practice and patient care on neurosurgical ICU, and finally closely examines infections and nosocomial diseases, including a description of the most common types, their agents, diagnosis and treatment. The second, empirical part focuses on the problems from a practical point of view. With the help of set of case studies it closer which specific complications are most commonly found on the neurosurgical ICU in patients after surgery of brain tumors, what are the most common methods of treatment and nursing procedures which are most used in the care of patients with these complications. In conclusion summarizes the...
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Hand hygiene as a prevention of nosocomial infections at healthcare professionals in Nemocnice Strakonice a.s.
HRACH, Filip
This bachelor thesis deals with the prevention and monitoring of infections which are associated with the health care in Hospital Strakonice, a.s. The main goal of this thesis was to analyse and describe the current situation in area of prevention of nosocomial infections in connection with the hand hygiene of the medical staff in this hospital. The knowledge of medical staff in area of nosocomial infections, activity of persons doing the cleaning or the quality of the hand hygiene of the medical staff was the main focus. The bachelor thesis is focused on several hospital wards - haemodialysis, anaesthesiology and resuscitation, intensive care unit and finally maternity ward The bachelor thesis has two parts - theoretical and practical. The already known knowledge in area of infections connected with the health care is described in the theoretical part. The focus was on the technique, manners, quality of hand hygiene and the hand disinfection, explanation of the term nosocomial infections, classification, definition and spreading of the nosocomial infections. The information was obtained and used from Czech and foreign literature. The practical part refers to the short research and observation in Hospital Strakonice, a.s. The main goal was to find out by means of different methods the quality of hospital hygiene. The research was conducted using semiquantitative and qualitative methods. Each method in the thesis is described methodically and practically. The results were commented on in the discussion.
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Incidence of resistant bacterial strains isolated from patients of Thomayer Hospital in Prague - pilot study.
JEŽKOVÁ, Natálie
Purpose of my thesis was to determine presence of the most notable bacterial agents of patients in Thomayer hospital in Prague and possibilities of usage of aquired data for nosocomial infections prevention. Data from microbiological examinations throughout years 2015-2017 were analyzed. Resistance of individual bacterial strains was determined and based on results of sensibility of antibiotics and determination of beta-lactamase production. Software of laboratory information system was used for data processing, which allowed elimination of identical findings of the same patient. Data of the most present pathogens in Thomayer hospital was aquired, their distribution within clinics and presence of fenotypical resistence. Most common pathogens were E. coli and strains of genus Klebsiella. Highest numbers of resitatnt genes were found within klebsiellas. During three years time horizon rising tendecies of resistant genes were found on children's clinic and geriatric unit. Presence in other clinics, had either constant or in some cases decreasing tendencies. Most notable decrease was recorded in case of resistant genes of klebsiellas in pulmonary clinic and urology clinic. Quite interresting is total low presence of acinetobacters and significant decrease of its resistance. Spectrum of detected genes responds to results of similar studies realized in Czech Republic. Resluts indicate quite beneficial state of presence of resistent genes in Thomayer hospital, which testifies to successful implementation principles of actions against nosocomial infections.
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The use of gloves in nursing care.
REJNARTOVÁ, Květa
Current Situation: New demands in health care are on the rise, especially in nursing care. Protection against infection is an integral part of this process. Every hospital has developed standards that describe the use of gloves during certain procedures. Glove use protects the nurse as well as the patient from infections. The responsibility of every health worker is to comply with these standards and norms. The Bachelor's thesis "The Use of Gloves in Nursing Practice" informs about the real practices regarding compliance with the standards and also about the occurrence of allergies. Aim of the research: The aim of the research survey was to verify theoretical knowledge, such as standards and norms, related to procedures during which the medical staff use gloves and compare this knowledge with the actual compliance. Two aims were selected: 1. Evaluate the use of gloves in healthcare according to the standards and compare them with reality. 2. Determine the occurrence of allergies in medical personnel related to the use of gloves. Methodology: The empirical part of the research survey was conducted using qualitative research. The data were collected anonymously in three hospitals by means of a semi-structured interview. The interview consisted of three identification and eight open-ended questions. All the interviews were rewritten and analyzed by a "paper and pencil" method. Hidden observations were carried out before the interviews and recorded on the sheet. Results: The results of the research survey showed that there were differences between the theoretical training of medical personnel and the practical implementation according to the standards. Glove use is perceived as insignificant and most of the procedures are done without them. Medical personnel do not realize the importance of the standards and they behave as they see fit, not afraid of transmission of infection. They do not endanger only themselves, but the patients as well. The occurrence of latex allergy among medical personnel was confirmed. This allergy appears despite the better quality of gloves and their availability. The analysis of the research survey showed that the quality of gloves is also key to compliance with standards. Management should carry out more frequent inspections and audits. Conclusion: The Bachelor's thesis explored the discrepancies between theory and practice in patient care according to standards. Hospitals should not focus only on the economic aspect of protection of medical personnel but should purchase quality gloves. Training in glove use should be regular and consistent with the standards. The issue could be solved by regular inspections by the management of the department and regular audits. Next solution could be an adequate motivation of medical personnel by the hospital management. Protection of an individual means protection of the entire health facility.
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Nursing care measures in the prevention of ventilator-associated pneumonia
Kukol, Václav ; Heczková, Jana (advisor) ; Feixová, Dagmar (referee)
The thesis is focused on ventilator-associated pneumonia and its possible preventive measures during nursing care. In the theoretical part of the work we have included chapters on nosocomial infections emphasizing on the etiology and epidemiology of ventilator-associated pneumonia and its clinical manifestations. We have analyzed the issues of artificial airway management with a detailed focus on the peculiarities of nursing care of the ventilated patients. There, we focus primarily on the care of the patients oral cavity, respiratory tract and the ventilation circuit. A big chapter is dedicated to preventive measures and to the possibilities of prevention in the nursing practice. The empirical part includes research on preventive measures that are implemented in practice and comparative analysis of the measures between different facilities as well as their compliance to the guidelines. We have also determined the level of VAP awareness and its prevention among the nurses. KEYWORDS nosocomials infections, nursing care, prevention, ventilator-associated pneumonia
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The incidence of postoperative infectious complications in neurosurgical ICU
Brindová, Jana ; Mrákava, Vlastimil (advisor) ; Hocková, Jana (referee)
This thesis examines in detail the nature of postoperative infectious complications in patients who underwent brain tumor surgery. It deals with the incidence of these complications and their severity, depending on various factors and suggests the most appropriate nursing procedures used in the care of a patient in whom these complications occurred. For the structure of the work is divided into two parts - theoretical and empirical. The theoretical part deals with the issues examined in terms of the medical field Neurosurgery (closer diagnoses, conditions, operations and other procedures, and complications to occur after these operations or expected performance), analyzes a nursing practice and patient care on neurosurgical ICU, and finally closely examines infections and nosocomial diseases, including a description of the most common types, their agents, diagnosis and treatment. The second, empirical part focuses on the problems from a practical point of view. With the help of set of case studies it closer which specific complications are most commonly found on the neurosurgical ICU in patients after surgery of brain tumors, what are the most common methods of treatment and nursing procedures which are most used in the care of patients with these complications. In conclusion summarizes the...
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Treatment of Peripheral Venous Input
Černohorská, Jitka ; Hošťálková, Monika (advisor) ; Ulrych, Ondřej (referee)
The bachelor thesis deals with the treatment of peripheral venous catheters. The theoretical part is devoted to basic terms such as nursing care, peripheral venous catheter and complications associated with it. A lot of attention in this thesis is focused on nursing care prior to, during and after the application of the catheter. Furthermore, the thesis introduces us to complications of catheter sepsis resulting from nosocomial infections. In the practical part the quantitative method was used in the form of anonymous questionnaires and hidden observations. The survey was conducted at the Military University Hospital Prague at different intensive care units. The obtained results show that 50,00 % of the respondents use non-woven fabric for re-bandaging the peripheral venous catheter and 50,00 % of the respondents use a foil. Furthermore, it was found that 88,10 % of the respondents use gloves by the application of peripheral venous catheter and 82,14 % by re-bandaging.
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