|
|
Mumps among adolescents and young adults.
BÖHMOVÁ, Monika
Objectives of the work The aim of the work was to determine the course of mumps in adolescents and young adults and to map the specifics of nursing care in adolescents and young adults from the point of view of nurses of general practitioners. The following research questions have been chosen: What was the course of mumps in adolescents and young adults? What are the specifics of nursing care in adolescents and young adults from the point of view of nurses of general practitioners? Methods used To supply the necessary information was elected qualitative research using in-depth interviews with patients who have had mumps and nurses working with general practitioners for adults or children and adolescents. Interviews were captured by a recorder, recorded on the phone or written, and processed by direct transcription. Results The rewritten interviews were subjected to detailed analysis by open coding, using the paper and pencil method. From the data analysis, a total of six categories were formed, divided into two groups: Nurse interviews and Interviews with patients with mumps. Categories from interviews with nurses are: Vaccination, Measures in mumps, Mumps course according to nurses. The categories of interviews with mumps patients are: Collaboration with medical staff, Patient information and vaccine used, and Mumps course in patients with mumps. The individual categories are assigned subcategories, which are encoded to important information and all are included and illustrated in the various schemes. Conclusion From interviews with respondents, we found out how mumps had progressed by adolescents and young adults. It was found that half the respondents had more serious complications, but without lasting consequences, just in one case, the hearing remained impaired, the other serious complications after the cure disappeared. For nurses the result showed what are the specifics of nursing care in adolescents and young adults from the point of view of nurses practitioners. In the main issue, all nurses were oriented correctly. We have found that nurses have a minimum of experience with this disease because they have encountered it sporadically in their practice, and they know it only theoretically, although the incidence of mumps has increased in recent years and nurses should gain more experience. This finding may result in insufficient awareness of compliance with all treatment measures. The results obtained suggest that it would be advisable for doctors and their nurses who did not experience this disease to attend an education seminar focused on mumps, their symptoms, treatment, possible complications and anti-epidemic measures, with which the nursing care of mumps is related.
|
|
|
A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
|
|
|
THE ISSUE OF PROVIDING HIGLY SPECIALIZED CARE TO PATIENT WITH INTRA-AORTIC BALLOON COUNTERPULSATION
ŠMERÁKOVÁ, Věra
This thesis is focused on the issues linked with providing highly specialized care to critically ill patients with intra-aortic balloon pump (IABP) in intensive care units. IABP helps these patients overcome period of acute phase of heart failure or overcome period of time necessary before definitive intervention or surgical solution. A nurse has an irreplaceable role from the very beginning of patient's preparation before insertion of mechanical support (psychological as well as physical), assumes the assistance and instrumentation during insertion of heart support, observation during counterpulsation to psychological support of the patient leading to disconnection (weaning). This thesis is divided into two parts. Theoretical part is organized in several theme units focused on description and method principles, main indications, contraindications, and complications occuring with counterpulsation. The next part is dedicated to nurse's role in the problematics of saturation of bio-psycho-social needs of IABP patients. And the last part characterizes the specifics of intensive care. The core of practical part was qualitative research as per defined goals. The main objective was to map demand for quality nursing care in connection with IABP. This aim was reached through definition of four sub-aims and five research questions. The research questions were focused firstly on knowledge preconditions of nurses and problematic areas of care for IABP patients. Secondly, research effort was focused on the area of insufficient needs of patients in the bio-psycho-social area and on quality of information provided to patients. Imaginary centerpiece of research investigation consists of analysis of case studies of patiens, graphic visualisation of their thought map was used to survey the specifics of nursing care. For the evaluation of needs and mapping of patient's awareness the technique of individual half-structured interview with open questions was used. Same was used with nurses for mapping of problematic areas of nursing care. At the same time casuistry was formed as classical method of description followed by analysis of nursing case. Its meaning was to clarify optimization of means, processes and nursing interventions, i.e. mapping the specifics of nursing care of IABP patients. Research group consisted of patients selected intentionally with regards to the research problematics. For a complex conseption of the research the group for qualitative investigation consisted of four patients of cardio-surgery unit and one patient of coronary unit. Research investigation was realized in coronary intensive care units in České Budějovice hospital and Faculty hospital Plzeň and in Cardio-surgery unit of FN Plzeň. Research group for investigation of nursing problematic was formed by nurses of coronary units and cardio-surgery units of above mentioned hospitals. Eight nurses participated in the interviews. The selection of nurses was finalized only after the research topics were developed in detail. At that time sample selection was not bringing any new information any more, hence theoretical saturation of factual reality was reached. Based on analysis of research results within the goal defined and focused on the level of nurses' theoretical knowledge of nursing patients during IABP therapy it was observed that even though nurse's knowledge is sufficient, it is also significantly inconsistent. Relatively vast reserves were found especially in the area of communication with patients, hence in complex care for patient's psychological state.
|
|
|
The prevention of nosocomial infections at central venous catheters in standard inpatient departments and intensive care units.
PAŽOUTOVÁ, Petra
Nosocomial infections are one of serious problems of modern medicine and nursing also nosocomial infections mean real serious problems for future. Prevention of nosocomial infections, applied together with pointed and meaningful antimicrobial therapy is the only causal solution now. This work was aimed primarily at a comparison of knowledge of common nurses working in intensive care wards and common nurses in standard wards. In general, it could be said that the aim of this work was to map the scope of knowledge of common nurses as for nosocomial infections as well as aseptic care for central venous catheters including catheter sepses. The found deficit in knowledge of common nurses pointed out the occurrence of mistakes in nursing practices. Quality of nursing is connected closely with standardisation of nursing procedures. Quantitative research inquiry was realised in 4 medical facilities: Regional hospital Liberec, a.s., Masaryk city hospital in Jilemnice, Hospital České Budějovice, a.s. and Hospital with polyclinic in Semily. As the research method there was chosen a non-standardised questionnaire. The sample of respondents was chosen as an intentional selectionand and in to statistic processing included 290 relevantly filled out forms. The research investigation also included a comparison and quantification of nursing standards. In view of the performed comparison of standards in nursing we concluded that creation of incomplete or even inconsistent standards occurs here. We have prepared a "Proposal on a standard of nursing care for inserted venous catheter", of which form could enable to implement it in medical care facilities within the Czech Republic and define clearly basic nursing procedures within the scope of these problems.
|
|
|
Diabetic foot from the perspective of nurses.
OBERFALCEROVÁ, Eva
Abstract The topic of this bachelor thesis is ?Diabetic Foot Syndrome as Viewed by Nurses?. Diabetes mellitus is a frequent endocrinological disease, and the most frequent diabetes complication is the diabetic foot syndrome which occurs as the result of poor compensation of diabetes. The prevalence of this disease is very high, so it is important to timely detect any complications through screening.The research part of this bachelor thesis was processed by the method of qualitative research whose respondents were nurses working at a surgical and internal ward and nurses working at a diabetologic and podiatric outpatient surgery. The objective of this thesis was to ascertain the most frequent problems encountered in treatment of a diabetic foot and to ascertain the role of nurses in a standard screening evaluation of diabetics? feet within the scope of a common practice of diabetologists at outpatient surgeries and nurses at hospital. The research results were processed through interviews with nurses. We have put the following main research questions: What are the most frequent complications reported by clients suffering from a diabetic foot syndrome? What screening tests are carried out at a diabetologist?s outpatient surgery? Is there any difference between the evaluation of the feet of a diabetic in a diabetologist?s outpatient surgery and of a diabetic admitted to hospital? Is a nurse able to evaluate the feet of a diabetic on her own? Do nurses have sufficient information on treatment of a diabetic foot? Based on these questions we created sub-questions for the interviews. The interview consisted of 23 questions addressed to nurses. This thesis will serve as an information material for nurses working at hospital and for nurses working at an outpatient surgery. It may also be used as an information material for students undertaking specialization courses, such as Podiatric Nurse or Diabetologic Nurse. The result of the thesis draws attention to the problems concerning the treatment of a diabetic foot and the problems concerning the screening examination of diabetics? feet.
|
|
|
Technical intensity and time demandigness of a nursing care while using different techniques of cooling during a controlled hypothermia therapy from the view of a nurse
GALUŠKOVÁ, Soňa
ABSTRACT: My thesis deals with therapeutic hypothermia and associated methods of cooling. Focus is given to technical and time demands of the methods in terms of reaching the target body temperature and nursing care complexity. The first theoretical part gives a brief introduction to history of hypothermia and the first existent records of the technique. Another chapter is focused on the current use of induced hypothermia, medical fields in which induced hypothermia is used both in the local or overall controlled hypothermia. Physiology and pathophysiology of thermoregulation in humans is described. More details are given on classification of hypothermia and hyperthermia. Changes in the organism during shifts in body temperature and their causes, positive and negative effects of temperature changes on the organism are discussed. Another chapter covers the issue of controlled hypothermia, its definition, positive treatment effects, negative effects on the organism and methods of cooling. External and internal methods as well as nursing procedure while the methods are applied are described in detail. The final chapter of the theoretical part of my thesis summarizes comprehensive nursing care for patients with controlled hypothermia. The objective of my thesis was to evaluate the utilization of therapeutic hypothermia in intensive care units, assessment of technical and time demands of cooling methods for comprehensive nursing care from the view of a nurse, and to find the optimal combination of cooling methods to achieve the desired core body temperature as soon as possible and to maintain the temperature. The first assumption was that therapeutic hypothermia utilization would be influenced by the patients structure on the wards. The second hypothesis was that utilization of physical cooling methods and more technically and time demanding methods such as coolgard and extracorporeal circulation would be more time consuming for nurses. The method of quantitative research, the questionnaire method, was chosen to comply with objectives of the thesis. The questionnaire contained open questions with the possibility of more responses, closed questions and one semi-closed question. The following nursing staff members were addressed: diploma nurses, registered nurses, specialized nurses working in intensive care units and resuscitation departments of four different hospitals. The research was conducted in 2009. In the concluding part of my thesis results of my work are shown in the graphic form. Discussions with literary sources on the use and application of therapeutic hypothermia are brought in. A large proportion is devoted to practical experience with cooling methods, which are compared with the results of the questionnaire. The results of my theses may be used to make the comprehensive nursing care for patients with therapeutic hypothermia more effective, with increased comfort for patients in intensive care units and resuscitation departments .
|
guest ::
