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Scale assessment in nursing process for children
BENEDIKTOVÁ, Anna
Introduction The nursing process is an integral part of quality nursing care in paediatrics. This process contains many individual components that can work together to create a whole that not only assists nurses, but also makes patients' hospital stays more enjoyable. One of the components is assessment and measurement scales. These can be focused on pain, consciousness, nutrition or fall risk. Objectives of the work The aim was to become familiar with assessment and measurement scales in paediatrics and to find out their application in the nursing process in selected paediatric wards. First, we investigated which assessment scales can be applied in the nursing process in children. This was followed by interviews in which we focused on the assessment scales used in the selected wards and how nurses view the use of assessment scales. Methodology The research was conducted in two phases. In the first phase, we searched the literature for assessment and measurement scales in paediatrics. In the second phase, we conducted closely interviews, which were conducted with nurses working in standard wards or in the ICU. The research investigation was developed by searching information from the literature and also using closely interviews with nurses in our selected wards. Data collection was conducted from January to June 2023. All interviews were recorded on a dictaphone and then transcribed into MS Word. The "pencil paper" method was used to analyse and code the data. Subsequently, the data was broken down into units, which were assigned appropriate codes and these were grouped into categories. These categories and subcategories were then worked into clear diagrams and described in detail. Results From the research we found that there are many scales for assessing pain, and not all can be applied to the same age. In addition, for each of the scales the correct tally or technique needs to be found and each is rated differently in the result. Nurses are familiar with the assessment scales they use on the wards and know what they are used for, but do not know their exact names, but rather a general one for the assessment issue. Most nurses spoke in general terms such as 'pain assessment', 'fall risk assessment', 'consciousness assessment'. Not all units use the same assessment techniques, nor do they all use the same assessment domains. Conclusion The results show that rating scales are an essential part of nursing documentation. So many assessment scales have been used that most wards are able to choose one that suits their particular issue and the department we selected did so. However, it is important to choose the right one with respect to the age and psychomotor development of the child. This bachelor's thesis can be used in the theoretical and practical part of teaching in Paediatric Nursing. The assessment techniques can be used in professional practice in the respective departments or we can offer a pain assessment scale that we have devised. It could assist nurses in diagnosing and determining the degree of pain in all ages.
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Rating scales in traumatology
PROKOPOVÁ, Martina
This diploma thesis is split into two parts - a theoretical and an empirical one. Most of the content of the theoretical part is created by description of individual scales and tests, used for different areas. There are briefly mentioned phenomena of traumatology, the history of trauma centers in the Czech Republic and the nursing care. In this part there is also information regarding nursing documentation which the evaluation scales are part of. The first unit of research part of the diploma thesis was realized in the form of quantitative survey on the basis of semi-structured interviews with nurses working at trauma department. The results of this survey were examined in details with help of categorization and coding. The most important answers of the people surveyed were shown in diagrams, which were created according to the defined categories. For the second unit was chosen quantitative research, performed in the form of non-standardized questionnaire with the total of 110 people surveyed. The results of the questionnaire survey were statistically processed. Regarding the questionnaire survey, five research questions and two hypothesis were identified. The aim of this paper was to research the use of evaluation scales for patients in traumatology and at the same time to map the point of view of nurses on the issue of evaluation scales and their use in nursing. According to the statistical results it is true that the opinion of nurses, regarding the scales, is affected by the length of their praxis and the level of education. The results of the research concluded that evaluation techniques are positively accepted by the nurses. With their help, it is possible to evaluate a patient´s skills, needs and problems with nursing care, in a simple way. According to the survey, nurses did not see some of the scales as objective because in case of some items, there might occur projection of personal perception into the process of evaluation. The reason is the lack of information which nurses are missing when using the scales. The nurses are aware of benefits of using these scales but they do mind the time spent for filling it. The struggle with time is a commonand constant problem the nurses have. It is given by the disproportionate number of tasks caused by the lack of staff. That is the reason why no greater interest can be expected. In traumatology, according to the result, the greater application of scales will be found with VAS and CGS scales.
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Rating scales in traumatology
PROKOPOVÁ, Martina
Modern lifestyle (technology, increasing intensity of sport activities, motor sports) results into increasing number of injuries and traumas and their seriousness. Injuries are at the first place in the assessment of cause of death among children and adults. Traumatology deals with prevention, diagnosis and treatment of injuries involving soft tissues, bones and joints. Traumatology should be considered as a complex diagnostic-therapeutic process, which includes medical history, clinical examination and imaging methods. Based on this examination, the diagnosis is made. Then comes therapeutical considerations and possibly a patient is indicated for surgery. Evaluation scales in nursing are elementary and integral part of nursing documentation. With their help, it is possible to define the object of observation and the way of evaluation (scoring of selected manifestations). Based on the received information it is then possible to precisely identify, objectify and document the problems arising in connection with nursing care. The result is finding an adequate solution to the problem and improving the quality of nursing care. Therefore, nurses should be equipped with basic skills on how to use the scales and how to work with them. The thesis is divided into two parts, a theoretical and an empirical one. The theoretical parts contains information about traumatology, its history and trauma centers in the Czech republic. It also contains information about nursing documentation, which includes assessment scales. We mainly focused on individual assessment scales for evaluation of state of consciousness, the risk of bedsores, the risk of falling and scales for evaluation of the degree of self-sufficiency. Among other scales we dealt with pain assessment, nutritional screening and screening tests for cognitive function evaluation. We have discussed these scales further in the text. The first part of the research part of this diploma paper was carried out in the form of a qualitative survey based on semi-structured interviews with nurses, working in the traumatology department. The interviews included basic and supplementary questions which were asked later, in case of need during the interviews with interviewees. The survey was conducted in April, in a trauma center in the Czech Republic. After finishing the interviews, the results were examined into detail by coding and categorization. The most important answers of the respondents were shown in the diagrams, which were created according to the defined categories. For the second group, a quantitative research, conducted in the form of an anonymous survey, was chosen - a survey with 50 respondents. This technique was chosen as a support for the received qualitative data. The goal of this thesis was to find out the use of assessment scales for evaluation of a patient in traumatology and at the same time to map the nurses´ point of view of the issue of using assessment scales in traumatology. To achieve the goal, following questions were formulated. RQ1: What assessment scales are used in traumatology for evaluation of patients? RQ2: How can the assessment scales contribute to improving the patient care? RQ3: Are the assessment scales actively used for determining the patient care intervention? RQ4: What is the opinion of nurses on using the assessment scales in traumatology? RQ5: What assessment scales are comfortable and beneficial for nurses to use in traumatology? During the research was found out that using of assessment scales results into improving the patient care, it helps us to regularly evaluate patient´s condition and to assess the risks the patient is during his/her hospitalization, endangered with. Although the nurses see the scales as beneficial, the scales are just another administrative burden for nurses in the traumatology department. However, the results of these scales are actively used to determine suitable intervention.
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The safety and quality of health services provided in the field of perioperative care
Panušková, Markéta ; Jirkovský, Daniel (advisor) ; Kolomazníková, Václava (referee)
Bachelor thesis "The safety and quality of health services in Perioperative Care" deals with quality control of nursing care in selected inpatient health care facilities as well as prevention and management of potential risks associated with the provision of nursing care. The empirical part of the thesis focuses on the awareness of perioperative nurses regarding the use of and adherence to standards, recommended work practices and quality control of nursing care in operating theaters. Custom survey was carried out at the University Hospital Motol in Prague 5 and simultaneously at the General University Hospital in Prague 2. The obtained data were evaluated using statistics CZ 12 and are presented in tables and figures. In the final discussion the information obtained were compared with the results of previously completed studies, and recommendations were set for improving the quality and safety of nursing care in operating theaters.
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Nursing documentation in the Intensive Care Unit
Matoušková, Lenka ; Prošková, Eva (advisor) ; Hocková, Jana (referee)
The dissertation is about nursing documentation in the Intensive Care Unit (ICU) and resuscitation units of Ústřední Vojenská Nemocnice (ÚVN). The paper describes the development of the nursing process and all required documentation used when completing this task. From a theoretical perspective the paper deals with the content and application of all nursing documentation in terms of the relevant legislation. From the practical perspective the research was completed utilizing a questionnaire approach. The questionnaire was delivered at ÚVN in Prague. The research focus is about getting the information about documentation, how information is interpreted between departments as well as the incidence or impact of incorrect documentation. One of the goals of the research was to determine the satisfaction of staff regarding nursing documentation. The research concluded that clear education regarding nursing documentation requirements is required when the nurse first is exposed to the area. Furthermore the research describes that nurses are well informed about the required documentation during the orientation process. It also demonstrates that nurses are kept informed regarding legislation changes as well as the consequences of incorrect documentation. Key words: nursing process, nursing documentation
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Nursing documentation by the home nursing care
CHMELAŘOVÁ, Zdeňka
Nursing documentation is currently still very hot topic. Perhaps because they are still many health workers (physicians and non-physicians) sufficiently understand the importance and seriousness of this document. The documentation not only provides valid information about the client and his health, but also ensures continuous flow its nursing care and ultimately became a piece of evidence in case of litigation. Documentation can also be used for education and research purposes. Home care is a field that has recently rapidly growing and gaining in popularity. As part of primary and community care nursing provides clients in its natural, familiar and domestic environment, which is a big advantage for him, he does not spend his days in hospital, which is economically difficult anyway. Home Care provides health care services indicated by the treating physician or practitioner and are paid for by health insurance. This thesis deals with the nursing documentation in home care agencies, which aims to describe the demographic impacts on the use of nursing documentation, check the attitude of nurses from selected agencies of home care to nursing documentation and analyze the nursing documentation in selected home care agencies. The thesis is composed of two parts, theoretical and empirical. The theoretical part deals with the history of home care, statistical data shows the growth of agencies, their employees and clients, providing comprehensive home care and medical documentation. The empirical part was realized in the form of qualitative research. The information was gathered in-depth interview technique, which was compiled from 1 identification questions and 11 open-ended questions that formed the framework for the entire interview. In fact, respondents to individually comment on the issue to the extent that they saw fit. The research group consisted of seven sisters of different age, education and length of experience, currently working from home care. Due to fears nurses were promised total anonymity, so you can just tell that they were sisters from ADP capital city of Prague and Central Bohemia. Complementary research was conducted in seven home care agencies for the same regions, but any of nurses does not belong to the Agency from the second survey. In the first phase of the research we examined the influence of nurses' demographic factors such as age, education or length of experience in the management of nursing documentation and own attitudes of nurses from selected agencies in the management of nursing documentation. The research sample consisted of seven nurses working in home care agencies that were selected purposefully and were willing to cooperate in research. In the second phase of the research we tried to analyze individual nursing documentation of selected home care agencies. For this part, we chose seven agencies, which have been their leadership under the promise of anonymity willing to cooperate. The research investigation set up three goals and three research questions. The first objective was to describe the demographic impacts on the use of nursing documentation. The second objective was to determine the attitude of nurses from selected agencies of home care to nursing documentation. The third objective was to analyze the nursing documentation in selected home care agencies. At the outset of the investigation, we asked the following questions: they influence the management of the nursing documentation demographic factors such as age, education or length of practice nurses? What attitudes toward nursing documentation occupy the sisters from selected home care agencies? Correspond to different parts of the nursing documentation with the phases of the nursing process? Results of the research can be an inspiration not only for the nursing management ADP, but also for the nurses working in home care agencies throughout the Czech Republic, only selected agencies.
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Nursing Documentation in Selected Countries
ČERNÁ, Simona
This thesis deals with nursing documentation in the Czech Republic and Germany. Nursing documentation is an inseparable but also independent part of medical documentation and the specifications of its keeping is both in the Czech Republic and Germany based on law. Nursing documentation should reflect the level of provided nursing care and serve to promote its quality. In the introduction of the theoretical part the term of nursing documentation based on the law of the Czech Republic and Germany is defined. Due to the fact that nursing documentation is a part of medical documentation itself the term is explained, too. The following part is concentrated on a detailed analysis of single steps of nursing process because it should serve as a basis for the further control work with it. The law defines the minimal requirements for the nursing documentation which is each medical facility due to fulfill. In order to complete the idea of this thesis, two objectives have been set. The first one is concentrated on nurses´ opinion collection about work with documentation in the selected medical facilities in the two selected countries. The next aim is to compare nursing documentation in the selected medical facilities in the two previously mentioned countries. Furthermore, two research questions have been formulated: What is the view of nurses in the Czech Rebublic and Germany in selected hospital departments on work with the documentation? What is the difference in the documentation in the selected departments between the Czech Republic and Germany? The practical part summarizes the results of qualitative research, which have been obtained by a semistructured interview and by the anylysis of the documentation. The first part of the research consists of the interviews with nurses, which have been recorded by indirect transcription and further processed through the open coding method. Additionally, pencil and paper method was used to unify the answers which were followingly organized into categories and subcategories through the technique of opened coding. The second part represents the anylysis of Czech and German nursing documentation. Both research questions have been answered through the proceeding of the research. The research of the first research question shows that Czech nurses see the documentation as neccessary evil, they do not use it an active way. Furthermore, they have answered that recording of all procedures related to the patient is done additionally. However, the German nurses have stated a steady presence of the documentation during the errands. The main reason for that is a possibility of immediate recording after a procedure which allows not only to make the documentation more effective but also provides the safety for the patient. Next, they state they have all the neccessary information with them. In addition, they share the idea that a high-quality nursing care cannot lack high-quality nursing documentation. The main difference between the two hospitals is that the German one performs open nursing documentation audit. This means that the management controls mainly if what has been written has been done, specifically nursing interventions carried out in patients who are still hospitalized. Nevertheless, the Czech hospitals conduct closed nursing documentation audit, which does not force them to use the documentation in a more active way. Next, the majority of the nurses have agreed on rising amount of paperwork.The second research questions have been answered through the analysis of the documentation. This meant a comparison of the documentation in the selected countries. The subject of the analysis was the nursing anamnesis, nursing care plan, its realization and nursing discharge summary. The German documentation for the nurse contains more points they must go through than the Czech one.
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Injury prevention related to falls of the residents of Home for the elderly.
SOUKUPOVÁ, Hana
The diploma thesis is structured into a theoretical part and an empirical part. The theoretical part consists of four chapters. The empirical part of the diploma thesis is based on qualitative research. The data were collected via semi-structured interviews with the senior citizens and the nurses. The replies were processed into clearly arranged charts and categories with brief descriptions. Another research method applied was observation. The interviews were followed by a detailed analysis of the documentation, which involved the analysis of the medical records of the senior citizens with a focus on medical diagnosis, chronic medication, and processing of the fall risk and its evaluation. The diploma thesis pursued three objectives by means of four related research questions. The first objective was to ascertain the extent of the clients' awareness of fall risks. The second objective was to assess the discomfort associated with usage of the special device preventing hip joint injuries resulting from falls during common everyday activities of the senior citizens. Finally, the third objective was to obtain the opinions of the healthcare staff on working with clients wearing special devices preventing the hip joint injuries. Four research questions were formulated in connection with these three objectives. Research question No. 1: What is the quality of information provided by the healthcare staff as part of the preventive intervention regarding the falls? Research question No. 2: How willing are the clients to accept changes contributing to fall prevention? Research question No. 3: To what extent is the comfort of the client affected by using special devices preventing fall-related hip joint injuries? Research question No. 4: To what extent is the work of the healthcare staff affected if their clients use devices preventing fall-related hip joint injuries? The results of the qualitative research suggest that the extent of information provided by the healthcare staff as part of the preventive intervention regarding the falls is insufficient in terms of awareness of the risky places. In particular, the research revealed that the nurses fail to sufficiently monitor the effects of chronic medication which may contribute to psycho-motor inhibition of the senior clients. As far as mobility aids are concerned, the nurses offer these devices sufficiently. The nurses demonstrated very good knowledge of all the mobility aids which may facilitate self-reliance of the senior clients. Another problematic issue is the safety of the rooms, particularly in terms of various protrusions and unevenness in the bathrooms. The results of the research do not show any unwillingness of the clients to accept changes contributing to fall prevention. Nevertheless, two of the respondents failed to engage in the activities and maintain physical fitness by regular exercise in the Retirement House. Furthermore, the results do not show any limitation of the clients' comfort resulting from using special devices preventing fall-related hip joint injuries. Finally, according to the research the healthcare staff does not feel restricted in any way when working with senior clients using such device. The results of the research will be used for repeated meetings with the senior clients and particularly with the nurses. The management of the Retirement House, together with the healthcare staff, are working on a new educational material which would indicate risky places with increased probability of falls. These results could be beneficial also for other facilities where healthcare staff takes care of senior citizens. Last but not least, the results are of interest also to the health insurance companies which could provide this special device with at least partial subsidy as part of the primary prevention programme.
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The comparison of chronic wound treatment in general physician's practice and in surgical outpatient treatment
ŠUPLEROVÁ, Michaela
Current state: The treatment of chronic wounds is a complex process which is applied in the form of different interventions by nurses in the general practitioner's office for adults and nurses from the surgical outpatient clinic. The treatment is influenced by different equipment used in particular offices, by the presence or absence of the interest in implementing modern methods and, of course, by poor participation of health insurance companies as regards the problem in question. The treatment of chronic wounds should be accomplished by completing all the phases of the nursing process. It is necessary to seek for motivation towards further education in this field. Pursuing moist wound healing is mostly cheaper as it makes the treatment shorter, which leads to patient's satisfaction. Objectives: The objective of the thesis was to evaluate the nursing process applied during the treatment of chronic wounds in the general practitioner's office for adults and the surgical outpatient clinic, as well as observe the influence of education on the nurse's professional performance regarding this treatment. The research included the analysis of the competencies of nurses in the treatment of chronic wounds and the treatment methods chosen by the nurses to benefit the patient. Last but not least, we observed the circumstances of the admission of a nurse specialist as a GP's partner for chronic wounds treatment, and the obstacles to moist wound healing implementation in the GP's office for adults and the surgical outpatient clinic. Methods: To compare the treatment of chronic wounds in the general practitioner's office for adults and the surgical outpatient department we carried out qualitative research investigation. Data collection was based on in-depth interview with prepared open questions. The interviews were recorded by voice recorder, transcribed literally and subsequently analysed. When analysing the transcripts, we used the method of open coding, by the technique "pencil and paper". The text of the dialogues was reduced and segmented into individual codes. On the basis of similarity, the codes were classified in analytical units. The categories were classified into schemes by means of SmartArt programme in Microsoft Office Word. The results were interpreted with the use of the open cards technique. The first group of respondents consisted of nurses from a practitioner's office for adults and a private surgical outpatient department. The other group comprised practitioners for adults and surgeons treating outpatients. Research sample: The research sample consisted of 12 respondents from three medical facilities in České Budějovice. In the first set there were three nurses working in the practitioner's office for adults and three nurses working in the surgical outpatient department. The second set comprised three women MDs for adults, two surgeons treating outpatiens and a woman surgeon. The intentional selection was dependent on respondents' willingness to participate in the research and it ceased when the state of theoretical saturation was reached. Results: The research investigation showed that modern moist healing of chronic wounds is mostly implemented in the offices of practitioners rather than in surgical outpatient clinics. The surgical department is aseptic and they want to minimize the risk of possible infection. Apart from moist healing the surgeons use other modern healing methods such as laser biostimulation, biostimulatory polarized light and instrument-aided lymphatic drainage. The education of the nurses involved in chronic wounds treatment is not provided within academic courses. Just two nurses completed university education whereas the other nurses get acquainted with current information at commercial presentations provided by pharmaceutical representatives. These nurses lack the capability of objective assessment of basic and specific parameters of the wounds and of subsequent treatment.
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Administration and documentation of nursing care in the nursing career
NOVÁKOVÁ, Kateřina
Administration and documentation are inseparable and obligatory parts of nurse's everyday work. Documentation in healthcare serves to communication of necessary patient information. Medical documentation is kept by physicians. Nursing documentation is conducted in parallel with medical documentation. Nursing documentation records facts of the nursing care provided to a particular patient. Duly kept nursing documentation is a quality indicator of qualified nurse's work. It has to comply with applicable legislation and reflect the latest research results. Documentation has to be brief, clear, concise and factual. It should definitely not be extensive, time consuming, complicated and it should not contain useless information and duplicities. Nurses should not be overloaded by document keeping and should not spend more time on it than with patients. The aims of the thesis: Aim 1: To map the approach to documentation among nurses at selected hospital departments. Aim 2: To map how nurses perceive document keeping in terms of time, how much time they really spend on documentation within their working hours. Aim 3: To analyse nursing documentation at selected hospital departments. Research questions: Research question 1: Do nurses feel overloaded by nursing documentation keeping? Research question 2: How much time do nurses have to spend on documentation within their working hours? Research question 3: Is the time spent on documentation used effectively? Research question 4: Would nurses welcome changes in nursing documentation? Applied methods: The research part of the thesis was based on qualitative research method applied at selected departments of a regional type hospital.The research results from the interviews, document analysis and working hours scanning will be provided to the examined hospital management. They may help the hospital management with better insight into their documentation and lead to improvement of the document keeping in general and particularly ease the work of nurses as they are overloaded anyway.
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