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Nursing process in a patient with hydrocephalus
Suková, Elishka ; Průšová, Kateřina (advisor) ; Nikodemová, Hana (referee)
The present bachelor thesis is devoted to the nursing process and education in a patient with hydrocephalus. The aim of the thesis was to determine to what extent the disease affects the patient's quality of life, focusing on the period before and after the insertion of a ventriculo-peritoneal shunt. Furthermore, how the patient felt during the hospitalization, whether he was satisfied with the attitude of the staff, whether he was properly educated before and after surgery or before discharge to home care. The theoretical part of the thesis is devoted to a detailed description of the disease, its causes in neonatal, childhood and adulthood, symptoms of patients of all ages and treatment options. The empirical part of the thesis is based on quantitative research investigation, analysis of the obtained data and comparison of the results of the thesis with similar works. The research method chosen was a quantitative survey using a non-standardized questionnaire. The questionnaire survey was carried out at the Neurosurgical Clinic of Motol University Hospital and the 2nd Medical Faculty of Charles University, after prior approval of the deputy for nursing care and with the consent of the management of the clinic. The results of the survey showed that 86.11% of the respondents reported an improvement...
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The nurse's role in the education of patients on surgical ward
KUBEŠOVÁ, Miroslava
The theoretical part of the bachelor thesis defines the role of a nurse-educator, the education reality consisting of the educational process, constructs, and the environment, it also concentrates on more particular introduction of the individual education topics in the pre-surgery and the post-surgery periods on a surgical ward. Four research goals were set in the empiric part of the thesis. The goals of the thesis were to find out in what ways nurses educated patients in the pre-surgery and the post-surgery periods. Further goals were to map the educational needs of patients before and after the surgery. The qualitative research form and the technique of semi-structured interviews conducted with nurses from a surgery department and patients before and after a planned surgery were chosen for the implementation of a significant part of the thesis. The criterion for the selection of respondents was that they should be patients of a surgery department with planned hospitalization longer than 2 days. The same patients were also interviewed during the post-operation period. The criterion for the selection of the nurses-respondents was that they had really worked at the standard ward of a surgery department for more than 3 months. The research sample set consisted of 9 nurses and 5 patients. Final categories and subcategories were defined based on the analyses of the carried our interviews. Educational material was prepared based on the research carried out with the patients and the nurses as the outcome from this bachelor thesis. The material was prepared in a form that enables its availability for a patient for the whole time of hospitalization. The use of the educational material can support the patient education on the surgical ward.
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Comprehensive nursing care of the patient with gallbladder disease from perspective of nurse and patient
HLINŠŤÁKOVÁ, Lucie
This bachelor thesis deals with comprehensive nursing care for patients with gallbladder diseases. The aim of the work was to find out how not only the patient but also the nurse looks at preoperative and postoperative care. Four objectives were set in the work, as the first "Map the comprehensive preoperative preparation before gallbladder surgery in the surgical department from the nurse's point of view." after the gallbladder surgery in the surgical ward from the nurse's point of view." And fourth "Map postoperative care after gallbladder surgery in the surgical ward from the patient's perspective." A qualitative research survey using a semi-structured interview technique was chosen for data collection. The research group consisted of patients who underwent gallbladder surgery and nurses working in the surgical department. It turned out that patients do not really perceive the preoperative sequence of nursing care, but rather follow the instructions of nurses. Further investigation has shown that all patients know the principles they must follow after discharge from the hospital (diet, wound care, rehabilitation), which testifies to the quality education of nurses. The results for nurses show that nurses know the principles of preoperative and postoperative care. The results of the research pointed to the insufficient psychological support of the patient by the nurses. The nurses perceive this problem, which according to them is related to the lack of staff and thus also the time per patient. The bachelor's thesis, as a recommendation for practice, showed that it is necessary to create a time reserve in the work of nurses so that they can also focus on the psychological support of patients.
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Strategy how to deal with a fear before surgery
ROSOVÁ, Monika
The diploma thesis deals with the strategies that the nurse uses in her practice to alleviate preoperative fear in patients. Waiting for surgery or being taken to the operating room can be stressful events for the patient. The overall mental state of the patient has a significant effect on the postoperative outcome, especially on the length of hospitalization or infection. The aim of the research was to find out patients' expectations from nurses and their attitude to nursing interventions to manage fear, factors influencing patients' fear, communication techniques of nurses and information that nurses provide to patients in the preoperative period. The research was carried out using a qualitative method, the technique of semi-structured interviews. The obtained data was analyzed by the technique of open coding with subsequent division into categories and subcategories. The research sample consisted of two groups of respondents. The first research sample was general nurses working in the surgical department. The second research sample consisted of patients who were hospitalized in the surgical department due to surgery. 21 open-ended questions were used to interview general nurses, focusing on information provided by the general nurse in the preoperative period, measures related to the COVID 19 pandemic and their impact on preoperative preparation, but also on nurse interventions used to alleviate patients' fears. 24 open-ended questions were used to interview patients, focusing on the impact of the hospital environment, factors affecting the patient's fear, awareness in the preoperative period, or COVID 19 measures and their effects on the patient. The results of the research survey showed that medical staff, the family and the hospital environment have a major impact on reducing fear. For the interviewed patients, the approach of general nurses, the influence of co-patients, the family and awareness have an irreplaceable role in reducing preoperative fear. The interviewed nurses consider the most important intervention to be an individual and empathic approach, proper education with an explanation of all risks. They use educational cards or notice boards for education. Measuring fear instruments are not used in practice. The patient's expressed confidence in the medical staff has a fundamental effect on reducing preoperative fear. The output of the work is the creation of a new scale for measuring preoperative fear. This scale should very easily and quickly find out how much fear the patient is experiencing.
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Planned surgery from patient's point of view
KARŠULÍNOVÁ, Pavla
The present bachelor's thesis deals with planned surgical procedure from a patient's point of view. Planned surgical procedures include unfamiliar experiences and information for the patients. A proper preoperative patient teaching is, thus, advisable. The thesis is divided into two sections: a theoretical and a practical section. The theoretical section focuses on surgical procedure (surgery), preoperative procedures, intraoperative care, preoperative patient education, nurse-patient communication, postoperative care, and cooperation with patient's family. The practical section consists of a research into the matter. The aim of the practical research section is to map patient's subjective preparedness for planned surgical procedure. To reach a conclusion, it is crucial to answer the following questions: 1. What is the patient's assessment of preoperative education performed by nurse? 2. What are the patient's preoperative expectations? 3. What are the patient's postoperative experiences? A qualitative research has been conducted. Semi-structured interviews with patients who were to undergo planned surgical procedures were used as the primary source of data for the research. The interview has two parts, first is before procedure and second is after procedure. The patients were to answer 17 questions. The 9 patients were to answer. The results have shown that almost all of the patients were well-prepared for the planned surgical procedures thanks to the preoperative education performed by nurses. They were preoperatively educated by a nurse, who provided education on essential nursing care related to the planned procedure. Some patients were educated by a nurse of a particular specialized outpatient department. According to the research results, the patients were satisfied with nurse-patient communication that took place in the surgery department. The patients also expected the nurses to be at a professional behaviour, to be kind, and to deliver essential nursing care. A professional article that informs nurses about the importance of preoperative patient education is the practical outcome of this thesis.
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The role of nurses in patient education prior to anesthesia for surgical procedures in orthopedics
Slouková, Michaela ; Di Cara, Veronika (advisor) ; Hakenová, Renata (referee)
The thesis is focused on the role of nurse in patient education prior anaesthesia in surgical procedures in orthopaedic. Description of this role is based on the experience at the orthopaedic clinic and problems related to it are seen in the results of survey. The aim was to assess the level and effectiveness of patient education done by nurse before anaesthesia, measure the level of satisfaction and patient awareness before surgery, assess the quality and content of education provided by nurse and identify the current competencies of nurses in patient education before anaesthesia. Data for the research survey were obtained through two questionnaires designed for nurses working at the orthopaedic clinic and for patients who have undergone scheduled intervention in this clinic. The most important finding of the research results was crossing the competencies of nurses in the preoperative patient education because the lack of visits by anaesthesiologist. Based on what I studied in the available literature and the research results, in the discussion I am presenting proposals for solutions of this situation and I suggest active offering of the information material to patient during admission, the creation of improved education material for preoperative preparation, using of different teaching methods...
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Foreknowledge of patients with total hip replacement at orthopedic department of Jinřichův Hradec hospital a.s.
DOUDOVÁ, Klára
Basic theoretical background: Because this thesis mainly deals with the awareness of clients, it was necessary in the beginning to mention the importance of the communication in a medical environment. Communication takes place between two or more people. During communication, people communicate necessary information, feelings, attitudes, talking about relationships and moods. There are several communication rules that one should follow, however, it depends on the individual, whether follow it or not. Communication skills can be developed gradually for they are important to us and in our personal lives. If a person loses the ability to communicate, it can lead to danger to his relationships with others. For healthcare professionals, it is very important social skill ( Mikuláštík 2003). Main aim of the thesis: To verify the information rate of clients in preoperative phase of total hip arthroplasty and in postoperative care. Discover also whether patients after total endoprosthesis have possibility of aftercare (rehabilitation, spa treatment). From these targets were developed following questions : In what areas are the clients in preoperative stage informed? How are clients reporting in a post-operative care ? What options of aftercare patients after total endoprosthesis have? Methodology: For the research was used the qualitative survey data collection. A qualitative investigation was approved by head nurse of the hospital, where the research has been done. The interviews was realized at home of clients. Survey was conducted through semi-structured interviews, interviews were anonymous. The data were collected in March 2015 in the set of seven respondents. Despite the fact that interviews were realized in the clients' home, we needed approval for the research from the head nurse. Especially because the subsequent care for patients after total prosthesis was also investigated. It was therefore important to identify initially the applicable patients in the hospital and up to a certain time after the surgery to interview them.
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Watching the awareness of mothers of children hospitalized in the surgical ICU as a basis for improving nursing care
VOTROUBKOVÁ, Iveta
This diploma thesis focuses on information awareness among mothers of children hospitalized at surgical intensive care units. Four research questions were formulated on the basis of literature review. The theoretical part of this thesis gives an overview of basic facts concerning information awareness and care of children at surgical ICUs. Furthermore, it describes the way information is passed on in praktice. A part of the theoretical section also comprises of the list enumerating the most common diagnoses with which children found themselves to be placed at surgical ICUs and it contains, as well, the description of admittance of children for a surgical intervention, pre-surgical care, post-surgical care and discharge of children from hospital to homecare. Collection of data for the practical part of the diploma thesis was conducted at two intensive care units in the University Hospital in Motol, Prague, and UH Brno in the CR. Five respondents were intentionally selected from each ICU with whom semi-structured interviews were conducted, which are summarized in sub-chapter 4.2. The results of interviews with individual respondents were further subjected to analysis and summarized in summary tables. The Diploma thesis had two objectives. The first objective was to ascertain subjective information awareness of mothers about their children´s illnesses and possible complications or consequences related to these illnesses. We wanted to find out whether mothers were subjectively satisfied with information provided about thein children´s illnesses and possible complications or consequences related to these illnesses. We also wanted to discover whether they experienced any information deficit in this area and what were their most frequent questions to the medical personnel. It was ascertained through interviews that the majority of respondents was not satisfied with information provided. The second objective was to discover subjective information awareness pertaining to the period of hospitalization at surgical ICU and child´s subsequent homecare. We wanted to know whether mothers felt that they were kept informed enough about pre-surgical and post-surgical care of their child and whether or not they were satisfied with information pertaining to child´s subsequent homecare. We were also interested in whether or not they experienced any deficit of information received and what were their most frequent questions to the medical personnel. It was discovered through an analysis that the majority of respondents was not satisfied with information pertaining to pre-surgical care and complications which might have arised during the surgical intervention. As for information centred on the date of operation and possible duration of hospitalization most respondents were satisfied with it. Furthermore, the majority of respondents were satisfied with information provided about child´s subsequent homecare. We discovered that respondents were not informed satisfactorily by medical personnel about other contacts such as for clubs for parents, stoma clubs and centres of early intervention. It was possible to ascertain from the results that each respondent saw deficits in different areas of information provision as well. In the list of such information deficit areas are information about the character of surgical intervention, the ward rules, and the fact that doctors and nurses do not have enough time. Moreover, the respondents also perceived the deficit in sharing of information among medical personnel. On the basis of final results which point to experience of unsatisfactory information awareness among mothers about pre-surgical care for the child we developed in a written form the Information for parents about pre-surgical and post-surgical care brochure. We also prepared due to the fact that mothers sensed the lack of written information about the ward the Information for parents about the ward brochure.
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Nursing perioperative care on the gynekological section.
WOLFOVÁ, Petra
The bachelor thesis focuses on nursing care before, during and after a gynaecological surgery. Gynaecological surgeries are divided into small and big. Small gynaecological surgeries require only one surgeon and the hospitalization of the patient is shorter than 24 hours. Big surgeries require more surgeons, the patient is under anaesthesia for a longer time and the hospitalization is longer than 24 hours. In this bachelor thesis, we focused on perioperative care in women after a big gynaecological surgery. Care during the preoperative period is an integral part of the work of a birth assistant, as gynaecology is largely a surgical specialisation. With advancing technical progress and development of new surgical methods, various types of surgeries appear with specific requirements for nursing care. Effective perioperative care is important for trouble-free convalescence of women after surgeries. Perioperative care includes both nursing procedures and informing the patient about the hospitalization and care course. Perioperative care is very demanding for the woman herself and for the whole team participating in the care. Interaction of all the medical staff is necessary in perioperative care to provide specialised care according to the standards. The aim of this bachelor thesis was to determine the needs of patients that are affected in the highest extent during perioperative period. The research focused on the way women perceive perioperative period and the approach of health care professionals and the extent these items meet their expectation. The research was performed at a gynaecology-obstetrics department of a hospital, using qualitative assessment in deep interviews. The interviews included 13 open questions. The research group consisted of 8 women after a big gynaecological surgery. The participation in the interview was voluntary. The results of this research were carefully transcribed and analysed using the "pen-paper" method. These results were divided into four categories and further subcategories.
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The Patients´ Intimacy Problem during the Preoperating Preparation and the Transport to the Operating theatre on the Orthopaedic clinic.
FERENCZOVÁ, Romana
The bachelor thesis is specialized in the intimacy of the patients during pre-operative preparations and movement to the operating theatre in the orthopedic department. The thesis is also specialized in the nurses?s behavior which these activities are doing. The intimacy is still discussed topic. It is the conflict of the right of patient to privacy and the effort of medical staff members to the best pre-operative preparations and subsequent movement on the operating theatre. In spite of the big efforts of medical staff members there are the situations which cause the shyness and the shame of patients. The main reason is time pressure which is exerts on the medical staff members. The disruption of the intimacy can be caused by the wrong communication between the nurse and the patient but also between the staff themselves. Every patient is individuality and therefore there is not possible to set one standard working procedure which solves this situation. The main objective of this thesis was to find out how the intimacy of patients during pre-operative preparation is secured and to study possibilities of the ensuring intimacy during movement to the operating theatre. The next objective was to find out during which activities (performances) during pre-operative preparations the intimacy used to be frequently devastated. The data were obtained within qualitative research from two non-standard interviews. One type of interview was done with seven randomly chosen patients of the orthopedic department. The second one was done with seven nurses working in the medical facility. One of the nurses is working in the operating theatre. The nurses from the inpatient ward were asked if they respect the patient´s intimacy consistently than the nurses in the operating theatre. They were also asked if there is difference in observance of patient´s intimacy during pre-operative preparations in the scheduled operating performance and urgent performance. The objectives of the bachelor thesis were fulfilled. During interviews there was found out that the disruption of the intimacy was most often realized during movement to the operating theatre. The identified results will be provided to the management of the medical facility to create the standard for the securing of the patients intimacy on the operating theatre.
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