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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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Issues of nursing care in prevention of contractures of immobile persons
KULAJEC, Lilija
Contractures as one of the physical symptoms of immobilization syndrome influence further components of a personality and the life quality. This is why prevention of the occurrence of contractures is one of the roles of a nurse. She does it by means of the rehabilitation treatment elements, i.e. positioning, mobilization, verticalization, in cooperation with a multidisciplinary team. The aim of the thesis was to examine to what extent nurses are informed on contractures in immobile persons and to learn about the role of a nurse in prevention of contractures in immobile persons and to examine the level of cooperation between a nurse and a physiotherapist on the prevention of contractures in immobile persons. To meet the goals, we chose qualitative research in the form of semi structured interviews with nurses and physiotherapists. We analysed the results by means of open coding, the pencil and paper method. The results processed this way were categorized. They have shown that the questioned nurses consider their theoretical knowledge and practical skills in prevention of contractures sufficient and they mainly achieved them through the practice. Nevertheless, some unclear points that might affect the provided care appear in some replies. The results indicate that insufficient attention is paid to contractions by the interviewed nurses. They particularly prevent them by positioning, but mobilization and verticalization stand aside. Some of the respondents add the elements of the basal stimulation. The questioned nurses except others cooperate with a physiotherapist, which leads to overleaping of their functions, particularly in positioning and verticalization. The work has revealed insufficient orientation of the nursing care to the prevention of the occurrence of contractions among the questioned nurses. This finding as well as the other results of the research might be used as an input for a seminar tailored to this topic.
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Rehabilitation treatment of patients with severe movement disorders
STEINBAUEROVÁ, Iveta
Current status: The numbers of patients with some sort of movement disorder (mostly caused by genetic load, unhealthy lifestyle, falls and collapses, carelessness during sport activities and also car crashes) grows every year and the rehabilitative treatment becomes increasingly important. Subject: The objective of this study is to determine whether nursing staff actively approach rehabilitative treatment care according to the development and improvement of the patients mobility. Following four hypotheses were defined to achieve the objectives. H1: rehabilitative treatment treatment of patients with severe movement disorders is conducted in a multidisciplinary team. H2: The effectiveness of the treatment is continuously recorded in the nursing documentation. H3: Nursing management inspects the rehabilitations treatment. H4: The nursing staff plan their rehabilitative treatment actions according to the progress and improvement of the patients' condition. Methodics: To ensure the data required for this bachelor thesis, was used a quantitative research survey using questionnaires. The questionnaire consisted of several parts and was composed of 30 questions, which were later used for identification of the respondents and subsequently to confirm or refute the hypotheses. A total of 60 questionnaires were distributed (100%) with a 88% return rate. For further data analysis was then used 53 (100%) questionnaires. Participants: The survey was answered by nurses employed in the inpatient physiotherapeutic wards of the following hospitals: Nemocnice České Budějovice a.s., Nemocnice Tábor a.s., Nemocnice Písek a.s., Nemocnice Havlíčkův Brod, Městská nemocnice Plzeň Privamed a.s. and Institute of Oncology and Physical Rehabilitation Na Pleši s.r.o. Nurses filled the survey voluntarily, anonymously and with approval of the Directors of nursing and head nurses. Results: The research part was focused on collaboration with the multidisciplinary team. The answers indicate that the nursing staff collaborate with all team members (see grafh no. 23). Mostly, they cooperate with physiotherapist (100%) and with physician (96%). Also 96% of respondents admitted they cooperates with other nurses (see graph no. 24). The hypothesis was confirmed. One of the other objectives was the question of regular and continuous recording of the documentation. This hypothesis was also confirmed according to the obtained data: nursing staff regularly updates the progress into the documentation during their shift each day (see graph no. 18). Most nurses (90%) make records into the general nursing documentation, but there is one health facility in my list of participants with specialised physical rehabilitation documentation. According to the data received from survey, nursing management performs inspections of the rehabilitative treatment (see graph no. 25). Checks are performed by head nurses or ward nurses. In most cases the inspections take place at regular intervals or at random without notice. Thus, this hypothesis was also confirmed. Last surveyed areas was whether nursing staff plan their treatment interventions based on development of the patients' condition. Of the 53 nurses, 85% of them reported that they plan their intervention based of the patients' progress (see graph no. 16). The most commonly used interventions are positioning, education about self-sufficiency and mobility aids. The hypothesis was confirmed. Conclusion: The obtained results show that all of my hypotheses were confirmed and objective of this thesis fulfilled. In case of interest, the results of this research may be provided to all personnel responsible for quality assurance of provided healthcare and to head and ward nurses of all participating facilities as well. Results of this thesis may be provided also to students interested in this issue.
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Rehabilitation Treatment of Patient with Stroke
BŘEZOVSKÁ, Lucie
This bachelor thesis is on the topic of rehabilitative nursing of stroke patients. It is analysing how the issue is dealt with in the rehabilitation department and Department of Neurology. The bachelor thesis is divided into two separate chapters, theoretical and practical. The theoretical part focuses on the causes, symptoms, diagnosis and Treatment of patients after a stroke and the current state of rehabilitative care. One of the parts of rehabilitative care is the collaboration of the nurse and the multidisciplinary team. Furthermore, the thesis describes the possible complications that may occur from the stroke. These complications include mainly pressure sores and immobilization syndrome. Rehabilitative treatment of patients with strokes include positioning, communication, passive movements, active movements, verticalization, breathing exercises. Other methods used in rehabilition nursing, application of heat and cold and basal stimulation. The thesis also includes chapters dealing with nursing management, medical documentation and evaluating the scale of a patient after a stroke. For the practical part there was a set goal, determine the working conditions for nurses who provide the patients rehabilitative treatment after a stroke. There were four main hypotheses defined, which were the subject of an anonymus questionnaire: Hypothesis - H1: There are only positioning aids available for nurses to provide rehabilitative treatment. Hypothesis - H2: Nurses are documenting the rehabilitative treatment regularly used in the nursing process. Hypothesis - H3: Nurses state that the problem of providing rehabilitative care is the lack of time. Hypothesis-H4: Results of rehabilitative nursing care are monitored by the nursing management. As additional research investigation case reports have been formulated with the Barthel index in four patients. Results of the research shows that nurses are using not only positioning aids, but other available tools as well. Rehabilitative care nurses regularly document treatments, especially in nursing documentation. Nurses stated that there is lack of time for providing rehabilitative nursing and nurses state that the treatment is monitored by nursing management.
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Role of a Nurse in Physiotherapy on Ward and at the Physiotherapy Department
JANOUŠKOVÁ, Iva
This thesis describes the role of a nurse in physiotherapy care at general and physiotherapy wards. At the same time it tries to point out the level of knowledge about physiotherapy at surgery and physiotherapy wards and compare them. Ichose the above mentioned wards, where I performed my analysis. I questionned 100 nurses from these wards. 100 % of the distributed quesstionnaires were returned and fully answered, so I could use them in my study. At the begining I set the aim and hypothesi of my thesis. The hypothesi was confirmed at the end of my analysis. I used available literature and informations from the internet in my study. The results of my research can be used by personnel at general wards to increase the duality of physiotherapy care. This thesis ca also be used for study purposes.
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Preoperative rehabilitative preparation provided by a nurse
SOUKUPOVÁ, Pavla
Summary The bachelor thesis {\clqq}Preoperative Rehabilitation Provided by a Nurse`` is a research project. The thesis is devided into two parts theoretical and practical. In the theoretical part I deal with the branch of gynaecology, gynaecological surgeries, gynaecological treatment as well as the role of nurse working in a surgical gynaecology ward. Further I pay the attention to preoperative preparation and immobilization syndrom. Preoperative rehabilitation, however, forms the most essential part of the thesis.I am concerned with the prevention of postoperative complications occurance and practice of particular rehabilitation excercising. The practical part contains quantitative research provided by the technique of two questionnares ( for both nurses and clients), in which I try to confirm specified hypotheses related to project goals setting. The hypothesis 1 : {\clqq}The nurses in a surgical gynaecology ward don´t train postoperative rehabilitation practice with a client`` was confirmed but the hypothesis 2 : {\clqq}The reason for disusing postoperative rehabilitation by clients is non-practising rehabilitation in preoperative time`` wasn´t confirmed. During the research period there were distributed 156 questionnaires, 56 for nurses and the rest (100 questionnaires) for women after heavy gynaecological surgery. 139 questionnaires turned back , the rate of return was 89 %. The total set of acceptable and thoroughly completed questionnaires was formed by 51 questionnaires from nurses and 81 questionnaires from clients.
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