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Cooperation of nursing staff with the ostomy nurse
HÁLOVÁ, Kateřina
The bachelor thesis is focused on cooperation between stoma nurses and general nurses, their procedures in the education of stoma patients, and nursing problems related to stomas. The bachelor thesis is divided into two parts - theoretical part and research part. The theoretical part contains characteristics of a stoma nurse, stoma, stoma indications, complications and appropriate stoma care. It also defines cooperation among healthcare staff, and education of ostomates. The research part is focused on cooperation between stoma nurses and general nurses, education of ostomates, and the most common nursing problems related to stomas. Two objectives were set for the research part, namely: To explore cooperation between nursing staff and stoma nurses. To identify the most common nursing problems encountered by stoma nurses in the education of nurses. This part had the form of a qualitative research survey using semi-structured interviews. Interviews were taken with two research sets. The first set consisted of three stoma nurses and the other one of four general nurses. After theoretical saturation was reached, the information was processed in the form of open coding and was subsequently categorized into seven categories. The results show that cooperation between stoma nurses and general nurses in taking care of ostomates is very common. In most cases such cooperation involves professional help in dealing with complications, provision of stoma care supplies, or patient education. Concerning the second objective, it has been found out that the most common problem in the education of nurses is poorly cut holes in ostomy bags and subsequent occurrence of complications. It has also been found out that stoma nurses try to educate staff in accordance with their nursing procedures so that the education of patients is of the highest quality possible. The findings were used to create an information material for nurses and students of nursing professions.
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Nursing care for the colostomy from the perspective of patients
CHOMOVÁ, Sandra
Present situation This bachelor thesis deals with nursing care of colostomy, namely from patients' point of view. The theoretical part focuses on the anatomy of colon and rectum. The chapter Stoma explains this term. The thesis also contains chapters dealing with the history of stomas and the history of their treatment. It is useful to know what the care looked like in the history and what it looks like now to gain comprehensive insight. The part dedicated to the indication of colostomy application is important as well, because there is not just one reason but more. The necessity of surgery is logically linked to the indication. Another chapter thus deals with pre- and post-surgery care and also mentions the differences from "normal" pre surgery preparation. Poor post-surgery care may lead to various complications of stomas particularly early complications in the post surgery stage. Later complications are mostly caused by poor care after longer time from the operation. This is why the proper education by a stoma nurse is necessary. One of the next chapters, stoma nurse and her role deals with the main tasks of a stoma nurse. Stoma aids also form an inseparable part of colostomy treatment. This aids are divided into a one-piece system and a two-piece system, and various accessories are also worth mentioning. There are of course small differences in replacement of the one-piece and the two-piece system, which are mentioned in the chapter replacement of the one-piece system and the two-piece system. Proper nutrition and water intake are important part of colostomy treatment. This chapter explains proper and improper habits and food. The last chapter of the thesis deals with the clubs of ostomists as these are able to help a patient cope with the stoma. Goals of the thesis and research questions Goal 1: To find the differences between the nursing care provided by a stoma nurse and a nurse from a standard ward. Goal 2: To find how a patient copes with colostomy treatment after being released to home care. Research question 1: What activities does a stoma nurse perform within colostomy care? Research question 2: What activities does a standard ward nurse perform within colostomy care? Research question 3: What problems does a patient face in colostomy treatment in home environment? Research question 4: What knowledge was a patient given before being released to home care? Results The results have shown that the main role of a stoma nurse is based on patient education. A worrying finding was that there had been insufficient education before the operation. As for the nutritional information, each patient was informed to different extent, some were not informed at all. The information on complications seems to be sufficient, the nurse informed the patients on the basic possible complications. The standard ward nurse most often redressed the post-surgery wound within colostomy care and asked about pain and administered painkillers. As of direct colostomy care she changed the pouch or the flange. The respondents however often mentioned that she was not experienced enough in their responses. When the nurse changed the pouch, she always check whether the colostomy was draining, how much stool was in the pouch, she checked and treated the colostomy surrounding and the colostomy itself. The standard ward nurse did not teach the patient any new skills, only the stoma nurse taught them. None of the respondents has faced any serious complications yet. Respondents of higher age have problems with cutting the hole in the flange. Before the end of hospitalization all the respondents were provided with comprehensive information on colostomy treatment and the nurse checked whether they do it properly. All the respondents were also given contact.
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Cooperation of a stoma nurse with multidisciplinary team
VOTRUBOVÁ, Veronika
A stoma is an opening of a hollow organ on the surface of the body. The care for a stoma aims at returning a patient to ordinary life and it is exactly in this process that a stoma nurse should help the patient. The stoma nurse guides the patient through the pre-operative preparation, the post-operative preparation and also through the outpatient preparation in which the patient visits the stoma nurse in a stoma clinic. Cooperation of the stoma nurse with other members of the multidisciplinary team is important because it makes it possible for the stoma nurse to meet all the needs of the patient. The theoretical part deals with the anatomy and physiology, definitions stoma stoma and also the history of its development in nursing. The next chapter deals with the indications, types of stoma and possible complications. The chapters on preoperative and postoperative care, nutritional advice and clubs for stoma patients. Other chapters are devoted to stoma nurses. The primary intention of the thesis is to meet one objective which is to find out how a stoma nurse cooperates within the framework of a multidisciplinary team in various departments of a healthcare facility. The following hypothesis was set for this objective: "The integration of a stoma nurse in a multidisciplinary team is different in every department." The research question was: "How is a stoma nurse integrated in a multidisciplinary team?" The research was carried out by means of a quantitatively qualitative investigation. A method of questioning using the technique of questionnaires was used for collecting data in the quantitative research of the bachelor's thesis. The questionnaires were addressed to nurses in the internal medicine and surgical wards. The collected data were evaluated by means of processed graphs. The qualitative research was carried out with stoma nurses in the surgical ward by means of interviews. The quantitative survey implies that the shift nurses in a surgical ward cooperate much better with the stoma nurse than nurses in an internal medicine ward. In the surgical ward the cooperation is better in terms of communication with shift nurses because they exchange information about patients with stomas, the occurrence of complications and the nursing procedure. On the other hand, in the internal medicine ward this communication in many cases does not work. In most cases the nurses at the internal medicine ward do not feel a need to communicate and discuss the care for a patient with the stoma nurse. The stated objective was achieved using the research question and the confirmation of the hypothesis. From a qualitative investigation implies that stoma nurses are integrated in the education of patients before and after operations. The pre-operative preparation includes also the drawing of a suitable place for a stoma on the body of a future stoma patient. In most cases they discuss a suitable procedure of caring for a stoma patient with shift nurses and inform each other about the occurrence of complications. If they are interested, the stoma nurse informs the nurses of new appliances and findings from seminars. She has got also her own specific documentation where she writes down details about patients. Two stoma nurses also point to the option of cooperating with a nutritional therapist as a part of the nutritional consultation of a patient with a stoma. When cooperating with a physical therapist the stoma nurse informs him of the patient's overall condition and the physical therapist provides total rehabilitation. The results of the findings established by this bachelor's thesis will be provided to the management of hospitals where this research took place.
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Awareness of the care of urostomy patients among general nurses.
HOROVÁ, Petra
The aim of the thesis was to find out how informed nurses were on the care about urostomy patients, whether nurses had experience with urostomies, knew aids used for urostomy patients and mastered the correct urostomy care techniques. 4 hypotheses were set for these goals. H1: Nurses working at various departments have personal experience with urostomy patients, was confirmed. H2: Nurses know available aids for urostomy patients, was not confirmed. H3: Nurses are able use the aids for urostomy patients, was confirmed. H4: Nurses master the correct technique of caring about urostomy patients, was not conformed. We chose quantitative research by means of an anonymous questionnaire performed at various clinics of the Faculty Hospital Královské Vinohrady in Prague as the research method to achieve the goals and confirm the hypotheses.
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The problems of nursing care in children with stomia of small and large intestines
BARTYZALOVÁ, Martina
The bachelor thesis is aimed at the problematics of the children patiens with stomia. Stomia is the taking out of the small or large intestine out of the body. The most often indications with insomia is to remove the large intestine, inborn development defect and the necrotising enterocolitidis (NEC). The most often reasons for the by-passing with the colostomy are also the development defects and the Hirschsprung desease. Children with the stomia are few in the Czech Republic. They are mainly newly-borns or suckling infants, with whom stomia is tempoval. Children with this desease are usually taken care of by the parents in the home invironment. The parents are dependant on the assistance of a stomia nurse, which educates them and informs about everything connected with the illness. The goal of the bathelor thesis is to map the needs of the children with stomia of the small and large intestine and specify the needs of the nursing care. The work was also aimed at the task of the stomia nurses caring for the children with stomia. A qualitative research with the method of questioning was applied together with the discussion method with the parents of the sick children and the stomia nurses, who have already had experience with caring for the children with the stomia disease. All in all ten parents have been contacted, six of which have participated in the interview. Fourteen stomia nurses have been contacted, but due to little experience with treating the stomia children just three of them have been interviewed. The respondents came from various parts of the Czech Republic. As for the specifics of the nursing care we were interested in three aspects of the nursing care. The first sphere was skin care, where it was found out that the parents of the children with ileostomy should pay special care to the skin in the place around stomia. It is caused by the fact that ileostomy takes out watery and agressive substance, which causes skin damage in the place of stomia. Another important fact was that the patents use common children cosmetics, which is considered to be absolutely unsuitable for the children with stomia. It is also important to mention that due to a wide choise of stomia amendments the nursing care is on a much higher level than before. As for catering it was found out that newly-borns and suckling infants should be breast feaded and with the ileostomics the stool should be was thickened by adding rice puding without milk. The third sphere was evacuation. Childer with stomia evacuate in a specific way with the help of bags and systems. It was found out that the most suitable system for children with stomia was the simple one. The other goal was to map the needs of stomia children. From the research it was found out that stomia has a negative effect on the quality of life of both the children and their parents. Stomia affects the life socially but mainly mentally. As for the mental aspects it was found out that the services of psychiatrists are not used. It is also supported by the fact that just one parent out of six uses consultations with the stomia nurse regularly, who should be their main support. It was also found out that every child cried while stomia was treated. From the social side it was found out that children with stomia can be isolated from other children at kindergartens and schools. Stomia also restricts children when doing sport and other activities. As for the fysiological needs, they have already been mentioned in the specifics of the nursing care. The last goal was to find out what role in treating children stomia the stomia nurse plays. It was found out that the education of the stomia nurse is very important for the parents of the children with stomia but their opinions do not coincide. Some nurses say that they educate the parents before and after the operation, but we have found out that it was not true. Very few parents were educated before and after the operation.
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Reality of cooperation of a stoma nurse with shift nurses.
KRATOCHVÍLOVÁ, Markéta
Abstract Reality of cooperation of a stoma nurse with shift nurses Pernicious diseases of intestines and rectum often lead to creation of a temporary or permanent intestinal outlet alias stoma. Having been diagnosed, the patient is confided to the care of healthcare workers, in particular nurses, who endeavour to provide the patient with the highest possible quality care in the most intensive manner. At present, almost every hospital has a specially trained stoma nurse who should play the role of an advisor or coordinator in the nursing team. Regrettably, non-cooperation between shift nurses and the stoma nurse harm in particular the patient. Five hypotheses were raised. The first hypothesis was to confirm whether the shift nurses on surgical wards cooperate with the stoma nurse more efficiently than the shift nurses in other than surgical wards. This hypothesis was confirmed. The second hypothesis was to confirm whether the stoma nurse provides the shift nurses with regular information on developments in the concerned area. This hypothesis was not confirmed. The third hypothesis was to confirm whether the shift nurses cooperate with the stoma nurse as early as in the period before the operation; this hypothesis was aimed at surgical nurses and was not confirmed. The fourth hypothesis was to verify whether the shift nurses have sufficient information from the stoma nurse so that they could substitute her adequately when she is absent. This hypothesis was not confirmed. The fifth hypothesis verified whether the shift nurses ask the stoma nurse to provide them with information concerning correct handling of the stomal equipment. This hypothesis was not confirmed. The data were collected in the quantitative research supplemented with an interview with the stoma nurse. The shift nurses in surgical and non-operational wards obtained anonymous questionnaires. The research was conducted in seven hospitals in the Region of South Bohemia. The objectives were fulfilled. The information will be provided to deputy managers for the nursing care and stoma nurses. We believe that our results may contribute to higher efficiency of the cooperation between nurses, which will have a positive impact on provision of comprehensive care of patients with a stoma.
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Status of stoma nurse in the Czech Republic
MÁTLOVÁ, Monika
Abstract The Czech Republic is one of the states where the occurrence of colorectal cancer is very high, we are the leading state in Europe. 8 new occurrences come up every year and 5000 patients die of colorectal cancer each year. In spite of progress in surgical treatment applying new methods, temporary or permanent stoma is being created. Nursing stoma patients and the extent of the care is so specialized that a qualified expert, called stoma nurse is required. This paper deals with the ``position of stoma nurse in the Czech Republic{\crqq}. The paper aims at describing the position of the stoma nurse in the Czech Republic, to determine the position of the stoma nurse in medical institutions and find out about the competences and conditions stoma nurses have for carrying out their specialization and to find out about the specialized education stoma nurses must have. To fulfill this goal a quantitative survey was applied by means of a structured interview with 30 open questions. 6 stoma nurses took part in the survey. The interviews were written down in a anonymous record, authorized by the stoma nurses. The analysis of the interview was carried out by means of tables. The analysis has shown that the majority of stoma nurses carry out their specialization as their main workload. In medical institutions where the nurses do not carry out this specialization as main workload, more nurses work in parallel in the capacity of stoma nurse. The nurses do not have appropriate conditions to carry out their specialization. They lack appropriate premises, a clearly described duties and competences. However cooperation in a multidisciplinary team runs well. Education and training of stoma nurses is done by means of courses organized by particular medical firms. Stoma nurses improve their knowledge in courses and seminars.
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The nursing care quality from the point of view of stoma patients
VLČKOVÁ, Veronika
Person with stoma is any handicapped human with temporarily or permanently drawn hollow organ out onto body surface. The most common it concerns colon, small intestine or urinal system. Uncontrollable emptying of faecal matter or urine happens by innatural way with necessary use of stoma appliances. In stomas sphere the most important factor is informedness not only of the patient himself but of nurses as well. Sufficient education of a patient and ability of a nurse to treat stoma is the base of good nursing care. The aim of the thesis was to find out to what degree the stoma patients are informed on ways of stoma treatment and how they are satisfied with the quality of given nursing care. The work is divided on contemporary state and methodological procedures. Contemporary state includes especially pre-operation, post-operation, home and out-patient care, clients´ education, importance of stoma nurse and association of stoma patients, kinds of stoma appliances, specifics of stoma patients´ nutrition, social problems of stomas etc. For the research part six hypotheses were established. They concerned the quality of nursing care, problems of stomas treating, cooperation with nurse and club of stoma patients. It was found out that 81% addressed people are satisfied with the quality of given nursing care, 98% are familiar with problems of stomas treating, 99% were able after six months after setting of stoma to take care of stoma themselves,72% are members of the club and 90% cooperate with a stoma nurse. On the base of the research all hypotheses were confirmed and the aim of the thesis was fulfilled.In the thesis a method of quantitative research was chosen. The research proceeded in Hospital České Budějovice, Inc. in clubs of stoma patients in Tábor and Příbram. The technique of data collecting was anonymous questionnaire established for clients with a stoma. 100 respondents were addressed. The research proceeded on the base of personal contact and cooperation with stoma patients, therefore the return of questionnaires was 100%. Two questionnaires were from the reason of incompleteness taken out. The results are given in percentages and diagrammatized.
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