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Brno City Hospital
Seďa, Ondřej ; Hybská, Bohumila (referee) ; Sedláček, Michal (advisor)
The topic of the diploma thesis is the design of a town hospital at Kraví hora in Brno. The design of the new city hospital in Brno replaces the functions of two existing city hospitals, the Merciful Brothers Hospital and the Trauma Hospital, whose technologies do not meet the medical requirements of the 21st century. In the hospital there are standard facilities, namely outpatient medical facilities, including day hospitals, central blood collection, emergency, operating rooms, central sterilization, anesthesiology and resuscitation departments, intensive care units, maternity and neonatology departments, examination complement , laboratories, rehabilitation departments, inpatient departments of surgical and internal medicine, non - medical and commercial premises, personnel background, technical background and parking. The hospital is a 10-storey building. The main idea of the design was to create a hospital with the views of the park even Brno skyline.
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Therapy of arterial hypertension in prehospital emergency care and at urgent admission
SYNKOVÁ, Kateřina
The bachelor thesis on the topic of Therapy of arterial hypertension in prehospital emergency care and in the emergency room is focused on dealing with states in cases of sudden escalation of patient's blood pressure. The thesis is divided into a theoretical part and a practical part. In the theoretical part, blood pressure is characterized, including the methods of its measurement, arterial hypertension and hypertensive crisis. Furthermore, there are descriptions of the basic classes of anti-hypertensives and their use in specific groups with arterial hypertension. In the practical part of the bachelor thesis, three goals were set. The first goal was to map out how arterial hypertension is treated in prehospital emergency care within the competences of paramedics and guidelines of given workplace of the emergency medical service. Second goal was to map out the way in which arterial hypertension is treated in emergency rooms of given workplaces, and the third goal was to find out what are the differences between therapy of arterial hypertension in prehospital emergency care and in the emergency room. The research study was carried out via qualitative method of data collection using semi-structured interviews. The interviews were conducted with paramedics operating within the Emergency medical services of the South Bohemia region in the districts of Písek, Tábor and Český Krumlov. In addition, selected paramedics working in the emergency department of České Budějovice Hospital also took part in the interviews. From the results of the research part of the bachelor thesis can be concluded, that the interviewed paramedics have enough experiences and knowledge in the area of treating a patient with arterial hypertension and know when it is adequate to reach out to a medical professional about possible therapy.
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Communication as part of nursing care in the emergency department
KREJČÍ, Natálie
Abstract The aim of this thesis was to chart the specifics of communication between nurses and patients in the emergency department. Two research questions were formulated based on this goal: "What are patients' experiences with communication from nurses in the emergency department?" and "What communication problems occur between nurses and patients in the emergency department?" Additionally, two hypotheses were developed, namely: "Nurses' knowledge of communication principles differs according to their level of education" and "Nurses' knowledge of communication principles differs by length of experience." A mixed research strategy was used, including semi-structured interviews and an unstandardised questionnaire. The study involved 12 patients treated in the emergency department and 216 nurses working in the department. The interviews were evaluated with the open coding method, using pencil and paper, and the results were subsequently categorised. Hypotheses were tested using nonparametric correlation Spearman's correlation coefficient in IBM SPSS Statistics 28 program. The results of the qualitative research emphasise the importance of communication in the emergency department. Patients evaluate their experiences primarily based on the approach and communication from the staff. The most frequently reported communication issues are unsuitable communication from nurses, followed by the staff not having enough time, high numbers of patients in the waiting room, and insufficient information. The quantitative results demonstrate a statistically significant effect between nurses' educational level and knowledge of communication principles. The test result yielded a p-value of 0.01%. Thus, the higher the educational attainment, the higher the knowledge of communication principles. In contrast, there was no statistically significant association between the length of experience and knowledge of communication principles. According to the test result, the p-value was 19.6%. Therefore, knowledge of communication principles is not related to nurses' experience. The most common barriers from the perspective of nurses are aggression from patients and a lack of time. One of the solutions to the barriers is certainly to increase the number of staff and to ensure lifelong communication skills education for nurses.
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Medical and sanitary staff reaction on physical attack in a health-care institution
KÁCHA, Vojtěch
This bachelor thesis deals with the matter of physical attack on medical personnel in health-care institution, especially on the emergency unit. Medical staff can get into confrontation with pacient, who can be influenced by drugs, alcohol, serious mental illness, or by difficult life situation, which evoke conflict behavior. This confrontation then can be dangerous for safety of health workers, but also their patients. Theoretical part will be based on characteristics of violence, agression and theoretical methodology during encounter with agressive pacient. Study define violence and it´s categories. It also shows resolving methods already escalated confrontation. In practical part study searches and compares aggression resolution between two regional and two district hospitals. It mainly identifies, which techniques health-care institution workers use in order to prevent physical attack from patient, then how health-care workers react to it and also how often do they encounter verbal and physical aggression during their shift. For this research the qualitative technique, along side with inquiring method and in-depth conversation will be used, whereas the research sample is going to be medical staff on the emergency department i.e. nurses and paramedics. Result of the study shows, that health-care workers are in contact with verbal aggression almost every workshift, with physical then only occasionally, eventhough the number of cases have grown. Result of thesis tells, that there is bigger number of cases in district hospitals, than,logically, in regional hospitals, especially because of higher number of patients in district hospitals. But in percentage sign it could be told, that the number is same, no matter the location. The more the health-care personnel are in contact with aggressive behavior, the more they had to adapt to it. And so if they notice, that the situation cannot be deescalated, they will rather call for security service of the hospital, or for the police, so they would not have to risk their own, or the patients' health. But primarily they are trying to handle the situation with principles of correct communication. Unsettling discovery is, that patients' conflict behavior is for hospital personnel on daily basis and it is no longer suprising for them. Prevalence It seems, that for society agrressive behavior became standart way of how to achieve it's goals. There should be enough attention for society to realise, that aggressive Aggression prevalence in hospital instituon points to more komplex society problem, where aggressive behavior is more and more seen as legitimate way, of achieving goals. Study is warning before aggressive prevalence in healt-care institutions. Solution of this problem stands on cooperation of several pillars. Hospital headquarters should provide enough safety for their workers and patients from aggressors and also organise educational programs about correct approach towards aggressive people a eventually elementary courses of self-defence, if needed. These results should also alarm media companies, which should aim for primary prevention a should actively draw attention and convey people about that there is no place for aggression in health-care instition without legitimate reason, because resolution of conflicts is exactly what holds off personnel from providing quality and effective health-care.
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Patient intimacy in the Emergency department
KUBÍNOVÁ, Jitka
This bachelor's thesis, named "Patient's intimacy at an emergency department", focuses on patient's intimacy, privacy, and human dignity during his treatment at the emergency department. We live in modern times, everything focuses on innovations, researches and mainly time demands. So, it is in the health service, the medical part is more interesting from the perspective of treatment methods and resources. The intimacy and human dignity topic lag behind the medical one but not so much as before. It is getting more and more into public awareness. In the intensive medicine, this topic is complicated. Hall type care system is developing even in emergency department and keeping patient's intimacy is being disturbed by many circumstances and factors. The theoretical part describes the development of the intensive medicine and emergency departments abroad as well as in the Czech Republic. Then there are being described fields such as intimacy, privacy, human dignity, holism, communication, patient's needs as well as patients' rights and their enforceability. In the practical part, the research was processed by a qualitative method using an interview and participating hidden observation. Interviews and observations took place in March 2021, in a selected emergency medical facility. A research cohort was formed by 10 paramedical workers. The practical part was purposely focused on paramedical staff. The goal was to find out their perception and respecting of intimacy. The results of the research showed that the medical staff at the emergency department have some theoretical knowledge about intimacy and human dignity but are not always able to demonstrate practice. This is a topic that every healthcare professional should work on a lot.
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Admission of polytraumatized patient to the hospital - preparation of simulated scenarios for paramedics and nurses
ŠEVČÍKOVÁ, Tereza
The most common cause of death of children and adolescents is trauma. The Czech Republic is dominating and ranks in leading positions in Europe. Children mostly occur in situations such as falls, traffic accidents, when the child is in the position of a passenger or is represented as a pedestrian or cyclist. Other causes include burns, drowning or suffocation. Treatment in the first 20 minutes is most important for the patient's further prognosis. Therefore, it is necessary to proceed quickly during treatment and provide emergency assistance first - which means securing the airways and circulation. A polytraumatized patient is considered as one in a very serious condition who needs acute assistance from rescue services. When admitting a polytraumatized patient to the hospital, it is important for the rescue team to organize the work and provide it to the patient with the fastest and highest quality care. The diploma thesis is elaborated in theoretical form and is divided into four parts. Scientific information was obtained when studying professional literature. It was Czech and foreign literature and both monographic works and scientific periodicals were used. The process of nursing care procedures for children with polytrauma and my personal experience as a nurse working at the resuscitation department for children greatly contributed to the extended data collection for the diploma thesis. The diploma thesis creates a summary of procedures for the admission of a polytraumatized patient and enables a better orientation in the provision of nursing care for children. It focuses on differences in the provision of emergency care for children and highlights priorities in the treatment of patients in pre-hospital and hospital care. It also points to the clash of non-medical staff with doctors and the ability to cooperate in the provision of care within the rescue team. The diploma thesis provides information on the topic of admission of a polytraumatized patient to the hospital and is intended primarily for non-medical healthcare professionals, but also for the professional and lay public.
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Brno City Hospital
Seďa, Ondřej ; Hybská, Bohumila (referee) ; Sedláček, Michal (advisor)
The topic of the diploma thesis is the design of a town hospital at Kraví hora in Brno. The design of the new city hospital in Brno replaces the functions of two existing city hospitals, the Merciful Brothers Hospital and the Trauma Hospital, whose technologies do not meet the medical requirements of the 21st century. In the hospital there are standard facilities, namely outpatient medical facilities, including day hospitals, central blood collection, emergency, operating rooms, central sterilization, anesthesiology and resuscitation departments, intensive care units, maternity and neonatology departments, examination complement , laboratories, rehabilitation departments, inpatient departments of surgical and internal medicine, non - medical and commercial premises, personnel background, technical background and parking. The hospital is a 10-storey building. The main idea of the design was to create a hospital with the views of the park even Brno skyline.
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The acquisition,development and comparing of the emergency in Czech republic
Hluchá, Lenka ; Šeblová, Jana (advisor) ; Jankovcová, Kateřina (referee) ; Chvojková, Kateřina (referee)
Introduction to the issue and the importance of the topic: Emergency Department (ED) is a new type of the health care service and these departments are organized in a different way in the Czech Republic so far. However, ED is an integral part of the acute care system, and the Emergency Deaprtment is capable to ensure the continuity of care between the field and the hospital despite of the increasing atomization of medical disciplines. In recent years, it is a model that is able to deal with all acute conditions of all severity, 24 hours a day, with an adequate level of safety for patients, because they can be briefly observed at the observation unit of the ED. Goal of the thesis and methodology: The main goal of the diploma thesis is a comprehensive analysis of the existing Emergency Departments in the Czech Republic. The first partial goal was to find out the disposition and organization of Emergency Departments in details, how many acute beds for emergency care are available and how is the work regime organized. The second partial goal was to find out staffing of the Emergency Departments. Whether a specialised emergency physician is continually present and whether there ais enough qualified non-medical medical staff. The third partial goal was the intention to find out how are Emergency...
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The issue of the competencies of the medical rescuer in intensive care and urgent reception according to current legislation
LNĚNIČKA, Roman
The bachelor thesis is titled "Issues related to competences of paramedics in the departments of intensive care and emergency reception in accordance with current legislation". The thesis addresses the position of paramedics and their competences. Thereupon, the history and definition of paramedics is introduced, including their employment options. Given the fact that paramedics are required to complete a 1-year practice within the intensive care unit and the emergency reception department, the thesis outlines the individual levels of intensive care, including the intensive care unit and the anesthetic-resuscitative department, followed by the types of emergency reception. The above-mentioned departments are also related to nursing care which is also part of the job. Last but not least, the thesis describes individual competences of paramedics and paramedics in the area of emergency medicine. Additionally, the competences of general nurses and nurses in the intensive care unit are also mentioned. The theoretical part of the bachelor thesis is concluded with a section focusing on professional organizations of paramedics. The author of the thesis has laid down two goals. The first aim of this bachelor thesis is to map out the opinion of paramedics on Section 18 of Act No. 96/2004 Coll., on non-doctor medical occupations, as amended in 2017. The second goal is to determine what the paramedics think of their competences which have been specified for them in the 2017 amendment to Regulation No. 55/2011 Coll., on activities of paramedics and other specialized workers, specifically whether they consider their competences to be sufficient for the procedures which they perform as part of their work, or whether they would appreciate their competences to be extended. In order to meet the goal of this thesis, the method of qualitative research survey has been chosen, particularly a partly structured interview. 10 respondents competed an interview of 20 questions. These were paramedics, specifically 5 women and 5 men of various age, different previous workplaces and various periods spent working in the emergency reception and intensive care departments in Prague and the South-Bohemian Region. The conclusion of the thesis summarizes the issues related to paramedics working in the departments of intensive care and emergency reception. Furthermore, the conclusion offers several solutions which could resolve the given situation and related issues. It is clear that the paramedics go beyond their competences, particularly for the reasons of either due to the negligence of their professional competences or for being required to do so.
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The benefit of emergency for emergency medical services
ČÁP, Marek
In certain cases rescue team workers can find themselves unable to identify the patient´s condition with sufficient precision and decide about which department the person should be delivered to for treatment. Such a situation may result in what is known as the "admission vacuum". The issue should be addressed by establishing a system of emergency wards that will become the sole points whereto the rescue teams will deliver their patients. The theoretical section of the bachelor paper defines different types of the emergency wards, describes their main activities and chronicles their history in the world and the Czech Republic. Moreover, it lists the different units of the wards and depicts their overall arrangement. The paper aims to examine the major benefits that emergency wards might offer to the paramedic teams, to map their positive and negative experience with emergency wards, and (3) to enhance the effectiveness of cooperation between the teams and the emergency wards. In preparing the paper the author relied on the qualitative method of in-depth interviews with rescuers and emergency ward nurses from Jindřichův Hradec. Our research has shown that the rescue teams members are not fully aware of all the benefits that the emergency wards may provide. They see the only advantage for themselves in the single dedicated point of delivery. In addition, the rescue workers trying to hand their patients over perceived as problems the deficiency of available emergency beds and the overcrowding of the wards. Finally, I succeeded in obtaining from the rescuers some suggestions for structural changes such as the increase in the number of emergency beds and the separation of entrances for patients brought in by ambulances and those coming on their own.
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