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Chronic wound care - shin ulcer
Kümmelová, Tereza ; Hromádková, Jaroslava (advisor) ; Nikodemová, Hana (referee)
The bachelor thesis Chronic wound care - shin ulcer deals with the issue of chronic wounds focusing on tibial ulcers. The aim of the thesis was: To collect data on treatment options for and to study the available resources. To obtain data from the database "Care of the patient with a non-healing wound" at the University Hospital in Motol. These data were then assessed and statistically processed. To calculate a qualified estimate of the burden of nursing staff related to the care of patients with shin ulcer in internal medicine units, surgical units and in general in the University Hospital in Motol. The theoretical part of the thesis gives a basic overview of the problem. The empirical part of the thesis presents the results of the own investigation and their comparison with the results of previously conducted studies. The method of the research investigation was secondary data analysis from the database "Care of a patient with a non-healing wound" at the University Hospital in Motol. The research investigation included 164 patients with shin ulcer hospitalized in the period from January 1, 2022 to June 31, 2022 at the University Hospital in Motol. Results: It was found that more males were hospitalized with shin ulcer than females in Motol University Hospital during the period. More patients with...
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Development of parallel visualisation of subdermal regeneration by tomographic and hystological methods
Ruszová, Kristína ; Macíček, Ondřej (referee) ; Skopalík, Josef (advisor)
The aim of the thesis is to review suitable methods for quantifying the regeneration of subcutaneous layers and collagen structures in tissue defect, especially MRI methods and histological techniques. The theoretical chapters contains basic overview of skin anatomy and healing process, brief overview of histological methods and description of MRI as well. The practical part contains a description of data acquisition and optimization of methods for obtaining these MRI images with the best possible visualization of the condition of the skin layers. It also describes the designed software for comparing the acquired MRI images and the classical histological image from the tissue post-mortem. Finally, the evaluation of suitable modifications of gels and coatings that would affect the contrast characteristic of these planar medication layers is summarized.
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Úloha sestry v mobilizaci pacienta po operaci kýly
KRAMÁŘOVÁ, Iva
This bachelor thesis deals with the nurse´s role in mobilizing patients after hernia surgery. Post- surgery care partially consists of early mobilization of patients from their bed. Mobilization is movement, i.e. getting up from the bed, sitting up in a chair and walking practice. Early getting up after surgery helps increasing the venous circulation which prevents the development of a tromboembolic disease. Three objectives were set. Find out in what ways nurses mobilize their patients after hernia surgery. Find out what steps nurses follow when mobilizing patients after hernia surgery from the perspective of education and find out how patients perceive the nurse when taking care of them after hernia surgery. For the purpose of these objectives, four research questions were set. The thesis contains two research samples. The first research sample consisted of 6 nurses and the second research sample of 4 patients. The empirical part was implemented using qualitative research, interviewing method, the technique of standardized interview with nurses and patients on the surgical inpatient department. Interviews were transcribed word for word, analysed, and then coding was carried out. The method of ´pen and paper´ was chosen. The survey was run during March, April and May 2021. The results of interviews done with the nurses have proven that all of the interviewed nurses mobilize the patients after hernia surgery by getting up over their hip, however, they do not follow all other steps of correctly carried out mobilization. Nurses educate their patients orally, they use oral education right before the first getting up from bed. Some nurses, together with the oral education also clearly show their patients how to get up from bed. Further, it was found out that patients are being given sufficient amount of time by the nurses. The results of this bachelor thesis may serve as study material to students of medical subjects or nurses as inspiration for supplying high quality care of their patients. The survey results will be passed on to the workplace where the survey was carried out. Based on specific findings, the current educational methods may be updated including the means of improving after-surgery care for patients after hernia surgery. Thesis results are divided into individual categories. In Nurses´ survey, they are Mobilization, Education and Environment. In Patients´ survey, they are named as Communication, Mobilization, Nurse´s Surveillance when Getting Up from Bed and Nursing Care.
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Changes in the manner of dressing of surgical wounds in the last 30 years
SPILKOVÁ, Eliška
Surgical wound care - dressing is a set of activities that favorably affect the healing process. The course of dressing under aseptic conditions is important to avoid infection in the wound and unpleasant complications. The aim of this diploma thesis is to analyze the changes in the way surgical wounds are used, especially in the last three decades. In connection with the analysis of the text, a research question was asked: How has the method of dressing surgical wounds changed in the last 30 years? We set 5 hypotheses. H1: nurses who have been in practice for more than 10 years prefer sterile devices stored in containers to wound dressings over nurses who have been in practice for less than 10 years. H2: Nurses who have been in practice for more than 10 years prefer the no-dose system more often than nurses who have been in practice for less than 10 years. H3: Nurses who have been in practice for more than 10 years have seen more changes in the method of dressing in the last 30 years than nurses who have been in practice for less than 10 years. H4: Nurses who have been in practice for more than 10 years claim that there have been no changes in the disinfectant and treatment solutions used for dressings during their practice. H5: From the point of view of nurses who have been in practice for more than 10 years, wound dressings are performed more aseptically now than 30 years ago. The empirical part of this diploma thesis was processed on the basis of qualitative and quantitative research. Data collection was performed through a questionnaire and a semi-structured interview. After saturating the answers, a total of 10 interviews and 272 questionnaires were included in the empirical part of this work. The results of the research show that the main changes that have occurred in the last three decades include changes in medical and disinfectant solutions, wound dressings, sterilization packaging, sterile material handling system, wound dressings used and, last but not least, wound healing .
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Changing the role of a nurse in chronic wounds
LUSKOVÁ, Pavlína
The bachelor thesis is focused on the care of chronic wounds. It seeks to map the education of nurses in this field, to present the cooperation between physician and nurse, to introduce relationships in the workplace, to examine what influences physician and nurse in choosing material, such as success in wound healing, and last but not least to announce more products of wet healing. A chronic wound is a disorder of the integrity of the skin cover, which, despite adequate treatment for the period of 6-9 weeks, fails to show some signs of healing. Chronic wounds are a nursing problem and the care of a patient with a chronic wound carries certain specifics with it. Knowledge of phase healing and modern products are the main pillar of success, thanks to which it is possible to substantially help in the treatment of chronic wounds. The objective of the thesis was to underline the remarkable progress in the care of chronic wounds and also to get deeper into the whole issue. The bachelor thesis was divided into two parts, theoretical and empirical. The first part of this work introduces the concepts of chronic wound, the types of chronic wounds and the healing of wounds in general as well as the stages of healing and the means by which healing can be influenced. It also focuses on wound evaluation, wound dressing, document management, modern wet healing products, the role of nurses and, finally, education in this area. The second part of this work was dedicated to research investigation. Two goals were set in the practical part of the work. The first one: To map the cooperation between a physician and a nurse in the care of chronic wounds. The second one: To map the nurse's decision-making in the choice of material in the care of chronic wounds. Therein, four research questions have been identified: 1. How do nurse and physician work together in the care of chronic wounds? 2. What material do nurses most often use to heal chronic wounds? 3. What factors influence the nurse when choosing material in the care of chronic wounds? 4. What role does the nurse play in caring for a chronic wound? The research part was processed by a qualitative method using a semi-structured interview with selected nurses and physicians who take care of chronic wounds day-to-day. The interview consisted of 16-18 questions that were more elaborated during the interview so that respondents could present their ideas and impressions in relation to the topic more. The results obtained from the responses were then categorized and further processed. The results of the investigation showed that the cooperation between the nurse and the physician is generally effective, communication and trust between them is at a good level, and therefore the nurses are very strongly involved in the decision-making process regarding the choice of material. However, the cost of some products does not allow staff to work with them, although they find it particularly useful. Nevertheless, the wet healing method is economically less demanding, very effective and more comfortable for patients. It can also be stated that nurses are well trained with individual products and their workplaces offer them many opportunities in the development of education, which most of them are interested in. The conclusion of the work summarizes that a number of new products in the care of chronic wounds is still increasing, and therefore it is vital to constantly learn in this area. This work can serve as information material for people who are interested in this issue. It also brings with it useful opinions from nurses and physicians.
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Wound care in context of the nursing process
NĚMEČKOVÁ, Jana
Wound dressing is a part of patient care not only in the departments specialized in surgical procedures. Given that the patient with a wound has certain specific needs, an effective method of providing nursing care can be found in the application of the nursing process. The aim of the thesis was to map the issue of dressing in the context of the nursing process. Other goals were to find out what patients expect in connection with the treatment of a wound from a nurse and what patient's needs are satisfied in the treatment of wounds. Three research questions were identified. How does wound dressing work in nursing practice? How do nurses perceive their competencies for wound dressings? How do patients perceive wound dressings? The method of elaboration of the empirical part was a qualitative research investigation, which was carried out by the technique of semi-structured interview with patients who had an acute or chronic wound and were treated in hospital in connection with its treatment. The second group of informants consisted of nurses who work at surgery department and take care of patients and their wounds during their work. The research group consisted of eleven patients and twelve nurses. Based on the study of the literature, ten basic questions for interviews with patients and eleven basic questions for interviews with nurses were created. With the consent of the informants, all the interviews obtained were recorded on an audio recording and subsequently cleaned from padding words and transcribed. The method chosen for processing the obtained data was open coding, the "pencil and paper" technique. The results of the research survey are presented in the form of categories and subcategories. From the answers of the informants it was clear that wound care is very different according to workplaces and care system. The results of the research revealed that the most frequently reported need of patients with a wound is the need to be pain-free. Furthermore, it was found that even though the informants claimed that the nursing process in their workplaces is both partially and fully used, they did not demonstrate comprehensive knowledge of the nursing process in other issues. Thanks to the mapping of the issue by the above groups, some opinions were connected, and the shortcomings or necessary changes were revealed, which can be the basis for new research work.
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Knowledge of nurses about methods of treatment of the leg ulcer
Dvouletá, Zuzana ; Sojková, Monika (advisor) ; Pekara, Jaroslav (referee)
The topic of this thesis is "Knowledge of nurses about methods of treatment of the leg ulcer". The purpose of this thesis was to document current methods of treatment of the leg ulcer and to evaluate nurse's knowledge of this area. The thesis is divided into two sections - a theoretical and an empirical one. The theoretical section is devoted to the leg ulcer as a term and its causes, then it concerns wound healing and factors, which it is influenced by. It also describes the currently used methods of treatment of the leg ulcer and other chronic wounds. The empirical section is based on a quantitative research performed as a questionnaire study, which has been carried out in medical and surgical wards in three teaching hospitals in Prague. The goal of this research was to determine nurse's knowledge of chronic wounds, the leg ulcer, its risk factors and prevention, of wound healing, compression therapy and to find out, in which ways nurses get access to information on wound healing and treatment of the leg ulcer. This goal was met. The findings of the research are summarized in the conclusion of the thesis. Key words: moist wound healing; leg ulcer; wound; chronic wound; debridement; compression therapy; nursing care
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Healing of wounds during history and nowadays.
ŠVANCÁROVÁ, Kristina
My bachelor thesis "Healing of wounds over course of time" has a theoretical character. Its aim is to analyse the development of wound healing as an integral part of nursing care from prehistoric times up to the present days. This work is a historical-analytical study of primary and secondary literal sources with a following elaboration of an interpretative text. To achieve this it was crucial to set a few research questions: What was the development of wound care from a historical perspective? What influenced wound healing in the historical context? In connection with these research questions it can be stated that the development of wound care started in prehistoric times, where it was influenced by the development of society. Further on it developed in connection with some major events. Among these we can name mostly the influence of Christianity in the Middle Ages, building of medical facilities thanks to the Theresian and King Josef's reforms during the Enlightenment period. Last but not least we have to mention the 19th century which was a breakthrough for the development of wound care due to the new position of women in medicine, nursing as a profession, the establishment of nursing schools and the systematic training of nurses, which continues to develop up to the present days. The historical context that has had an impact on wound healing is characterized in prehistoric and ancient times primarily by the organization of society, religion, and cultural practices that have led to a development of surgery. In the Middle Ages the methods of wound healing stagnated, in comparison with Renaissance, where, thanks to Paré, Mondeville and Paracels, surgery underwent a significant development. The era of Enlightenment and the 19th century were characterized by the development of war surgery, the industrial revolution, the discovery of antisepsis (Lister) and antibiotics (Fleming). Furthermore, the 20th and 21st century were significant due to the discovery of modern materials for wet wound healing and various medical treatments used in wound healing.
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Comparison of wound healing management in acute and follow-up care
ŠTEFFLOVÁ, Veronika
Thesis objectives: The thesis deals with the comparison of wound healing management in acute and subsequent care. The theoretical part presents the knowledge of acute and chronic wounds, wound healing and their phases. Furthermore, the thesis deals with methods of wound treatment. The last chapter of the theoretical part deals with management and the role of a nurse in caring for a patient with a wound. In the empirical part, the first goal was to find out whether nurses from the Hradec Králové Region hospitals know the division and types of wounds. The second goal was to map out the possibilities for nurses to heal wounds. Another aim was to compare the differences between wound healing in acute and subsequent care. The fourth goal mapped the knowledge of nurses about wound healing materials. The following aim was to find out which materials for wound care are available at the hospital of the Hradec Králové Region. The sixth goal was to compare the economic and time-consuming wound healing at the acute and aftercare departments. The last goal of the thesis is to elaborate a seminar within the framework of lifelong education of general nurses on the topic of effective wound healing. Five hypotheses and two research questions were formulated to meet the goals of the thesis. Method for achieving the objectives: The set goals were achieved through quantitative questionnaire research and qualitative observation and interview research, which were chosen to complement the results. The sample included general nurses working in the internal department, the surgical department, the intensive care unit, the anesthesiology-resuscitation department and the aftercare departments in the hospitals of the Hradec Králové region. The total number of respondents was 120. Scientific benefits of the thesis: Overall research shows that nurses have sufficient knowledge of wounds and their treatment, but deficiencies in some areas are still evident. Furthermore, the research shows that nurses do not have enough therapeutic material to work on their workplaces. The interviewed group of general nurses said they think that modern dressing materials have a positive effect on wound healing. The results of the work can be used for practice, in hospital and other health care facilities to improve wound healing. The findings and conclusions: In the tracked file, we verified that the length of treatment of wounds on beds of acute and subsequent care differs (p = 0.002); the results show that the average time of wound dressing is prolonged in subsequent care. Conversely, the availability of dressing materials in the respective departments did not differ (p = 0.159). Furthermore, we found that the economic intensity of the after-care beds is lower, despite the fact that more wound dressings are done than in the acute care.
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Knowledge of nurses about posibilities of using moist wound healing in neonatology.
Konečná, Veronika ; Kulhavá, Miluše (advisor) ; Novák, Ivan (referee)
This thesis deals with nursing care of skin defects using a wet therapy in neonatology. The first section summarizes information related to preterm infants, the development of the individual layers of the skin in the embryonic period. It lists the types of skin defects which the neonatolgy nurse may frequently encounter at the department with including a list of modern therapeutic coverage that can be used. It lists a brief history of wound healing too, focusing just on the development of the wet therapy . Furthermore is marginally discussed the evaluation and documentation of damage to the skin wound. For interest, the thesis mentions a case reportof the preterm newborn with the necrosis of the lower limb, accompanied by commentaries of the alternative treatment for this type of skin damage from my own experience. The second part is assessing the awareness of the nurses in the modern methods of the healing. The priority is the mapping of the experience in using the wet therapy through the quantitative research, which is mediated by an anonymous questionnaire. The main goal of the research is to determine the awareness of the nurses from the neonatology intensive care unit, resuscitation and intermediate care in the nursing of the skin defects using a wet therapy. For this purpose the chosen method...
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