Bakgrund: Malnutrition är vanligt hos patienter med kroniskt obstruktiv lungsjukdom (KOL). Malnutrition hos patienter med KOL kan orsaka nedsatt immunförsvar, ökad dyspné, minskad livskvalité samt att KOL-sjukdomen riskerar att öka i allvarlighetsgrad samt ha ett snabbare sjukdomsförlopp. År 2030 bedöms KOL vara den tredje vanligaste sjukdomen i världen. Därför är det viktigt som sjuksköterska att ha kunskap i vilka omvårdnadsåtgärder som kan användas vid malnutrition hos KOL-patienter. Syfte: Syftet med denna litteraturöversikt var att sammanställa KOL-patienters upplevda problem vid nutrition samt vilka omvårdnadsåtgärder sjuksköterskan kan vidta vid malnutrition. Metod: Litteraturöversikt baserad på 15 vetenskapliga artiklar. Resultat: Det fanns många olika problem som KOL-patienter upplevde i samband med nutrition. Dessa faktorer kunde vara både fysiska och psykiska. Sjuksköterskan kunde som omvårdnadsåtgärd upprätta kontakt med dietist för individuella råd och åtgärder till patienten. Som sjuksköterska var den stödjande samt kunskapsförmedlande rollen viktig, likväl att ge egenvårdsråd utifrån patientens önskemål samt förutsättningar. Slutsats: Den problematik som KOL-patienter upplevde i relation till nutrition var individuell. Nutrition hos KOL-patienter var ett komplext område då det innefattade både fysiska och psykiska bekymmer. Det är viktigt att sjuksköterskan arbetar personcentrerat vid vård av KOL-patienter då patienterna upplever olika problemområden i samband med nutrition, detta för att ge en god och säker vård. / Background: Malnutrition is common in patients with chronic obstructive pulmonary disease (COPD). Malnutrition in patients with COPD can cause impaired immune system, increased dyspnoea, decreased quality of life, and the COPD risk being increased in severity as well as having a faster disease course. In 2030, COPD is estimated to be the third most common disease in the world. Therefore, it is important as a nurse to have knowledge of which nurse care can be used in malnutrition in COPD patients. Aim: The aim of this literature review was to compile COPD patients' perceived problems with nutrition and what nurse care the nurse can take in malnutrition. Method: A literature review based on 15 scientific articles. Results: There were problems that occur for COPD patients that were caused according to their nutrition. These conditions could be both physical and psychological. The nurse could seek advice from a dietician to be informed of the best solution regarding nutritional needs of the patient. As a nurse it was important to pass on knowledge and give support to the patient whilst also advising on selfcare according to the patient's current condition and preferences. Conclusion: The variety of nutritional problems COPD patients face were highly individual and are therefore a complex subject as the effects are both physical and psychological. In general, the nurse should work closely with the patient as there can be nutrition related problems and in doing so, ensures appropriate and safe care.

The concept of basal stimulation is currently one of the most popular concepts in nursing care. Basal stimulation is intended for people with changes in perception and communication. The aim of this thesis was to map the use of basal stimulation in the surgical department of the district hospital of South Bohemia. Furthermore, I investigated the possibilities of using this concept for restless patients hospitalized in a standard surgical ward. The last goal was to determine whether basal stimulation effects medical treatment. The topic of the thesis was researched using expert sources. The research part uses methods of qualitative research. The research was conducted in four phases. The research showed that respondents have little knowledge of the concept of basal stimulation, but showed interest in it during the implementation its elements. The surgical ward, where the research has been conducted, currently does not use any elements of basal stimulation, nor is it being used in the hospital itself. During the research in the surgical ward, only two elements of the basal stimulation were implemented, the application of which is summarized in the tables showing the results of stimulation in the individual case reports. Patients showed both verbally and nonverbally increased levels of well-being, peacefulness, relief and comfort during stimulation. Nurses who participated in the research and monitored the patients also held this view. The third focus of the research did not provide unambiguous data. I focused only on the treatment of pain, the area in which the data obtained proved to be insufficient. It would be appropriate to expand the scope of the study in this respect, using both qualitative and quantitative methods.

Bakgrund: Patienter med psykisk ohälsa är vanligt förekommande inom den somatiska vården. Tidigare forskning har visat att dessa patienter upplever att sjuksköterskors bemötande och kunskap kring psykisk ohälsa är bristfällig, vilket leder till diskriminering och en olämplig omvårdnad. Syfte: Att identifiera hinder för sjuksköterskors omvårdnad till patienter med psykisk ohälsa inom somatisk vård. Metod: Allmän litteraturöversikt där sju kvalitativa och fem kvantitativa studier ligger som grund för resultatet.   Resultat: Två huvudkategorier framkom med faktorer som hindrar sjuksköterskors omvårdnad till patienter med psykisk ohälsa inom somatisk vård. En huvudkategori är Personliga egenskaper som hinder, där sjuksköterskors begränsade kunskap och negativa attityd ingår. Den andra huvudkategorin är Bristande förutsättningar som hinder, som innefattar brister i vårdmiljö, resurser och organisatoriska förutsättningar. Slutsats: Genom att sjuksköterskor får mer utbildning om psykisk ohälsa och förbättrade förutsättningar skulle diskriminering och negativa attityder mot patienter med psykisk ohälsa kunna reduceras. Med ökad kunskap, positiv attityd, och goda förutsättningar i form av en lämplig vårdmiljö, tillräckliga resurser och tydliga rutiner skulle sjuksköterskors omvårdnad till patienter med psykisk ohälsa kunna förändras till det bättre.

The topic of my Dissertation is a role of a nurse in subsequent care at a patient after reimplantation of a total coxe endoprosthesis. The aim of this Dissertation is to find whether nurses provide patients with specific (medical) intervention (after reimplantation of a total coxe endoprosthesis) according to the diagnosis for care or in a standard way according to the performed act. Another aim was to find specific needs of patients (after reimplantation of total coxe endoprosthesis) and to create a plan of care, as possible. The last aim is to find whether patients after reimplantation of a total coxa endoprosthesis are provided with sufficient information about prevention of possible complications.To gain the necessary data, quantity research in combination with quality one was carried out. The hypothesis that nurses provide nursing intervention in a standard way, no matter if patients are after a primary implantation of a total coxa endoprosthesis or after a reimplantation of a total coxa endoprosthesis, was not proved. The other hypothesis, that nurses does not differ nursing care of clients after a reimplantation of a total coxa endoprosthesis from nursing care of clients after a primary implantation of a total coxa endoprosthesis, was not proved.

Optimization of the number of nursing staff at selected workplaces of the České Budějovice Hospital As the title shows determination of the optimum number of non-physician health care staff members at surgical departments of České Budějovice Hospital is the main question this thesis deals with. The topic is up-to-date mainly for the lack of funds in health care and for the permanent pressure from the general public on the need of health care quality improvement. The works of Karla and Otakar Pochylý, who published their first book dealing with these issues in 1999, were the basic inputs for the research part of the thesis. We set the following hypotheses before commencement of the research: 1 ? The numbers of nursing staff at standard health care units are in line with K. Pochylá?s methodology. This hypothesis was partly confirmed. The average numbers of nursing staff workloads are in line with K. Pochylá?s methodology at two surgical departments only. 2 ? Qualification representation of nursing staff at the individual health care units complies with the recommended methodology of K. Pochylá. This hypothesis was not confirmed. Representation of the nursing staff qualifications is based on the individual needs of the particular departments. 3 ? The number of nursing staff members at the intensive care unit corresponds with the recommended methodology of K. Pochylá. This hypothesis was not confirmed. The number of nurses is lower by 2.23 in average at the intensive care unit. The content of the work has more informative character and should actually serve as an insight into the existing situation at the particular departments. It might also serve as a guide helping top managers with efficient utilization of human resources in health care facilities. This is why the results will be provided to the surgical department management of the České Budějovice Hospital.

Made available in DSpace on 2014-07-29T15:04:34Z (GMT). No. of bitstreams: 1 Dissertacao Claudia Cleinne Barcelos Cunha.pdf: 1623906 bytes, checksum: 23b284fd9c188471088ad2655980ff55 (MD5) Previous issue date: 2011-03-17 / This descriptive quantitative study aimed to evaluate quantitatively and qualitatively the nurse staff in a surgery clinic unit at a school hospital in Brazilian Center West Region. Search subjects were all the inpatients of a surgery clinic unit in the period of data collecting. The project followed the terms of the Resolution 196/1996 and it was approved under Protocol nr. 032/2008. Data were collected from September to October 2009, during 30 consecutive days. One used the design method used was that proposed by Gaidzinski (1998). It includes an impatient classification stage concerning to nurse care dependence. Fugulin instrument (2002) was used. The parameters of COFEN Resolution 293/2004 were used for establishing assistance hours and percentage distribution of each professional category. Absenteeism rates were determined by Gaidzinski s definitions and equations (1998). The inpatients were daily classified in an amount of 1464 evaluations in that period. From them, 53.7% needed minimal care; 39.3% intermediate, 5.9% high dependence, 9.9% semi-intensive and 0.2% intensive care. The determined technical safety index in this study was 58% for nurses and 68% for middle level professionals. Among previewed absences, weekly holiday ones showed the highest rate, 40%. Among not previewed ones, the higher index was for medical licensees: 0.8% for nurses, 3.0% for technical nurse assistants and 1.5% for trainees. Technical nurse assistant showed the higher index for not planned absences (7.5%). The designed scale had 29 nurses and 62 technical assistants. It was noted that the number of nurses corresponds to 27.6% of the designed ones and the middle level professionals complete the table, which shows a deficit of 30.4% in the staff. The rate of registered nurses found in this study is far below what is recommended by COFEN and this may compromise assistance quality and improve adverse events occurrence as well length and costs of hospital stay. A reduced amount of professionals in the team may have negative consequences on nurse staff health, which could increase absenteeism. This search considered that is no denying the importance of design staff as a management instrument and indicator to consider the amount of nursing human resources. However, it cannot grantee alone attendance quality. One needs also actions concerning to planning and implementation of strategies of Continuing Education as well motivation work processes that may give to nurse team more satisfaction in work environment in order to get a continuum improvement in patient assistance. / Estudo descritivo de natureza quantitativa que objetivou avaliar o quantitativo e qualitativo de pessoal de Enfermagem da Unidade de Clínica Cirúrgica de um hospital universitário da Região Centro-Oeste. A população constituiu-se por todos os pacientes internados na Unidade de Clínica Cirúrgica no período da coleta dos dados. O projeto seguiu a Resolução 196/1996 e foi aprovado sob Protocolo 032/2008. A coleta de dados ocorreu de setembro a outubro de 2009, durante 30 dias consecutivos. O método de dimensionamento utilizado foi o proposto por Gaidzinski (1998) que inclui a etapa de classificação dos pacientes com relação à dependência dos cuidados de Enfermagem, em que se utilizou o instrumento de Fugulin (2002). Para as horas de assistência e distribuição percentual de cada categoria profissional foram adotados os parâmetros da Resolução 293/2004 do COFEN e a determinação dos índices de absenteísmo foi feita por meio das definições e equações elaboradas por Gaidzinski (1998). Os pacientes internados foram classificados diariamente. Foram realizadas 1464 avaliações nesse período. Dos pacientes classificados, 53,7% requeriam cuidados mínimos; 39,3% cuidados intermediários; 5,9% cuidados de alta dependência; 0,9% cuidados semi-intensivos e 0,2% cuidados intensivos. O índice de segurança técnico determinado pelo estudo foi de 58% para os Enfermeiros e de 68% para os profissionais de nível médio. Entre as ausências previstas, a por folga semanal apresentou o maior índice, com 40%. Das ausências não previstas, o maior índice foi para as licenças médicas, de 0,8% para os Enfermeiros, 3,0% para os Técnicos/Auxiliares de Enfermagem e 1,5% para os estagiários. Os Técnicos/Auxiliares de Enfermagem se destacaram com os maiores índices de ausências não previstas, 7,5%. O quadro projetado foi de 29 Enfermeiros e 62 Técnicos e Auxiliares de Enfermagem. Observou-se que o número de enfermeiros existentes corresponde a 27,6% do projetado e o número de profissionais de Enfermagem de nível médio corresponde a 89,7%, existindo no quadro geral um déficit de 30,4% profissionais. A proporção de Enfermeiros encontrada no estudo está muito aquém do que é preconizado pelo COFEN, o que pode comprometer a qualidade da assistência prestada, aumentando a ocorrência de eventos adversos, o tempo de internação e os custos. Um quantitativo reduzido de profissionais na equipe pode trazer consequências negativas sobre a saúde dos profissionais de Enfermagem, causando adoecimento e aumentando o absenteísmo. A pesquisa considerou que é inegável a importância do dimensionamento de pessoal como instrumento de gestão e indicador para equacionar o quantitativo de recursos humanos em Enfermagem, mas ele, por si só, não garante a qualidade do serviço prestado. São necessárias ainda, ações voltadas para o planejamento e implantação de estratégias de educação continuada e processos de trabalho motivacionais que proporcione à equipe de enfermagem maior satisfação no ambiente de trabalho e o alcance da melhoria contínua na assistência ao paciente.