Diploma thesis entitled focuses on acute pain in general, as well as on post-operation pain, which is one of the types of acute pain. The first part of the thesis deals with acute pain as such and its characteristics. The second part deals with intensive care units (ICU). The third part contains description of post-surgery pain, treatment thereof, and the nurse?s role in taking care of clients suffering post-surgery pain. Three goals have been outlined. Goal 1: Identification of the techniques that nurses use at ICUs to sooth clients? pain. Goal 2: Map the monitoring the pain of clients hospitalized at ICUs. Goal 3: Find out whether the techniques for reducing pain of clients hospitalized at ICUs are effective. A quality-oriented research was applied for evaluation of the results, using a method of non-standardized interview with nurses and clients.The results can be used as a comparative overview of the most common pain-reducing techniques and proof of their effectiveness for clients.

The overall development of scientific and technical disciplines has enabled the introduction of minimally invasive surgical techniques in cardiac surgery practice. Implementation of minimally invasive cardiac surgery brings many positive effects for patients and healthcare. At the same time, however, it requires for the nurses to have appropriate knowledge, skills and experience to effectively provide comprehensive nursing care. The thesis is divided into theoretical and empirical parts. A total of four objectives were set. The first goal determines the specifics of nursing care of the patient before and after minimally invasive cardiac surgery. The second mapping the differences in nursing care in minimally invasive cardiac surgery from heart surgery classical approach. The third objective determines the role of nurses in patient awareness of minimally-invasive cardiac surgery. The fourth objective is focused on the needs and feelings of patients undergoing minimally invasive cardiac surgery. The results of qualitative research showed that preoperative and postoperative nursing care for minimally invasive cardiac surgery is similar to nursing care before and after cardiac surgery by standard median sternotomy approach. Nurses often wipe away differences associated with nursing care of standard and minimally invasive surgery, differences arose mainly after analysis of the data obtained. The differences include shorter hospital stay, shorter duration of mechanical ventilation, lower incidence of postoperative confusion, differences in invasive inputs, rehabilitation and awareness. For the majority of respondents from the ranks of the patients minimally invasive heart surgery technique had clearly positive impact on their mental condition.

The current period is characterized by profound scientific and technological progress not only in the medicine but also in the field of nursing, which is now based more on scientific knowledge than ever before. Nursing as a science requires professionally trained nurses providing high quality nursing care. Therefore, the development of modern medicine, particularly in the field of cardiology, justifies the need to change the perception and status of nurses with respect to patient care together with strengthening the prestige and status of nurses in society. The main research intention of the dissertation was to determine how the nursing behaviour in connection with the procedure of radiofrequency catheter ablation (RFA) due to atrial fibrillation (AF) is perceived by nurses and patients, what is the impact of the RFA on the life quality of patients with AF, and what is the level of education in patients with AF. To meet these goals the research, the empirical part was divided into two phases. In the first phase, a non-standardized questionnaire was used, role of which was to assess the needs of patients with AF before and after RFA comparing baseline and 1 year follow-up data. In the second phase, which only examined the conditions 1 year after the RFA, a standardized questionnaire CBI - 24 (Caring Behaviour Inventory) was additionally used together with another form with questions investigating education of patients. Further data were obtained from nurses taking care for patients during the medical intervention. The research results show that quality of life of patients with AF before ablation was reduced. Patients´ most common problem areas included pain, physical and mental problems. Our research also showed that if we compared meeting patients´ physical and mental needs, meeting physical needs was evaluated better. Another area under consideration was the education of patients. Evaluated results showed the fact that education was focused on its content rather than its form. Evaluation of the perception of nursing care from the perspective of patients and nurses was the last part of the research. The results of the survey showed that nurses evaluated technical competence better than the humanistic approach to patients. It was also discovered that patients evaluated areas focused on performance of nurses better than creating a relationship of security and safety for patients. Finally, the results indicated that communication is also problematic area. We managed to meet the set goals and gain both theoretical and practical recommendations. Analyzing the results, we found out that there is a need to support humanistic approach in nursing care for cardiac patients, communication and education.

The thesis titled Securing airways in pediatric patients on ARD deals with the specifics of nursing care of airways. Care of airways of children hospitalised at the Anaesthetic Resuscitation Department is an integral part of comprehensive nursing care. Each nurse must have a sufficient theoretical and practical knowledge, as well as experience to independently perform nursing care of airways of pediatric patients. Free and patent airway is a prerequisite for ensuring one of the basic life functions. The aim of the theoretical part of the thesis was to summarise the issue of securing airway in children and to focus on nursing care for airways in pediatric patients. The aim of the research was to determine the specifics of nursing care for children hospitalised at the Anaesthetic Resuscitation Department due to impaired breathing. Based on the aim of the thesis, the author set out four research questions: 1. What nursing activities are performed by nurses when securing an airway in a child? 2. How nurses treat airways of intubated children? 3. What nursing care do nurses provide for children before, during and after extubation? 4. What nursing care do nurses provide for children with a tracheostomy? In the empirical part of the thesis the author employed qualitative research. Data collection was performed by the use of individual interviews with nurses. The survey was conducted at a pediatric ICU and a children's Anaesthetic Resuscitation Department. Based on the research questions and information obtained from literature sources the author drew up the basic points for interviews with nurses. The interviews were supplemented by an observation performed on a children's Anaesthetic Resuscitation Department. Interviews and observation were complemented with two case reports of pediatric patients. The reports were processed in accordance with Henderson's model. The thesis's results show specifics and difficulties of nursing care of pediatric patients hospitalised at an Anaesthetic Resuscitation Department. The thesis maps nursing care for pediatric patients when securing airway, it focuses on intubation, tracheostomy tube, extubation, aspiration, and care for oral and nasal cavities. The objective of the thesis is to show not only the specifics of this kind of nursing care and also to demonstrate the importance of communication and emotional support to pediatric patients before, during, and after the medical intervention. The intensive nursing care is continuously improving thanks to new methods and devices. The results will be provided to the nursing management of the pediatric ICU and the children's Anaesthetic Resuscitation Department. They will also be presented at professional seminars and in professional journals.

Nosocomial infections, which do not often relate to the diseases are increasing nowadays. Clostridium difficile belongs to the frequent nosocomial infections and it is known as post-antibiotic colitis. The main reason of colitis is the usage of antibiotics, especially broad-spectrum antibiotics. The thesis is divided into the theoretical part and practical, as well. Theoretical part describes the division of the nosocomial infections, infection of the intestinal tract, anatomy, physiology of the intestines and infectious diarrhoeal diseases. The thesis is subsequently aimed to the clostridial infections and precautions against the spread of the disease. Practical part is aimed to the knowledge of the nurses, skills and attitude towards this issue.The thesis uses quantitative investigation and technique of the questionnaires, hidden observation of the nurses working on the selected wards and additional interviews with head nurses. The research was conducted in hospital in Tábor, a.s. The questionnaires were distributed on the surgery, orthopaedics, surgical JIP, ARO, ONP, infective ward, rehabilitative ward, TRN, cardio JIP, internal ward-cardio, internal ward-gastro. The thesis was formed from 143 questionnaires and 171 questionnaires were distributed. Hidden observation was made by head nurses from individual wards and it was logged to the relevant observation sheets.From existing findings we can say that there exist specifics of nursing care at the patient with the clostridium difficile. Among to these specifics we can cite the barrier nursing care where we can include the isolation of the patient, disinfection and hygiene of hands,using protectors, appropriate usage of laundries and infectious waste, location of the patient according to the epidemiological perpective and individualization of the tools for the patients. From another investigation ensue that the nurses keep barrier nursing care, superficial disinfecion, decontamination of the tools. From the results is evident that the nurses do not know the methods of the transmission of the clostridial infection. On the base of another investigations we have found out that the nurses do not know principles of the barrier nursing care. In conclusion is it possible to say that the nurses do not have so extensive information, that are essential for care for the patiens with clotridium difficile. In order to care for these patients in right way is neccessary to know principles of the barrier nursing care and keep them all. Keeping the principles of the barrier nursing care is crucial step in preventing the transmission nosocomial infections. The results will be provided to the officials of the individual hospital´s wards as an option of improvement in caring for the patiens with clostridial infection. The results were partially presented at a conference in Tabor´s hospital in May 2014. We recommend to re-train the staff of the hospital, which would be specifically aimed towards the principles of the barrier nursing care and towards the disinfection and decontamination in related to the nosocomial infections. On the base of these findings was made a proposal of the nursing care standard, which would specify and unite the care for the patiens with clostride infection. Subsequently, it would be apropriate to repeat the research in 1 2 years and than both researches compare together.

This diploma paper aims at defining and mapping out patient satisfaction in intensive care units for surgery patients and comparing results in dependence on length of hospitalization and facility. Diploma paper consists of theory and research. Theory is divided into 5 chapters. Empirical part of this diploma paper was carried out using the method of combined research. The first part is created by qualitative research using semi-structured interview, second part comprises quantitative research using non-standardized, structured questionnaire face to face survey. Processed results were arranged into Excel tables and graphs. All research was based on eight dimensions of patient-centered care delineated by the Picker Institute. Qualitative research sample consists of 11 respondents, quantitative research sample comprises 142 respondents. Data collection took place in surgical ward. This diploma paper defines four aims with two related research questions. The first aim is to determine the level of patient satisfaction with postoperative care. The second aim focuses on patient satisfaction with nursing care, the third aim is to define positive and negative factors influencing patient satisfaction in intensive care units and the last aim points at patient satisfaction with nursing care in intensive care units in relation to the type of facility and length of hospitalization. These two quantitative research questions were posed: 1. What are the possibilities to improve patient satisfaction in nursing care? The research survey showed that an area of concern is patient awareness. It is necessary to improve patient awareness after admission to an intensive care unit and during transfer to a standard ward. Pain and insufficient pain relief often occurred. Nurses should cooperate more with doctors in this respect and, above all, monitor patients more and offer alternative ways of pain relief. Other problems were mentioned in relation to bed adjustment possibilities. Despite the fact that nurses were trying to do their best, not all the circumstances could be influenced that way, for example mattress hardness. The last concern area, mentioned by patients, was perceived loneliness. Nurses should conduct considerate and sensitive conversation, create feeling of trust and support patients. The second question: What factors influence patient satisfaction? The results show that it is, above all, nursing staff attitude, followed by patient awareness, pain and sufficient pain relief, intensive unit environment and last but not least bed adaptation. Quantitative part set six presumptions using statistical methods independence test, chi-square test, Yates correction, t-test, and correlation-regression analysis. Questions from the first part of this paper were processed (in percentage) into clearly arranged graphs. Research survey shows that respondents were satisfied with nursing care and nursing staff. Patient awareness during admission to intensive care unit and staff anonymity proved to be the biggest areas of concern. Pain and insufficient pain relief turned out the clear reason for dissatisfaction as well as absence of information about performed surgeries. Conclusion of quantitative research survey showed that there is no statistically significant difference in patient satisfaction according to health-care facility or length of hospitalization.

Introduction Nursing is a independent scientific discipline with one main aim: maintain and support health of population. Nursing care is performed by skilled nurse using nursing techniques. Particular nursing techniques are always modified by current state of health and needs of patient. Together with other disciplines, also nursing must refect changes of the modern age. Nursing practice and theory lead to qualitative changes by implementing of evidence-based practice. Evidence-based practice in nursing is process connecting best nursing experience and expertise of nurses, which together determine the optimal care. Goals of the thesis To complete this thesis, three goals were determined. Firts goal was to find out, what was the source of particular nursing techniques performed by nurses. Second goal was to find out, if "good practise" was used when performing particular nursing techniques. Last goal was to fin out, what was the general knowedge of the "evidence based practise" phrase among nurses. Materials and methods Research investigation of the thesis was performed using the methods of qualitative and quantitative research. Quantitative research was perfefomed using the questionnaires distributed among general nurses working at inpatient wards. Results of research were evaluated using graphs and tables. Pearson´s chi square test was used for statistical processing. Qualitative research was executed using the direct observation method. Six different categories were set. Data were colected to record form, which was later on used for analysis of observed figures. Observation was focused on comprehensive hygienic care, divided into following categories: oral hygiene, care of hospital clothing, bathing of not self-sufficient patient, care of nails, skin and washing the hair. Results Results of the thesis allowed to clarify links between performing the hygiene care and evidence-based practise / good practise. These results can also be used as a contribution on coferences regarding this topic and as a material in teaching the nursing. Using the statistically preocessed data, hypotehsis were evaluated. H1: General nurses perform particular nuring techniques more based on habitual practise of their department than on local professional health care standards. H1 was confirmed. H2: General nurses perform particular nursing techniques more based on habitual practise of their department then on EBN. H2 was confirmed. H3: General nurses with the bachelors or masters degree have better awareness of EBN than nurses witout university degree. H3 was confirmed. Research question was asked - What is the role of EBN in particular nursing techniques? Observation study revealed that EBN is not of high importance in performing nursing hygiene care. Conclusion Thesis could highlight weaknesses in providing hygienic care and evidenced based nursing. It could also inspire all who perform their job with joy and respect and wish all the best for their patients. Last but not least, thesis could inspire all who want to provide fist-rate and safe care and leave the work with self-satisfaction.

The aim of this thesis is to inform in detail about the latest clinical and nursing practice trends concerning the needs of patients in vegetative state and their carers. It also deals with relations in the system of long-term nursing care, providing medical and social services and rehabilitation. It also tries to point out the most pressing problems of the current situation of patients in vegetative state and their families, especially in terms of patient discharge to home care and availability of services specified for this target group. The latest findings and proven methods will be summarized in a simple and understandable form, which will serve as a guide both for health professionals and caregivers.For this thesis the Review and synthesis method will be used. The overview of current knowledge and studies in the field of care for patients in vegetative state will be synthesized and focused on home care with recommendations for practice and indications of weak spots.Long-term follow-up nursing and rehabilitative care is necessary for these patients. A special chapter is focused on the specific needs of patients in vegetative state and appropriate nursing care, rehabilitation and release issues. The fundamental part is the consistency of formal and informal care, caregiver preparation for their future role and related socio-economic issues. In conclusion the legal and ethical aspects of the whole field are mentioned regarding medical and nursing care of patients in vegetative state.In line with the objective of this thesis a manual will be created for potential informal carers on how to care for their loved ones, where to go in the case of emergency and what steps to take during the intermediate stage of institutional and home care. The results can be used for further exploration and as an additional source of information for health professionals.

Pulmonary sanatoriums are facilities where efficient and useful therapy for patients suffering from respiratory diseases is provided. They use treatments including the methods of climatotherapy, drinking cures or inhalation therapies. Diseases such as asthma bronchiale, chronic obstructive pulmonary disease, various forms of pneumonia, lung cancer and also tuberculosis are cured here. Just the tuberculosis treatment regimen is so specific that the research part of this thesis is devoted mainly to this phenomenon. Currently, tuberculosis represents a large medical problem in our country. Although the number of cases in the last decade has decreased, today it remains a serious medical and social problem with a huge economic effect on the entire society. The epidemiological situation is deteriorating on the global scale. The main causes of this deterioration are AIDS, the influx of refugees and immigrants from various risky countries, an increase in adherence to drug abuse and failure to keep to treatment measures. According to the WHO, two billion people are infected with tuberculosis globally. The urgency of this topic is seen in the fact that despite all measures, over 3 million people die of this disease globally and 90% of this number die in developing countries. This thesis is focused on the importance of pulmonary sanatoriums and also on the mapping of intensity of nursing care in particular pulmonary sanatoriums. To a great extent, the thesis deals with the issue of the specific needs of patients and the method of providing nursing care. The thesis describes individual facilities in the Czech Republic and their importance. It also deals with the specifics of nursing care for individual pulmonary diseases and goes into detail about provision of care at isolated units for patients with tuberculosis. It also deals with the holistic approach to the patient and multicultural nursing. A great part of the thesis is devoted to the needs of patients, and changes in their role in the sanatorium. The objective of this master´s thesis was to outline the difficulty of nursing care in specialized pulmonary sanatoriums and find the specific needs of patients in these facilities. Another objective was to discover the role of the nurse in provision of care and outline differences between individual facilities. All these objectives have been performed. Four research questions were set at the beginning of the research. The first research question dealt with how nursing care in pulmonary facilities is provided. The second research question was focused on finding the specific needs of patients in these facilities. The third research question dealt with the role of the nurse in providing care for patients in specialized pulmonary sanatoriums. And the last research question focused on differences between the individual sanatoriums. The practical part of the thesis contains the results of qualitative research gathered on the basis of a semi-structured interview. Final interviews were recorded, transcribed and subsequently processed by the technique of open coding. The research file consisted of 6 nurses working in pulmonary sanatoriums and 5 patients hospitalized with tuberculosis. Based on the information acquired, the patients perceive isolation units as a very simple and depressing place, where they miss contacts with their closest. The stay in the isolation unit is a shock for them. Foreigners complain of the language barrier. Nurses regard the nursing care as very demanding. They must care for patients with various diagnoses and provide multicultural care with respect to the national and cultural specifics of patients. Based on the results found, an information brochure was created, and this can help as a source of information for hospitalized patients in sanatoriums. Furthermore, the results of this thesis will be presented to individual sanatoriums for the purpose of making changes related to their equipment.

Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.