(in English): The topic of the master thesis "Palliative care in hospitals" focuses on an area that is unknown not only to the general public but to health professionals as well. The care for the dying is not an attractive and sought subject. Nevertheless, it can concern everyone directly or indirectly through family and friends that are close and dear. In the past recent years palliative care in the Czech Republic has advanced. The principles are being applied by some providers of health and social care. In medical establishments palliative care is still not automatically provided even though hospitals in the Czech Republic are a place where most deaths occur. The theoretical part clarifies, describes and introduces palliative care, defines its content and principles from the social and logistic aspect. It focuses on ways to apply palliative care in hospitals, on the conditions of its integration into medical establishments, organizational forms and describes experiences in this field from abroad. Based on the fundamentals of quality research the practical part of the thesis maps the conditions in which patients spend their last days in a specific hospital from the point of view of the medical personnel. The main outcome of this thesis is the ambiguous statement that hospitals lack palliative...

This diploma thesis focuses on examining the process of introduction of supervision as an effective tool for improving the work quality at the institutional care facilities. More specifically it inquires the process when the supervisor enters the working field as ,,pre- selected'' through the ,,external'' European projects. The research issues are examined from the point of view of the supervisors, at the basis of questioning their opinions and experience. This paper describes how the supervisors perceive the status quo from their own position. This survey consists of two interconnected parts. The first, theoretical part comprises the chapters describing the organisational culture, supervision, institutional facilities and the European projects. The second, empirical part defines the research issues, determines the methodology and the research structure. The research is made by the qualitative approach, when the data are collected through in-depth semi-structured interview, analysed by the method of an opened coding and the constant comparison technique. The results of the analysis consists of five following categories: entering: the supervisor enters the organisation ,,sideways''; place: the supervisor meets the organisation of ,,machine''; effects: the supervisor experiences the consequences of...

This dissertation deals with the position of foster-mother in SOS children's villages. The first part focuses on the legislative background of the operation of these facilities for foster care in the context of the development organization SOS Children's Villages in the Czech Republic and the international organization SOS Kinderdorf International. It discusses the problem of Czech SOS Children's Villages, when foster-mother is responsible for the child entrusted to foster care, which is the difference from the Czech villages than villages in the other countries. The second part analyzes the role of the SOS foster-mother. It offers a reflection on the meaning of the concept of the archetypal mother and changes of maternal role. The dissertation maps a question of motivation and readiness for fostering.Step by step are described SOS foster-mothers's career stages and are development cycles of SOS families. The work deals with the controversial topic, such as support for an SOS foster-mother. It introduces the concept of an integrated following educational community youth, boarding facilities for teenagers and young adults from the SOS villages. Work thinks how sustainability cyclic replenishment of children and families in the SOS families and possibilities and individualized needs of clients in the SOS...

Methicillin-resistant Staphylococcus aureus (MRSA) is an antibiotic-resistant bacterium of epidemiologic importance in Canadian healthcare facilities. The contact between MRSA colonized or infected patients with other patients, healthcare workers (HCWs) and/or the healthcare environment can result in MRSA transmission and healthcare-associated MRSA (HA-MRSA) infections in hospitals. These HA-MRSA infections are linked with increased length of hospital stay, economic burden, morbidity and mortality. Although infection prevention and control programs initiated in 2009 in Canada and other developed countries (e.g., UK, France, Belgium, Denmark, etc.) have been relatively successful in reducing the rate of HA-MRSA infections, they continue to pose a threat to patients, especially to the more vulnerable in long term care and geriatric institutions. Historically, MRSA was a problem mainly in hospital settings but after mid-1990s new strains of MRSA have been identified among people without healthcare-related risks and have been classified as community-associated MRSA (CA-MRSA). Furthermore, the distinction between HA-MRSA and CA-MRSA strains is gradually waning due to both the introduction of HA-MRSA in communities, and the emergence of CA-MRSA strains in hospitals. The purpose of this thesis was to explore the feasibility of constructing healthcare networks to evaluate the role of healthcare providers (e.g., physicians) and places (e.g., patient rooms) in the transmission of MRSA in a large tertiary care facility. Method of investigation: a secondary data case-control study, using individual characteristics and network structure measures, conducted at The Ottawa Hospital (TOH) between April 1st, 2013 and March 31th, 2014. Results: It was feasible to build social networks in a large tertiary care facility based on electronic medical records data. The networks' size (represented by the number of vertices and lines) increased during the outbreak period (period 1) compared to the pre-outbreak period (period 0) for both groups and at all three TOH campuses. The calculated median degree centrality showed significant increase in value for both study groups during period 1 compared to period 0 for two of the TOH campuses (Civic and General). There was no significant difference between the median degree centrality calculated for each study group at the Heart Institute when compared for the two reference periods. The median degree centrality of the MRSA case group for period 0 showed no significant difference when compared to the same measure determined for the control group for all three TOH campuses. However, the median degree centrality calculated for period 1 was significantly increased for the control group compared to the MRSA case group for two TOH campuses (Civic and General) but showed no significant difference between the two groups from the Heart Institute. In addition, there was a correlation between the two network measures (degree centrality and eigenvector centrality) calculated to determine the most influential person or place in the MRSA case group networks. However, there was no correlation between the two network’s measures calculated for physicians included in MRSA case group networks. Conclusions: It is feasible to use social network analysis as an epidemiologic analysis tool to characterize the MRSA transmission in a hospital setting. The network's visible changes between the groups and reference periods were reflected by the network measures and supported also by known hospital patient movements after the outbreak onset. Furthermore, we were able to identify potential source cases and places just prior of the outbreak start. Unfortunately, we were not able to show the role of healthcare workers in MRSA transmission in a hospital setting due to limitations in data collection and network measure chosen (eigenvector centrality). Further research is required to confirm these study findings.

The aim of this thesis is to identify and to describe barriers to the implementation of person-centered care in specific residential care facility for the elderly. For this purpose, the author firstly conceptualizes the concept of person-centered care. Consequently, she develops the Framework for conducting research. The theoretical portion consists of five chapters. The first chapter focuses on the person- centered care concept introduction, then it describes the relationship between concepts 'individualization of care' and 'person-centered care'. In the conclusion of the first chapter, the Schema of the concept is introduced. The Schema visualizes the structure for chapters two to five. In those chapters, a description of the systems defined in the Schema is provided. Those are: Care Recipients, Direct Care Actors, and Service Providers. The end of the first part brings the topic of a suitable organizational culture. The empirical portion firstly offers the summary of the theoretical background - so follows the Framework for the consequent analysis and data interpretation - then introduces relevant aspects within researched organization, particularly within organization currently implemented a psychobiographical model of care that is the approach to person-centered care. The empirical portion...