Nursing Procedures of Oxygen Administration to Newborns The diploma thesis is to outline the current perspective of oxygen therapy of newborns who need highly specialized care as early as in the delivery room and subsequently in intensive and resuscitation care units of perinatologic centres. The research in the diploma thesis is focused on the assessment of the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The theoretical part addresses the first treatment and evaluation of a newborn. Then the reasons leading to oxygen administration are discussed as well as the methods of oxygen application in the delivery room and intensive and resuscitation care units. Being at the forefront, oxygen is one of the most often administered medicines. Inadequate use of oxygen as a medicine increases the risk of complications for the newborn. The delivery and the first weeks after the birth rank among the crucial periods of every child. Adherence to the recommended procedures improves the outlooks of premature newborns for leading quality life. The objective of the thesis is to ascertain the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The research was quantitative and used the questionnaire technique. The author created one kind of the questionnaire for the selected research set. The set consisted of nurses working in neonatal wards of selected hospitals. A total of 65 questions were created to ascertain the level of implementation of recommendations of the Czech Neonatology Society concerning oxygen administration on all levels of neonatal care. The research set consisted of 184 respondents. In order to attain the objective, the following hypotheses were raised: H1: Nurses know the current recommendations for oxygen administration to newborns. H2: Delivery rooms have sufficient technical equipment for oxygen administration to newborns. H3: Nurses are theoretically and practically trained for situations requiring oxygen administration to newborns. H4: Clearly formulated rules of oxygen therapy are available for nurses in a written form in a well visible place in the delivery room. Based on the statistically processed results, the first three hypotheses have been confirmed. The fourth hypothesis was disconfirmed. The objective of the thesis has been attained. The research results may be used for better understanding of the issue of oxygen administration to newborns in a hypoxic condition with regard to the findings of its toxicity. In order to secure adherence to the recommendations for oxygen administration to newborns, it is appropriate to create a nursing procedure and standard and secure its availability in every delivery room and station.

In the first part of the diploma thesis we describe current state of taking care of newborns with special regard to mother's and newborn's needs and to the individual developmental care. We pay attention to the composition of the nursing team and to the conditions for its effective functioning. We cope with the importance of breast milk, breastfeeding and whole-community-based activities supporting breastfeeding. In the chapter about lactation consultancy we look into the history and present day to give a sense of this topic. The aim of the thesis is to make the description of the role of lactation consultant in the multidisciplinary team which takes care of premature newborns. We try to assess contribution of his presence to mothers of newborns and to nurses in the perinatal centres and at the same time to identify the problems lactation consultant are facing. We applied a qualitative research method of semi-structured interview for purpose of the study. We conducted the interviews with mothers of preterm infants, with nurses from the nursing team and with lactation consultants in ÚPMD in Prague and in České Budějovice Hospital. We investigated the rate of integration of lactation consultants into the nursing team within all perinatal centres in the Czech Republic. Lactation consultant provides mothers help with the stimulation of milk production and with the long-lasting breastfeeding maintenance. Lactation consultant supports mothers in breastfeeding and resolves problems related to breastfeeding a premature newborn. This help includes the psychological support. In relation to nurses, lactation consultant takes part in mothers' education in breastfeeding, manages human colostrum and mediates the mother-and-child contact when mother is separated from her baby. Nursing team is enriched with special knowledge and skills of lactation consultant. There were several problems identified: a lack of time for consultancy, the language barrier along with different cultural habits within minorities and the negative influence of layman discussion forums in the internet. Related to collaboration in the nursing team we encountered the problem of poor communication among lactation consultants and other team members. Mothers together with other team members, they all benefit from presence of lactation consultant in the nursing team.

This diploma thesis deals with the role of the child nurse in the adaptation of the newborn after delivery.In the theoretical part we devote to the available scientific knowledge focused on the course of pregnancy, the way of giving birth (vaginal and operative), assessment of postnatal adaptation of the newborn, breastfeeding and its importance. The essential part is mapping the role of child nurse in newborn care using the NOC system to evaluate their postnatal adaptation. The Czech and foreign literary sources were used for the theoretical part of the diploma thesis. The first aim of the diploma thesis was a detailed mapping of the role of the child nurse in postnatal adaptation of the newborn after physiological and operative delivery. Two research questions have been selected for its solution. The first research question was, what Apgar values the newborns show after the physiological and operative delivery. The second research question was the success of the first application of the newborn to breastfeeding within 30 minutes after physiological and operative delivery. The second aim of this diploma thesis was to verify the classification of the NOC on the evaluation of the newborn adaptation. For the solution, a research question has been determined, what is the opinion of nurses on the use of the NOC classification system in postnatal adaptation. For the empirical part of the research we have chosen a qualitatively quantitative strategy. Observation, individual semi-structured interviews with nurses and written filling of NOC classification system forms were used for data collection. The first research group was 10 newborns after the physiological - vaginal delivery and 10 newborns after the operative delivery by Caesarean section. The second research group consisted of 2 child nurses working with neonates as part of postnatal adaptation in Hospital Jihlava. Analyzing and interpreting the obtained results, we found out that newborns born by vaginal delivery had an average Apgar score of 8.03 and newborns born by Caesarean section had an average Apgar score of 9.50. The average values of the indicators in the NOC classification system code 0118 The adaptation of the newborn showed slightly poorer results after vaginal deliveries. Two groups of newborns that we followed did not match the generally expected results. Newborns after the Caesarean section are threatened by risk factors, but due to careful nursing care and gentle childbirth, such a risk does not occur and the process of postnatal adaptation can be successful. In the NOC classification system code 1000 Beginning of breastfeeding child showed the indicators at vaginal deliveries, at least 8 feedings per day and infant satisfaction after feeding, better results. In the NOC classification system code 1001 Beginning of breastfeeding mother the average values of breast suction indicators and satisfaction with the breastfeeding process resulted better in favour of neonates born vaginally compared to neonates after Caesarean section. As regards the success of the first feeding of neonates to breastfeeding within 30 minutes after delivery, a clearly superior result was obtained for newborns born vaginally. The conclusions drawn from our research in relation to child breastfeeding by mother confirm the clear benefit of vaginal births for the successful adaptation of newborns. A child nurse undoubtedly plays an important role in the assessment of postnatal adaptation of the newborn. The research of the diploma thesis shows that the classification system NOC is very well sophisticated in the context of a newborn adaptation and it is even detailed in connection with the follow-up and subsequent provision of newborn care. Its full use in current practice in the established care system of particular healthcare facilities is not possible due to insufficient staffing of the department. The existing documentation system does not provide reserves

The diploma thesis deals with neonatal abstinence syndrome which occur to newborns whose mothers were on addictive illegal drugs in the time of pregnancy. The most frequently taken drugs are canabinoids, stimulancias, opiods and opiates, halucinogens, and drugs taken during substitutional therapy. Neonatal abstinence syndrome is a multisystem disorder that frequently affects central nervous system, gastrointestinal system, respiratory system and autonomic system. To diagnose neonatal abstinence system is the most important careful monitoring of baby in the first days of its life. There are different scoring systems which have been developed for assessing the severity of neonatal abstinence syndrome, we use the Finnegan scoring system. Treatment of neonatal abstinence syndrome is mainly supportive and pharmacological therapy. There are also social serious consequences of this problems; mothers are usually not able to take care of babies and children live in children's homes. The aims of this study were to find out special needs of newborns born to mothers using addictive illegal drugs during pregnancy, to find care interventions which help newborns with neonatal abstinence syndrome in their first days of life and to discover interventions helping mothers stop using addictive illegal drugs. The theoretical part of this study is based on research of already presented scientific studies. The practical part of the study problems of neonates of mothers using addictive illegal drugs in first days after delivery. We have used Virginia Henderson's need theory to evaluate neonate's need. We have chosen only the most important elementary components out of 14 components in Virginia Henderson's need theory. I was also trying to find out if nurses know how to help neonates with neonatal abstinence syndrome and what nursing interventions have positive influence to neonates. Another goal was to know how nurses communicate with mothers and if they have positive influence on mothers. The method of communication with mother using addictive illegal drugs was semistructured interview. I wanted to know what kind of addictive drugs mothers were using during pregnancy and if mothers tried to solve their problem in pregnancy, before delivery. Results are sorted into categories and subcategories and showed in diagrams and tables. Neonates of mothers using addictive illegal drugs during pregnancy have problems in all investigated needs such as breathe, eat and drink adequately, sleep and rest, thermoneutral zone and social need. I also found out that some nursing intervences have positive influence on neonates with neonatal abstinence syndrome. Very important intervenes were individual contact with each neonate and quick reaction to every change in behavior. It is also necessary to respect their sleep and rest time, take nursing and medical care together in blocks, use non-pharmacological treatment of pain, feed them individually according to their needs and also try different techniques of feeding, put babies into the right position and eventually nestle, rock or touch them. In last part of the study we discuss mothers who use addictive illegal drugs. We found out that nurses did not speak with them very actively, did not offer them to breast-feed in special conditions, did not tell them about possibility to be with neonate together in the hospital until a discharge. On the other hand, mothers were not interested in the breast-feeding or staying with babies. The goal of the study was to create brochure with information of negative consequences of taking addictive drugs on babies. This brochure is convenient for education of mother and students as well.

Currently, the care of premature newborn infants and their parents is mainly focused on the so-called Newborn Individualized Developmental Care and Assessment Program (NIDCAP) that is aimed at protection of the developing central nervous system of a premature child.The aim of nursing care is to help premature child to cope with the premature delivery. To adjust the environment and the way of care so it suits the individual needs of every child. The support of the parental role and the efforts to involve parents in the care of a newborn infant as early as possible are stressed. The following objectives were defined in the diploma thesis. To process experience with introducing new forms of the developmental care of excessively or extremely premature newborn infants from the point of view of nursing. To characterize current provision of individualized developmental care of newborn infants born before week 32 of gestation. To map the role of the nurse in delivering individualized developmental care and to find out how parents perceive the developmental care of excessively and extremely premature newborn infants. 4 research questions were raised on the basis of the objectives of the thesis. Which forms of the individualized developmental care are used in care of a newborn infant born before week 32 of gestation most? Which problems do nurses have to cope when employing individualized developmental care in the day-to-day care of newborn infants born before week 32 of gestation with and which roles of nurses are applied most when providing care? How do parents of newborn infants born before week 32 of gestation perceive the care of their child included in the individualized developmental care? The theoretical part of the thesis deals with the issue of excessively and extremely premature newborn babies, characteristics of the individualized developmental care and the nursing strategies, the role of a nurse and the role of parents. The practical part is focused on the qualitative research. The results of the research suggest the nurses have included the individualized developmental care into the nursing care of premature newborn infants at the Department of Neonatal Medicine in the Hospital in České Budějovice, however, not in its full extent. The parents perceive the included aspects of this care positively,the nursing staff is important. The research has identified problems nurses have to cope with when they implement this care and what the reserves in the implementation are. A map of the individualized developmental care that can be used by nurses in practice is the result of the research.

The aim of my thesis is to summarize all the information regarding newborn and infant hearing screening programmes, to find out about the awareness of mothers-to-be and to give account on the possibilites of the further professional development of the infant hearing screening. The theoretical part consists of the definitions of terminology relating to this topic, the historical development of the hearing screening and the latest findings and current level of knowledge of the issue both in the Czech Republic and abroad. The practical part of my master's thesis aspires to detect the awareness of expecting mothers and non-professionals through a questionnaire survey. Apart from the results of the survey the practical part also contains an interview with a specialist. Besides the research analysis, I have also focused on informing the target group about the prospects and significance of the newborn and infant hearing screening tests as this is a current issue now. KEYWORDS: Newborn Otoacoustic emissions Hearing screening Hearing loss Early detection

This Master's thesis deals with the topic of impaired communication skills in premature infants. The thesis is divided into theoretical and practical parts. The theoretical part consists of three main chapters devoted to the development of children's speech, premature babies and care for premature babies. The first chapter describes speech and language, the ontogenetic development of speech, language levels in the ontogenesis of speech and impairment of communication skills in childhood. The second chapter defines a premature baby and discusses the most common postpartum complications. The third chapter is devoted to the care of premature babies in the Czech Republic, describes the logopaedic care regarding such children and their prognosis. The practical part is based on the methods of qualitative research. A triangulation of research methods was chosen - document analysis, observation and interview. The main goal was to describe how impaired communication skills are manifested in premature infants. The partial goal was to find out what postpartum complications occur in premature infants. To achieve the goals of the research, five research questions were formulated. Five respondents were included in the survey, namely four boys and one girl. Based on the obtained data, case studies of individual...

UNIVERZITA KARLOVA V PRAZE 1. LÉKAŘSKÁ FAKULTA Studijní program: Specializace ve zdravotnictví N5345 Studijní obor: Intenzivní péče MIP 5345T024 Bc. Tereza Morávková Psychická podpora a komunikace s rodinou novorozence na ARO/JIP Psychological support and communication with family on newborn resuscitation, ICU DIPLOMOVÁ PRÁCE Vedoucí diplomové práce: PhDr. Alena Mellanová, CSc. Praha ABSTRACT This diploma thesis is theoretical and empirical, and focuses on emotional support and communication with parents of a newborn in a resuscitation department or ICU. It analyzes the approach that the medical staff has towards these parents, specifically psychological support in the form of sufficient and adequate communication. The theoretical section begins with the classification of newborns. Next the reasons for intensive and neonatal care for very premature babies are discussed. The following chapter contains an analysis of the psychological changes that the parents of a newborn in a resuscitation department or ICU may experience. This chapter describes the general characteristics of fear and anxiety. The next section describes the reasons, possible manifestations and consequences of this fear and anxiety experienced by the families. The next chapter sets out the principles of communication with a family in a...

Stabilisation and resuscitation in the delivery room is an integral part of the care of extremely premature newborns. The main task is to support essential life functions and to facilitate the adaptation of the immature organism to the extrauterine life. The current recommendations are well defined for the full term and late preterm newborns, but there is a lack of targeted recommendations for the stabilisation and resuscitation of extremely premature newborns. The research part of the submitted thesis summarises the most important results of clinical research performed in 2010-2015 at the Department of Neonatology of the Department of Gynecology and Obstetrics, VFN and First Faculty of Medicine, Charles University in Prague. The research evaluates the efficacy and side effects of the currently recommended methods of stabilisation and resuscitation of extremely premature neonates in the delivery room and presents some new and potentially useful techniques for delivery room care. A significant output of this work is the recommendation for practice, structured according to the gestational age of extremely premature newborns. The proposed guideline is based on our results of partial clinical trials and aims to improve the current level of stabilisation and resuscitation of extremely premature newborns...

The aim of the diploma thesis was to observe the capability of imitation in orofacial area of three days old infants and analyze if the capability relates to quality of psychomotor development, thus whether it relates with a global motor model. This paper is a pilot study comprising seventeen infants. Each of them was supposed to attend four visits during the first six months of their life. It included visits in the first few days, between the fourth and the sixth week, the third month and the sixth month of their life. The psychomotor development was examined and within the first visit there was established communication with the child by means of eye contact and imitation. Each child's attempt at imitation and response was recorded. This thesis can serve as a basis for further research dealing with this topic that includes the imitation skill of mirror neurons related to psychomotor development.