Application of the ?vaccination? nursing standard in primary child care Vaccination is a topic having been discussed since the very beginning. It is one of the most important parts of prevention of infectious diseases. Thanks to vaccination we only know some infectious diseases from historical resources nowadays. The vaccination history is not really long, however vaccination has helped save a lot of children lives. Despite undisputable benefit of vaccination there are still more opponents of vaccination, whose arguments are very often groundless or taken out of context. Diseases that had been nearly eradicated thanks to vaccination have spread in countries where some vaccination ended. This is why vaccination is so important. There are a lot of vaccines on the market nowadays, new vaccination substances still appear and compulsory and no-compulsory vaccination is being changed with gradual scientific development. My thesis presents a complex outline of information on children vaccination and vaccination procedures. The aim of the thesis was to explore the present situation and vaccination procedures applied by practitioners for children and adolescents. Another aim was to develop a nursing standard for children vaccination and to check its practical applicability. To meet these goals the thesis is divided into a theoretical part including structured information on children vaccination and vaccination procedures in the past and at present. The practical pat of the thesis is focused on quantitative examination of the present situation, vaccination procedures and collection of information on novelties in vaccination in surgeries of practitioners for children and adolescents. The data were collected by means of a questionnaire, which was distributed to 130 surgeries of practitioners for children and adolescents in Vysočina and South Bohemia regions. 93 of the 130 questionnaires were suitable for processing. The practical part then contains an audit and an inquiry about the elaborated nursing standard performed in 6 surgeries of practitioners for children and adolescents. The questionnaire and the inquiry were anonymous. Both the set goals were met. The results show that there are differences both in vaccination procedures and in approach to children vaccination in the individual surgeries of practitioners for children and adolescents. The research results also point out that information on vaccination is sufficient, however unclear. The result of the audit and the inquiry showed that the elaborated standard is practically applicable and is beneficial for nurses. These result confirm that a nurse always participates in vaccination process, which is why it is important for her to be informed enough on children vaccination and related activities and to be able to perform vaccination as well as related administration. The thesis may be useful in my opinion as it contains complex and structured information on children vaccination. This is why it may be used both in a surgery of a practitioner for children and adolescents and for educational purposes. Of course with consideration to vaccination related amendments of the Ministry of Health Care.

Hyperbaric oxygen therapy is a treatment method that involves inhalation of 100% oxygen, and under higher pressure than the atmospheric. Blood has the ability to deliver more oxygen authorities. Treatment takes place in facilities called the hyperbaric chamber. During treatment, patients must adhere to certain principles that are given by the doctors and nurses working in these workplaces.The main objectives of this thesis were to map the influence of preparation on the course of treatment in a hyperbaric chamber and to determine how the patients are instructed by nurses during treatment in the hyperbaric chamber. Three research questions were set up to clarify how the preparation affects the patient during treatment in a hyperbaric chamber, as the patient is educated before treatment and what output the patient receives after leaving the hyperbaric chamber. In order to fulfill the objectives qualitative research methods were done, using a semi structured interview. The survey was conducted in two selected hospitals, in the České Budejovice Hospital, and at the University Hospital Plzeň - Lochotin. An individual, semi-structured interview was used as data collection technique, which was initially recorded on a cell phone and then transcribed into written form. At the beginning of the research interviews were conducted with nurses, who gave a comprehensive view of their job description. These conversations only complement the research. We included the brochure with basic information in our research and that was supplemented by information obtained from these interviews. The sample included patients treated in a hyperbaric chamber. They were subsequently divided into three subgroups. The first subgroup consisted of chronic patients, the second subgroup of patients undergoing hyperbaric oxygen therapy for the first time and who got the booklet with background information before their first exposure and in the third were also new patients but who were given a booklet after their first exposure. The survey was conducted in January and February 2015. Analyzed data formed four categories. Careful preparation of the patient is an essential part of treatment in a hyperbaric chamber, largely because of the specificity of this treatment, which consists mainly of placing the patient in an enclosed space, the need for a breathing mask and the inability to quickly leave the hyperbaric chamber without health risks. Therapy in a hyperbaric chamber alone is, in compliance with the indication, contraindication and dosing schedules and well-executed preparation, relatively safe and simple. From the above mentioned reasons it is necessary that the nurses in the area are sufficiently educated and that the patient who enters the hyperbaric chamber is properly prepared. Nurses educate each patient just before their first exposure, but also before every following one. There is very much information given to patients during preparation for entry into a hyperbaric chamber. The research showed that almost all the respondents had difficulty to remember all the details. Nurses tell them about hyperbaroxy essence, indications, contraindications, the exposure pattern, they select a breathing mask with them, and teach the patients to equalize the pressure in their ears, check their clothes and what they have with them. The nurses also check whether they are greased with creams, makeup and other cosmetics, and in the case of wounds if they are treated using a moist treatment instead of greasy. Before each exposure, the patient is asked about their health (a cold is a contraindication), their blood pressure is measured and the necessary nasal drops are applied. Precisely because of the considerable amount of information that patients get at their first exposure, we decided to include the booklet, which contains basic information for patients who are treated in a hyperbaric chamber for the first time, in our research.

There are still large migrations of populations taking place, which are also reflected in the Czech healthcare system. The number of patients cared for foreigners from various close and distant countries is increasing. Currently, there is an increasing number of foreigners, mostly from Arab countries. This is partially due to the current political situation in these countries. The theoretical part is divided into several sections. The first section deals with the Arab states. The last section of this chapter explains the history of Arab healthcare. Another section focuses on Muslims in the Czech Republic, The next chapter describes the specifics of treating Muslim patients. The afore mentioned specifics are followed by a chapter on multicultural nursing and general nurses. Therefore, the last theoretical chapter covers the ethical aspects of multicultural nursing. The thesis has four objectives. The main objective is to: Determine the experiences of Arab patients with the provided care within the Czech healthcare system. The partial objectives are then: Objective 1: To find the most common problems in treating Arab patients from the perspective of a nurse. Objective 2: To determine the experience of Arab patients, who have been in contact with medical personnel. Objective 3: To determine the differences between the healthcare delivered in the Czech Republic and in the Arab countries. The main research question is: What are the experiences of Arab patients with the provided care within the Czech healthcare system? SQ 1: What are the most common problems in treating Arab patients from the nurses' perspective? SQ 2: What are the experiences of Arab patients who have been in contact with medical personnel? SQ 3: What are the biggest differences between the healthcare delivered in the Czech Republic and in the Arab countries? In order to achieve the objectives and to answer the research questions, a qualitative investigation was conducted using semi-structured interviews with Arab patients and also with general nurses. The snowball method was used to obtain the required respondents. The criterion for selecting the respondents was that they were from an Arab country and that at the same time they had experienced Czech healthcare. Overall, 17 respondents were obtained. The criterion for selecting the nurses was that they had, during their professional conduct, provided nursing care to patients from Arab countries. The interview was conducted with 10 general nurses. The interviews were copied verbatim into Microsoft Office Word 2007. A pictogram was then created for each area using the XMind 6 program. The results of the survey show that the respondents' overall assessment of Czech healthcare is very positive. From the nurses' perspective the language barrier and the lack of familiarity with the specifics of the cultures is the major concern. A positive finding is that nurses are willing to accommodate some of the special needs of these patients. Mostly these include serving meals without pork, being treated by a person of the same gender, ensuring privacy while praying, or being accompanied by relatives during examinations. The respondents also reported, in line with the nurses, that the biggest problem is the language barrier. The fundamental difference between the Czech and Arab healthcare systems is especially seen by the respondents in the absence of health insurance in the Arab countries. Furthermore, the respondents praised the clean hospitals in the Czech healthcare system, quality equipment and well-educated medical staff. Compared to the care in their homeland it is incomparably better. The results of the research have been presented at the National Student Scientific Conference of bachelor and master non-medical degree courses in Pardubice, 23. 4. 2015. Furthermore, they will be published in the form of an article in a professional journal in order to inform the public about the lessons learned.

Currently there are noticable changes in nursing concepts, shifts in thinking and attitude towards nursing. Unlike in the past, when nursing care was provided in accordance with the biomedical model, current nursing shows attempts at greater use of interaction models reflecting a holistic approach and humanism. This fact was pointed out in the 1960's by Joyce E. Travelbee, a New Orleans psychiatric nurse, educator and nursing theoretician. The disseration intituled 'Joyce E. Travelbee's Inspiration for Nursing' is of theoretical character with the aim of analysing the legacy of Joyce E. Travelbee as a nursing history personality and her work with a tendency to express her significance for nursing. It is concieved as a historical-analytical study and a zpracována formou studia literárního odkazu a jeho analýzy s následným vypracováním interpretativního textu. In connection with the study of literary legacy and its analysis questions, for which the answers were sought, were asked: How did Joyce E. Travelbee reflect current nursing practice? What suggestions did she make in changing current attitude towards patients? What is key to longterm contribution of Joyce E. Travelbee as a theoretitian to the nursing concept? Which of Joyce E. Travelbee's ideas and literary legacies are inspirational for nursing? The contents and meaning of some terms are set out in Chapter 1. Chapter 2 reflects the development of nursing as a theory, science and practice in a chronological order and also on a national and international level, especially the period, in which Joyce E. Travelbee (1926-1973) lived and formulated her ideas. The chapter was conceived in the sense of referring to the ideas and work of individual nursing theoreticians in connection with contributions to nuring theory and practice. Chapter 3 is dedicated to the personality Joyce E. Travelbee, her biography, publishing activity and specialist texts relating to her person and work bases. Chapter 4 interprets the work of Joyce E. Travelbee. The chapter is divided into four sub-chapters with the aim of illustrating the logical sequence in the development of ideas in Joyce E. Travelbee's work. The first part deals with nursing from Joyce E. Travelbee's point of view, in the second part space is given to introduced concepts in Joyce E. Travelbee's work, the third part focusses on the explanation of the human-to-human relationship concept and the fourth part deals with nursing supervision as a tool for forging human relationships. The fifth chapter was concieved with the aim of pointing out the fact that Joyce E. Travelbee's work has been an inspiration for the authors of many publications, research studies, dissertations, contributions on web pages, and for international scientific conferences participants. Interpretation analysis of primary and secondary text sources showed that an inspirational change in nursing is that of nurse-patient and patient-nurse attitudes and the emphasis on satisfying patients' needs as well as nurses' needs. Changes in attitude can be seen in nursing education which should prepare nurses for satisfying patients' emotional and spiritual needs with an emphasis on empathy, sympathy and rapport. One of the possibilities of achieving this change in nurses' education is to include more communicative exercises, philosophy, psychology and the clarification of values in nursing educational programmes the training of nurses in self reflection, critical thinking and carrying out of supervision.

The thesis titled "The Level of Awareness and Analysis of Mistakes in the Use of Inhalation Systems in Patients with Chronic Pulmonary Diseases" maps the present problems of the care of patients with chronic diseases with bronchial obstruction whose medication contains some inhalation preparation. This thesis is divided into a theoretical and an empiric parts. The theoretical part deals generally with the issue of the care of patients with chronic pulmonary diseases, with focus on patients with chronic obstructive pulmonary diseases, who formed the biggest part of the research sample of patients. It also focuses on their treatment and the principles of proper administration of medicines by means of inhalation systems. The empiric part focuses on the patients' awareness and skills and on their attitude to their own skills in these terms.

Thesis: The role of the nurse in the nutrition of cancer patients. Nutritional issues concerning cancer patients are often discussed in recent years and they are still a current theme of debates. The results from surveys of recent years show the seriousness of the situation and urge to its fast solution. The situation is not favourable: the nutritional care in oncology is still underestimated, even though it forms significant foundation for the general success of treatment

Current status: Medication errors within the context of safe and high quality health care are one of the most frequently discussed topics of recent years. They are part of the medical process, occur in different forms, affect patients of all ages and decrease the quality of provided health care. Prescriptions of medication in medical documentation have to be clearly legible and include all the required information. Nurses' role within the medicaiton process could be described as an ultimate "safeguard" that can prevent medication errors. Goals: The objectives of this research are to assess nurses' awareness of medication errors, ssess their ability to detect medication errors and find out the level of their knowledge regarding the correct procedures and measures following medication error detection.Methodology: The research was conducted using a qualitative research method. The in-depth interviews with nurses were carried out at a surgical critical care unit at the hospital in Jindrichuv Hradec. Following the collection of a sufficient amount of data the interviews were coded using the "pen and pencil" technique and then divided into categories.Research file: In order to achieve the highest level of objectivity the research was carried out with a group of nurses who work at the same unit of a hospital department. The research file included nurses who had varied levels of education and numbers of years of experience. Results: Surgical critical care unit nurses are not aware of the exact definition of medication errors. Only one nurse was able to discuss adverse events with related consequences. The remaining nurses' awareness of medication errors corresponded to the classification described in the relevant foreign and Czech academic literature. None of the interviewed nurses detected all the errors included in the simulated scenarios. Only one nurse, who is currently completing her qualification in this specialty, detected a wrongly prescribed antidote. The simulated scenarios also included a group of high-risk medications that is commonly used at the unit. The first medication included in this group was a 7.45% solution of potassium (KCl). A majority of the participants detected the high concentration of this high-risk medication. Another high-risk medication was a 10% concentrate of NaCl in an infusion; this error was also detected by the majority of the nurses. The third high-risk medication was a wrongly prescribed insulin (it lacked the detailed description of units, time and route). This prescription error was not detected by the majority of participating nurses. Another type of medication error included in the simulated scenarios was a group of medications used specifically in critical care. Only half of the participating nurses successfully detected the errors related to the prescription of this group of medications. The last type or medication errors focused on incomplete prescription by doctors. The most frequently detected error was a prescription of an opiate that lacked the route and the least frequently detected error was a wrong prescription of an infusion administration. It is evident that the nurses always inform the doctor when they detect a medication error. They are more willing to inform the ward sister in cases of incidents caused by somebody else. Only a small group of nurses are willing to inform the senior consultant, the head nurse or the hospital management. Only one nurse associated medication error reporting with an audit. However the majority of nurses agrees that it is important to report any medication errors.Conclusion: The analysed data suggested that the nurses were aware of medication errors. The analysis of the results of the simulated scenarios suggested that nurses' ability to detect medication errors in prescriptions was related to the number of years of experience and the level of education.

Introduction: Atrial fibrillation is the most common sustained arrhythmia. The quality of atrial fibrillation treatment in clinical practice varies between hospitals and doctors. Due to the increasing prevalence of atrial fibrillation in the more elderly population, it might be difficult in the future to refer patients to a limited number of heart specialists. At the same time, a new generation of University educated nurses is growing, but, unfortunately, their competencies are as low as their colleagues' with high-school education. However, in some areas, such as diabetology or gastroenterology, specialist nurses, whose aim is to supplement medical doctors to some extent, are gradually occurring. In the Czech Republic, there are no specialist nurses in cardiology, even though they are quite common abroad. Our aim is to assess the feasibility of a specialist nurse for diagnosis and treatment of atrial fibrillation. Methods: Main inclusion criterion for our study was a diagnosis of atrial fibrillation made on one of the non-internal medicine wards or in the general practitioners' practice. An exclusion criterion was previous examination by one of the heart specialists either internal medicine doctor or a cardiologist. During the first interview, I checked previous investigations for the atrial fibrillation and the arrhythmia treatment. The questionnaire contained questions on demographic parameters and patients' knowledge about their disease and possible complications. Subsequently, I recorded my recommendations regarding further investigations and therapeutic possibilites. All patients were sent to a cardiologist as required by our national guidelines. The second interview was made over the phone 2 months later and comparison of the doctor's recommendations with my suggestions was made. During this interview, an assessment of the concept of a nurse specialist in atrial fibrillation was performed. Results: Forty patients with atrial fibrillation documented on an ECG were recruited. At a time of the first interview, only 10 patients (25%) had their echocardiogram performed and only 23 (57,5%) patients had their thyroid gland hormones checked. 26 (65%) patients were on anticoagulation medicine while CHADS2-Vasc score of 2 and more was documented in 34 (85%) patients. There was an agreement between doctor's and nurse's recommendations regarding missing investigations and anticoagulation treatment. However, no agreement was achieved in the area of arrhythmia treatment, which means that this should remain a doctor's responsibility. Patients were informed about possible complications in only 11 (27,5%) cases and about all therapeutic options in 2 (5%) cases. 29 (72,5%) patients would be interested in consulting a specialist nurse in the future, whereas 11 (27,5%) patients would prefer a doctor. Results: We managed to confirm that the novel concept of a specialist nurse for the diagnosis and treatment of atrial fibrillation is feasible. The specialist nurse is able to confirm the diagnosis, check the completeness of the investigations, educate patients and assess the risk of the thromboembolic disease. Competencies of the nurses should be extended, so this concept could be introduced into the clinical practice.

Ethylene glycol intoxication, suicidal as well as accidental, belongs to serious, immediately life-threatening poisonings, which can however be cured even in the most severe cases (provided early recognition and correct treatment), including the restoration of renal function to the original state. Ethylene glycol is most notably present in anti-freeze cooling liquids for vehicles (such as Fridex). Consumption of 100-150 ml of such a solution is considered a lethal dose in humans. follows Oral ingestion is followed by rapid absorption. Metabolic decomposition takes place predominantly in the liver by way of alcohol dehydrogenase, to glycoaldehyde, which is further metabolised to glycolic acid and oxalic acid. The clinical aspect is dominated by acute renal failure which is caused by acute tubular necrosis. Toxicological examination including an assessment of ethylene glycol levels in both blood and urine, with prognostic relevance, is indispensable to diagnostics of the poisoning as well as from the standpoint of differential diagnostics. Therapeutic measures include gastric lavage within one hour of ingestion and administration of activated charcoal. Administration of ethanol and fomepizole, compounds that bind alcohol dehydrogenase and thus prevent the conversion of ethylene glycol to its toxic metabolites, is considered valid causal treatment with simultaneous early institution of hemodialysis (even in cases of hitherto intact renal function). As fomepizole is currently not available in the Czech republic, ethanol remains the only antidote. Therapy further includes correction of metabolic acidosis by way of bicarbonates, and intravenous application of thiamine and pyridoxine. Therapy of such a grave condition must entail infirmary care provided by professional nurses as a necessary complement. The nurse serves their function in securing the patient's airways, connecting the patient to mechanical ventilation, monitoring physiological functions, assistance with invasive entry, as well as conducting sample extractions, assuring proper hygiene, the prevention of decubitus ulcers etc. It has been the aim of an extensive effort during my analysis of this topic to collate an up-to-date summary of practical knowledge on ethylene glycol intoxication, as well as subsequent therapeutic options for such patients, based on collected information and available source material. This final thesis, entitled "Approach and Options for Nurses in Therapy of Ethylene Glycol-intoxicated Patients" has been created relying on a body of purely theoretical Czech and foreign sources. To attain awareness of the current state of medical sciences described on the following pages, many professional and scientific publications, books as well as journals and websites of registered professional societies had to be studied. The aim of a detailed inspection of such an extensive body of data has been to provide relevant findings based on the facts determined. The accumulated information is further specified in particular sections. The first deal with intoxication, elimination and first aid in the pre-hospitalization phase from a broader perspective. Without these elementary notes the thesis as a whole would lack in conclusiveness. From this section the thesis fluidly continues with ethylene glycol intoxication itself, its treatment and all the way to the role of the nurse including particular therapeutic measures. These sections contain specific recommendations issuing from news and cutting-edge research on ethylene glycol poisonings.

The dissertation thesis deals with the issue of violence during mutual contact of a patient and a nurse in the Czech Republic. Its main aim is to map violence which appears only during mutual contact between general nurses and patients. The secondary aims were to identify the most common problems in these situations, and to find possibilities to solve them. The aims were tested by four hypotheses and one research question. Mixed design - a combination of quantitative methods, qualitative in-depth interviews, and ex-post evaluation of my own teaching method - was used in this research. The quantitative sample included 896 respondents (500 general nurses, 92 doctors, 151 paramedics, 25 ambulance drivers, 60 physiotherapists, 18 safety workers and 50 auxiliary health care workers). Qualitative research is based on ten in-depth interviews with nurses (from various departments including outpatient care and emergency pre-hospital care) who have experienced a violent incident (analyzed by coding according to Glaser and Strauss). Unlike quantitative research, in-depth interviews are carried out on a smaller sample of respondents. Originally, there were 50 interviews carried out, but some attributes were being repeated, thus only 10 interviews were chosen to show the most important aspects. Ex-post evaluation included evaluation of practical training of 550 non-medical health care workers (general nurses, porters, auxiliary workers) in 14 workshops that were organized during 11 months. The total number of non-medical health care workers in the project was 550. After 12 months, 239 questionnaires were returned (42 % response rate). The first hypothesis, that both female and male health care workers alike experience violence in providing nursing care in the Czech Republic, was verified. The second hypothesis proved that general nurses in the Czech Republic are the professional group that is most exposed to verbal violence. Violence in health care in the Czech Republic is thus mostly a problem of nursing care. The third hypothesis proved that nurses with secondary education are exposed to violence more often than nurses with tertiary education. Qualitative analysis discovered a new dimension of violence in nursing - nurses' behaviour adds significantly to conflict escalation and is one of the causes of violence. The fourth hypothesis proved that it is possible to prepare nurses for dealing with a violent patient and prevent violence by choosing the correct style of communication.