The subject of this thesis is called ?The influence of the middle nursing management on the nursing care quality?. The theoretical part focuses on head nurses, their preferred characteristics, skills, competencies, leadership styles and the way of implementing changes. The component of the theoretical part is also a description of the nursing care quality, and some ways how to achieve it. The practical part focuses on the influence of head nurses on the nursing care quality. For the processing the thesis has been used the combination of both qualitative and quantitative surveys. Our inquiry was conducted in the South-Bohemian hospitals and head nurses were the respondents. During the questioning survey and interviews we have managed to achieve all our pre-defined targets. Through the interviews we have managed to answer all given research questions. We found that all interviewed head nurses have the professional knowledge of the nursing management field. We identified ways of implementing changes to enhance the nursing care quality in practice. The head nurses stated, that nurses accept these changes after a presentation of professional arguments, and that the head nurses are led and supported during the introduction of the changes by top management. The head nurses, interviewed by us, believe that the adoption of changes to enhance the nursing care quality will help to increase the prestige of nursing and support the independence of this field. Based on the evaluation results of the survey we have identified the reluctance of nurses to learn new things as the most common problem in the implementation of changes.

The social development of last decades brings about rapid changes, affecting also medicine and nursing. It also contributed to a positive shift, so a hospitalization of a child does not necessarily mean breaking bonds with its parents, siblings, and the broader family. Yet, a nurse remains an irreplaceable link in the process of child's treatment. It is a nurse who spends most of the time with the child during a hospitalization. A nurse has therefore a great potential of influencing child's adaptation to the hospitalization either in a positive or a negative way. Regardless of health or illness, a child retains a need of play activities. A play is an important healing component, it improves emotional condition, facilitates an adaptation to a changed health situation and enables saturation for activities the disease makes difficult or impossible. This diploma thesis aimed to analyze how spare time and play activities are ensured in small hospitals, regarding personnel, time and material. The author also set the task of finding out what importance the nurses give to their own role in the educational process. The research was conducted in two ways. The qualitative part contains interviews with children of primary school age who answered questions about what they wanted and what children hospitalized in small hospitals generally miss. Hypotheses were subsequently formed according to results of this part. These hypotheses were then tested by a quantitative research. The research group for the quantitative research were nurses working in pediatric departments of hospitals in the regions of Plzen, Karlovy Vary and Central Bohemia. The research shows that many pediatric departments of small and medium-sized hospitals have to deal with nurses' time troubles and with an insufficient staffing in order to fill meaningfully and effectively the child patients' spare time. The results of this research will be used as a platform for improvement of hospitalized children's conditions in one particular department.

The work is divided into a theoretical and practical part. The theoretical part of the work is focused on explaining the basic concepts in allergology, types of allergies are presented, their symptoms and treatment. Furthermore, the work describes the types of prevention and the task of a nursing in allergology. In the practical part of the work three goals were set up. The first goal was to determine the role of a nurse in secondary prevention in patients / clients with an allergic disease. The second objective of the research was to determine whether differences exist by nurses in the provision of secondary prevention in patients / clients with an allergic disease at selected sites. The third objective was to determine how nurses prepare patients / clients for the adherence to a treatment regimen associated with their allergic disease. To achieve these objectives a qualitative research method of semi-structured interviews has been selected. The research group consisted of ten nurses, two nurses working in the allergology ambulance at the hospital and four nurses from private ambulances in České Budějovice, two nurses from private ambulances and one from the allergology ambulance at the hospital in Písek, and one nurse from the private allergology ambulance in Strakonice.

To enable the nurse at least to perform her profession at a standard level, she needs not only material equipment, but also most of all the moral support of her superiors. Sufficient knowledge and experience are important for that profession as well. Another important aspect is to be able to see the meaningful tasks of her work and to have a feeling of certainty. My work has got three targets, which are: Target 1: To show, how the nurses of the middle management motivate their juniors to make them work more efficiently. Target 2: To analyze experience of middle management nurses with a team management. Target 3: To show whether, and in which way the nurses in the middle management motivate their juniors to increase their professional competence. I have used a qualitative research method for my study. A technique of an in-depth discussion was used for the collection of data. The research group contained 14 nurses in chief positions. The statements of individual nurses were categorized. They were divided into six basic groups, which are: Motivation factors, de-motivation factors, composition of the working team, work in a team, education and registration.

This diploma thesis dealt with the issue of awareness of a patient and his or her opportunity to co-decide during hospitalization at an internal department. There were set three targets. The first one was to find out the level of the awareness of the patient during hospitalization about a care plan. From the result of a research is evident that patients feel lack of clear information about the care plan. The second target was to find out whether the patient has a chance to co-decide about a provided care during hospitalization. Comparing results from particular investigations there was a contrary between opinions of patients and medics. Patients think that the opportunity to co-decide is given to them. However, medics think that the opportunity of the patient to co-decide is limited. The third target was to find out, which questions in connection with a process of hospitalization patients ask nurses. Results of the investigation show that the most frequent questions are about the length of hospitalization. The diploma thesis is divided into two parts-theoretical and empirical. The theoretical part describes issues of the process of hospitalization of the patient since his/her income until his/her discharge from hospital. The investigative part was implemented by combination of a quantitative and a qualitative research. For the quantitative part of the investigation there was chosen the method questionnaire with a technique of half-structured interview offering open questions. Into the research file was involved 15 patients hospitalized at the internal department involved. There were set three investigatory questions. 1. What obstacles do exist in order to provide clear information during hospitalization of the patient? The research found out that the most frequent obstacle of intelligibility is a large amount of given information and frequent usage of terminology. 2. What obstacles do exist in order to make the patient an active participant when giving information? The investigation surprisingly resulted that that is not a misunderstanding or lack of empathy from the medic?s position or lack of interest from patient?s position. The main problem to make the patient the active participant during giving information is lack of medic?s time on patients. 3. Does the level of awareness of the patient saturate his or her need of certainty and security? The investigation showed that by the level of awareness is saturated the need of certainty and security. To gain data for the chosen issue of the quantitative research we used the method of questioning by a questionnaire. The questionnaire consisted of 17 questions, 14 closed questions, 2 half-opened questions and 1 open question which offered to show a personal opinion. Respondents that were asked were students of paramedic assistant, nursing and paramedic resque worker, furthermore working nurses from both ambulant and bed sector, nurses from management and teacher of praxis. For the quantitative research we had two hypotheses: 1. Frequency of asking questions about the length of hospitalization equals to asking about the health condition. From the research was found out, that frequency of asking about the length of hospitalization is much higher than questions about the health condition. The first hypothesis was not verified. 2. During giving information nurses take for granted to include needs of the patient. The investigation showed that nurses during the hospitalization take for granted to include also patient?s opinions expressing his or her needs. The second hypothesis was verified. Results of our investigation gained in this diploma thesis will be used as sources for a distribution of informative materials for patients. We also think that it would be useful to inform nurses working at internal departments about the results. The results could also be interesting for students of high schools or universities preparing themselves for jobs of medical workers.

This thesis deals with not only a question of competence of nurses and their children's development, but also in terms of preparation of professional nurses. The nursing skills are necessary competence to perform the nursing profession. Represent this area of knowledge, skills and attitudes that are acquired through education. One of the ways to qualify nurses to the profession, is today a university course. The second method is a specialized education, provided that the candidate meets the conditions for admission and received his professional competence to practice nurses. Determination of the competencies of nurses in the Czech Republic is governed by Law No. 96/2004 Coll. Acquisition and recognition of eligibility for non-medical professions and for activities related to providing health care and amending certain related acts, the last decree on the activities of health workers and other professionals, No. 55/2011 Coll. The thesis is divided into theoretical and practical part. The theoretical cross section contains the history of pediatrics and nursing, selected chapters from health legislation and development of children's ward in České Budějovice Hospital. For the practical part, I chose a qualitative research method of interviewing and pediatric nurses. The research sample consisted of 10 nurses who work or have worked on the inpatient pediatric ward. There were set three goals in this work. The first task was to determine the development of competencies nurses. The second objective was to determine the extent of the authority nurses at present. In the last part of my job I surveyed whether nurses are aware of their general competence. The research showed that their competencies developed. A large share of this development has the technological development in medicine, new insights in treatment and use of modern diagnostic methods and increasing nursing education. Results of this research can serve for professionals in pediatric congresses and publication in professional journals.

Abstract Sleep disorders occur frequently during child development. Cause of these disorders are physical but more frequently psychogenic. In diploma work we addressed the nurse role dealing with sleep necessity for child in-patients.. In the theoretical part we dealt with sleep characteristic,sleep disorders and child needs which can be detected not only with child in-patients in hospital ward. Furthermore we engaged in sleep fysiology and other factors which can influence the sleep quality. In the quest for that I did use the semi-structured conversation conducted in hospital child ward in Tábor hospital a.s .and České Budějovice hospital a.s. The conversation contained 15 questions which were answered individually by nurses. Data collection took place in April, 2012. The total number of questioned nurses was 16. In the connection with the theme 2/two objectives and 2 research questions were set. To achieve the objective it was necessary to find what is important to secure child in-patient sleep and find if nurses provide conditions for child in-patient quality sleep. The research questions were raised: ? What principles are considered by nurses to be important to secure the child in-patient sleep mode? ? and secondly ? How the nurses secure the conditions for quality sleep of the child in-patient? ?. As for the theoretical field concerns the nurses do not have the basic knowledge of the sleep fysiology (REM, non REM). As it comes out from response of the nurses, each nurse has an individual opinion of the factors which ensure the child in-patient quality sleep. The conditions for quality sleep are secured by nurses in creating quiet environment, cool room and where necessary also their presence with falling asleep children. The diploma work results are individual On the basis of these findigs, I consider to be necessary, the educative material to be worked out and acquaint the child nurses with its content.

Theoretical Framework Although the beginnings of nursing reach deep into our history, nursing is a relatively young profession. In the course of human history nursing has been influenced by many factors that have changed public values and attitudes to nursing issues and to providing the most effective nursing care. Nursing is focused on an active search and satisfying biological, psychological, social and spiritual needs of the sick and healthy people in the care of their health. The main representative of nursing practice is Florence Nightingale, who has affected health care throughout the world. She is considered the founder of modern nursing, because she has elevated nursing to such a profession that is as important as that of a physician. Aims of the Thesis To compile the thesis three goals were set. 1) To find out the views and ideas of the general and professional public on the nursing profession. 2) To determine the views of the general and professional public on what the most important and effective procedures in nursing are. 3) To identify what the general and professional public expect nursing can provide to modern society and how nursing can contribute to its development. Methods Used To compile the diploma thesis a quantitative method using interviews through questionnaires was applied. The data collection technique was snowball sampling. Based on the initial pilot study two forms of the survey were determined, for the professional and the general public. The professional public was represented by nurses working in primary care, home care, in hospitals and other medical facilities. The general public was represented by people who visit general practitioners, use home care services, hospitalized patients and other general public. Results The results of the thesis have helped explain opinions of the public and their attitudes to nursing care. They can be used as background material for teaching nursing subjects or as a contribution to professional seminars, courses and conferences dealing with this issue. The answers to the hypotheses are discussed in detail in the research section of the thesis. Based on the statistically processed data the hypotheses were evaluated as follows: H1: By the general public nursing is perceived rather as a profession focused on maternity care than as a professional discipline. H1 was confirmed. H2: As for the general public, men´s perception of nurses as nursing representatives is different from women´s perception of nurses as nursing representatives. H2 was confirmed. H3: The professional public perceive the profession as a mission, unlike the general public, who take it more as a matter of routine from the part of nurses. H3 was confirmed. H4: The professional public perceive the attitude of the general public towards nursing more positively than the general public themselves. H4 was not confirmed. H5: Nurses´ strengths are perceived more than their weaknesses by the general public. H5 was not confirmed. H6: To the public the value of nursing depends on how the professional public express satisfaction with the care provided by their colleagues. H6 was confirmed. H7: Education is a fundamental value of nursing more from the perspective of the professional public than from the perspective of the general public. H7 was not confirmed. H8: The potential contribution of nursing to modern society from the perspective of professional public is higher than from the perspective of the general public. H8 was not confirmed. H9: The general public´s view on the value of nursing is directly dependent on the image of nursing presented by the media. H9 was confirmed. Conclusion The benefit of this work is publication of the findings related to opinions and ideas of today´s society on nursing and pointing to the issue and identification of weak parts.

The diploma thesis addresses the issue of increasing the authorities of nurses of general practitioners in primary care. The theoretical part summarizes the information about primary and community care, defines authorities and professional activities of general nurses and physicians, and deals with the roles of nurses in primary care and the relations between general nurses and physicians. The objective of the diploma thesis was to survey the opinions of nurses of a possible increase in their professional powers, and to ascertain whether nurses are ready to assume certain authorities. It was also ascertained what physicians think of a possible transfer of certain authorities to nurses, and whether nurses are satisfied with their growing independence and responsibilities in connection with the increasing requirements for their profession. The results of the qualitative survey were evaluated by their summarizing in thematic areas and subareas; the text also contains authentic quotes of respondents (written in italics). The research set consisted of 15 respondents who were selected systematically. The set consisted of six physicians (general practitioners specialized in adult or paediatric medicine and general dentists). The set of general nurses consisted of nine nurses working for general practitioners. The selected general nurses had the work experience of various duration and various educational backgrounds ? they had either secondary or higher professional education and one nurse had university education. It has clearly followed from the research that the nurses do not wish to assume any activities falling within the authorities of physicians. A large number of respondents are very busy and any other authorities would be beyond bearable. Physicians would not transfer many medical activities to the nurses; they would rather transfer most of paperwork to them, such as writing opinions in respect of traffic accidents, spa treatment requests and other requests. Nurses are not afraid of increased authorities but agree that the authorities will mostly result in greater responsibilities and paperwork. The nurses think that there are clear boundaries between the authorities of nurses and physicians. Clear boundaries are seen mostly in diagnostic and therapeutic activities, nursing treatments, prescription of medicines, application of intravenous injections, and statement of diagnosis. Above the scope of their authorities, general nurses are charged to perform activities of a mostly administrative nature, write requests and sick certificates, administer intravenous medicines without expert supervision, write various recommendations, and monitor warfarinisation of patients.

Surgical procedures of gastrointestinal diseases often lead to the creation of an ostomy. The number of clients with an ostomy is increasing as the Czech Republic ranks among the countries with the largest incidence of malignant colon disease. Health care professionals in any field can often encounter the client with a stoma. Therefore, it is essential for them to understand and manage this issue well. Nursing care of such individuals is very extensive and specialized. Nursing team usually focuses only on physical care but other problems associated with stomas are pushed aside. The only highly knowledgeable and qualified expert in this area is a stoma nurse specialist (an ostomy nurse). This thesis deals with the importance of the role of the stoma nurse specialist in the postoperative phase from the perspective of nurses from surgical departments as well as from the perspective of patients with a colostomy. The thesis is divided into theoretical and empirical part. The theoretical part is further divided into four chapters: colostomy, care about stoma patients, life with a colostomy, an ostomy nurse. Two objectives were determined for processing of the empirical part. We used a combination of quantitative and qualitative research to achieve our goals. The first objective was to determine whether general nurses have the knowledge to care for a client with colostomy in the postoperative phase. To obtain data for the quantitative part of the survey the method of anonymous interviews using a questionnaire, in which the research group was formed by general nurses, was selected. The survey results revealed that nurses have sufficient knowledge to treat and educate clients with a stoma. Although not all general nurses encounter colostomy patients, they widely believe the knowledge of this issue is important for the occupation of a nurse. For the quantitative part three hypotheses were selected and tested statistically. Hypothesis 1: General nurses have the knowledge to treat the client with a colostomy. It was confirmed. Hypothesis 2: General nurses have enough knowledge to educate the client with a colostomy. It was confirmed. Hypothesis 3: General nurses positively evaluate the benefits of an ostomy nurse in care for stoma patients in the postoperative phase in the surgical department. It was confirmed. The second objective was to determine the significance of the stoma nurse for clients with a colostomy. For the qualitative part of the survey the method of direct questioning by means of a semi-structured interview with open questions was chosen. The study group consisted of patients with a colostomy. For this part of the survey a research questions was specified: What is the importance of an ostomy nurse for the stoma patient in the postoperative period? We concluded that the ostomy nurse is viewed as an educator, counselor and psychological support. The ostomy nurse is the only one who can provide stoma clients with coherent and comprehensive information they need to live with a colostomy. Both groups of respondents agree that the stoma nurse is the irreplaceable specialist. Shift nurses fail to provide comprehensive care stoma patients need. An ostomy nurse needs to be a part of nursing care not only in the postoperative phase, but also in the preoperative period. There is need for closer cooperation between general nurses and the ostomy nurse. Nurses indicate their willingness to be educated in this area, while preferring seminars, lectures and conferences. The results also led us to create information material Care of the client with colostomy, as the nurses indicated that they would welcome a brief, clear, visual information material.