The thesis principles of nursing care for a child with renal failure is engaged in nursing activities in nephrology and cardiology intensive care unit of a hospital in Prague - Motol. Acute renal failure is defined as a condition where there is a sudden , usually reversible renal impairment, which were totally wrong , or very little damage. Besides the medical approach to this disease in acute renal failure urgently needed highly skilled nursing care. When nursing care for sick children teamwork is essential . A child with acute renal failure , always requires hospitalization in intensive care.The thesis is divided into a theoretical and an empirical part . In the theoretical part , attention is paid to the current issue of treating a child with acute renal failure. The work also includes anatomy and physiology of the kidney , and nephrologic basic concepts. Attention is also pays attention to the methods of investigation , communication with patients and nursing diagnoses . There acquaintance with elimination methods and nursing care for the child , unless they use the elimination method .

This diploma thesis focuses on the monitoring of hemodynamics in intensive care units; the main objective was to create an educational material for newly employed nurses. This educational material should facilitate the adaptation process of nurses at Anaesthesiology-Resuscitation Units (AR) or Intensive Care Units (ICU).The diploma thesis is divided in two parts: theoretical and empirical. The topics covered by the theoretical part include the concept of intensive care, the technical equipment, the scope of work of intensive care nurses, anatomy and physiology of the cardiovascular system, cardiovascular system monitoring, hemodynamic monitoring, adaptation of new nurses at the workplace, and the possibilities of educational methods aimed at newly employed nurses. The empirical part was conducted as qualitative inquiry in the form of interview. The interviews were semi-standardised and they were held at the AR unit in the České Budějovice Hospital. The subjects were the nurses from the RES 1 and RES 2 stations. The first part of the research inquiry consisted in interviews with the nurses at the Anaesthesiology-Resuscitation unit. The interviews were not taped, due to the respondents' request. All the answers were carefully recorded and immediately transcribed and processed to prevent any inaccuracy of information. The results were organised in charts according to the categorisations, in a well-arranged manner. The second phase consisted in creating the educational material for the newly employed nurses and the third phase concluded the project by distributing the educational materials at the hospital unit where the interviews were conducted. The nurses could therefore assess whether the educational material meets their requirements and will be useful in practice. The respondents were interviewed again and the results were subsequently also organised in charts.The results of the research inquiry show that the nurses at the Anaesthesiology-Resuscitation Unit in the České Budějovice Hospital perceive the correct hemodynamic monitoring as important, that they know what hemodynamic monitoring is and are aware of the monitoring possibilities. The nurses of this unit perform both invasive and non-invasive monitoring of hemodynamic parameters. The basic task is measuring the central venous pressure and arterial pressure. Other parameters are monitored by the doctors with the application of the Swan-Ganz catheter. The most frequently used monitors are PICCO, Lidco, Vigileo and Vigilance. All interviewed respondents agreed that their only help during the adaptation process was the manufacturers' materials and the advice from the nurse-trainers. A small part of the respondents was trained directly by the company distributing the monitors. The final phase of the research inquiry revealed that the nurses like the new educational material but they are afraid that it will end up collecting dust as the other materials supplied by students. The interviews established that it is easier to directly communicate the necessary information to the new nurses along with practical demonstration than to recommend an educational material for studying of at least the theoretical part.

The thesis deals with the realization of the criteria for saturation of the patient's needs. In the current system of nursing care, the principles of modern nursing are failing to realize and therefore we want to find out the main obstacles of this situation and the possibilities of their removal. For the purpose of the thesis there were set three objectives. The first of them has set the objective of finding out the most common problems in meeting the criteria for saturation of the patient's needs. The research showed that the nurses see the problem in a lack of staff at the wards, a lack of time, excess of documentation, excessive demands for nurses. The purpose of the second objective was to find out what supports the realization of the criteria for saturation of the patient's needs. Results have shown that what helps nurses is a positive work environment, motivation, nurse´s personality, own scale of values, salary, good leadership, organization, nursing care. The third objective was to find out the opinion of nurses on meeting the criteria for saturation of the patient's needs. It turned out that the majority of respondents think that nurses do not effectively satisfy all the needs of patients for a number of reasons: there are few nurses and they are overloaded, the nurses do their best but still cannot satisfy all the patients´ needs. We also found out that the higher patients´ needs are omitted. Less than a third of the nurses indicated that nurses effectively meet all the patients´ needs. For the qualitative part of the research, we set two research questions in advance. Which criteria nurses use in patients´ needs saturation? The research showed that time, which is very valuable for nurses and very often is in short supply, is an important criteria for the saturation of the patient's needs. Furthermore, it is knowledge and manual dexterity when nurses additionally reported a lack of education of some nurses especially within the nursing process. As the next criteria, it was mentioned the cooperation with the patient as it is necessary to engage patient himself in care planning. The next criteria is monitoring of the patient´s response, which is included in every phase of the nursing process. Furthermore, the nurses agreed on criteria, which include communication as a key skill of every nurse, then individual care, a suitable environment and utilities, education, critical thinking, effective nursing process and empathy. The second research question tried to find out which obstacles prevent nurses in effective saturation of the patients´ needs. We found out that nurses are concerned about a lack of staff at wards and the excess of administrative load, which is related to a lack of time for patients. These three factors are also obstacles for nurses and prevent them from effective satisfying of the patients´ needs. The next obstacles in satisfying the needs are burnout, reluctance of nurses to work, excessive demands for nurses, poor workplace relationships, a lack of evaluation both in a form of praise and appreciation, and finance. We also found a lack of information, which is related to a lack of time, as nurses do not have a chance to collect all the information concerning the patient. As another possible obstacle, nurses also mentioned personal problems. The results of the thesis can be used as a small contribution to currently ongoing effort of the Czech Association of Nurses.

It is inconceivable for only one person to take care of ill people in a health care. To achieve the aim which is in particular maintenance of the highest life quality of specimens in health or in disease, is important mutual cooperation of professionals in the branch, where every single ensure care for a patient on the basis of his own knowledge and skills. It is about team co-operation, where every single member of the team has his own obligations, but also rights and authority. The term multisiciplinary care means co-operation of more scientific branches. Hemodialysis patients'nursing care is about team of professionals, who are fully involved in satisfying patients' needs. This co-operation enables primarily the unitary communication, reduction of patient's issue analysis, unified and consecutive nursing care, complete documentation and quality evaluation of provided nursing care of these patients. The aim of the dissertation was to chart multidicsiplinary care's issues at hemodialysis, on the basis of available literature. The dissertation is based on theoretically processed topic by the method of documents' content analysis and method of review and synthesis. Information is obtained from domestic but also foreign science books, scientific magazines, and internet sources. Findings from the 42nd international conference EDTNA/ERCA, which topic was Innovation of renal care through multi-professional leadership, which took place in Malmö, Sweden, from 31st of August to 3rd of September 2013, also contributed. The dissertation is divided into three basic chapters. The first part is focused on team characteristic. There are definitions, types, features, building, composition, roles, conflicts within a team and elemental description of multidisciplinary co-operation. The second chapter deals with a history and hemodialysis as a medical extracorporal method. The third, and the broadest section, is focused on multidisciplinary co-operation at the centre of hemodialysis. It is divided into several sub-chapters. In each of them the information descend from general field to concrete needs of hemodialysed patient and continue to the description of each member of a multidisciplinary team. The result is comprehensive view on provision of multidisciplinary care in the centres of hemodialysis. The output of the dissertation is a draft of the nursing care algorithm within the purview of multidisciplinary care at the centres of hemodialysis. Multidisciplinary care is necessary requirement for assumption of effective, high quality and continuous medical and nursing care at all the centres.

This diploma thesis called "Need of non-pharmacology pain relieving for patients afflicted by Arthritis rheumatic" has been created as a next step of a previous pilot research. Respondents of the previous investigation expressed their interest in non-pharmacology pain relieving. It is very important to relief pain caused by Arthritis rheumatic as chronic disease in balance manner by usage of both approaches pharmacology and non-pharmacology. The goal of this study has been to investigate possibilities of non-pharmacology pain relieving among patients afflicted by Arthritis rheumatic and how these patients cooperate with nurses. The research comprises following goals: 1. Ascertain, whether patients afflicted by Arthritis rheumatic prefer pharmacology to non-pharmacology pain relieving. 2 Ascertain, which method of non-pharmacology pain relieving is mostly used. 3 Ascertain the interest of patients to relief pain by usage of non-pharmacology methods. 4 Ascertain the nurses' influence on the non-pharmacology pain relieving. The theoretical part is focused on pathophysiology of the disease, the issue of chronic pain and quality of patient life. The second, empirical part, is dedicated not only to actions of the investigation itself, but also its characteristics and results. There were issued 130 questionnairs for qualitative analisis. 102 of 130 questionairs has been retrieved and filled in properlly. Data from questionairs was compiled and hypotheses were tested by usage of Chi-squared test. 3 hypotheses have been built: H1 Patients afflicted by Arthritis rheumatic prefer pharmacology pain relieving to non-pharmacology. This hypothesis H1 was affirmed only for patients in acute stage of Arthritis rheumatic. H2 Patients afflicted by Arthritis rheumatic prefer thermotherapy to rehabilitation when considering non-pharmacology pain relieving. This hypothesis H2 was not confirmed due to low number of respondents. H3 Patients achieved higher education degree express higher interest in non-farmacology pain relieving. Higher education degree of patients has only impact on method in acute stage of Arthritis rheumatic. Qualitative investigation was carried out by half-structured interview with 7 respondents working on inpatient department and also outpatient department. Several statements could be concluded out of qualitative investigation: Nurses have been persistently educating by passive or active participation on various seminars or congresses. They have been trying to convey information about non-pharmacology treatment to their patients. They cobnsider non-pharmacology treatment as a indiscerptible part of a treatment. Investigation results will ne provided to all collaborative departments to support improvement in cooperation between nurses and patients.

This thesis is concerned with assessment of the health risks of lifestyle of basic school children. The topic of the healthy nutrition, the healthy lifestyle and the healthy eating habits has been more and more popular. The healthy eating habits influence the whole human life and the term health has to be understood as a constant value that we have to protect and develop. Nutrition of children and youth is one of the most pronounced matter nowadays all over the world. First part of the thesis is focused on the lifestyle of basic school children, it´s parts and results too (especially the part about nutrition). Then it is focused on work of pediatric´s nurse who takes care about them. In my thesis I found two goals: to assess the specific lifestyle risks of basic school children and to find if basic school children keep the rules of healthy eating. Based on these goals four hypotheses were set: the H1 - Children eat more fruit than vegetables. H2 - Children drink sweet drinks more than water. H3 - Children don´t keep healthy eating habits. H4 - Children prefer fast-food meals to school meals. The hypotheses number H1, H3 and H4 were accepted. The H2 wasn´t accepted because the statistic showed that children drink more water than sweet drinks. The quantitative research was done to reach the goals and confirm the hypotheses via anonymous questionnaire for children from 13-15 years old. This research was given to approximately 310 pupils of primary school. The results were put into charts and tables and statistically assessed with Pearson chi square test. The results of research of my thesis were used for a booklet about healthy eating habits for children and their parents. The material should be ready for use for pediatric´s nurses who work for general practitioner for children and adolescents. The brochure can serve for gaining more information about healthy nutrition.

Theoretical Foundations Ageing and old age are natural parts of every individual during their lives. Most of the population wants to live an active life of the best quality possible. Nutrition is a factor that influences healthy aging most significantly. Adequate nutrition plays an important role in maintaining the quality of life and good physical condition. Nutritional needs of the elderly are highly specific. The nutritional needs of the elderly are defined mainly by changes in the organism and a wide range of influencing factors resulting from a person's lifestyle. An important role is played especially by eating habits, social and cultural environment, education, social status, economic standards and, ultimately, health and psychological condition of a person. Proper nutrition of the elderly contributes to their health and wellbeing; it is also important for recovery from the illnesses to which the elderly are more vulnerable. When providing nutrition to the elderly in hospitals, the role of nurses is important. Objective of the Thesis Four objectives were specified for the thesis: 1 To find out whether nurses follow the principles of providing nutrition to the elderly. 2 To identify the most common factors that affect nutrition of the elderly in hospitals. 3 To map the most common nutritional disorders in the elderly occurring in hospitals. 4 To find out what diet is the most common in the elderly staying in hospitals. Methodology The research qualitative inquiry was conducted in the form of covert observation. The objects of observation were the nurses working at a department of aftercare, which were observed in serving food to the elderly. The covert observations were complemented with depth interviews, also with the observed nurses working at the department aftercare. The observations were processed in Microsoft Excel in the form of tables and the interviews were processed in the Atlas.ti programme. Results The observations of the nurses in serving of food to the elderly showed that all the observed nurses failed to comply with the principles of providing nutrition to the elderly in the hospital. More or less each of the observed nurses made some mistakes. The most frequently occurring mistakes were as follows: While serving food, the nurses did not use aprons or serving overalls; the nurses did not prevent direct hand contact with the food. Almost half of the observed nurses did not provide the patients with sufficient time and the support to the patients while serving the food by the observed nurses was also inadequate. Further, nearly half of the observed nurses did not wish a Bon appetite to the patients. Also noteworthy is the latest most frequent mistake: nearly half of the nurses did not put away their aids after serving food. In the interviews, the nurses surveyed identified the most frequent factors influencing nutrition of the elderly in hospitals as follows: biological changes in old age, various types of dementia, psychological condition of the individual, co-morbidities, medication use, eating habits of the individual, the state of dentition (dental prosthesis), and the influence of the family. The most common nutritional disorders identified were as follows: absence of appetite, dehydration, excess weight, obesity and malnutrition. The most common diets eaten by the elderly in hospitals were identified as follows: diets no. 3, 9, 4, 0 and also diets in ground form, puree form and food served through an NGS (nasogastric tube). Conclusion Based on the research survey and the review of expert literature, a standard of nursing care, called "Serving food to patients with deficient self-care in nutrition", was designed for nursing staff. Nursing staff will have the opportunity to use the manual that will serve them as good practice when serving food to patients with deficient self-care in nutrition, and nurses will not consider the activity as a routine procedure.

This thesis deals with the effectiveness of use of aids intended for incontinent ill people in subsequent care. The thesis is divided into a theoretical part and experience part. The experience part of the thesis has been implemented by means of qualitative research. The data have been obtained on the basis of two different half pen and paper interviews with patients/clients who are using incontinence aids prescribed by a doctor on a coupon or by a matron or a ward sister from the subsequent care department in hospitals with the state-funded organization and in hospitals with the joint-stock company organization. The result of the qualitative research showed, that both groups of respondents use mostly only plastic pants or nappies out of the whole assortment of aids. For patients/clients living at home the reason is that on the basis of anamnesis the general doctors prescribe the incontinence aids only in the most serious incontinence cases. At the subsequent care department the situation is caused by a big number of immobile fully incontinent patients/clients. The results show, that the quantity of absorb aids prescribed by general doctors is insufficient. It does not reach the quantity limits given in the documents by VZP (Public Health Insurance Company). Taking into consideration the low income of seniors, the respondents have to pay considerable amounts of money for incontinence aids which are necessary for them. There is an absolute lack of absorption aids in the hospital with the state funded organization. The incontinence aids are financed by three different ways. Patients/clients themselves have to get and pay the absorption aids at the Geriatrics department I and subsequent care department 2. The hospital provides them only with one-off mats and hygienic aids free of charge. The reason for this is a low limit of material. The respondents regard this system of financing negatively. It burdens patients/clients and nurses too. If patients/clients do not have the aids, the hospital has to lend the aids, make a list of debts and collects them back. On this account conflict situations often arise in families. At these departments there are reserved five social beds which enable patients/clients the prescription of aids by a doctor on a coupon likewise the patients who are ill and cure at home. At the stopgap department patients/clients pay a monthly fee; this includes the costs on incontinence aids too. At the subsequent care department 2A, B of the hospital with the join-stock company organization the aids are fully paid by the hospital. There is available a sufficient assortment and quantity of absorb and hygienic aids, which enable an individual attitude.

Czech health care and nursing is undergoing a significant transformation during the last years and it touches the changes in the education of health professionals. There are changing demands on the training, on the knowledge level and also on the graduate profile in accordance with the recommendations of the Europlan Union. Following these recommendations the requirements of lifelong education of nurses are also profiled. E-learning education is an important tool in use in the educational process of nursing and an effort to use processes of nursing care based on evidence.The aim of the study was to determine how nurses use e-learning in lifelong education and whether nurses prefer classical forms of education to e-learning, to map whether they have possibilities of e-learning within the facilities they work in and whether there is a sufficient supply of e-learning courses supporting lifelong education of nurses in the Czech Republic. The last goal of the study was to create an e-learning course focused on specific problems at the orthopedic ward of the Hospital Tábor, a.s. In relation to the objectives the following hypotheses were designed: H1-Nurses with university education use e-learning more than non-graduates. H2-Nurses with university education consider e-learning in clinical practice for more beneficial than traditional forms of education, unlike non-graduate nurses. H3-Nurses with clinical practice shorter than 5 years prefer e-learning more often than nurses with practice longer than 5 years. For the thesis was selected a quantitave survey form using anonymous questionnaries that were distributed electronically to the individual clinical departments. The research sample consisted of registered nurses according to Act 96/2004 Coll., As amended, from specialized outpatient clinical departments of 16 providers of medical facilities in the Czech Republic. The questionnaries were processed by matrix method in Excel 2013 and the results were converted into graphs and tables using descriptive statistics. A statistical evaluation of hypotheses was made as well. Hypotheses were tested by chi-square test in contingency tables. The selected level of significance was 5%.Results: Nurses mostly use e-learning to get professional information for nursing care. The most common reason for not using or even rejection of e-learning by nurses is that this form of education does not suit them. Most nurses do not have the opportunity to e-learning in facilities where they work and also they cannot implement the knowledge gained by e-learning. The offer of e-learning courses over time is constantly changing and evolving, some courses have even completely disappeared. A course offer is sufficient, although nurses miss some types of courses. There was to create an e-learning course "Collection of biological material, or how not make mistakes in the pre-analytic phase" focusing on specific problematic aspects of blood collection within the medical facility Hospital Tábor,a.s. The results of the survey will be together with the e-learning course given to the leading management of the Hospital Tábor,a. s.

The diploma thesis deals with the motivation of nurses, which work at palliative care. The thesis is divided into a theoretical and a practical part. The specifics of palliative care, the motivation of nurses, and the process of dying and death are described in the theoretical part. The practical part contains the processing and the evaluation of results gained in the research. Three aims are set in the thesis. The first aim is to determine the purpose, which nurses have for working at palliative care. The second aim is to find out what motives lead nurses to work with terminal patients. The last aim is to point out the disadvantages of providing palliative care. I chose the semi-structured interview for achieving the aims. The interview contains thirty questions. Ten nurses, which work at palliative care, answered the questions. The results support the fact that nurses perceive the palliative care as an important part of health care. According to nurses, the nursing care preserves the dignity of dying patient. It also respects his or her autonomy, individual needs, and their wish. The motivation for working with terminal patients results from previous experience with a hospice facility or from encounter with death in a previous employment. Another motivational factor is the need to care for dying patients or the experience of the death of a close family member. The substantial part of the job is a strong collective, which contributes to the motivation. The meaningful care and the positive reactions of terminal patients and their families are very fulfilling. The negative motivational factors are the physical and psychological exhaustion, another caregivers' sceptical view about the palliative care, or close relationships with the patients and their families.