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Aim: The analysis of special nursing care focusing on arterial sheath removal at interventional sites in the Czech Republic. Methods: The empirical data was collected by means of a questionnaire created by us for the purposes of this article. The questionnaire consisted of seven questions (six closed, dichotomous; one open). According to the National Register of Cardiovascular Interventions (NRKI) of the Czech Republic, there are 22 centres performing cardiovascular interventions. All of them were approached with a request to fill in the questionnaire. The questionnaire was distributed through official e-mail addresses. The results for each monitored item were put into a chart showing absolute frequency. Results: The analysis showed that the most common approach in the Czech Republic is via radial artery, in up to 78% of cases. Sheath decannulation from the arterial basin is performed by nurses at 16 centres, 10 of which have implemented the specialised nursing standard. Nurse training for professional performance takes place at four centres only, which is disproportionate to the number of decannulations carried out by nurses. Conclusion: The introduction of the nursing standard for sheath removal is not a condition for a nurse to perform it, despite the fact that it is carried out quite routinely at 16 centres. According to the data obtained, the management of sheath decannulation in the Czech Republic is very disunited. Source

Children and adolescents with cognitive disorder are a heterogeneous group of children with different aetiology of disability and also with a higher risk of pain. These children and adolescents are not often able to verbalize the presence of pain nor they are able to score the intensity of pain using the self-assessing scales. Detection of pain in children can be improved by providing methods of pain assessment, which correspond to their development and cognitive abilities, and can assist in the understanding of adults and subsequent care. This paper presents the results of a systematic analysis of literary sources. The aim was to review the reliability of the recommended measurement tools for assessing pain intensity in children with cognitive impairment at the age of 3-19 years, appropriate for the pain assessment by a paediatric nurse. Search selected studies confirming the reliability of measurement instruments have been made by methods practice based on evidence. For searching of valid sources were used licensed professional database and freely accessible databases - Medline, ProQuest, Google, Google Scholar, Web of Science, Springer, Wiley, Science Direct, Cochrane Library. For a systematic analysis the period of 1990-2010 was selected. Criteria for inclusion: included were randomized controlled studies and nonrandomized studies. Only 16 studies have met the selected criteria focus of the study and underwent assessment quality as per adopted methodological filter. None of the studies have demonstrated a level of evidence 1 or 2. Analysis of the results did not demonstrate unambiguously the reliability of a single measurement instrument. Review study, of which the level of quality was defined as level 3 and focused on measuring instruments recommended by the Royal College of Nursing and Royal College of Paediatrics and Child Health to measure pain in children with cognitive disabilities, showed some evidence confirming the reliability of the recommended assessment tools. Selected studies also included the self-assessment of children using a simplified (three-) facial scale. Most of the results coincided with the clinical significance of observational scales measuring pain, using indicators of behavioural and physiological pain. From the analysis of results implies that the best information value of measuring instruments is Face, Legs, Activity, Cry, Consolability Scale (FLACC), the Non-Communicating Children's Pain Checklist-Revised (NCCPC-R), Non-Communicating Children's Pain Checklist-Post-Operative Version (NCCPC-PV). As the results show, the assessment of movement of the limb in the stated methods is the least reliable indicator for pain assessment. Recommended range of tools and measuring instruments of the intensity of pain resulting from the systematic analysis, however, cannot be understood as standard, which provides precise guidance rating of pain intensity in children, because it is not possible to ignore the individuality and uniqueness of each child and situation. Nurses' and paediatric nurses' future efforts should aim to increase professional awareness of pain in children with cognitive disabilities, to establish practice guidelines, and initiate research in this area. Source

Valusova D.,Zdravotnicka zachranna sluzba Moravskoslezskeho kraje stanoviste Ostrava | Jarosova D.,Ustav osetrovatelstvi a porodni asistence
Pediatrie pro Praxi

Aim: The aim of the work was to determine how the quality of nursing care is evaluated by parents of child patients hospitalized in Ostrava hospitals. Methodology: The survey group was comprised of 227 respondents, there of 71 parents from University Hospital Ostrava, 90 from Municipal Hospital Ostrava, 66 respondents were from Vítkovice hospital. The survey was carried out by standardized evaluation tool of Picker's dimensions of quality, modified by for persons accompanying hospitalized child patients. Results: In all studied hospitals assess quality of care parents mostly as good. The problem areas included noisiness at night time, insufficient cleanliness of the rooms, toilets and shower baths. Some parents were also dissatisfied with the quality of food, lacked publication of the menu, perceived the time of putting the child to hospital bed during admission as too long, there was also a problem with availability of services. Conclusion: Parents of hospitalized children are an important part of the treatment regimen of children, so it is important to know their satisfaction with the care provided to respond to the identified shortcomings and, if possible, eliminate them. Source

Buzgova R.,Ustav osetrovatelstvi a porodni asistence | Havelkova K.,Hospic sv. Lukase
Casopis Lekaru Ceskych

Background. The aim of palliative care is the solution of bio-psycho-social and spiritual problems of patients and achievement of the highest possible quality of life. This is related to a need of understanding the patient and his needs. The aim of our research was to determine bio-psychosocial- spiritual needs of patients in hospice care in conjunction with the quality of life and rate of their saturation. Further then to determine, whether the needs vary depending on length of stay in hospice, gender, age and religion. Methods and results, The sample consisted of 36 patients from the hospice of St. Luke in Ostrava. For data collection we used modified questionnaire for the identification of needs PNPC and questionnaire for assessing the quality of life EORTC QOL-C30. As the most important need patients considered the privacy (4,80), the opportunity to make their own decisions (4,77), treatment with respect and dignity (4,75) and pain relieve (4,72). The most frequently reported problem was fatigue, sleep and fear of addiction. Patients have positively rated pain prevention. In repeated measurements were reported significant improvements of assessment of saturation needs in 10 items (p<0.05). The patients evaluated overall quality of life rather positively. A relationship between quality of life and saturation of needs in the area of autonomy and physical needs (p<0.05) was found. Conclusions. During the stay in hospice patients' satisfaction with saturation of some needs and overall assessment of quality of life increased. © Ceská lékarská spolecnost Jana Evangelisty Purkyne, Praha 2012. Source

The aim of the research was to determine the quality of life, adaptation to chronic pain and social coping in the elderly with chronic pain. Then, to determine the influence of pain intensity, adaptation and social coping on the quality of life of elderly people. The study group included 186 individuals older than 60 years with chronic pain. The collection 4 assessment tools were used: a/ World Health Organization questionnaire for assessing quality of life WHOQOL-BREF, b/ questionnaire for the evaluation of adaptation on chronic pain ACPQ (Adaptation on Chronic Pain Questionnaire), c/ questionnaire to assess social coping with chronic pain SCCPI (Social Coping with Chronic Pain Inventory), d/ visual analogue scale VAS-I for assessment of pain intensity. Patients with chronic pain were least satisfied with their physical health. They rated all domains of quality of life significantly worse than the general population (p <0.01). When evaluating social coping with chronic pain patients demanded more social support than they perceived they were receiving. When evaluating the adaptation to chronic pain, most patients indicated changes in self-assessment in the context of pain (a self-perception scale) and worse pain experience during stressful situations (a perception tolerance scale). There was no statistically significant difference in the quality of life, social coping and adaptation to chronic pain by sex. However, a correlation between the quality of life in all domains and social coping with chronic pain, adaptation to chronic pain and pain intensity was found (r = 0.2-0.7; p<0,05). The elderly who perceived in the context of chronic pain greater limitations, changes in self-esteem and higher pain intensity assessed their quality of life worse. Source

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