Rehabilitation nursing at the surgical department

Abstract

This diploma thesis deals with the problem of rehabilitation nursing in surgical wards. The aim of the research was to find out whether nurses are perceived as part of a multidisciplinary team for rehabilitation care, also to what extent the documentation of rehabilitation care is effective, finally the investigation involved the patients experiences of the nurses involvement in rehabilitation care. The empirical part of the thesis was conducted using quantitative and qualitative methods. The quantitative method data collection was carried out using a standardized questionnaire consisting of seventeen questions for nurse practitioners, general nurses and nurses with a masters degree, from selected surgical wards. For the qualitative method, semi-structured interview technique was chosen and was conducted with patients from trauma and orthopedic intensive care units. Information from the interviews were coded and four categories were based on the analysis. The interviews were analyzed using the "pencil and paper method". The selection of informants was deliberate. The informants were from the Hospital České Budějovice within a maximum period after surgery being fourteen. The results of the quantitative research showed that there were communication gaps in the multidisciplinary team. Thus, the possible risk of errors by staff is increased, where patients may be harmed. Another bit of findings, based on the documentation, showed that nurses perceive the implementation of rehabilitation interventions as more of an evidence of improvement in the patient's condition than as unnecessary workload. Furthermore, as is statistically demonstrated in the third hypothesis, we found that nurses provide rehabilitation treatment based on the input of other health care professionals rather than from their own initiative. In the questionnaire survey, nurses most frequently reported that their physician encouraged them to provide rehabilitation treatment. In the qualitative research part of the thesis, we mapped patients' experiences with nurses' involvement in rehabilitation treatment. The interview revealed that the informants had difficulty distinguishing between the terms rehabilitation treatment and physiotherapy. What we also learned was that most informants are satisfied with the communication between them and the nurse staff, which is necessary in promoting self-sufficiency. The interview also showed that none of the patients were educated in the preoperative period and about self-sufficiency training or verticalization. Another insufficiency, which was found through the research was in the area of education about respiratory rehabilitation, where informants showed gaps in information about prevention of complications. The informants had positive responses in the area of pain reduction in rehabilitation treatment. It is evident from the responses that nurses pay attention to analgesic treatment of patients during rehabilitation treatment. Finally, we asked informants about compensatory aids. As a result, informants from orthopedic wards were better informed about compensatory aids than informants from trauma wards. This is probably due to longer preoperative preparation. Through the analysis of the empirical part of the thesis, it is obvious that although the nursing care in the selected wards is of a high standard, there are obvious deficiencies in rehabilitation care. Therefore, the results could be helpful in order to focus on the problems in rehabilitation care. This could help facilitate the actions of management and medical staff in the selected surgical wards to improve the quality of nursing care