Technical intensity and time demandigness of a nursing care while using different techniques of cooling during a controlled hypothermia therapy from the view of a nurse

ABSTRACT: My thesis deals with therapeutic hypothermia and associated methods of cooling. Focus is given to technical and time demands of the methods in terms of reaching the target body temperature and nursing care complexity. The first theoretical part gives a brief introduction to history of hypothermia and the first existent records of the technique. Another chapter is focused on the current use of induced hypothermia, medical fields in which induced hypothermia is used both in the local or overall controlled hypothermia. Physiology and pathophysiology of thermoregulation in humans is described. More details are given on classification of hypothermia and hyperthermia. Changes in the organism during shifts in body temperature and their causes, positive and negative effects of temperature changes on the organism are discussed. Another chapter covers the issue of controlled hypothermia, its definition, positive treatment effects, negative effects on the organism and methods of cooling. External and internal methods as well as nursing procedure while the methods are applied are described in detail. The final chapter of the theoretical part of my thesis summarizes comprehensive nursing care for patients with controlled hypothermia. The objective of my thesis was to evaluate the utilization of therapeutic hypothermia in intensive care units, assessment of technical and time demands of cooling methods for comprehensive nursing care from the view of a nurse, and to find the optimal combination of cooling methods to achieve the desired core body temperature as soon as possible and to maintain the temperature. The first assumption was that therapeutic hypothermia utilization would be influenced by the patients structure on the wards. The second hypothesis was that utilization of physical cooling methods and more technically and time demanding methods such as coolgard and extracorporeal circulation would be more time consuming for nurses. The method of quantitative research, the questionnaire method, was chosen to comply with objectives of the thesis. The questionnaire contained open questions with the possibility of more responses, closed questions and one semi-closed question. The following nursing staff members were addressed: diploma nurses, registered nurses, specialized nurses working in intensive care units and resuscitation departments of four different hospitals. The research was conducted in 2009. In the concluding part of my thesis results of my work are shown in the graphic form. Discussions with literary sources on the use and application of therapeutic hypothermia are brought in. A large proportion is devoted to practical experience with cooling methods, which are compared with the results of the questionnaire. The results of my theses may be used to make the comprehensive nursing care for patients with therapeutic hypothermia more effective, with increased comfort for patients in intensive care units and resuscitation departments