Problems of patients with left ventricular asisst device and access nursing sisters.

In my thesis we devote to problems of patients with the implanted system HeartMate II, which is now approved as a support for an indication to bridging the time to heart transplantation and for a destination therapy for patients with a refractory heart failure. We also devote to the access of nurses to these patients. The theoretical part of the thesis is generally devoted to mechanical cardiac supports and indications to their introduction. Next part describes HeartMate II, specifics of the nursing care for a patient who is after implantation mechanical cardiac support HeartMate II and limitations, which follow for a patient at home. The target of the work is to: 1. Find out, what the priorities of needs of the patient with a mechanical cardiac support are in a nursing care. 2. Find out, how the patient with a mechanical cardiac support perceives himself and his future. 3. Find out possibilities of nursing interventions to a saturation of needs by priorities of patients with mechanical cardiac supports. For the qualitative part of the empirical research the method of questioning with technique a semi-structured interview with opened questions was chosen. The research group consists of four patients after the implantation of left-hand mechanical cardiac supports HeartMate II. In this part we were finding out answers to four research questions. 1. Which damaged needs are predominant by patients with mechanical cardiac supports? 2. Do patients with mechanical cardiac supports have enough information about possible complications related to the life after the implantation of a mechanical support? 3. How does the patient with a mechanical cardiac support perceive his future? 4. How does the patient with the mechanical cardiac support HeartMate II perceive himself? Then results of research were analyzed and written into schemes. In the quantitative part of the research four hypotheses were determined. 1. Interventions of nurses during a nursing care which is oriented to monitoring of vital functions are predominant over the orientation of needs that are changed by the life with a mechanical cardiac support. 2. Nurses are available to answer to patients with mechanical cardiac supports questions which are related to a service of the device HeartMate II. 3. Nurses are well informed about possible complications after the implantation of the left-hand mechanical support. 4. Nursing interventions of nurses are predominant over interventions of the other members of the team during the care of patient after the implantation of the left-hand mechanical cardiac support. The research group of the research consists of nurses, who are working at the department with beds, the intensive care unit of clinic of a cardiovascular surgery and at the resuscitation department of an anaesthesiology and resuscitation in IKEM. 95 respondents were addressed. The returnability of questionnaires was 69% from the beginning number. On the basis of the result of the research we think that targets were fulfilled. Patients have enough information about complications related with the life with the mechanical cardiac support HeartMate II. Patients consider a satisfaction of psychical needs, especially the feeling of a safety and a security, as a priority, although they are highly specific problems. In this view a psychotherapeutic access and a therapeutic communication of a nurse with a patient are important. We are going to hand results of the research over to the management of IKEM. A thematic schedule of a tutorial was created. This tutorial engaged in psychic needs of a patient, a psychotherapeutic access of nurses and a therapeutic communication with a patient