Problems of nursing care in endoscopic retrograde cholangiopancreatography.

Theoretical groundwork Endoscopic Retrograde Cholangiopancreatography (ERCP from now on) is nowadays referred to as the golden standard in diagnostics and treatment of bile duct and pancreas diseases. At the same time it is regarded as the most reliable method of modern medicine in diagnostics of most common oncogenic diseases of pancreas. This examination combines endoscopic diagnostics with X-ray screening and it is unique thanks to the direct display of bile and pancreas ducts. Final picture is made by probing of Vater papillae filled by a contrastive liquid. Other merit consists of completing eventual therapy that follows the diagnostic ERCP. Disadvantages of this examination are complications that may arise already when probing or after a certain period of time. Therefore it is essential to consider each ERCP procedure carefully. Nursering ERCP at the endoscopy section as well as at the ward block of the gastrointestinal department bears its particularities. The priority at the endoscopic section is to employ manually and technically competent nurses skilled in ERCP so they can assist the gastrointestinalist properly. The nurses must be also able to establish contact with the patient to guide him through the examination, using professional skills. Exactly the nurses moderate possible concerns of the examined person. Communication at the ward block is crucial as well ? the nurses explain particularities of the treatment and instruct the patient in basic rules of hospitalisation. They also must be professionally skilled to care for patients after ERCP. Goals of the thesis The aim of this thesis is to monitor particularities of nursing ERCP at the endoscopic section of the gastrointestinal department and to learn how the general treatment of ERCP patients is carried out at the ward block.Qualitative methodology was used for the empirical part of the thesis. Data were collected by interviewing and hidden observations.Results The research survey indicated that ERCP examination nursing treatment bears its particularities that are well known and reflected by nurses at the endoscopy section. Patients confirm that the skills of nurses minimize their stress when undergoing the treatment. The survey indicated that an ERCP examination should be assisted by a nurse with not only technical and manual skills but also empathic and anticipating qualities in order to react appropriately without confusion. Nurses should be able to explain the treatment to the patient properly and to create a comfortable ambience. The survey also indicates that nurses actively seek for courses to keep their knowledge up to date. Particular complications are managed very well by the nurses, they are familiar with specific complications and are always prepared and able to provide the patients adequate nursing. Nursing at the ward block is also at high level in the field of knowledgeableness when informing patients or preparing arrangements and regimes. The patients themselves are satisfied with the overall care after the ERCP examination. The hidden observations show that the nursing after ERCP examination follows the literature properly. Pleasant surprise was that nurses at the ward block of the gastrointestinal department fully implement the five parts of nursing process ? from reviewing the health status of the patient in the beginning to their final evaluation, and that they concurrently create up-to-date nursing diagnoses