Antidecubital Care as a Nursing Problem

This thesis deals with the issue of providing antidecubital care and observes the fulfilment of nursing interventions in the care about non-self sufficient patients. During performing her duties, every nurse encounters the issue of decubitus ulcers formation and with this related antidecubital care. Thus, it can be stated that the occurrence of decubitous ulcers serves also as the indicator of the quality of provided nursing care. A lot of people think that the problem develops particularly in elders, but young people who are bedridden after injuries and accidents are also affected and this complication degrades the quality of their life. The thesis is divided into theoretical and empirical parts. The theoretical part describes the anatomy of skin and its function, decubitus and classification of decubitus ulcers are defined, their localization with characteristics of predilection sites are specified, outlining complications in decubitus ulcers. The theoretical part pursues antidecubital care with the division into subheads on positioning, antidecubital aids, nursing interventions, and the mission of the European Pressure Ulcer Advisory Panel is described. The separate chapter includes the risk assessment of decubitus ulcers formations, as is e.g. Norton scale, etc. The last chapter embraces the specification of conservative and surgical treatment of pressure sores. The aim of the research examination was to determine whether the nurses perceived antidecubital care as a nursing problem and to map the opinions of the nurses relating to antidecubital care. Three research questions were set to achieve the objectives: first, what the pitfalls of nursing care were on the part of the nurses, secondly, what areas within antidecubital care were neglected and finally, how antidecubital care at selected inpatient wards was provided. The research was implemented at the chosen inpatient wards in České Budějovice Hospital, PLC, from the period of February to April 2014. The research file consisted of the general nurses and the medical assistants. A hidden participant observation was conducted and then questionnaires with 15 questions that were closed or semi-closed were distributed to the nurses. 45 questionnaires were handed out, 31 handed back and all 31 questionnaires could be processed. Thus, the total return of the questionnaires was 69%. Questions in the questionnaire were based on the observation criteria. The hidden participant observation was processed and plotted on the observation sheet and then classified according to the given criteria. After delivery, the returned questionnaires were checked and evaluated graphically. All results were processed using Misrocoft Office Excel program, were plotted in graphs with keys and descriptions. By processing and comparing the results, we ascertained that in some fields the opinion of the nurses was different from the practice that was really performed. It could be also caused by the fact that antidecubital care is very time-consuming, demanding and comprises a lot of nursing interventions. Sufficient number of aids with which the ward is equipped is relevant as well, be it preventive aids or medical ones. And last but not least the organization of the care. At present, the time spent on completing documentation is increasing and the time that can be used by nurses for contacting a patient and satisfy his/her needs is decreasing. Nevertheless, the patient´s state and his/her contentment reflect and demonstrate our care. After previous arrangement, the results of our research examination will be communicated to the ward sisters at the selected inpatient wards where the research examination was performed