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- Ballangrud, Randi, 1959-
(författare)
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Building patient safety in intensive care nursing : Patient safety culture, team performance and simulation-based training
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing.Methods: Quantitative and qualitative methods were used. In Study I, 220 RNs from ten ICUs responded to a patient safety culture questionnaire analysed with statistics. Studies II-IV were based on an evaluation of a simulation-based team training programme. Studies II-III included 53 RNs from seven ICUs and ten RNs from a post-graduate programme (II). The data were collected with questionnaires (II) and measurement scales (III), and analysed with statistics. In Study IV, 18 RNs were interviewed and the data were analysed with a qualitative content analysis.Main findings: The RNs had positive perceptions of the overall patient safety culture in the ICUs. Hence, a potential for improvements was identified at both the unit and hospital level. Differences between types of ICUs and between hospitals were found. The dimensions at the unit level were predictors for the outcome dimensions (I). The RNs evaluated the simulation-based team training programme in a positive way. Differences with regard to scenario roles, prior simulation experience and area of intensive care practice were found (II). The expert raters assessed the teams’ performance as advanced novice or competent. There were differences between the expert raters’ assessments and the RNs’ self-assessments (III). One main category emerged to illuminate the RNs’ perceptions of simulation-based team training for building patient safety: Regular training increases the awareness of clinical practice and acknowledges the importance of structured work in teams (IV).Conclusions: Patient safety culture measurements have the potential to identify areas in need of improvement, and simulation-based team training is appropriate to create a common understanding of structured work in teams with regard to patient safety.
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- Hansson, Per-Olof, et al.
(författare)
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Teaching Avatars on Controversial Issues: Lessons Learned
- 2023
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Ingår i: IAFOR Journal of Education. - 2187-0594. ; 11:2, s. 61-78
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes and evaluates student teachers’ virtual simulation training on teaching a controversial issue. In the fourth year of their program to become social science teachers at lower and upper secondary schools, 43 student teachers in Sweden conducted simulation teaching on conspiracy theories as an example of a controversial issue. Conspiracy theories appeal to young people and they often encounter these theories online, but they can be met with increased knowledge about how conspiracy theories work, and how they can be identified and countered. Thus, students at primary and secondary school need to develop their critical source skills. The Swedish Schools Inspectorate (2022) found that these issues were not properly taught because they were not connected to schools’ values-based work or to the development of students’ democratic competence. To analyze the simulation teaching, data was collected through observations, video-recorded simulation teaching, interviews with student teachers, and reflective documents. The results show that simulation teaching offers student teachers the opportunity to integrate content knowledge, pedagogical content knowledge, and subject knowledge, by being trained to become flexible and responsive to avatars’ individual differences as well as their different attitudes and understanding of the subject.
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- Samuelsson, Bodil
(författare)
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Gender differences in patients with hip fracture : aspects on care and recovery
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hip fractures in the elderly are common and impose a substantial burden on the healthcare system. This fracture population consists of many subgroups that often require differentiated and extensive acute and postfracture care. The aim of this thesis was to basically characterise a hip fracture population at time of admission, present postoperative results and discuss aspects that may influence recovery. Gender differences are specifically addressed. Study I, II and IV derive from a consecutive series of 2213 patients with hip fracture admitted to four major hospitals in Stockholm, while Study III was a small pilot study. In Study I we investigated the effect of time-to-surgery on: ability to return to own home, incidence of pressure ulcers, length of stay (LOS), and mortality. Patients who had surgery within 24, 36 or 48 hours were compared with those who had surgery later. The ability to return to own home was affected in patients who had to wait longer than 36 and 48 hours. The incidence of pressure ulcers and LOS increased at all time limits. In Study II we investigated gender differences in two subgroups, characterized by normal cognitive function versus cognitive dysfunction, and whether such differences influenced patient ability to: return to own home, regain walking ability and perform activities of daily living (ADL). Cognitive function was assessed by the Short Portable Mental Status Questionnaire (SPMSQ). Dysfunction was equally common by gender. Patients with normal function (SPMSQ 8-10) were younger and healthier, resided more often in their own homes and were able to manage ADL independently, with no gender differences. In patients with dysfunction (SPMSQ 0-7), men had more comorbidity on admission, greater loss of walking ability and higher mortality after the fracture episode. We found that cognitive status was the overarching most important factor for predicting outcome. In Study III we examined gastric emptying time of 400 ml carbohydrate rich drink in ten elderly women with acute hip fracture, and compared results with two reference groups of healthy women. The mean half gastric emptying time in the study group was 57 ± 5 (39-82) minutes, to be compared with 58 ±4 (41-106) and 58 ±5 (33-72) in the two reference groups. No adverse event was observed during anesthesia. Consequently, it should be possible to give patients a carbohydrate-rich drink before surgery instead of ordering strict fasting (NPO), which in turn could improve the patients’ chances to recover and regain prefracture status. In Study IV we focused on gender differences in complications; specifically on factors associated with common general complications. Complications were common with an incidence of 59% in men and 56% in women (ns). Most common were urinary tract infection, pressure ulcer, cardiac complications and pneumonia. Male gender emerged as an independent risk factor for suffering from pneumonia, and female gender for urinary tract infection. Besides gender, time-to-surgery, cognitive function, cardiovascular and pulmonary disease on admission were independent risk factors for suffering complication. In conclusion, there are gender differences among patients admitted to a hospital for acute hip fracture, both with regard to status on admission and outcome. Cognitive dysfunction, equally common among women and men, has a major impact on incidence of complication and functional recovery. Men with cognitive dysfunction are at greater risk. With increased awareness of risk factors and gender bias, along with reduced waiting time for surgery, it should be possible to decrease complication incidence and improve outcome. We found no evidence for prolonged gastric emptying time of a carbohydrate-rich beverage, which implies it may be possible to provide patients with a carbohydrate-rich drink before surgery instead of adhering to strict fasting
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- Samuelsson, Maria, 1982-, et al.
(författare)
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Cancer specialist nurses' experiences of supporting family members of persons diagnosed with colorectal cancer : A qualitative study
- 2022
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 61, s. 102205-102205
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of the present study was to explore cancer specialist nurses' experiences of supporting family members of persons diagnosed with colorectal cancer.Method: The study was designed as a qualitative study. Data was collected using individual semi-structured telephone interviews with 21 cancer specialist nurses. The interviews were transcribed and analysed with reflexive thematic analysis.Results: The analysis generated one overarching theme, In the shadow of the person diagnosed with colorectal cancer, and four themes: striving for confidence, searching for ways to support, seeking individualization, and balancing between needs. Swedish colorectal cancer care is organized with the persons diagnosed with colorectal cancer as the centre of care and lacks both structure and allocated resources for supportive care for family members. Thus, support for family members has to be provided within the existing colorectal cancer care. The support provided focuses mainly on strengthening the family members' ability in the caregiving role and is offered primarily at the time of diagnosis.Conclusion: There is an apparent need for developing supportive care plans for family members, involving repeated assessments of multidimensional needs, a tailored support, and follow-ups. Accordingly, a re-evaluation of the cancer specialist nurse's role is needed so that key nursing responsibilities are not ranked second to administrative tasks.
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