| 51. |
- Holst, Göran, et al.
(författare)
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Quality of care : prevention of pressure ulcers - nursing students as facilitators of evidence based practice
- 2010
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Ingår i: Vård i Norden. - : Sage Publications. - 0107-4083 .- 1890-4238. ; 30:1, s. 40-42
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Tidskriftsartikel (refereegranskat)abstract
- This development project was aimed at engaging nursing students in a project targeting the prevention and reduction of pressure ulcers on an education based hospital ward. An intervention was implemented based on systematic assessment, skin observation, together with training and educational sessions, i.e. on how to make risk assessments and how to prevent and treat a pressure ulcer, were carried out. The project demonstrated the importance of offering nursing students an environment for clinical practice which supports them in participating and developing patient care starting from Evidence-Based Practice. During the project no patients developed pressure ulcers while on the ward. The opportunityto act as facilitators of evidence-based methods was found to enhance student ability to draw conclusions and make connections between quality of care and end result.
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| 52. |
- Hälleberg-Nyman, Maria, 1968-
(författare)
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Urinary catheter policies for short-term bladder drainage in hip surgery patients
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to evaluate methods for urinary catheter handling in patients undergoing hip surgery. The intention was to gain knowledge in order to provide optimal and cost- effective care regarding urinary catheterisation in this group of patients.In Study I , 45 of the 86 catheterised patients (52%) contracted nosocomial urinary tract infections (UTIs). Diabetes was a risk factor for developing UTI, and cloxacillin as a perioperative antibiotic prophylaxis seemed to offer a certain protection. Study II was a randomised controlled trial on the effect of clamping (n = 55) or not (n = 58) of the indwelling urinary catheter before removal. No significant differences were found between the groups with respect to time to normal bladder function, need for recatheterisation, or length of hospital stay. Study III was a randomised controlled trial among patients with hip fracture and hip arthroplasty, in which the patients were randomised to intermittent (n = 85) or indwelling (n = 85) urinary catheterisation. No significant differences in nosocomial UTIs (9% vs. 12%) or cost-effectiveness were shown. The patients in the intermittent group regained normal bladder function significantly sooner after surgery. Fourteen percent of the patients in the intermittent group did not need any catheterisation. In Study IV , 30 patients were interviewed about their experiences of bladder emptying and urinary catheterisation. The patients’ views were described through the main category ‘An issue but of varying impact’. Both bladder emptying through micturition and bladder emptying through catheterisation were described as convenient, but also as uncomfortable and an intrusion on dignity. The patients were aware of risks and complications of urinary catheterisation.In conclusion, this thesis indicates that UTI is common in hip surgery patients. Clamping of indwelling catheters seems not necessary. There is no preference for either intermittent or indwelling urinary catheterisation according to the results of this thesis, either for the development of nosocomial UTI or, for cost-effectiveness, or from the patient perspective. Nurses should be aware that catheterisation might make the patients feel exposed, and it is essential that their practice reflect the best available evidence.
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| 53. |
- Idvall, Ewa, et al.
(författare)
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Inledning
- 2013
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Ingår i: Kvalitetsindikatorer inom omvårdnad. - : Gothia Förlag AB. - 9789172058576 ; , s. 7-9
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 54. |
- Islamoska, Julli, et al.
(författare)
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Arbetsmodeller som säkrar sjuksköterskekompetensen-en systematisk litteratursammanställning
- 2009
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Ingår i: Vård i Norden. - : Sjuksköterskors samarbete i Norden, SSN. - 0107-4083 .- 1890-4238. ; 29:2, s. 44-47
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Forskningsöversikt (refereegranskat)abstract
- The Swedish healthcare system is organized in a way that all nurses despite formal competence and experience have the same responsibilities. A newly graduated nurse has the same work-load and responsibility in patient care as the experienced nurse. newly graduated nurses need supervision by clinical experts in the process of developing skills, but also to reduce risks that exists when their authority is above their skills and level of experience. The aim was to identify existing organizational models were the nurses´work has been formalized according to their level of competence and experince in order to improve patient safety and patient satisfaction. A search with a systematic approach in CINAHL, The Cochrane Library and MedLine was performed. A total of 397 studies were identified and 31 articles were screened in full text. Finally three articles , which are insufficient with regards to issue recommendations, presented common factors as models that focus on experienced nurses´competence and the organization of patient care. The research regarding models of organization that secure nursing competence in patient care, how it is utilized and, it´s effect on patient care is insufficient. there is a need for extensive research examining this relation at ward level.
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| 55. |
- Israelsson, Amanda, et al.
(författare)
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Sömnfrämjande åtgärder för patienter inskrivna för vård på sjukhus – en systematisk litteraturstudie
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Upphov: Studien är en litteraturgenomgång, vilken ligger till grund för ett forskningsprojekt kring sömnstörningar hos medelålders- och äldre samt utvecklande av interventioner för att reducera dessa störningar. Syfte: Syftet var att beskriva omvårdnadsåtgärder för främjande av sömn på sjukhus samt deras effektivitet. Metod: En systematisk litteratursökning gjordes i CINAHL, MedLine, PubMed, Cochrane Database of Clinical Trials och Cochrane Database of Systematic reviews. Tjugo artiklar hittades och efter kritisk granskning återstod sexton. En sammanläggning av studiernas resultat samt en skattning av evidensstyrkan i de olika omvårdnadsåtgärderna gjordes. Resultat: Reducering av ljus och ljud samt titta på musikvideos eller lyssna till vitt ljud har begränsad evidens. Omvårdnadsåtgärder som massage, värmd filt, avslappningstekniker, akupunktur eller smärtbehandling har otillräcklig evidens.
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| 56. |
- Jacobsson, Catrine, et al.
(författare)
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The Swedish Society of Nursing's National Code of Core Values for Care
- 2011
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Konferensbidrag (refereegranskat)abstract
- Core values are essential to helathcare in order to promote knowledge based care within practice, and for the curricula development in for example nursing education. Professional ethics highlight core values and how these values are sustained in connection with patients and their families. Reflections and discussions about these core values as a point of departure will raise the level of awarness for ethical dilemmas. A code of core values for care can support a common approach and illuminate ethical dilemmas in nursing care and serve as a fundation for the practice of good care in all areas of the healthcare sector. In 2010 the Swedish Society of Nursing adopted a National Code of Core Values for care. All human behaviour has an ethical dimension and we are always responsible for what we do or fail to do. Good care depends upon keeping an open mind towards the patient and the families they confides, and respecting the patient's experience of health. The values described in the Code are those that occure in situations where people are dependent on, and in need of, care. The essential values that the Swedish Society of Nursing has chosen to highlight are, among others, the following; - respect of the vulnerable, - respect of dignity, - respect of integrity, - respect of self determination. The National Code of Core Values for care has been developed from knowledge in the scientific nursing field as well as from clinical experiences. To enable nurses to work with core values, the national Code of Values for care also suggests models for discussion and reflection when applied to work in health care.
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| 57. |
- Jangland, Eva, 1964-
(författare)
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The Patient–Health-professional Interaction in a Hospital Setting
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the thesis was to describe patient−health-professional interactions in a hospital setting, with a specific focus on the surgical care unit. The thesis consists of four studies and includes both qualitative and quantitative studies. Content analysis and phenomenography were used in the qualitative studies; the quantitative study was an intervention study with a three-phase quasi-experimental design. The findings of study I showed that patient complaints to a local Patients’ Advisory Committee about negative interactions with health professionals most often concerned the perceived insufficiencies of information, respect, and empathy. The findings of study II showed that experiences of negative interactions with health professionals caused long-term consequences for individual patients and reduced patients’ confidence in upcoming consultations. The findings of the phenomenographic study (III) showed that surgical nurses understand an important part of their work in qualitatively different ways, which can be presented as a hierarchy of increasing complexity and comprehensiveness. In the most restricted understanding, surgical nurses focus on the work task, whereas in the others surgical nurses demonstrate increasing degrees of patient-centeredness. Finally, the results of study IV showed that an uncomplicated intervention that invited patients to express their daily questions and concerns in writing (using the ‘Tell-us card’) improved the patients’ perceptions of participation in their care in a surgical care unit. For further implementation of the Tell-us card to succeed, it needs to be prioritized and supported by leaders in ongoing quality improvement work. The value of a patient-focused interaction needs to be the subject of ongoing discussions in surgical care units. Patients’ stories of negative interactions could be used as a starting point for discussions in professional reflection sessions. It is important to discuss and become aware of different ways of understanding professional interactions and relationships with patients; these discussions could open up new areas of professional development. Providing patients an opportunity to ask their questions and express their concerns in writing, and using this information in the patient−health-professional interaction, could be an important step towards improved patient participation.
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| 58. |
- Johansson, Maria Eiman, et al.
(författare)
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Nurses' clinical reasoning concerning management of peripheral venous cannulae
- 2009
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Ingår i: Journal of Clinical Nursing. - : Blackwell. - 0962-1067 .- 1365-2702. ; 18:23, s. 3366-3375
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe nurses´clinical reasoning regarding peripheral venous cannulae management by focusing on the clinical information and circumstances considered during the decision-making process. On every shift nurses make several decisions, among others concerning the management of peripheral venous cannuae. Thrombophlebitis is a common complication associated with its use, although more severe complications can arise. There are clinical practice guidelines within the area, but they are not always adhered to. Previous studies have examined decisions related to the management of peripheral venous cannulae, but did not include observations in a naturalistic setting. A qualitative study combining observations and interviews was designed. Methods: Participant observation facilitated open interviews about the clinical reasoning behind decision-making in observed situations, as well as semi-structured interviews regarding clinical reasoning about the general management of peripheral venouscannulae. transcribed interview texts were analysed with content analysis. Three main categories describe clinical information and circumstances: the individual patient situation, the nurse´s work situation and experience of peripheral venous cannulae management. The overall theme of the interview texts was that the clinical reasoning was a balancing act between minimising patient discomfort and preventing complications from the peripheral venous cannulae. Conclusion: At all times the patients´well-being was considered, but the ways the nurses approached this differed depending on how they considered clinical information in the individual patient situation, circumstances in their own work situation and their experience of peripheral venous cannulae management. Relevance toclinical practice: Knowledge of the clinical information and circumstances considered in naturalistic settings, is valuable when implementing and adjusting clinical practice guidelines to local settings. This knowledge is also useful in nursing education as student nurses´and nurses´ability tobalance between preventing complications and avoiding discomfort is important for enhancing patient care.
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| 59. |
- Johansson, Maria Eiman, et al.
(författare)
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Registered Nurses´Adherence to Clinical Guidelines Regarding Peripheral Venous Catheters : A Structured Observational Study
- 2008
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Ingår i: Worldviews on Evidence-Based Nursing. - : Blackwell. - 1545-102X .- 1741-6787. ; 5:3, s. 148-159
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Tidskriftsartikel (refereegranskat)abstract
- peripheral catheterization is a common procedure, which affects numerous patients in health care today. having peripheral venous catheters in situ might lead to complications such as thrombophlebitis and sepsis, and clinical guidelines have been developed to assist nurses in their decisionmaking. Several reasons are given for clinicians not always adhering to clinical guidelines, although such adherence might lead to fewer complications. This papaer aims to describe registered nurses´adherence to national and local guidelines on peripheral venous catheters by focusing on time in situ, site, size, and documentation at the dressing. An additional aim is to describe the thrombophlebitis frequency associated with peripheral venous catheters in situ. Structured observational study of patients with peripheral venous catheters in situ, conducted from December 2004 to June 2005. data of 343 peripheral venous catheters were analyzed. Nurses partly adhered to national and local guidelines concerning size and site. Guideline adherence concerning documentation at the dressing was low. The results showed that non-adherence pertaining to time in situ varied between 5% and 26.3%. Differences between adherence to national or local guidelines were shown for size, site, and documentation at the dressing. Mild thrombophlebitis (Grades 1 and 2) was observed in 7.0%. Nurses partly adhered to clinical guidelines. Differences in guideline adherence were observed for wards with local or national guigelines, as well as for wards with different specialities. In accordance with clinical guidelines, the nurses seemed to replace or remove peripheral venous catheters before any severe complications arose. Adherence to clinical guidelines has an impact for preventing patient complications and thus it is essential that nurses are aware of their existence. Feedback and discussions of guideline adherence or of complication rates might influence nurses´clinical decision-making.
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| 60. |
- Jönsson, Ann-Marie, et al.
(författare)
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Development of a consultation and teaching concept for leg wound treatment in home health care
- 2007
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Ingår i: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 13:5, s. 236-240
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Tidskriftsartikel (refereegranskat)abstract
- We developed a consultation and teaching concept about leg wounds and their care, for use by patients and caregivers in a home-health-care setting. Descriptive data were gathered through a survey distributed to three groups, comprising 21 individuals (18 nurses and 3 health administrators). These participants provided answers regarding group activities, meeting frequency, meeting notes and meeting content, as well as responses to questions regarding the Web site, Web materials, film and pamphlet. Seventeen people answered the survey (81% response rate). They made predominantly positive comments. The combined total average score was 3.6 (1= very bad to 4= very good). The concept was implemented in one municipality in a health-care region in southern Sweden using high bandwidth videophones (640 kbit/s). The result showed that elderly persons at home and nurses working in home health care were interested in using the concept and communicating via videophone. A strength of the Web-based information and communication material is its adaptability to suit both patients and caregivers.
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