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Sökning: LAR1:hb > Lundberg Lars

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1.
  • Abelsson, Anna, et al. (författare)
  • Cardiopulmonary resuscitation quality during CPR practice versus during a simulated life-saving event
  • 2018
  • Ingår i: International Journal of Occupational Safety and Ergonomics. - : Taylor & Francis. - 1080-3548 .- 2376-9130. ; 24:4, s. 652-655
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction. As a part of the emergency medical services, the Swedish fire brigade can increase the survival rate in out-of-hospital cardiac arrests.Aim. To compare the quality of cardiopulmonary resuscitation (CPR) performed by firefighters at a routine CPR practice versus when involved in a simulated life-saving event.Methods. In this study, 80 firefighters divided into two groups performed CPR according to guidelines: one group indoors during a routine training session; the other group outdoors during a smoke diving exercise wearing personal protective clothing and self-contained breathing apparatus. Descriptive and inferential statistics were used to analyze the data.Results. The results showed a tendency for the outdoor group to perform CPR with better ventilation and compression quality, as compared to the indoor group. The ventilation of the manikin was not hampered by the firefighters wearing personal protective clothes and self-contained breathing apparatus, as the Swedish firefighters remove their facial mask and ventilate the patient with their mouth using a pocket mask.Conclusions. Overall, the results in both groups showed a high quality of CPR which can be related to the fire brigade training and education traditions. CPR training is regularly performed, which in turn helps to maintain CPR skills.
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2.
  • Abelsson, Anna, et al. (författare)
  • Simulation as a means to develop firefighters as emergency care professionals
  • 2019
  • Ingår i: International Journal of Occupational Safety and Ergonomics. - : Taylor & Francis. - 1080-3548 .- 2376-9130. ; 25:4, s. 650-657
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this study was to evaluate the simulated emergency care performed by firefighters and their perception of simulation as an educational method.METHODS: This study had a mixed method with both a quantitative and a qualitative approach. Data were collected by simulation assessment, a questionnaire, and written comments. Descriptive analysis was conducted on the quantitative data whereas a qualitative content analysis was conducted on the qualitative data. Finally, a contingent analysis was used where a synthesis configured both the quantitative and the qualitative results into a narrative result.RESULTS: The cognitive workload that firefighters face during simulated emergency care is crucial for learning. In this study, the severity and complexity of the scenarios provided were higher than expected by the firefighters. Clearly stated conditions for the simulation and constructive feedback were considered positive for learning. Patient actors induced realism in the scenario, increasing the experience of stress, in comparison to a manikin.CONCLUSION: To simulate in a realistic on-scene environment increases firefighters' cognitive ability to critically analyze problems and manage emergency care. Simulation of emergency care developed the firefighters as professionals.
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3.
  • Abelsson, Anna, et al. (författare)
  • Trauma Simulation in Prehospital Emergency Care.
  • 2018
  • Ingår i: Journal of trauma nursing : the official journal of the Society of Trauma Nurses. - : Lippincott Williams & Wilkins. - 1078-7496 .- 1932-3883. ; 25:3, s. 201-204
  • Tidskriftsartikel (refereegranskat)abstract
    • Well-educated ambulance staff is a prerequisite for high-quality prehospital trauma care. The aim of this study was to examine how nurses in the ambulance service experienced participation in trauma simulation. Sixty-one nurses, working in an emergency ambulance service, performed simulated trauma care on four different occasions and afterward rated three statements on a 5-point Likert scale. A descriptive and inferential analysis was conducted. There are statistically significant increases between the pre- and posttests regarding all three statements: "I think simulation of severe trauma with manikins is realistic" (0.23 or 6% increase), "Simulation is a suitable method for learning severe trauma care" (1.3 or 38% increase), and "I am comfortable in the situation learning severe trauma care through simulation" (0.74 or 19% increase). With the experience of realism in simulation, participants become more motivated to learn and prepare for future events. If the participants instead feel uncomfortable during simulation training, they focus on their own feelings instead of learning. In a realistic simulated environment, participants are prepared to understand and manage the emergency care situation in clinical work. Participants learn during simulation when they are outside their comfort zone but without being uncomfortable or experiencing anxiety.
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4.
  • Andersson Hagiwara, Magnus, et al. (författare)
  • Effect of Simulation on the Clinical Competence of Swedish Ambulance Nurses
  • 2014
  • Ingår i: Australasian Journal of Paramedicine. - : Paramedics Australasia. - 2202-7270. ; 11:2, s. 1-7
  • Tidskriftsartikel (refereegranskat)abstract
    • ntroduction Simulation has become an established method for education and training of Emergency Medical Services personnel in different skills such as advanced airway techniques, also in evaluation and initial care of stroke patients and in pre - hospital trauma. Simula tion can be a useful method to improve learning. To our knowledge, there are only a few studies that relate simulation to the effect on clinical skills. The aim of the present study was to investigate the effect of simulation on the clinical competence in a pre - hospital trauma care course for ambulance nurses. Methods The study was performed using a before - after design. Seventeen ambulance nurse students who participated in a trauma care course were evaluated in two simulated trauma cases. All subjects had passed the initial theoretical part of the course. The pre - test was performed in the beginning of the following part of the course involving simulation and the post - test at the end of the course. The analysis was performed by assessment of performance, as seen on video - tapes from the pre - tests and the post - tests. A validated instrument was used to determine the level of student’ s clinical competence. Paired t - test was used to confirm differences between the pre - test and post - test results . Results There was a significant increase in the over - all results for the post - test, with a difference of 1.12 points (t=4.642, df=16, p= 0.001) Situation Awareness, Patient Assessment and Decision Making showed the most pronounced improvements. Conclusion The results imply t hat simulation in addition to traditional theoretical education improves the clinical competence of the students, in comparison to traditional education and training without any significant amount of simulation.
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5.
  • Andersson Hagiwara, Magnus, et al. (författare)
  • Measuring participants’ immersion in healthcare simulation : the development of an instrument
  • 2016
  • Ingår i: Advances in Simulation. - : BioMed Central. - 2059-0628. ; 2016:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundImmersion is important for simulation-based education; however, questionnaire-based instruments to measure immersion have some limitations. The aim of the present work is to develop a new instrument to measure immersion among participants in healthcare simulation scenarios.MethodsThe instrument was developed in four phases: trigger identification, content validity scores, inter-rater reliability analysis and comparison with an existing immersion measure instrument. A modified Delphi process was used to develop the instrument and to establish validity and reliability. The expert panel consisted of 10 researchers. All the researchers in the team had previous experience of simulation in the health and/or fire and rescue services as researchers and/or educators and simulation designers. To identify triggers, the panel members independently screened video recordings from simulation scenarios. Here, a trigger is an event in a simulation that is considered a sign of reduced or enhanced immersion among simulation participants.ResultsThe result consists of the Immersion Score Rating Instrument (ISRI). It contains 10 triggers, of which seven indicate reduced and three enhanced immersion. When using ISRI, a rater identifies trigger occurrences and assigns them strength between 1 and 3. The content validity analysis shows that all the 10 triggers meet an acceptable content validity index for items (I-CVI) standard. The inter-rater reliability (IRR) among raters was assessed using a two-way mixed, consistency, average-measures intra-class correlation (ICC). The ICC for the difference between weighted positive and negative triggers was 0.92, which indicates that the raters are in agreement. Comparison with results from an immersion questionnaire mirrors the ISRI results.ConclusionsIn conclusion, we present a novel and non-intrusive instrument for identifying and rating the level of immersion among participants in healthcare simulation scenarios.
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6.
  • Andersson Hagiwara, Magnus, et al. (författare)
  • The Effects of Integrated IT Support on the Prehospital Stroke Process: Results from a Realistic Experiment
  • 2019
  • Ingår i: Journal of Healthcare Informatics Research. - : Springer Science and Business Media LLC. - 2509-498X .- 2509-4971. ; 3:3, s. 300-328
  • Tidskriftsartikel (refereegranskat)abstract
    • Stroke is a serious condition and the stroke chain of care is a complex. The present study aims to explore the impact of a computerised decision support system (CDSS) for the prehospital stroke process, with focus on work processes and performance. The study used an exploratory approach with a randomised controlled crossover design in a realistic contextualised simulation experiment. The study compared clinical performance among 11 emergency medical services (EMS) teams of 22 EMS clinicians using (1) a computerised decision support system (CDSS) and (2) their usual paper-based process support. Data collection consisted of video recordings, postquestionnaires and post-interviews, and data were analysed using a combination of qualitative and quantitative approaches. In this experiment, using a CDSS improved patient assessment, decision making and compliance to process recommendations. Minimal impact of the CDSS was found on EMS clinicians’ self-efficacy, suggesting that even though the system was found to be cumbersome to use it did not have any negative effects on self-efficacy. Negative effects of the CDSS include increased on-scene time and a cognitive burden of using the system, affecting patient interaction and collaboration with team members. The CDSS’s overall process advantage to the prehospital stroke process is assumed to lead to a prehospital care that is both safer and of higher quality. The key to user acceptance of a system such as this CDSS is the relative advantages of improved documentation process and the resulting patient journal. This could improve the overall prehospital stroke process.
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7.
  • Andersson, L-O, et al. (författare)
  • Education in Military Medicine : The Swedish Model
  • 2005
  • Ingår i: AMEE 2005 Abstracts. - : AMEE. ; , s. 235-
  • Konferensbidrag (refereegranskat)abstract
    • The Swedish Armed Forces Medical Centre is nationally responsible for the qualified education in military medicine. Studies at university level for conscript medical personnel were introduced in 1997, with the course Battlefield emergency care for nurses (7,5 ECTS points). Two years later, a parallel course for physicians was started. Other courses have also been studied at university level. Starting in 2001, a total of fifteen units throughout the country have arranged the Basic course in battlefield emergency care for Medical Orderly (15 ECTS points). The units have received academic support from local colleges and universities, while curriculum, study literature, supervision and examination have been the responsibility of the Armed Forces Medical Centre. The present reorganisation of the Swedish Armed Forces will result in a situation where the entire military medical education will be located in Gothenburg. Physicians, nurses and medics will be educated at the same campus. A close connection to the University of Gothenburg has been established, in order to promote the educational process of military medicine. Teachers at the Medical Centre will have positions as lecturers at the university, which will be favourable for the students in their acquisition of knowledge.
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8.
  • Andersson, Sten-Ove, et al. (författare)
  • Doctors' and nurses' perceptions of military pre-hospital emergency care - When training becomes reality
  • 2017
  • Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 32, s. 70-77
  • Forskningsöversikt (refereegranskat)abstract
    • The aim of this study was to identify physicians' and nurses' perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomeno-graphic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine. These results indicate that the training should be developed in order to optimise pre-deployment training for physicians and nurses. This may result in increased safety for the provider of care, while at the same time minimising suffering and enhancing the possibility of survival of the injured. (C) 2017 Elsevier Ltd. All rights reserved.
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9.
  • Andersson, Sten-Ove, et al. (författare)
  • Fixing the wounded or keeping lead in the air-tactical officers' views of emergency care on the battlefield.
  • 2015
  • Ingår i: Military medicine. - : Association of Military Surgeons Us. - 0026-4075 .- 1930-613X. ; 180:2, s. 224-229
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to identify tactical officers' views of prehospital emergency care in the field before an international mission. A qualitative study with a phenomenographic approach based on interviews was used. The result of this study is a set of descriptive categories on a collective level, showing the variation in how the tactical officers perceived the phenomenon of emergency care in the battlefield. The result can be viewed as (1) noncombat-oriented including being able to do one's specialist task, being able to talk with local people, and being able to give first aid, and (2) combat-oriented including soldiers' skills and roles in the unit, being able to act in the unit, and being able to lead the care of injured. These findings are important for officers' preparation for international missions. The interaction between military and medical knowledge on-site care should be developed between the tactical officer and the medical personnel in order to minimize suffering and to enhance the possibility for survival of the casualty.
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10.
  • Andersson, Sten-Ove, et al. (författare)
  • Interaction, Action, and Reflection : How Medics Learn Medical Care in the Swedish Armed Forces
  • 2013
  • Ingår i: Military medicine. - : Association of Military Surgeons of the U S. - 0026-4075 .- 1930-613X. ; 178:8, s. 861-866
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study is to examine how medics within the Swedish Armed Forces perceive their learning outcome following military prehospital training. A qualitative study with a phenomenographic approach was used to investigate how learning is perceived among military medics. At meta level, the results can be viewed as an interaction, i.e., being able to collaborate in the medical platoon, including the ability to interact within the group and being able to lead; an action, i.e., being able to assess and treat casualties, including the ability to communicate with the casualty, to prioritize, and to be able to act; and a reflection, i.e., having confidence in one's own ability in first aid, including being prepared and feeling confident. interaction during the period of education is important for learning. action, being able to act in the field, is based on a drill in which the subject progresses from simple to complex procedures. reflection, learning to help others, is important for confidence, which in turn creates preparedness, thereby making the knowledge meaningful.
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