| 1. |
- Rudman, Ann, et al.
(författare)
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Sjuksköterskor i frontlinjen av COVID-19 pandemin : vilka blev konsekvenserna? Teknisk rapport om enkät och datainsamling
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport summerar datainsamlingen som genomfördes av SCB (Statistiska centralbyrån) i projektet ”Sjuksköterskor i frontlinjen av COVID-19 pandemin: Vilka blev konsekvenserna?”. Projektet är finansierat av AFA försäkring (Diarienr 200311). I kapitel 1 beskrivs bakgrund till LUST (Longitudinell Undersökning om Sjuksköterskors Tillvaro) studien. I kapitel 2 beskrivs studien utifrån design, rekrytering och datainsamling. I kapitel 3 redovisas översikt över innehållet i enkäten som skickades ut studiedeltagarna. Projektet bedrivs på Högskolan Dalarna och inom ramen för Petter Gustavssons forskargrupp vid Karolinska Institutet.Sjuksköterskor har varit i frontlinjen av COVID-19-pandemin och de stressorer som de utsatts för i sitt arbete inom hälso- och sjukvården kan orsaka hälsoproblem. I föreliggande projekt har en nationell kartläggning av sjuksköterskors arbetssituation och hälsa under COVID-19 pandemin gjorts. Undersökningen är gjord utifrån de tre sjuksköterskekohorter som följts inom ramen för LUST-studien sedan 2002 (Gustavsson et al., 2013; Rudman, Hörberg, et al., 2020; Rudman et al., 2010). I LUST-studien har närmare 4500 sjuksköterskestudenter följts med uppföljande enkäter från deras utbildningstid 11 till 15 år efter examen. En uppföljande enkätundersökning genomfördes i september 2021 till januari 2022 vilket motsvarar 15 till 19 år efter examen. En speciellt anpassad enkät med relevans och aktualitet för arbetet under pandemin hade utvecklats gemensamt med forskare som har expertis gällande sjuksköterskor i olika verksamheter som belastats under COVID-19 pandemin. Enkäterna besvarades när pandemin pågått i ungefär ett år och nio månader.I samarbete med SCB har datainsamlingen genomförts som en postenkät med påminnelser och med möjlighet att besvara frågorna online. Svarsfrekvensen för enkätstudien blev 57% för hela undersökningen (för samtliga kohorter), vilket bedöms vara en hög svarsfrekvens med tanke på hur belastad sjuksköterskekåren har varit under COVID-19 pandemin.
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| 2. |
- Koistinen, Susanne, et al.
(författare)
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Oral health and oral care in short-term care : prevalence, related factors, and coherence between older peoples and professionals assessments
- 2019
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 33:3, s. 712-722
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oral health is important for well-being and overall health. Older peoples oral health is well described in the residential care context, but remains understudied in short-term care.Objective: The aim of this study was to describe oral health, daily oral care and related factors among older people in short-term care and to compare self-perceived oral health with professional assessment.Materials and methods: This cross-sectional study included 391 older people in 36 short-term units in 19 Swedish municipalities. Oral health was assessed professionally by clinical oral assessment and the Revised Oral Assessment Guide (ROAG). The older peoples’ perceptions of their own oral health were measured with a global question on self-perceived oral health. Self-care ability was assessed with Katz Index of Activities of Daily Living (Katz-ADL).Results: Mean age was 82.9 years, 19% of participants were totally edentulous, and 43% had ≥20 teeth. Almost 60% had coating or food debris on their teeth, but only 19% received help with daily oral care. Those who were dependent on help with self-care had around a sixfold higher risk of having oral problems. There was a low level of agreement between the clinical assessment based on ROAG and self-perceived oral health.Conclusion: Professionals’ assessments of oral health differed considerably from the older peoples own assessments. A higher risk of oral problems and more occurrence of coating or food debris or broken teeth were seen among those dependent on help with self-care (ADL). This study indicates that in order to improve older peoples oral health and oral care we need to provide person-centred oral care and to develop a close collaboration between nursing and dental staff.
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| 3. |
- Koistinen, Susanne, et al.
(författare)
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Oral health-related quality of life and associated factors among older people in short-term care.
- 2020
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Ingår i: International Journal of Dental Hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 18, s. 163-172
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: It is well known that oral health status is associated with oral health-related quality of life (OHRQoL) in the general population. The aim of this study was to describe and analyze OHRQoL among older people in short-term care and its associated factors.MATERIALS AND METHODS: This cross-sectional study included 391 older people in 36 short-term care units. Data were collected via clinical oral assessments, questions about self-perceived oral and general health, Katz Index of Activities of Daily Living (Katz-ADL) and the Revised Oral Assessment Guide (ROAG). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Multivariate logistic regression models were applied in the analysis.RESULTS: Poor OHRQoL was reported by 34% of the older people. Associated factors were swallowing problems according to ROAG; quite poor/poor self-perceived physical, psychological, and oral health; and being a woman.CONCLUSIONS: There is an association between OHRQoL and older people's self-perceived health according to the OHIP-14. This indicates the importance of early detection of oral health problems in frail older people and to assess both oral health and swallowing problems among older people in short-term care.
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| 4. |
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| 5. |
- Ekdahl, A. W., et al.
(författare)
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Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting : a systematic review and meta-analysis
- 2015
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Ingår i: European Geriatric Medicine. - : Elsevier. - 1878-7649 .- 1878-7657. ; 6:6, s. 523-540
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Forskningsöversikt (refereegranskat)abstract
- Background: With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care.Objective: To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings.Data sources: CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015.Study eligibility: Randomized controlled trials.Participants: Older adults aged ≥ 65 years who were admitted to hospital with a complex condition, divided into frail and moderately frail groups.Intervention: CGA.Control: Usual care.Outcomes: Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality.Study appraisal and synthesis: The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences.Results: Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group.Conclusion: There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited.
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| 6. |
- Farrokhnia, Nasim, et al.
(författare)
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Emergency Department Triage Scales and Their Components : A Systematic Review of the Scientific Evidence
- 2011
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 19, s. 42-
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Forskningsöversikt (refereegranskat)abstract
- Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed: 1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED? 2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)? 3. How valid is each triage scale in predicting hospitalization and hospital mortality? A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (>= 15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted. We found ED triage scales to be supported, at best, by limited and often insufficient evidence. The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other scales. Two of the scales yielded limited scientific evidence, and one scale yielded insufficient evidence, on which to assess the risk of early death or hospitalization in patients assigned to the two lowest triage levels on a 5-level scale (validity).
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| 7. |
- Koistinen, Susanne, et al.
(författare)
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Older people’s experiences of oral health and assisted daily oral care in short-term facilities
- 2021
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318 .- 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older people’s oral health has improved, and many retain their natural teeth throughout their life. However, their daily oral care can be more difficult because of compromised general health and the reduced capacity for self-care that often comes with old age. More knowledge is needed about how older people view their oral health and oral care. The aim of this study was to describe how older people in short-term care experience their oral health and daily oral care.Method: A descriptive, qualitative study was performed through interviews with 14 older people (74–95 years) recruited from short-term care units in two Swedish regions. Data were analysed using inductive content analysis.Results: The findings are described in one main category, three categories and nine sub-categories. The main category was Adapting to a changed oral condition while striving to retain independence. The first category, Wanting to manage daily oral care independently, contained three subcategories: Having always brushed my teeth without help, Being satisfied with my mouth and teeth, and Having to accept help if necessary. The second category, Acceptance of changes in oral condition, had three subcategories: Difficulty in chewing and swallowing, Difficulty with tooth brushing, and Not considering a dentist visit to be worth the cost. The third category, Barriers to receiving assistance from staff, had three subcategories: Staff lacking the time to help, Not wanting to be a burden, and Lack of confidence in staff’s knowledge.Conclusions: The participants were generally satisfied with their oral health despite an expressed need for dental treatment. Daily oral care was something they wanted to manage themselves, and they had a strong desire to stay independent for as long as possible. Closer collaboration between dental and health care staff is necessary in order to implement clinical practice guidelines for oral health care and increase nursing staff’s attention towards older peoples’ oral health.
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| 8. |
- Nilsson, Karin, 1962-
(författare)
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Adherence to Venous Blood Specimen Collection Practice Guidelines Among Nursing Students and Healthcare Staff
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Patient safety is an undisputable part of healthcare. The use of clinical practice guidelines, usually based on evidence-based practice/best practice, promotes patient safety and high quality care, reduces unnecessary patient suffering, and healthcare costs. Analysing results from venous blood specimen collection is one of the most commonly used services within healthcare, and a substantial number of decisions on diagnosis, treatment, and treatment evaluation are based on the results. Hence, the accuracy of these tests are vitally important. Earlier research has demonstrated that healthcare staff report suboptimal adherence to venous blood specimen collection guidelines together with the need for improved practices. Blood sample collection is carried out by several professionals, among them registered nurses and, as a consequence, nursing students too. University nursing students learn and practice venous blood specimen collection in one of their first semesters. After initial skill training at clinical skill laboratories, they continue to perform the task during clinical placements in various clinical settings. Few or no studies have been performed on nursing students, hence it seemed important to assess guideline adherence to venous blood specimen collection among university students as well as to further explore adherence to guidelines among healthcare staff. Therefore, the overall aim for this thesis was to explore adherence to, and factors influencing venous blood specimen collection guidelines practice among university nursing students and healthcare staff.Methods The thesis includes four studies. Study I-III had a quantitative, cross-sectional design, study IV had a qualitative approach. Study I included 164 healthcare staff from 25 primary healthcare centres. Study II included 101 nursing students in their 5th and 6th semesters, and study III included 305 nursing students in their 2nd, 4th, and 6th semesters. To assess adherence to venous blood specimen collection guidelines, data were collected using the Venous Blood Specimen Questionnaire, completed with background variables (I, II, III) and additional scales (III). Descriptive statistics, multilevel and multiple logistic regression analyses were used to analyse the data. In study IV, data were collected through five focus group interviews among 6th semester nursing students (n=26). Data were analysed using qualitative content analysis.Results Workplace affiliation was found to explain variances in reported adherence between different primary healthcare centres. Associations between reported venous blood specimen collection practices and individual as well as workplace factors were revealed. Nursing students were found to increasingly deviate from guideline adherence during their education. Also among students, several associations between guideline adherence and other ivfactors were revealed. Reported research use at clinical practice was associated with higher levels of adherence, as were higher capability beliefs regarding both evidence-based practice and academic ability. Analyses from focus group interviews summarised students’ reflections on deviations from VBSC guidelines in the overall theme ‘Striving to blend in and simultaneously follow guidelines’.Conclusion Both healthcare staff at primary healthcare centres and nursing students demonstrate decreasing levels of guideline adherence with time. Factors influencing adherence are both individual as well as contextual. This indicate that both students and staff are subjected to socialisation processes that influences levels of adherence. In order to enhance venous blood specimen collection practices and thereby patient safety, actions must be taken - both in healthcare clinical contexts and by educators. The use of models in practical skill training, and in the ambition to bridge the theory-practice gap may be the path to success. It is reasonable to assume that collaboration between, on the one hand, education representatives and on the other, supervising RNs in clinical settings, will be fruitful. Finally, by empowering students their self-efficacy may be strengthened, and hence their ability to maintain guideline adherence.
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| 9. |
- Oredsson, Sven, et al.
(författare)
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A systematic review of triage-related interventions to improve patient flow in emergency departments
- 2011
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - London : Springer Science and Business Media LLC. - 1757-7241. ; 19, s. 43-
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Forskningsöversikt (refereegranskat)abstract
- Background: Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. Methods: A systematic literature search for flow processes in emergency departments was followed by assessment of relevance and methodological quality of each individual study fulfilling the inclusion criteria. Studies were excluded if they did not present data on waiting time, length of stay, patients leaving the emergency department without being seen or other flow parameters based on a nonselected material of patients. Only studies with a control group, either in a randomized controlled trial or in an observational study with historical controls, were included. For each intervention, the level of scientific evidence was rated according to the GRADE system, launched by a WHO-supported working group. Results: The interventions were grouped into streaming, fast track, team triage, point-of-care testing (performing laboratory analysis in the emergency department), and nurse-requested x-ray. Thirty-three studies, including over 800,000 patients in total, were included. Scientific evidence on the effect of fast track on waiting time, length of stay, and left without being seen was moderately strong. The effect of team triage on left without being seen was relatively strong, but the evidence for all other interventions was limited or insufficient. Conclusions: Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.
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