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- Annersten Gershater, Magdalena, et al.
(författare)
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Documentation of diabetes care in home nursing service in a Swedish municipality : a cross-sectional study on nurses’ documentation
- 2011
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 25:2, s. 220-226
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess what was documented by Registered Nurses regarding diabetes care in a Swedish municipality's home nursing service; to what extent diabetes-related nursing actions were planned for, performed and evaluated according to the goals of metabolic control, treatment and prevention of complications. Design: Cross-sectional study. Subjects: Registered Nurses' documentation of patients with diabetes mellitus (n = 172). Main outcome measurers: Number of recorded different nursing actions planned, performed and evaluated. Result: The overall standard of records was insufficient. Evaluation of blood glucose levels and metabolic control was documented in 61% of the records; weight was documented in 4% of the records. Blood pressure was recorded in 10%. Ongoing foot ulcers were documented in 21%. Patient education or actions to prevent foot ulcers was not recorded. Tablet and insulin administration were well recorded. The nursing process was not followed. Study limitation: Updated medicine lists were missing in many files, this might have resulted in an underestimation of the number of included records. Conclusion: The Registered Nurses are responsible for a vulnerable patient group suffering from multi-organ disease unable to maintain their own diabetes self-care. Insufficient documentation may lead to impaired quality of care. We suggest that improved documentation routines include a structure of planning, performing and evaluation of metabolic control (blood glucose measurements, Hba1c, weight and nutrition status), complications (regular blood pressure measurements, protective foot care) and education of health care assistants in assisted diabetes self-care.
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| 2. |
- Annersten Gershater, Magdalena, et al.
(författare)
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Patient education for the prevention of diabetic foot ulcers. Interim analysis of a randomised controlled trial due to morbidity and mortality of participants
- 2011
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Ingår i: European Diabetes Nursing. - : John Wiley & Sons. - 1551-7853 .- 1551-7861. ; 8:3, s. 102-107b
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Tidskriftsartikel (refereegranskat)abstract
- This study was designed to explore whether participant-driven patient education in group sessions, compared to provision of standard information, will contribute to a statistically significant reduction in new ulceration during 24 months in patients with diabetes and high risk of ulceration. This is an interim analysis after six months. A randomised controlled study was designed in accordance with CONSORT criteria. Inclusion criteria were: age 35–79 years old, diabetes mellitus, sensory neuropathy, and healed foot ulcer below the ankle; 657 patients (both male and female) were consecutively screened. A total of 131 patients (35 women) were included in the study. Interim analysis of 98 patients after six months was done due to concerns about the patients’ ability to fulfil the study per protocol. After a six-month follow up, 42% had developed a new foot ulcer and there was no statistical difference between the two groups. The number of patients was too small to draw any statistical conclusion regarding the effect of the intervention. At six months, five patients had died, and 21 had declined further participation or were lost to follow up. The main reasons for ulcer development were plantar stress ulcer and external trauma. It was concluded that patients with diabetes and a healed foot ulcer develop foot ulcers in spite of participant-driven group education as this high risk patient group has external risk factors that are beyond this form of education. The educational method should be evaluated in patients with lower risk of ulceration. Eur Diabetes Nursing 2011; 8(3): 102–107
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| 3. |
- Annersten Gershater, Magdalena, et al.
(författare)
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Prevention of foot ulcers in patients with diabetes in home nursing : a qualitative interview study
- 2013
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Ingår i: European Diabetes Nursing. - : John Wiley & Sons. - 1551-7853 .- 1551-7861. ; 10:2, s. 52-57
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Tidskriftsartikel (refereegranskat)abstract
- Summary Diabetes mellitus and foot ulcer increase the risk of amputation, and prevention of foot ulcers are therefore important. Patients with diabetes and other concomitant diseases are often cared for in a home nursing service and the registered nurses (RNs) have the opportunity to practise preventive care to avoid foot ulcers. How prevention of foot ulcer is performed in home nursing settings has not been previously described. The objective of this study was to explore RNs’ professional work with foot ulcer prevention in home nursing settings for patients with diabetes mellitus. Qualitative interviews were analysed, using manifest content analysis. The setting was four municipalities in Sweden (large and small cities, and rural areas). Fifteen RNs actively working in a home nursing service with more than two years’ experience were recruited. The participants were all women, had worked as RNs for 3–41 years (median 25), and in home nursing for 2–18 years (median 8). The results showed that the RNs work through leadership, coordination, education and evaluation. Health care assistants perform most of the nursing actions to prevent foot ulcers such as assessment of feet, off-loading, nutrition and hygiene. The RNs have medical and nursing responsibility but without the formal tools to execute this fully. The RNs’ formal education was some years back and they relied mostly on experience-based knowledge. It was concluded that patient assessment and nursing actions to prevent foot ulcers are mostly performed by health care assistants. The RNs need to be given formal responsibility in their role as leaders and educators, and need more education in pedagogy and leadership. Eur Diabetes Nursing 2013; 10(2): 52–57 Key words diabetes; diabetic foot ulcer; education; elderly; foot care; foot health; nursing; home care; pressure ulcer; prevention
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| 7. |
- Campbell, Ann-Mari, et al.
(författare)
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Night duty as an opportunity for learning
- 2008
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Ingår i: Journal of Advanced Nursing. - : Blackwell Publishing ltd. - 0309-2402 .- 1365-2648. ; 3:62(3), s. 346-353
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Tidskriftsartikel (refereegranskat)
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| 8. |
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| 9. |
- Carlson, Elisabeth, et al.
(författare)
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The team builder : the role of nurses facilitating interprofessional student teams at a Swedish clinical training ward
- 2011
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 11:5, s. 309-313
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Tidskriftsartikel (refereegranskat)abstract
- Interprofessional education (IPE) is an educational strategy attracting increased interest as a method to train future health care professionals. One example of IPE is the clinical training ward, where students from different health care professions practice together. At these wards the students work in teams with the support of facilitators. The professional composition of the team of facilitators usually corresponds to that of the students. However, previous studies have revealed that nurse facilitators are often in the majority, responsible for student nurses’ profession specific facilitation as well as interprofessional team orientated facilitation. The objective of this study was to describe how nurses act when facilitating interprofessional student teams at a clinical training ward. The research design was ethnography and data were collected through participant observations and interviews. The analysis revealed the four strategies used when facilitating teams of interprofessional students to enhance collaborative work and professional understanding. The nurse facilitator as a team builder is a new and exciting role for nurses taking on the responsibility of facilitating interprofessional student teams. Future research needs to explore how facilitating nurses balance profession specific and team oriented facilitating within the environment of an interprofessional learning context.
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| 10. |
- Carlson, Elisabeth, et al.
(författare)
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"This is nursing": Nursing roles as mediated by precepting nurses during clinical practice
- 2010
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Ingår i: NURSE EDUCATION TODAY. - : Elsevier. - 0260-6917 .- 1532-2793. ; 30:8, s. 763-767
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Tidskriftsartikel (refereegranskat)abstract
- In nursing education, it has been argued that professional socialization is facilitated by clinical experiences where students work together with precepting nurses. However, few studies found have focused on how nurses think and act as preceptors, hence providing a base for professional socialization to occur. Therefore; this study aimed to describe how preceptors mediated nursing as a profession to undergraduate nursing students during clinical practice. This was an ethnographic study guided by symbolic interactionism. A purposeful sampling of 13 precepting nurses was observed during the field work period. In addition, 16 staff nurses, purposively selected, and experienced in precepting, participated in focus group interviews. All text from field notes and interviews were read as a whole and analyzed following the ethnographic approach. Findings illustrated how nursing was mediated as the medical–technical, the administrative, and the caring role. Preceptors aimed for professionalism in their students by teaching the students to reflect on what they can do independently as nurses. Preceptors strived to verbalise their practical knowledge to make theory explicit and contextualize to student nurses. This knowledge can guide implementation of preceptor programmes focusing on the meaning and implications of professionalism.
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