| 1. |
- Allemann, Hanna, et al.
(författare)
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Nurses' actions in response to nursing assistants' observations of signs and symptoms of infections among nursing home residents
- 2015
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Ingår i: Nursing Open. - : Wiley-Blackwell. - 2054-1058. ; 2:3, s. 97-104
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo describe what nurses do during episodes of suspected infection in elderly nursing home residents and if these actions are linked to who is initiating an episode and whether the episode is considered an infection or not.DesignProspective descriptive study. Data were collected in 2008–2010.MethodsSummarized and categorized documentation by nursing assistants and nurses was used for summative content analysis.ResultsNurses' actions seem to be related to who initiated the episode and if the episodes are categorized as ‘non-infection’, ‘possible infection’ or ‘infection’. Actions could be ‘observation’, ‘screenings’, ‘engaged in waiting’, ‘follow-ups’, ‘nurse-prescribed actions’, ‘diagnosing’, ‘contacting the physician’, ‘carrying out an action prescribed by the physician’, ‘contacting an ambulance or arranging an emergency visit to the hospital’ and ‘prescribing screening’. As NAs often initiate episodes of suspected infection by observing changed conditions, it seems important to include the NA in the decision-making process as these observations could detect possible early signs and symptoms of infections.
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| 2. |
- Carina, Hellqvist, et al.
(författare)
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A national Swedish self- management program for people with Parkinson’s disease : patients and relatives view
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To identify and describe experiences that people with PD and their relatives after participation inthe self-management intervention NPS (National Parkinson School) find valuable for managing daily life. Background: A self-management program called NPS was developed as a collaboration of healthcare providers, researchers and patient organizations. NPS is aiming to provide tools and strategies for people with PD and their relatives to increase ability to manage symptoms and consequences of disease and thereby improving conditions for a good life. Self-monitoring and self-management are central concepts. NPS focuses on life with PD, which via 7 sessions consisting of education/lectures and group discussions are mediated. Home assignments make participants practice the new skills in their own life. Methods: The last session, evaluation of the NPS, was audio recorded in its whole and transcribed verbatim. Data was collected from five separate clinics and analysed both inductively and deductively usingThematic Analysis and by applying the Self-and Family management theory. Results: Through inductive analysis three themes; Exchanging experiences and feeling support, Adjustment and acceptance of PD for managing daily life and Promoting life satisfaction, were identified and described. The themes are capturing the meaning, value and experience of being a participant of NPS. Deductive analysis indicated thatthe Self-and Family management theory was useful and valid for this group of patients and generated a modified framework applicable for patients with PD and their families [figure1]. Conclusions: Living with PD affects patients as well as relatives. Meeting others in the same situation gives support and strengthen their self- image. Having the opportunity sharing experiences and practical advices showed that there was a hopeful future to come. Techniques to accept and manage life with PD included seeking information about disease and treatments, self-monitoring in order to adjust to new situations and improve symptoms of disease and having a positive mind-set. Living an active life, participating in enjoyable social, cultural, and physical activities were important to feel happy and satisfied with life. Participation in NPS covered many areas of importance for the ability of self-management in PD. The framework for self-management in chronic disease was found relevant also for the PD population
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| 3. |
- Edberg, Anna-Karin, et al.
(författare)
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Vanliga symtom hos äldre
- 2017
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Ingår i: Omvårdnad & äldre. - Lund : Studentlitteratur. ; , s. 355-395
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Sund Levander, Märta Helena, et al.
(författare)
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Fever or not fever - that's the question : A cohort study of simultaneously measured rectal and ear temperatures in febrile patients with suspected infection
- 2018
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Ingår i: Clinical Nursing Studies. - Toronto, Canada : Sciedu Press. - 2324-7940 .- 2324-7959. ; 6:2, s. 47-54
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study how ear and rectal body temperatures relate to each other over time in febrile patients.Methods: Descriptive cohort study with repeated measurements. The setting was a Unit for Infectious Diseases at a county hospital in Sweden. Patients, ≥ 18 years, admitted for suspected infection and with a rectal or ear temperature of ≥ 37.5°C were invited. 16 females and 24 men, 19 to 94 years were included. Ear and rectal temperature was measured simultaneously every two hours for one day.Results: Mean rectal temperature was higher, compared to both ear sites. Ninety-five percent of the differences between the rectal and ear sites were within 0.6°C to 1.1°C. Changes in rectal temperature were smaller and slower than in ear temperature, especially when patients were given temperature-lowering drugs.Conclusions: Adjustments from one temperature site to another is a risk of diagnostic error affecting clinical decision-making. Ear temperature reacts faster than the rectal site to body temperature changes and antipyretics, and is therefore more reliable in the assessment of the patient’s condition. Traditional paradigm for temperature measurement and assessment needs to be replaced with evidence-based science to improve patient safety.
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| 5. |
- Sund-Levander, Märta, et al.
(författare)
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The Challenge of Infections in Frail Elderly : The Story of Mr. Nilsson
- 2015
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Ingår i: Clinical Medical Reviews and Case Reports. - : ClinMed International Library. - 2378-3656. ; 2:9
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Tidskriftsartikel (refereegranskat)abstract
- Signs and symptoms of infection in Nursing Home Residents (NHR) are often atypical with a lack of specific ones, causing a delay in diagnosis and treatment. The complexity of detecting infections in NHR can be explained by difficulties in understanding and interpreting non-specific signs and symptoms and co-existing chronic diseases that blur the clinical picture. The case of Mr. Nilsson illustrates the process from the first signs and symptoms of infection to diagnosis in an elderly person with severe cognitive decline and physical impairment. What we can learn from this case is to reflect on changed behavior from habitual status and/or non-specific symptoms as possible suspected infection, and to consider a rise from individual baseline temperature, so called DiffTemp™, instead of traditional decided cut-off values for fever.
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| 6. |
- Toros, Andrew, et al.
(författare)
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Use of temperature changes and pro-inflammatory biomarkers to diagnose bacterial infections in patients with severe cerebral trauma
- 2022
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Ingår i: Journal of Neurocritical Care. - : Korean Neurocritical Care Society. - 2508-1349. ; 15:1, s. 21-31
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn patients undergoing neurosurgeries, inflammation and infection are strongly related; however, inflammation can be present without infection. Midregional proadrenomedullin (MR-proADM) is a relatively new sepsis biomarker that is rarely used clinically. Recently, the concept of DiffTemp was introduced, that is, a >1°C rise from individual normal temperature accompanied by malaise, as a more accurate definition of temperature assessed as fever. The aim of the present study was to examine the importance of C-reactive protein (CRP), white blood cells, procalcitonin, and MR-proADM levels and DiffTemp.MethodsThis prospective, comparative study had a quantitative approach. Forty-two patients, aged >18 years and presenting with severe cerebral trauma were included from a neurosurgical intensive care unit. The outcome variable was infection; group 0, no infection (n=11); group 1, suspected infection (n=15); and, group 2, confirmed infection (n=16). Group assignments were performed using biomarkers, medical records, bacterial cultures, and International Classification of Diseases-10, and by the clinical assessment of criteria for nosocomial infections by a neurosurgeon.ResultsOn comparing groups 1 and 2, MR-proADM and DiffTemp were associated with a higher risk of confirmed infection (odds ratio, 5.41 and 17.14, respectively). Additionally, DiffTemp had a 90.9% specificity in patients with no infection and a 93.8% sensitivity in patients with confirmed infections. CRP and procalcitonin levels were not associated with an increased risk of confirmed infection.ConclusionIncreased levels of MR-proADM were associated with a higher risk of confirmed infection. DiffTemp was associated with a higher risk of having a confirmed infection.
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