1.
Fredriksson, Johan, et al.
(author)
Effects of mobile video-mediated communication for health care professionals in advanced home care of children
2014
In: 27th IEEE International Symposium on Computer-Based Medical Systems. - Los Alamitos, California : IEEE Computer Society. - 9781479944354 ; , s. 363-368, s. 363-368
Conference paper (peer-reviewed) abstract
In this paper we explore the use of a mobile video-conferencing tool (MVCT) in advanced home care of children. We present the results from a qualitative study where we have evaluated mobile video communication between the patient's home and the hospital unit. Our results show that mobile video enhances communication between home care teams and medical staff at the unit, makes more effective use of practitioners' time and that the equipment have additional values for staff that extend beyond video communication. Challenges identified are related to technical problems, limitations in the MVCT's design and the concern that the inability to handle problems may affect health care professionals' role as an authority. The benefits of the MVCT rely to a great extent on individual users' creativity and the willingness of key actors in the organization's management to find ways of improving the present home care format.
2.
Näverlo, Simon, et al.
(author)
Patient perceptions of a Virtual Health Room installation in rural Sweden
2016
In: Rural and remote health. - : ARHEN - Australian Rural Health Education Network Ltd. - 1445-6354. ; 16:4
Journal article (peer-reviewed) abstract
Introduction: The Virtual Health Room (VHR) is an ehealth initiative in the village of Slussfors in northern Sweden. Construction of VHRs in other locations is taking place, and the Centre for Rural Medicine in the Västerbotten County Council primary care department has implemented a VHR evaluation framework. This research focuses on evaluation of patient perceptions of the usability of the VHR and its contribution to their health care.Methods: Nineteen of the 25 unique users of the VHR during 2014/15 completed a survey asking about their attitudes to their own health (using the 13-question version of the Patient Activation Measure (PAM)), their demographic attributes, and their satisfaction with their visit to the VHR.Results: Respondents with lower PAM scores were less satisfied with the technical performance of the VHR, but equally likely to think the VHR made a good contribution to access to health care. In contrast, older patients were less likely to value the contribution of the VHR, but no less likely to be satisfied with its technical performance. There were no relationships between level of education and distance travelled and perceptions of the VHR.Conclusions: The research clearly demonstrated the distinction between technical performance of an ehealth initiative and its overall contribution to health care and access. Evaluation frameworks need to consider both aspects of performance. Transferability of these findings to other settings may depend at least in part on the nature of the catchment area for the VHR, with the Slussfors catchment being quite small and the impact of distance on access consequently limited.
3.
Frennert, Susanne, PhD, et al.
(author)
The concept of welfare technology in Swedish municipal eldercare
2021
In: Disability and Rehabilitation. - London : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 43:9, s. 1220-1227
Journal article (peer-reviewed) abstract
Purpose: An ageing population presents a challenge for municipal eldercare in Sweden due to difficulties recruiting staff and there being a strained economy. A strategy involving welfare technology is presented as one such solution. An important group to carry out this strategy involves those who work with welfare technology in municipal eldercare. In this paper we describe their perception of welfare technology, and the challenges and opportunities they perceive in utilizing it. Methods: A self-administered online questionnaire was distributed to all Swedish municipalities and answered by 393 respondents. Analyses show that the respondents were representative of the different professions who work with welfare technology within municipal eldercare.Results: Welfare technology was perceived as being more reliable and safer than humans with regards to supervisions and reminders. The respondents acknowledged factors that slowed down the implementation of welfare technology in municipal eldercare organizations, such as resistance to change, lack of finances, lack of supporting evidence, lack of infrastructure, high staff turnover, difficulties with procurement and uncertainties about responsibility and laws.Conclusions: We found that the people who work with and make decisions about welfare technology in municipal eldercare organizations were generally very positive about the deployment and use of such technology, but there appear to be problems within municipal eldercare organizations to realize this vision. The lack of structured implementation processes and coherent evaluation models indicates inequality of the access to welfare technology and, as a result, even though Swedish eldercare is publicly funded, the availability of welfare technologies and their usage differ between municipalities.
4.
Lindblad, Marléne, 1963-, et al.
(author)
Development of a trigger tool to identify adverse events and no-harm incidents that affect patients admitted to home healthcare.
2018
In: BMJ Quality and Safety. - : BMJ. - 2044-5415 .- 2044-5423. ; 27:7, s. 502-511
Journal article (peer-reviewed) abstract
BACKGROUND: Adverse events (AEs) and no-harm incidents are common and of great concern in healthcare. A common method for identification of AEs is retrospective record review (RRR) using predefined triggers. This method has been used frequently in inpatient care, but AEs in home healthcare have not been explored to the same extent. The aim of this study was to develop a trigger tool (TT) for the identification of both AEs and no-harm incidents affecting adult patients admitted to home healthcare in Sweden, and to describe the methodology used for this development.METHODS: The TT was developed and validated in a stepwise manner, in collaboration with experts with different skills, using (1) literature review and interviews, (2) a five-round modified Delphi process, and (3) two-stage RRRs. Ten trained teams from different sites in Sweden reviewed 600 randomly selected records.RESULTS: In all, triggers were found 4031 times in 518 (86.3%) records, with a mean of 6.7 (median 4, range 1-54) triggers per record with triggers. The positive predictive values (PPVs) for AEs and no-harm incidents were 25.4% and 16.3%, respectively, resulting in a PPV of 41.7% (range 0.0%-96.1% per trigger) for the total TT when using 38 triggers. The most common triggers were unplanned contact with physician and/or registered nurse, moderate/severe pain, moderate/severe worry, anxiety, suffering, existential pain and/or psychological pain. AEs were identified in 37.7% of the patients and no-harm incidents in 29.5%.CONCLUSION: This study shows that adapted triggers with definitions and decision support, developed to identify AEs and no-harm incidents that affect patients admitted to home healthcare, may be a valid method for safety and quality improvement work in home healthcare.
5.
Lindblad, Marléne, 1963-, et al.
(author)
Identifying no-harm incidents in home healthcare : a cohort study using trigger tool methodology
2020
In: BMC Health Services Research. - : Springer. - 1472-6963. ; 20:1, s. 1-11
Journal article (peer-reviewed) abstract
BackgroundPatient safety in home healthcare is largely unexplored. No-harm incidents may give valuable information about risk areas and system failures as a source for proactive patient safety work. We hypothesized that it would be feasible to retrospectively identify no-harm incidents and thus aimed to explore the cumulative incidence, preventability, types, and potential contributing causes of no-harm incidents that affected adult patients admitted to home healthcare.MethodsA structured retrospective record review using a trigger tool designed for home healthcare. A random sample of 600 home healthcare records from ten different organizations across Sweden was reviewed.ResultsIn the study, 40,735 days were reviewed. In all, 313 no-harm incidents affected 177 (29.5%) patients; of these, 198 (63.2%) no-harm incidents, in 127 (21.2%) patients, were considered preventable. The most common no-harm incident types were “fall without harm,” “deficiencies in medication management,” and “moderate pain.” The type “deficiencies in medication management” was deemed to have a preventability rate twice as high as those of “fall without harm” and “moderate pain.” The most common potential contributing cause was “deficiencies in nursing care and treatment, i.e., delayed, erroneous, omitted or incomplete treatment or care.”ConclusionThis study suggests that it is feasible to identify no-harm incidents and potential contributing causes such as omission of care using record review with a trigger tool adapted to the context. No-harm incidents and potential contributing causes are valuable sources of knowledge for improving patient safety, as they highlight system failures and indicate risks before an adverse event reach the patient.
6.
7.
Skagert, Katrin, 1970, et al.
(author)
A prospective study of managers' turnover and health in a healthcare organization
2012
In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 20:7, s. 889-899
Journal article (peer-reviewed) abstract
Aims To assess turnover and health of Swedish healthcare managers, and identify important supporting factors relating to work and individual resources. Background Individual managers own sustainability in terms of turnover and health may be influenced by managerial working conditions and individual resources. Methods A 4-year prospective questionnaire study of 216 healthcare managers. Turnover and indicators of good health (healthy work attendance and no burnout) were related to work factors and individual resources using Cox regressions with constant time at risk. Results Forty per cent of the healthcare managers had left after 4 years. Fifty-two per cent had a healthy work attendance record and the proportion with no burnout had increased. Experiencing moderate/high job control was a predictor of remaining in the managerial position. Good health was predicted by having energy left for domestic work and being thoroughly rested after sleep. Conclusions Managerial turnover seems high in Swedish healthcare and linked to working conditions, while sustained health are linked to individual resources. Implications for nursing management Healthcare organizations should focus not only on developing individuals in their managerial role but also on strengthening the conditions that allow managers to exercise their leadership and to ensuring that the managers most suitable for their posts do not leave.
8.
Strömgren, Marcus, et al.
(author)
Social capital among healthcare professionals : A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements
2016
In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 53, s. 116-125
Journal article (peer-reviewed) abstract
Background: Social capital can be an important resource to facilitate the needed improvements in quality of care and efficiency in hospitals. Objectives: To assess the importance of social capital (recognition, vertical trust, horizontal trust and reciprocity) for job satisfaction, work engagement and engagement in clinical improvements. Design: A prospective cohort design was used. Settings: Intensive care units and emergency, surgical and medical units at five Swedish hospitals with ongoing development of their processes of care. Participants: Healthcare professionals (physicians, registered nurses, assistant nurses) at five Swedish midsize hospitals. Methods: The participants answered a questionnaire at two occasions, NN = 1602 at baseline and NN = 1548 at one-year follow-up. Mean hospital response rate was 53% at baseline and 59% at follow-up. Univariate, multivariate and logistic regression analyses were performed, and the prospective analysis was based on 477 respondents. Results: Social capital was associated with healthcare professionals' general work engagement and job satisfaction. Analysis showed positive associations between all measured aspects of social capital and engagement in clinical improvements of patient safety and quality of care. The prospective analysis showed that increased social capital predicted increased job satisfaction, work engagement and engagement in clinical improvements of patient safety. Conclusion: Social capital is strongly related to job satisfaction and active engagement with clinical improvements. The findings contribute to a deeper knowledge of social capital as a predictive factor that influences patient safety and health among healthcare staff.
9.
Elinder, Göran, et al.
(author)
Traumatic shaking : the role of the triad in medical investigations of suspected traumatic shaking
2018
In: Acta Paediatrica. - Hoboken : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 107, s. 3-23
Research review (peer-reviewed) abstract
The Swedish Agency for Health Technology Assessment and Assesment of Social Services (SBU) is an independent national authority, tasked by the government with assessing methods used in health, medical and dental services and social service interventions from a broad perspective, covering medical, economic, ethical and social aspects. The language in SBU's reports are adjusted to a wide audience. SBU's Board of Directors has approved the conclusions in this report. The systematic review showed the following graded results:There is limited scientific evidence that the triad (Three components of a whole. The triad associated with SBS usually comprises subdural haematoma, retinal haemorrhages and encephalopathy.) and therefore, its components can be associated with traumatic shaking (low-quality evidence).There is insufficient scientific evidence on which to assess the diagnostic accuracy of the triad in identifying traumatic shaking (very low-quality evidence).Limited scientific evidence (low-quality evidence) represents a combined assessment of studies of high or moderate quality which disclose factors that markedly weaken the evidence. It is important to note that limited scientific evidence for the reliability of a method or an effect does not imply complete lack of scientific support. Insufficient scientific evidence (very low-quality evidence) represents either a lack of studies or situations when available studies are of low quality or show contradictory results. Evaluation of the evidence was not based on formal grading of the evidence according to GRADE but on an evaluation of the total scientific basis.
10.
Bergstrom, A, et al.
(author)
Evaluation of an intervention addressing a reablement programme for older, community-dwelling persons in Sweden (ASSIST 1.0): a protocol for a feasibility study
2019
In: BMJ open. - : BMJ. - 2044-6055. ; 9:7, s. e025870-
Journal article (peer-reviewed) abstract
Older persons with functional limitations often need assistance from home care staff to thrive and continue to live in their home environments. Reablement, a proactive, preventative approach administered by home care staff, stimulating active engagement of the older person, is often recommended. Even though reablement has a potential to become a new rehabilitation model and has been implemented in different countries in various degrees, there is a lack of knowledge regarding the process of establishing reablement, the theoretical underpinnings and the conditionality and outcomes in different contexts. This knowledge is needed before full-scale recommendations can be made for implementation in specific contexts.AimThis study protocol aims to present a feasibility study of the intervention, ASSIST 1.0, a theory-based reablement programme, which includes coaching of home care staff and digitally based smart products, in a Swedish context.Methods and analysisThis feasibility study will evaluate the perceived value and acceptability of ASSIST 1.0 intervention programme regarding fidelity, reach and dose, and potential outcomes by using a pretest and post-test design involving an intervention group and a control group (n=30) of older persons living at home, needing home care services. Qualitative interviews with home care staff delivering ASSIST and the older adults receiving the intervention as well as their significant others will be conducted to explore aspects affecting the intervention.Ethics and disseminationThis study has been approved by the regional ethics board. The results of the feasibility study will form the base for refinement of the ASSIST programme and for the subsequent planning of a full-scale randomised controlled trial investigating the effect of the programme on a larger scale. Dissemination will include peer-reviewed publications and presentations at national and international conferences as well as information to involved stakeholders.Trial registration numberNCT03505619
