| 1. |
- Andersson, Ann-Christine, et al.
(författare)
-
Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare
- 2013
-
Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 13:48
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods: A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results: The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions: The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.
|
|
| 2. |
- Backman, Sara, et al.
(författare)
-
Material Wear of Polymeric Tracheostomy Tubes : A Six-Month Study
- 2009
-
Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 119:4, s. 657-664
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objectives were to study long-term material wear of tracheostomy tubes made of silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU) after 3 and 6 months of clinical use. Study Design: The study has a prospective and comparative design. Methods: Nineteen patients with long-term tracheostomy, attending the National Respiratory Center in Sweden, were included, n = 6 with Si tubes, n = 8 with PVC tubes, and n = 5 with PU tubes. The tubes were exposed to the local environment, in the trachea for 3 and 6 months and analyzed by scanning electron microscopy, attenuated total reflectance Fourier transform infrared spectroscopy, and differential scanning calorimetry. Results: All tubes revealed severe surface changes. No significant differences were established after 3 or 6 months of exposure between the various materials. The changes had progressed significantly after this period, compared to previously reported changes after 30 days of exposure. The results from all analyzing techniques correlated well. Conclusions: All tubes, exposed in the trachea for 3-6 months, revealed major degradation and changes in the surface of the material. Polymeric tracheostomy tubes should be changed before the end of 3 months of clinical use.
|
|
| 3. |
- Berggren, Magnus, et al.
(författare)
-
Audio Processing Solution for Video Conference Based Aerobics
- 2010
-
Ingår i: 2010 Digest of Technical Papers, International Conference on Consumer Electronics. - Las Vegas : IEEE. - 9781424443147 - 9781424443161 ; , s. 407-408
-
Konferensbidrag (refereegranskat)abstract
- In this paper an audio processing solution for video conference based aerobics is presented. The proposed solution leaves the workout music unaltered by separating it from the speech and processing each signal separately. The speech signal processing is also performed at a lower sample rate, which saves computational power. Real time evaluation of the system shows that high quality music as well as a good two-way communication is maintained during the aerobic session.
|
|
| 4. |
- Björling, Gunilla, Docent, et al.
(författare)
-
Clinical use and material wear of polymeric tracheostomy tubes
- 2007
-
Ingår i: The Laryngoscope. - : Lippincott Williams & Wilkins. - 0023-852X .- 1531-4995. ; 117:9, s. 1552-1559
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objectives were to compare the duration of use of polymeric tracheostomy tubes, i.e., silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU), and to determine whether surface changes in the materials could be observed after 30 days of patient use. METHODS: Data were collected from patient and technical records for all tracheostomized patients attending the National Respiratory Center in Sweden. In the surface study, 19 patients with long-term tracheostomy were included: six with Bivona TTS Si tubes, eight with Shiley PVC tubes, and five with Trachoe Twist PU tubes. All tubes were exposed in the trachea for 30 days before being analyzed by scanning electron microscopy (SEM) and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). New tubes and tubes exposed in phosphate-buffered saline were used as reference. RESULTS: Si tubes are used for longer periods of time than those made of PVC (P < .0001) and PU (P = .021). In general, all polymeric tubes were used longer than the recommended 30-day period. Eighteen of the 19 tubes exposed in patients demonstrated, in one or more areas of the tube, evident surface changes. The morphologic changes identified by SEM correlate well with the results obtained by ATR-FTIR. CONCLUSIONS: Si tracheostomy tubes are in general used longer than those made of PVC and PU. Most of the tubes exposed in the trachea for 30 days suffered evident surface changes, with degradation of the polymeric chains as a result.
|
|
| 5. |
- Björling, Gunilla, Docent
(författare)
-
Material Wear of Medical Technical Products : Impact on patient safety
- 2018
-
Konferensbidrag (refereegranskat)abstract
- The use of a central venous catheters (CVC) always involves an increased risk of infection and thrombotic complications, subsequently increasing patient suffering, prolonged care and health care related costs. One contributing cause of infection is that the surface of the catheter is quickly colonized by bacteria, forming a biofilm, hard to reach by and/or resistant to antibiotics and the patient’s immune defense system. Catheter related thrombosis may also promote colonization of microbes on the fibrin sheet at the surface, and at the same time impact on CVC functionality by lumen occlusion or, in a rare worst-case scenario – cause life threatening embolic events. Coatings with silver or metal alloys can reduce the risk for complications. Our research group have previously identified a correlation between material degradation in medical devices used in patients and exposure time and infections. This talk will discuss the impact of material degradation of different types of CVCs used for patients undergoing chemotherapy against breast cancer. The results from an evaluation study of a anti infectious noble metal alloy coated CVC compared with an uncoated CVC for tolerability (Adverse Events, AEs), performance and noble metal durability on the surface will also be discussed.
|
|
| 6. |
- Björling, Gunilla, Docent, et al.
(författare)
-
Risk Evaluation of Therapy Medical Devices and Implants for Increased Patient Safety : REMISS Horizon 2020 Research and Innovation Action
- 2017
-
Konferensbidrag (refereegranskat)abstract
- Current knowledge in the area of medical devices remains insufficiently complete, and many of the established test methods and international standards (ISO (International Organization for Standardization) standards) open up to individual interpretation on how the test should be performed and the results reported. Treating long-term diseases such as cancer imposes a stringent sequence of various treatments on patients. For instance, cancer may be treated with radiation and chemotherapy; the latter in many treatment protocols requiring the implantation of an intravascular catheter during a prolonged period of time. To maximize the effect of such measures, as well as issues related to the patient Health Related Quality of Life (HRQoL), integrated and validated methodologies are needed as decisional basis for appropriate risk management and patient safety with regard to clinical use of intravascular catheters.The ambition of the REMISS project is to: Establish integrated and validated methodologies for risk management of the clinical use of intravascular catheters with respect to the clinical service lifetime, improved patient treatment, safety and HRQoL. This is assumed to reduce patient suffering due to complications associated with material deployment and degradation associated side effects for e.g. cancer patients receiving treatment with chemotherapeutical drugs using an intravascular catheter.The main vision is to improve the standards for eliminating side effects (complications) caused by deployment from and degradation of intravascular catheters, as well as loss of performance due to material-drug-biological system interactions, compared to the current state-of-the-art. Realising the project goals the rate of catheter-associated complications can be lowered by 40-50%, which in turn will improve patient treatment, safety and HRQoL, as well as health care related costs.Package integrally developed methodologies, predictive models, databases, and other project findings, as a potential product with a holistic coverage. It is believed that commercialisation of (selected) results will be the best option in order to create sustainable availability of this service based on continued research on intravascular catheters according to integrated and validated methodologies.REMISS answer the call NMBP-12-2017 Development of a Reliable Methodology for Better Risk Management of Engineered Biomaterials Advanced Therapy Medicinal Products and/or Medical Devices Marcy, P. Central venous access: techniques and indications in oncology. European Society of Radiology, 2008; 18; 2333-44 Maki DG, et al The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006: 81 (9): 1159-71. Frostell, C., Björling, G., Strömberg, E., Karlsson, S., and Aune, R. E., Tracheal Implants Revisited, The Lancet (2017), 389(10075) pp.1191
|
|
| 7. |
- Britt, Östlund, et al.
(författare)
-
Vidgar IT gapet mellan generationer?
- 1999
-
Ingår i: IT i demokratins tjänst. - Stockholm : SOU. - 0375-250X. - 9176107507 ; , s. 157-182
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 8. |
- Coradeschi, Silvia, et al.
(författare)
-
GiraffPlus : A System for Monitoring Activities and Physiological Parameters and Promoting Social Interaction for Elderly
- 2014
-
Ingår i: Human-Computer Systems Interaction. - Cham : Springer. - 2194-5357. - 9783319084909 - 9783319084916 ; , s. 261-271
-
Bokkapitel (refereegranskat)abstract
- This chapter presents a telehealth system called GiraffPlus supporting independent living of elderly in their own home. GiraffPlus system is a complex system which monitors activities and physiological parameters in the home using a network of sensors. The elaborated information is presented to the primary user, the elderly, and to secondary users like health care and home care providers and possibly to family members as a help to assess possible health and wellbeing deterioration, provide acute alarms, and support health procedure. The secondary users can also visit the elderly via the Giraff, a teleoperated robot that can communicate and move in the home under the control of the secondary user. The chapter focusses in particular on the deployment of the system in six real homes in Sweden, Italy and Spain. The chapter outlines the technological various components used, the expectations of the users and the evaluation method.
|
|
| 9. |
- Craftman, Åsa, et al.
(författare)
-
Unlicensed personnel administering medications to older persons living at home : a challenge for social and care services
- 2015
-
Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 10:3, s. 201-210
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.Aim. The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.Methods. Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.Results. According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.Conclusions. Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients. Implications for practice. This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.
|
|
| 10. |
- Essen, Anna, et al.
(författare)
-
Laggards as Innovators? : Old Users as Designers of New Services & Service Systems
- 2011
-
Ingår i: International Journal of Design. - 1991-3761 .- 1994-036X. ; 5:3, s. 89-98
-
Tidskriftsartikel (refereegranskat)abstract
- Involving users in the design process is increasingly discussed as the quickest and most reliable way to capture the needs of users and consumers. In parallel, the fastest growing population segment in Asia and the West is older people. This article asks whether their involvement in the design process could accelerate a growing service market and if so, how? It addresses a knowledge gap that constrains service provision for a growing market of older people and which underestimates older people's potential contribution in the early phases of the development of new services. The current role of older users is limited to that of test persons later in the design process or as objects of randomized samples that explore consumers' reactions to existing products. The present case study provides an empirical example of how old users can be involved in the early stages of service design. In doing this, the article questions the concept of old users as laggards. It suggests great potential to include such users - been arounds - as sources of innovation in the earlier phases of the design process if they have the right tools and opportunities to act. In identifying unsatisfied needs and potential market solutions, the inclusion of old users in user-driven projects can contribute to the generation of business ideas.
|
|
