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- Alsved, Malin, et al.
(författare)
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Airborne bacteria in hospital operating rooms during ongoing surgery
- 2018
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Konferensbidrag (refereegranskat)abstract
- IntroductionPost-operative infections obtained from open-wound surgeries constitute an unnecessary load on both healthcare and affected patients. It is well established that increased air cleanliness reduces the number of post-operative infections. Therefore, the ventilation system is important in order to reduce the number of infectious particles in the air during surgery. Ventilation with high airflow, as in operating rooms, consumes a high amount of energy and it is thus desirable to find energy efficient solutions. ObjectivesThe purpose of this work was to evaluate air quality, energy efficiency and working environment comfort for three different ventilation techniques in operating rooms. MethodThe newly developed ventilation system temperature controlled airflow (TcAF) was compared with the conventionally used turbulent mixed airflow (TMA) and laminar airflow (LAF). In total, 750 air sample measurements were performed during 45 orthopaedic operations: 15 for each type of ventilation system [1]. The concentration of colony forming units (CFU)/m3 was measured at three locations in the rooms: close to the wound (<0.5 m), at the instrument table and peripherally in the room. The working environment comfort was evaluated in a questionnaire.ResultsOur study shows that both LAF and TcAF maintains CFU concentrations in the air during ongoing surgery significantly below 10 CFU/m3 at the wound and at the instrument table, and for TcAF also in the periphery of the room, see Figure 1. The median CFU concentration in TMA was at or above 10 CFU/m3 at all locations. TcAF used less than half the airflow to that of LAF, resulting in a 28% reduction in energy consumption. The working environment comfort was perceived less noisy and having less draft in the TcAF than the LAF ventilation.SummaryBoth the LAF and TcAF ventilation maintain high air cleanliness with low CFU concentrations throughout the operation. TMA is less efficient in removing bacteria from the air close to the patient.
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- Alsved, M., et al.
(författare)
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Temperature-controlled airflow ventilation in operating rooms compared with laminar airflow and turbulent mixed airflow
- 2018
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Ingår i: Journal of Hospital Infection. - : W B SAUNDERS CO LTD. - 0195-6701 .- 1532-2939. ; 98:2, s. 181-190
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate three types of ventilation systems for operating rooms with respect to air cleanliness [in colony-forming units (cfu/m(3))], energy consumption and comfort of working environment (noise and draught) as reported by surgical team members. Methods: Two commonly used ventilation systems, vertical laminar airflow (LAF) and turbulent mixed airflow (TMA), were compared with a newly developed ventilation technique, temperature-controlled airflow (T(c)AF). The cfu concentrations were measured at three locations in an operating room during 45 orthopaedic procedures: close to the wound (<40 cm), at the instrument table and peripherally in the room. The operating team evaluated the comfort of the working environment by answering a questionnaire. Findings: LAF and T(c)AF, but not TMA, resulted in less than 10 cfu/m(3) at all measurement locations in the room during surgery. Median values of cfu/m(3) close to the wound (250 samples) were 0 for LAF, 1 for T(c)AF and 10 for TMA. Peripherally in the room, the cfu concentrations were lowest for T(c)AF. The cfu concentrations did not scale proportionally with airflow rates. Compared with LAF, the power consumption of T(c)AF was 28% lower and there was significantly less disturbance from noise and draught. Conclusion: T(c)AF and LAF remove bacteria more efficiently from the air than TMA, especially close to the wound and at the instrument table. Like LAF, the new T(c)AF ventilation system maintained very low levels of cfu in the air, but T(c)AF used substantially less energy and provided a more comfortable working environment than LAF. This enables energy savings with preserved air quality.
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- Berg, Urban, et al.
(författare)
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Fast-track program of elective joint replacement in hip and knee - Patients' experiences of the clinical pathway and care process
- 2019
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Ingår i: Journal of Orthopaedic Surgery and Research. - : Springer Science and Business Media LLC. - 1749-799X. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The clinical pathway and care program in elective total hip and knee replacement (THR/TKR) has, during the last decade, undergone considerable changes in many countries influenced by the concept of fast-track surgery, resulting in a very short hospital stay. Studies into patients' experiences of the entire fast-track program, from decision-making regarding surgery until recovery 3 months after surgery, are lacking. The aim of the study was to increase the knowledge about patients' experiences of the clinical pathway and care in a fast-track program of elective THR/TKR in order to identify factors that may influence recovery and clinical outcome. Methods: A qualitative research design was chosen with data collected from interviews 3 months after surgery and analyzed using an inductive content analysis method. In total, 24 patients from three hospitals with a fast-track care program were included in the study: 14 women and 10 men, 13 with THR and 11 with TKR. The mean age was 65 years (range 44-85). Results: The analysis identified three chronological phases in the clinical pathway: preparation, hospital stay for surgery, and recovery. In the preparation phase, patients' experiences and involvement in the planning of the operation were highlighted. The need to know the risks and expectations of recovery and outcome were also central, although there was great diversity in needs for information and involvement. In the hospital stay for the surgery phase, there were mainly positive experiences regarding admission, early mobilization, and early discharge. Experiences about the recovery phase focused on management of daily life, rehabilitation program, and recovery. Rehabilitation involved uncertainty as to whether or not the progress was normal. The recovery phase was also filled with questions about unfulfilled expectations. Regardless of the different phases, we found the importance of a person-centered care to be a pervasive theme. Conclusion: Our study supports the view that a person-centered approach, from surgery decision until recovery, is an important element in optimizing care in a THR and TKR fast-track care program. More focus on the period after hospital discharge may improve recovery, patient satisfaction, and functional outcome. © 2019 The Author(s).
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- Boström, Eva, et al.
(författare)
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Registered nurses' experiences of communication with patients when practising person-centred care over the phone: a qualitative interview study
- 2020
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Ingår i: Bmc Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background To explore registered nurses' (RNs') experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. Methods Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention practising PCC by telephone. The interviews were analysed using qualitative content analysis. Results The results reflect three categories of their experience: realize the complexity of practising PCC by distance, gain insight into what PCC communication meant to RNs and their approach, and develop the professional role by practising PCC theory and ethics. Conclusions PCC over the telephone facilitate healthcare and support patients. Through careful listening, the RNs (1) created space for the individual patients to express their thoughts and feelings and (2) emphasized each patient's capabilities and resources. The RNs also gained an understanding of PCC and what it means to patients and to themselves as practitioners. Potential implications are that it is important for RNs practising PCC by telephone to remould their role, to listen carefully, and to communicate as equals in conversations that respect both parties' knowledge and expertise. Health professionals need supervision and support to fully understand the person-centred approach and provide communications that support it.
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- Boström, Martina, et al.
(författare)
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Senior alert : a tool for better care collaboration
- 2022
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Konferensbidrag (refereegranskat)abstract
- The increasing prevalence of negative events among older frail adults is a challenge for society which calls for pro-active and preventive actions. Senior Alert (SA) is a quality-registry focusing pro-actively on 5 risk areas common among older adults: malnutrition, pressure ulcers, falls, oral health and bladder dysfunction among people = 65 years. It is mandatory to assess risks in all risk areas. SA plays an unique roll among the more than 100 national quality registries in Sweden used for quality improvements, in aspect that it also stimulate staff to perform screening, action taking, and follow-up. However, the overall potential of the register to improve the care of older adults has so far not been recognized. Although the risks are registered to a high degree, the underlying causes are not identified to the same extent. If the need for intervention is not identified, the possibilities for an effective preventive care process and effective collaboration between different actors are missed. We want to study the factors that constitute support or obstacles to the preventive care process to contribute to an effective and robust preventive care process that promotes effective collaboration between different actors for best practice care of older frail adults. The project has an interdisciplinary approach and is based on a mixed method design meaning using both quantitative and qualitative methods
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