| 1. |
- Swenne, C.L., et al.
(författare)
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Patients' experiences of mediastinitis after coronary artery bypass graft procedure
- 2007
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Ingår i: Scandinavian Cardiovascular Journal. - 1401-7431 .- 1651-2006. - 1401-7431 ; 41:4, s. 255-264
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have focussed on patients' experiences of and suffering due to mediastinitis following Coronary Artery by-pass Graft ( CABG). Mediastinitis creates a complex and invasive experience for the patient with prolonged hospitalisation, and would be expected to be a significant stressor. The aim of the present study was to capture patients' experiences of the medical and nursing care they received for mediastinitis following CABG. Content analysis revealed three themes with regard to how the patients coped with the stress and threats of mediastinitis and its treatment and how they thought it would influence their future life. A first theme centred on physical and psychological discomfort and impact on autonomy. The staff's medical knowledge and the quality of nursing care as well as the patients' understanding of the situation influenced their experience. A second theme was how patients dealt with perceived danger and stress. Coping strategies such as problem solving, information seeking, dissociation, distraction, minimisation and expression of emotion were used to handle the situations. The third theme comprised the patients' belief that the mediastinitis would not affect the outcome of the CABG procedure, even though their confidence in this was influenced by uncertainty about the rehabilitation process.
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| 2. |
- Skytt, Bernice, 1957-, et al.
(författare)
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A longitudinal qualitative study of health care personnel’s perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 25:13/14, s. 1912-1922
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesIn this study, the aim was to understand health care personnel's expectations and experiences of participating in an intervention aimed at the implementation of three assessment scales for fall injuries, malnutrition and pressure ulcers, and the performance of preventive measures in these areas over the period of 18 months.BackgroundFall injuries, malnutrition and pressure ulcers among older people are challenging issues for caregivers at different levels in the health care system.DesignA descriptive design with a qualitative approach was used to follow health care personnel before, during and after implementation of a care prevention intervention.MethodsTwelve health care personnel with different professions at the hospital, primary care and municipal care levels participated in a preventive care introduction. Seminars were held at four occasions, with assignments to be completed between seminars. Lectures and group discussions were performed, and three risk assessment scales were introduced. The participants were interviewed before, during and after the introduction. Manifest and latent content analysis were used.ResultsThe main results are presented in the theme ‘Patient needs are visualised through a gradually developed shared understanding’ and in five categories. The work approach of performing three risk assessments simultaneously was perceived as positive and central to ensuring quality of care; it was not, however, perceived as unproblematic.ConclusionThe participants as well as health care team members showed a positive attitude towards and described the advantages of being given opportunities for shared understanding to improve patient safety and to provide structure for the provision of good care.Relevance to clinical practiceThe managerial approach of listening to and acting on issues stressed by health care personnel is important to ensure ongoing and future improvement initiatives.
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| 3. |
- Arvidsson, Lisa, et al.
(författare)
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Healthcare personnel's working conditions in relation to risk behaviours for organism transmission : A mixed-methods study
- 2022
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 31:7-8, s. 878-894
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To investigate healthcare personnel's working conditions in relation to risk behaviours for organism transmission.BACKGROUND: Healthcare personnel's behaviour is often influenced by working conditions that in turn can impact the development of healthcare-associated infections. Observational studies are scarce, and further understanding of working conditions in relation to behaviour is essential for the benefit of the healthcare personnel and the safety of the patients.DESIGN: A mixed-methods convergent design.METHODS: Data were collected during 104 h of observation at eight hospital units. All 79 observed healthcare personnel were interviewed. Structured interviews covering aspects of working conditions were performed with the respective first-line manager. The qualitative and quantitative data were collected concurrently and given equal priority. Data were analysed separately and then merged. The study follows the GRAMMS guidelines for reporting mixed-methods research.RESULTS: Regardless of measurable and perceived working conditions, risk behaviours frequently occurred especially missed hand disinfection. Healthcare personnel described staffing levels, patient-level workload, physical factors and interruptions as important conditions that influence infection prevention behaviours. The statistical analyses confirmed that interruptions increase the frequency of risk behaviours. Significantly higher frequencies of risk behaviours also occurred in activities where healthcare personnel worked together, which in the interviews was described as a consequence of caring for high-need patients.CONCLUSIONS: These mixed-methods findings illustrate that healthcare personnel's perceptions do not always correspond to the observed results since risk behaviours frequently occurred regardless of the observed and perceived working conditions. Facilitating the possibility for healthcare personnel to work undisturbed when needed is essential for their benefit and for patient safety.RELEVANCE FOR CLINICAL PRACTICE: The results can be used to enlighten healthcare personnel and managers and when designing future infection prevention work.
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| 4. |
- Arvidsson, Lisa, et al.
(författare)
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Nurses’ assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress
- 2023
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 74:2, s. 501-513
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Nurses’ working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees’ behaviour at work. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions.OBJECTIVE: To investigate the relationship between nurses assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress.METHODS: A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions of Work Effectiveness Questionnaire-II, Utrecht Work Engagement Scale-9 and the Health & Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed.RESULTS: The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis were 0.254–0.268. Significant differences in self-efficacy were found in the grouped working conditions.CONCLUSIONS: This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.
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| 5. |
- Arvidsson, Lisa, et al.
(författare)
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Nurses' assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress
- 2023
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 74:2, s. 501-513
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Nurses' working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees' behaviour atwork. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions.OBJECTIVE: To investigate the relationship between nurses' assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress.METHODS: A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions ofWork Effectiveness Questionnaire-II, the UtrechtWork Engagement Scale-9 and the Health& Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed.RESULTS: The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and selfefficacy to medical asepsis were 0.254-0.268. Significant differences in self-efficacy were found in the grouped working conditions.CONCLUSIONS: This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.
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| 6. |
- Engström, Maria, et al.
(författare)
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Staff Working Life and Older Persons' Satisfaction With Care : A Multilevel, Correlational Design
- 2021
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Ingår i: Journal of Nursing Care Quality. - : Lippincott Williams & Wilkins. - 1057-3631 .- 1550-5065. ; 36:1, s. E7-E13
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Tidskriftsartikel (refereegranskat)abstract
- Background: The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care.Purpose: The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care.Methods: A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care.Results: Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment.Conclusions: Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.
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| 7. |
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| 8. |
- Lindberg, Maria, 1977-, et al.
(författare)
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A complex challenge with unclear improvement : the need for involvement, contextualization and facilitation when managers implement a leadership model
- 2023
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Ingår i: Leadership in Health Services. - : Emerald Group Publishing Limited. - 1751-1879 .- 1751-1887. ; 36:2, s. 236-246
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager's job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers' perceptions of, prerequisites for and experiences from the implementation of changes in their manager's work conditions. Design/methodology/approach A grounded theory-based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis. Findings Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers' descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process. Originality/value This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.
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| 9. |
- Lindberg, Maria, et al.
(författare)
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A complex challenge with unclear improvement: the need for involvement, contextualization and facilitation when managers implement a leadership model
- 2023
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Ingår i: Leadership in Health Services. - : Emerald. - 1751-1879 .- 1751-1887. ; 36:2, s. 236-246
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Tidskriftsartikel (refereegranskat)abstract
- PurposeManagement and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager’s job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers’ perceptions of, prerequisites for and experiences from the implementation of changes in their manager’s work conditions.Design/methodology/approachA grounded theory–based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis.FindingsThree thematic areas were identified: engagement, facilitation and achievement. The second-line managers’ descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process.Originality/valueThis study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.
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| 10. |
- Lindberg, M., 1977-, et al.
(författare)
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Continued wearing of gloves : a risk behaviour in patient care
- 2020
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Ingår i: Infection Prevention in Practice. - : Elsevier. - 2590-0889. ; 2:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: The wearing of gloves is included in the standard principles for preventing healthcare associated infections. A continued wearing of gloves may, however, result in the transmission of organisms instead of preventing infections. Few studies have explored how common it is for surfaces to be touched by potentially contaminated gloves.Methods: Secondary analysis of field notes from 48 hours of unstructured observations of healthcare personnel's actions during patient care. The new focus was on to what extent healthcare personnel wore gloves that should have been removed or changed, what sur-faces were touched by contaminated gloves and what patient-related activities were involved.Results: A continued wearing of gloves occurred in about half of the observed episodes of patient care. On average, 3.3 surfaces were touched by contaminated gloves. The surfaces most frequently touched were 'unused single-use items', 'equipment controls/switches/ regulators/flush buttons' and 'bed linen'. This occurred mostly while helping patients with 'personal hygiene', when performing 'test taking' or during procedures involving the operation of medical or other 'equipment'.Conclusion: The continued wearing of gloves during patient-related activities carries the risk of organism transmission, as the gloves touch many surfaces. The most critical moments seem to be when the use of gloves is considered essential. A better under-standing of the motivators of improper glove-use behaviour is needed to develop inter-ventions that rectify the improper use of gloves.
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