| 1. |
- Stevenson-Ågren, Jean, et al.
(författare)
-
Factors influencing the quality of vital signs data in electronic health records : a qualitative study
- 2018
-
Ingår i: Journal of Clinical Nursing. - New Jersey : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 27:5-6, s. 1276-1286
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesTo investigate reasons for inadequate documentation of vital signs in an electronic health record.BackgroundMonitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent.DesignQualitative study.MethodsQualitative study. Data were collected by observing (68 hr) and interviewing nurses (n = 11) and doctors (n = 3), and analysed by thematic analysis to examine processes for measuring, documenting and retrieving vital signs in four clinical settings in a 353-bed hospital.ResultsWe identified two central reasons for inadequate vital sign documentation. First, there was an absence of firm guidelines for observing patients’ vital signs, resulting in inconsistencies in the ways vital signs were recorded. Second, there was a lack of adequate facilities in the electronic health record for recording vital signs. This led to poor presentation of vital signs in the electronic health record and to staff creating paper “workarounds.”ConclusionsThis study demonstrated inadequate routines and poor facilities for vital sign documentation in an electronic health record, and makes an important contribution to knowledge by identifying problems and barriers that may occur. Further, it has demonstrated the need for improved facilities for electronic documentation of vital signs.Relevance to clinical practicePatient safety may have been compromised because of poor presentation of vital signs. Thus, our results emphasised the need for standardised routines for monitoring patients. In addition, designers should consult the clinical end-users to optimise facilities for electronic documentation of vital signs. This could have a positive impact on clinical practice and thus improve patient safety.
|
|
| 2. |
- Stevenson-Ågren, Jean, et al.
(författare)
-
Recording signs of deterioration in acute patients : The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest
- 2016
-
Ingår i: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 22:1, s. 21-33
-
Tidskriftsartikel (refereegranskat)abstract
- Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPACTM Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety.
|
|
| 3. |
|
|
| 4. |
- Bitar, Dima, et al.
(författare)
-
Application to promote communication between midwives and Arabic-speaking women at antenatal care : Challenges met by researchers when developing content
- 2022
-
Ingår i: European Journal of Midwifery. - : European Publishing. - 2585-2906. ; 6
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION Providing good communication is at the core of recent international guidelines for improving women's outcomes at birth. Communication barriers are identified as major obstacles to providing effective and equal care among foreign-born women. There is a need for accurate communication tools in antenatal care. The aim of this study was to describe challenges met by researchers when developing culturally sensitive content in a Swedish-Arabic application for communication support at antenatal care in Sweden. METHODS A co-design methodology was used for the development of the application, entailing collaboration between users and researchers in five different phases: users' needs and preferences, development, field testing I, refinement, and field testing II. RESULTS Five challenges emerged: evidence-based information, time frame, realistic photographs, norm-critical perspective, and cultural issues. One challenge was to meet the needs of the users and combine it with information following evidence-based obstetric welfare guidelines. It was also challenging to produce short informational videos that could be adjusted for the duration of the visit with the midwife without omitting important information and to produce photographs which can become outdated. It was also a challenge to portray a less clinical environment and to maintain parents' integrity. It was also challenging to produce norm-critical content from the women's perspective. CONCLUSIONS When developing content of an application for antenatal care, converting content proposals into a finished product is challenging. Collaboration between a cross-disciplinary research team, midwives and target-language women is essential to ensure that the content is usable and reliable.
|
|
| 5. |
- Byrman, Gunilla, 1953-, et al.
(författare)
-
Sadima : Vänta barn på arabiska, engelska och svenska! Effektiv och integrerande design för interaktiv mödrahälsovård
- 2020
-
Annan publikation (mjukvara/multimedium) (refereegranskat)abstract
- Målet har varit att göra ett effektivt, integrerande och interaktivt dialogstöd (https://sadima.lnu.se/). Stödet är avsett att användas i mödravårdssamtal mellan kvinnor med begränsade kunskaper i svenska och svensktalande barnmorskor och är ett komplement till tolk. Samtalsstödet finns på arabiska, engelska, svenska och är fritt tillgängligt på internet. Vi vill uppnå förbättrad och effektiviserad kommunikation mellan barnmorskor och kvinnor. Samtalsstödet ska leda till ökad patientsäkerhet med färre komplikationer och minskad sjuklighet och dödlighet bland kvinnorna och deras barn, och därigenom öka vårdkvaliteten och effektivisera bruket av samhälleliga resurser. Avsikten är att sprida och nyttiggöra samtalsstödet till ansvariga i Sveriges Kommuner och Regioner (SKR) och samordningsbarnmorskor i Sverige. Stödet består av en del där information kan inhämtas och en del där information kan ges om graviditet, förlossning och preventivmedel. Genom webbsidan ska mödrahälsovården göras mer jämlik och kommunikativ, med ökad patientsäkerhet och egenmakt för kvinnor i mödravården.Vi har analyserat material med språkliga, normkritiska och vårdvetenskapliga metoder. I projektet har appen Sadima utvecklats i två versioner, en första testversion och sedan en andra version som utformats som en webbsida. För utvecklandet av den första versionen av appen fick vi medel av Vinnova (2016–2019). Vi arbetade med barnmorskor och skapade en testapp som sedan reviderades och förbättrades successivt genom forskning om kvinnornas och barnmorskornas erfarenhet av att använda samtalsstödet. Det befintliga stödets innehåll är patientsäkrat av läkare och barnmorskor i Region Kalmar. Vi har mätt funktionaliteten i samtalsstödet genom iterativa tester, enkäter och fokusgrupper med barnmorskor och arabisktalande kvinnor, där stödets information har problematiserats; det har gällt etnicitet (språk och kultur), klass (utbildning) och jämlikhet mellan kvinnor. Mätningarna har granskats och utvärderats av referensgruppen för bedömning av funktionaliteten hos samtalsstödet. Gruppen har bedömt att samtalsstödet bidragit till bättre förståelse, ökad patientsäkerhet och effektivare vård.
|
|
| 6. |
- Israelsson, Johan, 1970-, et al.
(författare)
-
Post cardiac arrest care and follow-up in Sweden – a national survey
- 2016
-
Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955 .- 1472-6955. ; 15:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundRecent decades have shown major improvements in survival rates after cardiac arrest. However, few interventions have been tested in order to improve the care for survivors and their family members. In many countries, including Sweden, national guidelines for post cardiac arrest care and follow-up programs are not available and current practice has not previously been investigated. The aim of this survey was therefore to describe current post cardiac arrest care and follow-up in Sweden.MethodsAn internet based questionnaire was sent to the resuscitation coordinators at all Swedish emergency hospitals (n = 74) and 59 answers were received. Quantitative data were analysed with descriptive statistics and free text responses were analysed using manifest content analysis.ResultsAlmost half of the hospitals in Sweden (n = 27, 46 %) have local guidelines for post cardiac arrest care and follow-up. However, 39 % of them reported that these guidelines were not always applied. The most common routine is a follow-up visit at a cardiac reception unit. If the need for neurological or psychological support are discovered the routines are not explicit. In addition, family members are not always included in the follow-up.ConclusionsAlthough efforts are already made to improve post cardiac arrest care and follow-up, many hospitals need to focus more on this part of cardiac arrest treatment. In addition, evidence-based national guidelines will have to be developed and implemented in order to achieve a more uniform care and follow-up for survivors and their family members. This national survey highlights this need, and might be helpful in the implementation of such guidelines.
|
|
| 7. |
- Oscarsson, Marie, 1956-, et al.
(författare)
-
Midwives' experiences of caring for immigrant women at antenatal care
- 2020
-
Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 24:June, s. 1-6
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe aim of this study was to describe Swedish midwives’ experiences of caring for immigrant women at antenatal care clinics.MethodsFive group interviews and one individual interview were conducted with 16 midwives working in the maternity care. The interviews were transcribed and analysed with latent content analysis.ResultsThree main categories emerged: 1) Be able to convey and receive information. Communication was influenced by the women's educational level and previous experiences. The interpreter's competence was of great importance, but also if the midwife was able to create a trusting relationship with the woman. 2) Experience other cultures. The midwife's duties and responsibilities differed from the woman's expectations of the visit. The woman's family was of great importance and influential. 3) Midwife's role and work situation. Midwives’ working conditions were challenged and they developed strategies to cope with this; however, they desired support and time for reflection and processing.ConclusionCommunication difficulties were cultural and linguistic in nature, and required extra care. This can be achieved if the midwife has time, but also support in managing cultural differences. In the future, new communication tools and ways of communicating must be developed.
|
|
| 8. |
- Stevenson-Ågren, Jean, Senior lecturer, et al.
(författare)
-
A bilingual evidence-based app to improve communication in maternity care
- 2019
-
Ingår i: Nursing World Congress on Nursing Education and Practice.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background. Sweden, with a population of 10 million, received approximately 300,000 refugees 2015-2016 (The Statistics Portal 2018), the majority from Arabic-speaking countries, many of whom were women of child-bearing age. Midwives in pre-natal care experienced communication problems despite telephone interpreters. Studies have shown that immigrant women have poorer outcomes in pregnancy (Bollini et al. 2009). This has been linked to communication and cultural difficulties. Although there are many health-related applications (apps), many are not evidence-based (Lewis & Wyatt 2014). AimThe aim of this project was to develop an evidence-based app to promote effective communication between midwives and Arabic-speaking women. MethodsA multi-disciplinary team was formed to develop a bilingual app in cooperation with midwives who worked in pre-natal care. End-user perspectives were prioritised. Data were collected by 1) focus group interviews to determine the objectives of maternity care, 2) observations to gain understanding of work processes and 3) workshops to discuss material with midwives and refine content according to user-needs. All material was further validated by professional midwifery sources.ResultsAn evidence-based, multi-modal, bilingual app with text, images and voiced recordings was developed to use as a complement to interpreters in pre-natal care. Both midwives and the pregnant women feel empowered; midwives do not have to risk inadequate translation by interpreters; women receive accurate information. Women receive information directly from the midwife through the app, rather than depending on an interpreter. ConclusionsThis app contributes to ensuring equity of care within midwifery services. It provides improved communication within pre-natal care to help promote safe pregnancy and delivery of a healthy baby. ReferencesBollini, P., Pampallona, S., Wanner, P., & Kupelnick, B. (2009). Pregnancy outcomes of migrant women and integration policy: a systematic review of the international literature. Soc Sci Med, 68, 452-461. Lewis T and Wyatt J. mHealth and Mobile Medical Apps: A Framework to Assess Risk and Promote Safer Use. Journal of Medical Internet Research. 2014; 16: e210.The Statistics Portal. (2018). Number of immigrants in Sweden from 2007 to 2017. Retrieved from https://www.statista.com/statistics/523293/immigration-to-sweden/
|
|
| 9. |
- Stevenson-Ågren, Jean
(författare)
-
A project to promote equality in ante-natal care for women who do not speak Swedish
- 2017
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundHealth care in Sweden aims to be equal. In antenatal care, women who do not speak Swedish have a higher rate of maternal and infant mortality (Essen et al. 2001, Wahlberg et al. 2013). Cultural and communicative problems have been identified as one reason for this disparity. Due to recent immigration, Arabic-speaking women (ASW) have been identified as a vulnerable group. Technology has the potential to solve language and cultural barriers (Haith-Cooper 2014). A pilot study in which midwives were interviewed suggested that an ‘app’ for a tablet with multimodal components could be an aid to cultural and linguistic understanding (Axelsson et al. 2016). AimThe aim of the project is to identify women’s and midwives’ information needs and cultural issues, and subsequently, to develop an app with norm-critical design for interactive communication in antenatal care (ANC). The app will serve as a complement to interpreters and provide essential information about ANC.MethodTwo data collection methods will be used. The first is to observe meetings between midwives and pregnant women. The second is to interview midwives in focus groups so that they can freely express their wishes. Following this, a trial version of the app will be constructed, which will then be tested and evaluated iteratively in midwifery practice. The material will be analysed in workshops using linguistic and norm critique methods.ResultsThe app is expected to improve and ensure the quality of ANC for ASW and improve their understanding of pregnancy, fetal development and parenting. It will hlep midwives to be sure that women have been given the correct information and improve patient safety. We will improve our own understanding of the risks in communication that can arise when two parties do not understand each other, and of how communication can be promoted through an app. ReferencesEssen, B. et al. (2001) Increased perinatal mortality among sub-Saharan immigrants in a city-population in Sweden. [Dissertation]. Malmö and Lund: Lund University; 2001.Haith-Cooper, M. (2014) Mobile translators for non-English-speaking women accessing maternity services. British Journal of Midwifery. 2014; 22: 795-803. http://www.magonlinelibrary.com/doi/abs/10.12968/bjom.2014.22.11.795Axelsson, C. et al. (2016). ”Det kan bli så mycket fel”: Förstudie om barnmorskors upplevelser av kommunikation med gravida kvinnor utan funktionell behärskning av svenska. Kalmar/Växjö: Linnéuniversitetet.Wahlberg, A. et al. (2013) Increased risk of severe maternal morbidity (near-miss) among immigrant women in Sweden: a population register-based study Epidemiology. 2013 Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala, Sweden
|
|
| 10. |
- Stevenson-Ågren, Jean, Senior lecturer, et al.
(författare)
-
Designing an App for Maternity Care : Improving Communication between Swedish Midwives and Arabic-speaking Women
- 2022
-
Ingår i: Proceedings of the 18<sup>th</sup> International Symposium on Health Information Management Research. - : Linnaeus University Press. - 9789189081093
-
Konferensbidrag (refereegranskat)abstract
- Good communication is essential for good healthcare. In maternity care, inadequate communication may contribute to poorer outcomes in pregnancy. A large number of Syrian, Arabic-speaking immigrants arrived in Sweden in 2015-2016. A trans-disciplinary team acted as intermediaries between midwives and a technical company to develop a Swedish-Arabic communication app for use in antenatal care. An earlier study describes the creation of the content and the development of the prototype. This paper describes the next phase of the study, i.e., testing the prototype, refining the structure and content, and development of the next version. A user-centred approach with a norm critical perspective was applied. Workshops and observations were performed for interaction between the midwives and the research group, facilitating development from a user perspective. A final version of the app was developed. Future plans are to evaluate the app and produce a Swedish-English version.
|
|
