| 1. |
- Adrian, Maria, et al.
(författare)
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Research protocol for mechanical complications after central venous catheterisation : a prospective controlled multicentre observational study to determine incidence and risk factors of mechanical complications within 24 hours after cannulation
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:10, s. 029301-029301
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Central venous catheterisation is a common procedure in intensive care therapy and the use of central venous catheters is essential for treatment of many medical disorders. Although rare, central venous catheterisation is associated with mechanical complications that can be life-threatening if untreated. Real-time ultrasound guidance reduces the incidence of mechanical complications when compared with the anatomic landmark method. The purpose of this study is to determine the incidence of and potential risk factors associated with early mechanical complications of central venous catheterisation in an era where real-time ultrasound guidance has become clinical practice. METHODS AND ANALYSIS: This is a prospective, controlled, multicentre, observational study. All participating hospitals follow the same clinical guidelines for central venous catheterisation. Each central venous catheter insertion will be recorded in the common electronic chart system according to a recently revised template. An automated script-based search will identify all recorded central venous catheter insertion templates during the study period and relevant variables will be extracted. Outcome measures and independent variables are pre-defined in this study protocol. Multivariable and univariable logistic regression analysis will be used to determine associations and risk factors of mechanical complications. ETHICS AND DISSEMINATION: The Regional Ethical Review Board in Lund, Sweden has approved this study. The results will be submitted for publication in peer-reviewed medical journals and presented at national and international scientific meetings. TRIAL REGISTRATION NUMBER: NCT03782324.
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| 5. |
- Brounéus, Fredrik, et al.
(författare)
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”Vi måste förbereda oss för att antibiotika slutar fungera”
- 2021
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Ingår i: Dagens Nyheter. - Stockholm : AB Dagens nyheter. - 1101-2447. ; :2021-02-17
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 11 forskare: En framtid utan verksam antibiotika är inte nödvändigtvis ett undergångsscenario eller en nattsvart dystopi. Men samhällets alla sektorer måste förbereda sig i god tid. Då kan detta postantibiotiska samhälle mycket väl utgöra en levbar framtid.
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| 6. |
- Glasdam, Stinne, et al.
(författare)
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Articulations of antimicrobial resistance in trade union financed journals for nurses in Scandinavia– a Foucauldian perspective
- 2021
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Ingår i: Nursing Inquiry. - : Wiley. - 1440-1800 .- 1320-7881. ; 28:3
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Tidskriftsartikel (refereegranskat)abstract
- Antimicrobial resistance (AMR) in bacterial infections is a growing threat to humanity and a challenge to healthcare systems worldwide. Healthcare professionals have an important role in preventing AMR and the spreading of infections. This article focuses on trade union financed journals for nurses in Scandinavia studying how the journals articulate AMR to its readership. A systematic literature search over an eleven‐year period was conducted, using web‐based national trade union financed journals, searching for ‘bacteria’ and ‘resistance’. A thematic analysis, inspired by Foucault's concepts of power and governmentality, was made of 131 texts to understand, which kind of practices, strategies and policies the journals frame regarding AMR. The time period studied resulted in the recognition of four separate themes: the horror scenario, the ‘dangerous’ other, healthcare professionals as a source of resistance development and AMR as a field of research and producer of research qualifications. The study concludes that the journals tend: to present AMR in apocalyptic terms with more research and pharmaceutical industries needed for avoidance; to point out problems in other countries, populations, and sometimes nurses’ working conditions, but primarily with other professionals’ behaviour; and lastly, to present the nurse as a good fairy and disciplinator of doctors.
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| 7. |
- Hansson, Linda, et al.
(författare)
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Challenges in the handover process of the new-born with congenital heart disease
- 2020
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 59
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: A new-born with congenital heart disease requires care that involves numerous specialists. Such care can be provided at tertiary referral hospitals and transportation is often needed. A crucial factor is the handover process, when the child is born at a distance, with transfer of both professional responsibility and continued care from one healthcare professional to another. Aim: The aim of this study was to identify crucial factors for the receiving healthcare professionals that influence the handover process of the new-born with congenital heart disease. Method: A cross-sectional questionnaire study with 53 receiving healthcare professionals at a paediatric intensive care unit at a tertiary referral university hospital in Sweden. The response rate was 48/53. Numerical variables were computed and a content analysis was performed. Findings: The handover process of the new-born with heart disease transferred to a tertiary referral hospital is complicated. A clear majority of the respondents identified one or more flaws in this process. Crucial factors identified were: relevant and structured information, clear communication, adequate patient knowledge and an enabling environment. Conclusion: A standardised procedure in the different phases of the handover process could improve communication, the working situation for healthcare professionals and thereby increase patient safety.
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| 8. |
- Norlinder, Jonas, et al.
(författare)
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Compressed Forwarding Tables Reconsidered
- 2022
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Ingår i: MPLR '22. - New York : Association for Computing Machinery (ACM). - 9781450396967 ; , s. 45-63
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Konferensbidrag (refereegranskat)abstract
- How concurrent compacting collectors store and manage forwarding information is crucial for their performance.In this paper, we propose CFW, a representation technique for forwarding information that guarantees that forwarding information for an entire heap can be stored in at most 3.14% of its size. By providing such a guarantee, we simplify the task of deploying programs with respect to memory needs. This is important given how memory is typically the dominating factor in the cost model for cloud-based deployments.We explore the design space of our technique through a prototype implementation on-top of ZGC. A rigorous performance evaluation shows promising results.
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| 9. |
- Wrigstad, Jonas, et al.
(författare)
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Incident investigations by the regulatory authority of Swedish healthcare - a 20-year perspective
- 2015
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Ingår i: Journal of Hospital Administration. - : Sciedu Press. - 1927-6990 .- 1927-7008. ; 4:6, s. 68-76
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to describe procedural changes in hospital incident investigations and show the consequences of these changes over time. Methods: A two-stage method was used. First component of the study was a content analysis of 87 incident investigations conducted 1995-2014 by the regulatory authority after adverse events in a Swedish university hospital. Second component was conducting semi-structured interviews with 11 investigators from all regulatory authority regional offices in Sweden. Results: In a minority of incident investigations, where further demands for action were required by the regulatory authority, a major portion of these were aimed at the micro-level. A plan for follow-up was expressed in only one tenth of the investigations. All investigators had a background from the healthcare system and saw this as advantageous. Their personal memory was claimed to be the only tool when referring to previous cases. Less fieldwork, more office work and more uniformity of language were recognised changes in comparison over time. The role of doing “auditing” was the most common description by the investigators themselves. Conclusions: The micro-level focus of the investigations reflected an organisational structure within the regulatory authority. We saw signs of parallel system weaknesses within the Swedish healthcare system with a clear absence of formalised organisational memory and a malfunctioning follow-up system of incident investigations. This can be seen both regarding the healthcare providers and the regulatory authority. The reports from the qualitative interviews data indicated that “auditing at the office” was considered the main occupation in incident investigations conducted by the regulatory authority.
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| 11. |
- Wrigstad, Jonas, et al.
(författare)
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On safety ontology : A cross-section analysis of incident investigations in a public healthcare system
- 2017
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Ingår i: Safety in Health. - : Springer Science and Business Media LLC. - 2056-5917. ; 3:13
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Tidskriftsartikel (refereegranskat)abstract
- Background:Due to new legislation in 2011 and 2013, the Swedish public healthcare system has undergone change as regards incident reporting and supervision. Focus has turned to learning from adverse events and sharing this learning with actors within the system. The aim of this study was to explore with what underlying safety ontology adverse events in the incident reporting system are investigated.Methods:A content analysis of 90 official and recently completed incident investigations from all six regionalsupervisory authority offices in Sweden was performed. Data was examined per nature of the investigation, numberof targets for intervention, specific final comments in the investigation and the decision from the supervisory authority. A coding scheme was used to identify the organisational level of the targets for intervention.Results:With different investigation methods in use, this incident reporting system still seems to contribute to are production of an organisational micro-level understanding of how risks emerge with a focus that operates inthe event’s immediate spatial proximity. There are no signs of constructive dialogue on exposed matters between the main actors: the healthcare provider organisation and the supervisory authority. There are strong examples of mistranslation of social infrastructure from other safety-critical organisations. Actors and individuals at the blunt endof the healthcare system adapt to new legislation and organisational change by balancing rhetoric and practiceduring fulfilment of stated obligations.Conclusions:Our findings support that traditional linear causality construction and traditional norms remain intactdespite new legislation and recent organisational change. Through efficient and adapted working procedures bythe main actors, this model still brings societal closure of harm and thereby a way to focus on moving on forward
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| 12. |
- Wrigstad, Jonas, et al.
(författare)
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One event, three investigations : The reproduction of a safety norm
- 2017
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Ingår i: Safety Science. - : Elsevier BV. - 0925-7535. ; 96, s. 75-83
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Tidskriftsartikel (refereegranskat)abstract
- Following an adverse event in a Swedish university hospital in 2010, three separate investigations seeking causal factors were conducted. We here review each of the analyses to see whether they together generate the kind of epistemological pluralism that could contribute to a systemic understanding of, and learning from, the event. Our content analysis shows that, while using vastly different amounts of time and resources, all three investigations make the same analytical choice to construct the causal factors as a deviation from norm in the event's immediate temporal and spatial proximity. We recognise that this both represents a strong discourse in the community analysing adverse events and seems to fulfil certain psychological purposes. Furthermore, we suggest that thorough analysis of adverse events in healthcare need to include aspects of system interaction from the micro to the macro, cognitive work configuration and design, as well as variability as a resource to harness rather than a threat to limit and control.
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| 13. |
- Wrigstad, Jonas
(författare)
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TEG-pucken: föreställningar om en framtida sjukhusvistelse
- 2021
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Ingår i: Att leva med bakterier : Möjligheter till ett levbart immunitärt liv - Möjligheter till ett levbart immunitärt liv. - 9789198439427 - 9789198439427 ; , s. 143-156
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Det uppskattas att år 2050 kommer tio miljoner människor att dö av infektionersom inte kan behandlas på grund av att bakterier blivit resistenta ochdärmed gjort antibiotika ineffektiv. Denna typ av dystopier är en form avresor både bakåt och framåt i tiden, och där samhället beskrivs som någotannat än vad vi är vana vid. Tanken om en framtid utan antibiotika – enså kallad postantibiotisk era – går tillbaka till början av 1990-talet och denökade kunskapen om resistens i kombination med frånvaron av nya antibiotika.Detta är en förändring som skulle kunna omskapa den mänskligahistorien på lång sikt. Men är framtiden så dystopisk? Och kan vi hittaalternativa vägar mot en sådan framtid som är mer levbar?Under 2019 och 2020 samlades elva forskare under Temat Postantibiotiskaframtider vid Pufendorfinstitutet, Lunds universitet, för att tvärvetenskapligtundersöka dessa problem. Antologin du håller i handen – ellerläser på en skärm – är ett av våra många resultat av dessa sammankomster.
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