| 1. |
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| 2. |
- Nyström, Maria, et al.
(författare)
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Being a non-urgent patient at an ECU : a strive to maintain personal integrity
- 2003
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Ingår i: Accident and Emergency Nursing. - : Churchill Livingstone. - 0965-2302 .- 1532-9267. ; 11:1, s. 22-26
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyse and describe experiences of being a non-urgent patient in an ECU (emergency care unit). Eleven non-urgent patients were interviewed. The research approach was inductive and interpretative. Seven tentative interpretations and an interpreted whole, i.e., an existential interpretation, revealed that the informants tried to be ‘good’ patients by not demanding much attention from nursing personnel, in an attempt to maintain good relations with the nurses in order to be assured of a positive reception. As health related problems jeopardise personal integrity, patients cannot afford the risk of being looked upon as inappropriate clients in the ECU.
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| 3. |
- Suserud, Björn-Ove, et al.
(författare)
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Nurse competence : Advantageous in pre-hospital emergency care?
- 1999
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Ingår i: Accident and Emergency Nursing. - : Churchill Livingstone. - 0965-2302 .- 1532-9267. ; 7:1, s. 18-25
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Tidskriftsartikel (refereegranskat)abstract
- Aspects of the organization and function of pre-hospital emergency care services in western Sweden were assessed by interviewing physicians (n=20) with administrative (n=10) or/and active (n=10) roles in the pre-hospital emergency care field. The data obtained indicate that although the present standard of care is acceptable, there is an obvious need for a more effective organization and the personnel involved should have a higher competence level. Ambulance personnel were not considered to have a high enough competence level. Therefore, a need for more nurses, preferably anaesthesia or intensive care nurses, was expressed. An awareness of the importance of research was noted among the physicians responsible for the services, and the research capability of nurses, along with their general competence in emergency medical service related problems, was considered an important argument for involving more nurses in pre-hospital emergency care. It was thought that by such an approach, a more scientific basis for assessing the efficacy of pre-hospital emergency care could be achieved.
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| 4. |
- Suserud, Björn-Ove, et al.
(författare)
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Role of nurses in pre-hospital emergency care
- 1997
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Ingår i: Accident and Emergency Nursing. - : Elsevier. - 0965-2302 .- 1532-9267. ; 5:3, s. 145-151
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Tidskriftsartikel (refereegranskat)abstract
- In order to increase the quality of pre-hospital emergency care services, the Swedish National Board of Health and Welfare advocates a switch to clinically better educated professionals. The aim of this study is to assess the attitudes of ambulancemen, paramedics and nurses to each others' professional roles in prehospital emergency care. Ambulancemen and paramedics appreciate nurses' experience in anaesthesia, intensive care and cardiology, but do not see the nurse's role as being ‘team leader’. Both groups of professionals acknowledge the advantage of ambulance crew members having complementing skills, in order to improve the service. There is some rivalry between nurses and ambulancemen and paramedics. However, the increasing number of nurses in pre-hospital emergency care is contributing to the quality of the service by raising the competence level of the team as a whole.
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| 5. |
- Adriansson, Camilla, 1962, et al.
(författare)
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The use of topical anaesthesia at children´s minor lacerations: an experimental study
- 2004
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Ingår i: Accident and Emergency Nursing. - 0965-2302. ; 12:2, s. 78-84
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Tidskriftsartikel (refereegranskat)abstract
- In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia. The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental prospective design was used where children were included in either an experimental (10) or control (10) group. The experimental group was given a Xylocain solution while eth control group received physiological Sodium solution. Pain was estimated by using VAS and by interviews. The study shows that a certain alleviation of pain does occur when using Xylocain, but not statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. Many children expressed fear and anxiety. Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children´s pain both from a nursing and from a medical point of view. No statistically significant differences was found in children´s reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.
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| 6. |
- Adriansson, C, et al.
(författare)
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The use of topical anaesthesia at children's minor lacerations : an experimental study
- 2004
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Ingår i: International Emergency Nursing. - : Elsevier Ltd. - 1755-599X .- 1878-013X. ; 12:2, s. 74-84
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Tidskriftsartikel (refereegranskat)abstract
- Background: In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced, ensuring that unnecessary pain in the cafe-and-treatment process is mot meted out to children. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia. Aim: The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental, prospective design was used where children were included in either an experimental group or a control group. The experimental group (n=10) were given a Xylocain solution while the control group (n=10) received physiological Sodium solution. Data collection for the study was made by making VAS estimates and by interviews. Result: The study shows that a certain alleviation of pain does occur when using Xylocain but no statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. The study also shows that many children express fear and anxiety. Conclusion: Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children’s pain, both from a nursing and from a medical point of view. No statistically significant difference was found in children’s reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.
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| 7. |
- Ahl, Caroline, et al.
(författare)
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Making up one's mind : patients' experiences of calling an ambulance
- 2006
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Ingår i: Accident and Emergency Nursing. - : Elsevier. - 0965-2302 .- 1532-9267 .- 1755-599X .- 1878-013X. ; 14:1, s. 11-19
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Tidskriftsartikel (refereegranskat)abstract
- The issue of the inappropriate use of ambulance transport and care has mainly been studied from the professionals' and caregivers' perspective, with few studies focusing on the patient and his/her experiences. To further understand whether patients use ambulance care in an inappropriate manner and, if so, why, it is important to obtain an overall picture of the patients' existential situation at the time they call an ambulance. The aim of this study was to analyse and describe patients' experiences related to the decision to call an ambulance and the wait for it to arrive. The design was explorative, and twenty informants aged between 34 and 82 years were interviewed. Qualitative content analyses were performed. The findings showed that calling for an ambulance is a major decision that is preceded by hesitation and attempts to handle the situation by oneself. Our conclusion is that the definition of inappropriate use of valuable health care resources should not be based solely on the professionals' point of view but also take account of the patients' reactions when they experience a threat to their life and health.
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| 8. |
- Andersson, S.-O., et al.
(författare)
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The criteria nurses use in assessing acute trauma in military emergency care
- 2007
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Ingår i: Accident and Emergency Nursing. - : Elsevier BV. - 0965-2302 .- 1532-9267. ; 15:3, s. 148-156
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Tidskriftsartikel (refereegranskat)abstract
- Emergency medical care for seriously injured patients in war or warlike situations is highly important when it comes to soldiers' survival and morale. The Swedish Armed Forces sends nurses, who have limited experience of caring for injured personnel in the field, on a variety of international missions. The aim of this investigation was to identify the kind of criteria nurses rely on when assessing acute trauma and what factors are affecting the emergency care of injured soldiers. A phenomenographic research approach based on interviews was used. The database for the study consists of twelve nurses who served in Bosnia in 1994-1996. The criteria nurses rely on, when assessing acute trauma in emergency care, could be described in terms of domain-specific criteria such as a physiological, an anatomical, a causal and a holistic approach as well as contextual criteria such as being able to communicate, having a sense of belonging, the military environment, the conscript medical orderly and familiarity with health-caring activity. The present study shows that the specific contextual factors affecting emergency care in the field must also be practised before the nurse faces military emergency care situations. This calls for realistic exercises and training programs, where experience from civilian emergency care is interwoven with the knowledge specific to military medical care. © 2007 Elsevier Ltd. All rights reserved.
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| 9. |
- Bendtsen, Preben, et al.
(författare)
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Implementation of computerized alcohol screening and advice in an emergency department - a nursing staff perspective
- 2007
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Ingår i: Accident and Emergency Nursing. - : Elsevier BV. - 0965-2302 .- 1532-9267. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Changes in attitudes towards alcohol prevention among nursing staff are evaluated after implementing an opportunistic computerized alcohol screening and intervention (e-SBI) at an emergency department. After having assessed the patients in the triage room the nurses asked patients to perform the e-SBI on a touch screen computer. Before the start of the project more than 60% of the nurses expected the patients to react negatively when asked about their alcohol habits. After one year of screening only 10% reported experience of negative reactions from the patients. More than 50% of the nurses found it easy or very easy to ask the patients to perform the e-SBI and more than 75% of the nurses agreed that the e-SBI did not affect their workload. The proportion of nurses who considered alcohol prevention to be part of their duties at the emergency department did not change (40%) after implementing the e-SBI. During the two-year study period, 1982 patients completed the e-SBI which constituted 10-20% of all patients between 16 and 70 years of age attending the department for a sub critical condition. The e-SBI seems to have better potential than ordinary alcohol screening and intervention for implementation into routine emergency departments due to its simplicity and low time consumption. © 2006 Elsevier Ltd. All rights reserved.
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| 10. |
- Elmqvist, C, et al.
(författare)
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More than medical treatment : the patient's first encounter with prehospital emergency care
- 2008
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Ingår i: Accident and Emergency Nursing. - : Elsevier Ltd. - 0965-2302 .- 1532-9267 .- 1755-599X .- 1878-013X. ; 16:3, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- A common feature of emergency care services is the short, fragmented encounters with great demands for rapid treatment and efficiency. The aim of this study was to describe and understand the patient's first encounter with prehospital emergency care as experienced by the patient and the first responders. A lifeworld perspective was used in four different traumatic situations. The data consisted of 18 unstructured interviews with patients and first responders. The phenomenological analysis showed that the concept of lifesaving means more than just upholding vital functions. The patient needs to retain his/her identity by means of a communicative contact, to be confirmed in the lived encounter and to recapitulate the elapsed time of the unexpected event in order to regain a state of equilibrium. Five constituents further described the variations of the patients' first encounter; the encounter with the helpless injured body, the confirming existential encounter, the encounter while waiting, the lived encounter and the recapitulated encounter. This finding highlights the importance of a new understanding about empowering the patient with narratives throughout the whole caring process. There are also implications for educating personnel and students in emergency care about the first encounter with the patient in emergency care where the senses, the time and the narrative are essential elements that are unique for each person.
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| 11. |
- Forslund, Kerstin, et al.
(författare)
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Experiences of adding nurses to increase medical competence at an emergency medical dispatch centre
- 2006
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Ingår i: Accident and Emergency Nursing. - : Elsevier BV. - 0965-2302 .- 1532-9267. ; 14:4, s. 230-236
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Prehospital care begins when the call is placed to the emergency medical dispatch (EMD) centre and ends when the patient is cared for at the emergency department. The highly technical and specialized character demands advanced medical competence. Communication problems, serious and unpredictable situations can often occur during the emergency calls. A two-year intervention study involved the addition of registered nurses to an EMD-centre team to increase medical competence. AIM: To describe registered nurses' and emergency-operators' experiences of working together at an EMD-centre after adding registered nurses to increase medical competence. METHODS: Qualitative content analysis was used to analyse the text from interviews with four registered nurses and 15 emergency-operators involved in the intervention. RESULTS: Initial frustration and scepticism changed to more positive experiences that resulted in improved cooperation and service. The registered nurses had difficulties dealing with the more urgently acute calls, while the emergency-operators had difficulties with the more complicated, somewhat diffuse cases. The two professions complemented each other. CONCLUSION: Combining the registered nurses' and emergency-operators' knowledge and experience at an EMD-centre can perhaps improve the prehospital care for those requiring emergency medical care.
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| 12. |
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| 13. |
- Göransson, Katarina E., et al.
(författare)
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Emergency department triage : is there a link between nurses’ personal characteristics and accuracy in triage decisions?
- 2006
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Ingår i: Accident and Emergency Nursing. - : Elsevier BV. - 0965-2302 .- 1532-9267. ; 14:2, s. 83-88
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A common task of registered nurses is to perform emergency department triage, often using an especially designed triage scale in their assessment. However, little information is available about the factors that promote the quality of these decisions. This study investigated personal characteristics of registered nurses and the accuracy in their acuity ratings of patient scenarios. Methods Using the Canadian Triage and Acuity Scale (CTAS), 423 registered nurses from 48 (62%) Swedish emergency departments individually triaged 18 patient scenarios. Results The registered nurses’ percentage of accurate acuity ratings was 58%, with a range from 22% to 89% accurate acuity ratings per registered nurse. In total, 60.3% of the registered nurses accurately triaged the scenarios in 50–69% of the cases. No relationship was found between personal characteristics of the registered nurses and their ability to triage. Discussion The lack of a relationship between personal characteristics of registered nurses and their ability to triage suggests that there might be intrapersonal characteristics, particularly the decision-making strategies used which can partly explain this dispersion. Future research that focuses on decision-making is likely to contribute in identifying and describing essential nursing characteristics for successful emergency department triage.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Lindblad, Christina, et al.
(författare)
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Battlefield emergency care : a study of nurses’ perspectives
- 2005
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Ingår i: Accident and Emergency Nursing. - : Elsevier. - 0965-2302 .- 1532-9267. ; 13:1, s. 29-35
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Tidskriftsartikel (refereegranskat)abstract
- Recent implementation of modern armoured fighting vehicles in Swedish army forces has been substantial. In consequence, changes in the knowledge area of battlefield emergency care have been so large that a new professional competence is demanded. The aim of this study was to explore and describe how nurses perceive battlefield emergency care. A qualitative design was used comprising in-depth research interviews with 11 male registered nurses who all had been trained as company nurses in the Armed Forces. Three major themes were described; Unpredictable and invisible, a contextual leadership and assimilation acts. From the first major theme, the characteristic of battlefield emergency care is that it is unpredictable and invisible with the subthemes: menacing, unknown, challenging and complicated. From the next major theme, that a contextual leadership is important to have, with the subthemes: field manners, responsibility capacity and capacity to determine. The third major theme assimilation acts with the subthemes: experience from combat casualty care, education, working experience and by utilizing research findings.If we are to be able to offer patients individualised and qualitatively good professional care, emergency care must be conducted on the basis of scientific and well-tried experience.
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| 19. |
- Suserud, Björn-Ove, et al.
(författare)
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Experiences of threats and violence in the Swedish ambulance service
- 2002
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Ingår i: Accident and Emergency Nursing. - : Elsevier. - 0965-2302 .- 1532-9267. ; 10:3, s. 127-135
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Tidskriftsartikel (refereegranskat)abstract
- Ambulance personnel often meet people in a crisis situation that requires a readiness to act, and which takes for granted a broad knowledge in caring, together with an ability to size up the circumstances in each separate incident. The afflicted individual's first contact with a medic in an emergency situation is very often ambulance personnel and this first meeting can involve incidents that may radically change the existing state of things for the ill or injured and, maybe, even for near relatives. Sometimes these situations can lead to threats and acts of violence aimed at the ambulance staff. The aim of the study was to describe how ambulance personnel perceive, how they are subjected to, and are influenced by, threats and violence in their day-to-day work. The empirical study was descriptive and consisted of a questionnaire comprising a total of 13 questions. Answers from the 66 respondents revealed that 53 persons (80.3%) were subjected to threats and/or violence. The majority were of the opinion that the relationship between the paramedic and the patient was most certainly affected when threat or violence is a part of the situation. The study shows that many ambulance personnel have, on occasion, been subjected to one or several threats and/or situations involving the use of violence. The majority regarded this as an unpleasant experience.
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| 20. |
- Suserud, Björn-Ove
(författare)
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How do ambulance personnel experience work at a disaster site?
- 2001
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Ingår i: International Emergency Nursing. - : Elsevier Ltd. - 1755-599X .- 1878-013X. ; 9:2, s. 56-66
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Tidskriftsartikel (refereegranskat)abstract
- Working at a major accident site is a complex matter where knowledge from various fields must be put into practice. In addition, the different situations at emergency and disaster sites place a variety of demands on personnel, equipment and organization. The aim of the present study is to investigate how the ambulance personnel perceived their own action and the functioning of the whole emergency organization at a major accident site (large discotheque fire) in 1998. Working from a list obtained from the fire department, a questionnaire with 57 questions was sent to the personnel (n = 36) who had participated at the accident site either as ambulance crew members or as members of a medical team sent out from the hospital. The response rate was 80 per cent. Despite the extreme situation, most of the ambulance personnel involved were satisfied with their own preparedness as well as the medical and nursing care performed at the site. Those who where not satisfied reported that the main reason for dissatisfaction was lack of time to calm and comfort people who were not injured or had only minor injuries. The need of more medical support for the medical team members at the site was also emphasized with regard to the care of the severely injured. The ambulance service crews from the suburbs, in comparison with the local city rescue service, were, in general, less satisfied with the co-operation from other rescue units.
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| 21. |
- Svensson, Anders, 1977-, et al.
(författare)
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Experiences of and actions towards worries among ambulance nurses in their professional life : a critical incident study
- 2008
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X .- 0965-2302 .- 1532-9267. ; 16:1, s. 35-42
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Tidskriftsartikel (refereegranskat)abstract
- Nurses working in the ambulance service are frequently exposed to situations in which they have to take sole responsibility for sick or injured patients, many of which can be emotionally trying. The purpose of this study was therefore to describe critical incidents in which ambulance nurses experience worry in their professional life and the actions they take in order to prevent and cope with it. The sample consisted of 13 male and 12 female nurses working in ambulance services in three small to medium-sized counties in the south of Sweden. The data were collected by means of interviews and analysed according to Critical Incident Technique (CIT). The result showed that nurses worried about specific emergency situations as well as situations related to their working environment. Worry was alleviated by their own actions or with help from others. It was also shown that, with increasing experience, came a responsibility to be able to cope with all kinds of situations. This responsibility was experienced as worrying. However, if the nurse felt confident in their colleague, the worry could ease. It was concluded that the worry experienced by ambulance nurses in specific emergency situations requires flexibility on the part of the ambulance service. Nurses must be given the opportunity to address their worries in the way that is most appropriate for each individual.
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