| 1. |
- Gunningberg, Lena, 1954-, et al.
(författare)
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Tracking pressure injuries as adverse events : National use of the Global Trigger Tool over a 4-year period
- 2018
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Ingår i: Journal of Evaluation In Clinical Practice. - : Blackwell Publishing. - 1356-1294 .- 1365-2753. ; 25:1, s. 21-27
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To examine the frequency, preventability, and consequences of hospital acquired pressure injuries in acute care hospitals over a 4-year period. Method: A retrospective record review was performed using the Swedish version of the Global Trigger Tool (GTT). A total of 64 917 hospital admissions were reviewed. Data were collected between 2013 and 2016 from all 63 Swedish acute care hospitals. Results: The prevalence of pressure injuries (category 2-4) was 1%. Older patients, "satellite patients", and patients with acute admissions had more pressure injuries. Most pressure injuries (91%) were determined to be preventable. The mean extended length of hospital stay was 15.8 days for patients who developed pressure injuries during hospitalization. Conclusion: The GTT provides a useful and complementary national perspective on hospital acquired pressure injuries across hospitals, informing health care providers on safety priorities to reduce patient harm. Clinical leaders can use information on the preventability and the consequences of pressure injuries, as well as evidence-based arguments for improving the health care organization.
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| 2. |
- Abrahamsen Grøndahl, Vigdis, 1964-, et al.
(författare)
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The use of life stories and its influence on persons with dementia, their relatives and staff : A systematic mixed studies review
- 2017
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Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955. ; 16:28
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dementia is an important predictor of nursing home admissions. Due to progressive dementia symptoms, over time it becomes difficult for persons with dementia to communicate their wishes and participate in decisions concerning their everyday lives. Their well-being, sense of dignity, integrity and personhood are at risk. The persons' life stories have been highlighted as particularly important in dementia care and are referred to as seeing the person beyond the dementia. The aim of this study was to explore and describe the use of life stories and its influence on persons with dementia living in nursing homes, their relatives and staff.METHODS: A systematic mixed studies review was conducted. The literature searches were performed in the following databases: CINAHL, PubMed and PsycINFO and the Cochrane library, as well as by hand searching references in the studies included. An updated search was performed eight months after the first search. Data was synthesised inspired by integrative analysis.RESULTS: Three studies using quantitative design and two studies (presented in three papers) using qualitative design representing research from 2006 to 2015 were included in the review. Life stories generally had a positive influence on the persons with dementia, their relatives, and staff. The use of life stories might contribute to 'Maintenance of the person with dementia as a whole person rather than a demented patient'. On the other hand, enabling persons with dementia to tell their own story could be a challenge. For the staff it could be challenging when sensitive information emerged uninvited. Involving relatives could also be difficult as to whose story were uncovered.CONCLUSIONS: The use of person's life story might be of significance, but there is not enough evidence to make any statement about its importance as the research is scarce. Studies, including randomised controlled trials, are needed to measure the impact of life story work on the physiological and psychological aspects of persons with dementia, and also how it influences their relatives and staff.
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| 3. |
- Allvin, Renée, 1956-, et al.
(författare)
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Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden : a cross-sectional survey
- 2020
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Ingår i: BMC Nursing. - : BMC. - 1472-6955. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (<= 0,5 year, > 0,5-5 years, and >= 6 years). Methods A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out. Results Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. Conclusions Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.
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| 4. |
- Andersson, Ingrid, et al.
(författare)
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A scoping review-Missed nursing care in community healthcare contexts and how it is measured
- 2022
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 9:4, s. 1943-1966
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To examine the extent and nature of missed nursing care in elderly care in community healthcare contexts from the perspective of healthcare staff, and to identify instruments used to measure missed nursing care and the content of these instruments. Design: Scoping review. Methods: Searches were conducted in the CINAHL, PubMed, Scopus and Google Scholar databases in March 2020. The selection process followed the PRISMA flow diagram. Results: Sixteen research papers were found from nine countries. The instruments used in the studies were Basel Extent of Rationing of Nursing Care for nursing homes (BERNCA-NH), modified MISSCARE survey and study-specific instruments or items. The item content differed, as did the number of items, which was between one and 44. The studies reported values for missed nursing care, as well as described reasons for and/or the relation between missed nursing care and organization, working climate and patient outcomes.
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| 5. |
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| 6. |
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| 7. |
- Andersson, Ingrid, et al.
(författare)
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Prevalence, type, and reasons for missed nursing care in municipality health care in Sweden : A cross sectional study
- 2022
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses' perspective. Methods A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question. Results The care activity most often missed in home care was: 'set up or update care plans' (41.8%), and in nursing homes: 'scheduled group activity' (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual. Conclusion Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.
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| 8. |
- Andersson, Ingrid, et al.
(författare)
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Registered nurse´s perception of staffing in community care – contributing to a sustainable health care workforce
- 2022
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Konferensbidrag (refereegranskat)abstract
- Background: Population ageing will lead to increased need for care, both as home care and in nursing homes. The time spent in hospital are shorten, so more and more advanced care takes place as community care. To meet this challenges, it will be important to ensure a sustainable health care workforce in which registered nurses (RNs) have a key role. Staffing in community care is related to patient safety and care quality.Aim of the study: To describe registered nurse´s perceptions of staffing in community care.Methods: A number of 56 RNs (age 26 to 65, median age 47) working in community care answered a questionnaire including questions about staffing. Data were collected in 2019/2020. Descriptive statistical- and qualitative content analyses were used. Results: The majority of the RNs (71%) perceived the planned staffing in community care as acceptable or good. Although, when looking back on the previous week, around half of the RNs (55%) perceived it to be lower that needed. The RNs holds perceptions of staffing in a continuum from positive to negative. The RNs perceptions of staffing are expressed in five sub-themes; “it´s working, it´s all fine,” “the willingness to do good”, “being in a vicious circle”, “having a feeling of resignation”, and “challenging for a vulnerable organization”.Conclusions and implications: RNs perceptions on staffing in community care are important in contributing to a sustainable and resilient workforce, they are like the organisation´s band-aid. There is a need to optimise and increase nurse staffing in community care.
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| 9. |
- Andersson, Ingrid, et al.
(författare)
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Validation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care, a Swedish version
- 2023
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:7, s. 4504-4514
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Tidskriftsartikel (refereegranskat)abstract
- AimThe aim of the study was to translate, adapt and validate the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care for use in the Swedish community health care context. DesignA cross-sectional study. Data were collected from October 2019 to January 2020, and the questionnaire was sent to Registered Nurses, Enrolled Nurses and assistant nurses. MethodsThe study was performed in four phases: (1) translation, (2) adaptation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care to the Swedish context, (3) content validity testing, and (4) evaluation of psychometric properties. The collected data resulted in 611 responses. Explorative factor analysis was performed to explore the interrelationship, and Cronbach's alpha was used to evaluate the internal consistency. ResultsExplorative factor analysis presented six factors/subscales: (1) fundamental care, (2) timely needed-based care, (3) dignity and support, (4) ensuring respectful treatment, (5) social activities, and (6) documentation, planning and reporting. The Cronbach's alpha for the components showed values between 0.7 and 0.9. ConclusionThe analyses indicate an instrument to be usable for Enrolled Nurses and nurse assistants in community health care. Additional tests, can contribute to refining the content of the items and further test reliability and validity of the instrument. No patient or public contributionAs this is a study of translation and validation of the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care.
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| 10. |
- Andersson, Ingrid
(författare)
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Vård som inte blivit utförd : Uppfattningar från vårdpersonal och enhetschefer inom kommunal vård och omsorg för äldre
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Övergripande syfte – Att undersöka samt öka och fördjupa kunskapen om vård som inte blivit utförd, inom kommunal vård och omsorg för äldre, utifrån vårdpersonals och enhetschefers uppfattningar och erfarenheter.Metod – Forskningsområdet vård som inte blivit utförd inom kommunal vård och omsorg för äldre kartlades med en scoping review, 16 artiklar inkluderades (I). Kvantitativ och kvalitativ metod användes för att samla in och analysera data (II-IV). Det genomfördes en tvärsnittsstudie med 624 sjuksköterskor, undersköterskor och vårdbiträden som besvarade ett frågeformulär med flervalsfrågor och en öppen fråga. Instrumentet Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH) samt studiespecifika frågor, för svensk kommunal kontext om vård som inte blivit utförd användes. Beskrivande och analytisk statistik användes samt kvalitativ innehållsanalys (II). En översättning, anpassning och validering av BERNCA-NH gjordes med explorativ faktoranalys (III). En intervjustudie genomfördes med 24 enhetschefer inom kommunal vård och omsorg för äldre, där deras uppfattningar av vård som inte blivit utförd efterfrågades. Analysen utfördes med fenomenografisk ansats (IV).Resultat – Det förekommer att vård inte blivit utförd inom kommunal vård och omsorg för äldre, orsakat av tidsbrist eller på grund av organisatoriska förhållanden (I, II). Instrumentet BERNCA-NH/HC, SWE indikerade en god reliabilitet och validitet, men ytterligare tester behövs (III). Enhetschefer som är medvetna om förekomsten av att vård inte alltid blir utförd, försöker följa upp händelserna för att förebygga att det ska hända igen. Vård som inte blivit utförd kan innebära negativa konsekvenser för både vårdpersonal och de äldre (IV).Konklusion – Det är av vikt att få kännedom om vård som inte blivit utförd samt att det går att mäta. Utifrån det kan orsaker diskuteras och förbättringsarbete ske. Vård som inte blivit utförd är relaterat till patientsäkerhet och behöver lyftas upp på agendan.
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| 11. |
- Andersson, Pia
(författare)
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Munhälsa
- 2013
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Ingår i: Ortopedisk vård och rehabilitering. - Lund : Studentlitteratur. ; , s. 113-125
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 12. |
- Anker-Hansen, Camilla, et al.
(författare)
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Informal caregivers and assistive technology in Norwegian nursing homes
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:10
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Tidskriftsartikel (refereegranskat)abstract
- Aim To explore informal caregivers’ experiences and perspectives concerning assistive technology (AT) in two nursing homes, through the conceptual lens of person-centredness. Background The integration and use of AT and a person-centred approach to care are political intentions within healthcare services, both internationally and in Norway. In nursing homes, informal caregivers are often collaborators with the staff, and can be important partners concerning the implementation of AT in a person-centred way. However, there is little knowledge about the informal caregivers’ perspectives on the use of AT in nursing homes, or of whether or how they are included in the integration and use of AT. Methods The study had a qualitative design and comprised eleven informal caregivers of residents in two nursing homes in Norway. In-depth interviews were used for data collection. The data were analysed using content analysis. COREQ reporting guidelines were applied to ensure comprehensive reporting. Results Emerging themes highlighted the slow-going transition from old to new technology, and how the informal caregivers experienced that AT both promoted and degraded the dignity of their family members. Informal caregivers were positive to the use of technology, but have sparse knowledge and information about ATs in the nursing homes. They express a desire for AT to increase activity and safety, which promotes dignity, quality of life, and quality of the care for their family member. The informal caregivers want their family member to be seen, heard, and to get assistance on their own terms, even with regard to technology. Conclusion Before AT can be implemented, informal caregivers need to be informed and listened to and included in the processes. Through their stories, one can form an idea of how important a person-centred approach is to contributing to individually tailored and introduced AT in collaboration with the informal caregivers.
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| 13. |
- Anker‐Hansen, Camilla, et al.
(författare)
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Pressure ulcer point prevalence, classification, locations, and preventive measures : Insights from a Norwegian nursing home survey
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:2, s. 409-416
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo report data from a point pressure ulcer (PU) prevalence survey on prevalence, PU categories, locations and preventive interventions at one Norwegian nursing home.MethodsA cross-sectional research design was used. One nursing home in Norway participated in the prevalence survey in 2020. The data were collected on one selected day. A total of 74 out of 88 residents (84.1%) participated. Descriptive statistical analyses were run.ResultsThe overall prevalence of PUs was 27% amongst all participants in the nursing home, who together had a total of 57 PUs categorised as category I–III. One major finding was that the most common site of the PUs was on the residents' toes. Interestingly, the prevalence of PUs in the residents' sacrum was considerably low. The most frequently used PU preventive interventions were foam chair cushions, nutritional supplements and pressure-reducing heel protection.ConclusionThis study identified a high prevalence of PUs, predominantly on residents' toes. Although preventive strategies were implemented, their application appeared limited. Implementing obligatory care packages and annual nationwide PU surveys might be worth considering in municipalities.
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| 14. |
- Athlin, Åsa Muntlin, et al.
(författare)
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Heel pressure ulcer, prevention and predictors during the care delivery chain - when and where to take action? : A descriptive and explorative study
- 2016
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central. - 1757-7241. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes. However, few studies have investigated optimal pressure ulcer prevention in the initial stage of the care process, e.g. in the ambulance care or at the emergency department. The aim of the study was to describe heel pressure ulcer prevalence and nursing actions in relation to pressure ulcer prevention during the care delivery chain, for older patients with neurological symptoms or reduced general condition. Another aim was to investigate early predictors for the development of heel pressure ulcer during the care delivery chain. Methods: Existing data collected from a multi-centre randomized controlled trial investigating the effect of using a heel prevention boot to reduce the incidence of heel pressure ulcer across the care delivery chain was used. Totally 183 patients participated. The settings for the study were five ambulance stations, two emergency departments and 16 wards at two hospitals in Sweden. Results: A total of 39 individual patients (21 %) developed heel pressure ulcer at different stages across the care delivery chain. Findings revealed that 47-64 % of the patients were assessed as being at risk for developing heel pressure ulcer. Preventive action was taken. However, all patients who developed pressure ulcer during the care delivery chain did not receive adequate pressure ulcer prevention actions during their hospital stay. Discussion and Conclusions: In the ambulance and at the emergency department, skin inspection seems to be appropriate for preventing pressure ulcer. However, carrying out risk assessment with a validated instrument is of significant importance at the ward level. This would also be an appropriate level of resource use. Context-specific actions for pressure ulcer prevention should be incorporated into the care of the patient from the very beginning of the care delivery chain.
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Bååth, Carina, 1959-, et al.
(författare)
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Assessments of patients’ pain, nutrition and skin in clinical practice : Registered and enrolled nurses’ perceptions
- 2012
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier. - 1878-1241 .- 1878-1292. ; 16:1, s. 3-12
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of the study was to describe registered and enrolled nurses’ perceptions of how they assess patients’ pain, nutrition and skin.Introduction: Planning for pain, nutrition and skin care management is an essential part of nursing. In Sweden, it is common that registered and enrolled nurses work together in the care of patients.Method: Interviews with nine registered and nine enrolled nurses were analyzed using qualitative content analysis.Results: One theme; blurring boundaries between registered and enrolled nurses regarding pain, nutrition and skin suit assessments was identified. The manifest content of interviews is described in four categories: nurse–patient interaction, using oneself as a tool, collaborating with colleagues and listening to patients’ next of kin.Conclusion: The analysis showed a blurring of boundaries between RNs and ENs regarding pain, nutrition and skin suit assessments. How they perform their assessments conforms to a large extent. However, even if the activities are the same, the education levels of RNs and ENs are different and therefore the assessment of the patients might be different in clinical practice. Taking the results into account it is important that RNs and ENs collaborate regarding assessment of the patients’ pain, nutrition and skin suit.
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| 19. |
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| 20. |
- Bååth, Carina, 1959-, et al.
(författare)
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Interrater reliability using Modified Norton Scale, Pressure Ulcer Card, Short Form- Mini Nutritional Assessment by registered and enrolled nurses in clinical practice
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:5, s. 618-626
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim. Examine the interrater reliability between and among registered and enrolled nurses using Modified Norton Scale, Pressure Ulcer Card and Short Form-Mini Nutritional Assessment. Background. In Sweden, registered nurses and enrolled nurses usually co-operate in patient care. National guidelines emphasize that reliable and valid assessment tools should be used. Interrater reliability for regular use of assessment tools is seldom studied. Design cross-sectional. Registered nurses and enrolled nurses made 228 assessments of patients’ skin, risk for pressure ulcer and malnutrition, in patients with hip fracture and patients who had suffered a stroke. Results. The interrater reliability of the Modified Norton Score total score was very good among registered nurses, good among enrolled nurses and between both groups. There was good, moderate and fair agreement on the subscales. Interrater reliability of Short Form Mini-Nutritional Assesment screening score was very good between both groups, good among registered nurses and moderate among enrolled nurses. There was good and moderate agreement on the items. There was good, moderate and fair agreement between and among registered nurses and enrolled nurses when using the Pressure Ulcer Card. Conclusion. The Modified Norton Scale and Short Form Mini-Nutritional Assessment were reasonably understandable and easy to utilize in clinical care. Therefore, it seems possible for nurses to accomplish assessment using these tools. The agreement level was low for most skin sites except sacrum when nurses assessed patients’ skin with the Pressure Ulcer Card. Relevance to clinical practice. The utilize of reliable and valid assessment tools is important in clinical practice. The tools could be used as an aid to the clinical judgement and therefore identify patients at risk for pressure ulcers and malnutrition. Pressure ulcer grading is a difficult skill that requires training and time to develop.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Bååth, Carina, 1959-, et al.
(författare)
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Pressure reducing intervention among persons with pressure ulcers : results from the first three national pressure ulcer prevalence surveys in Sweden
- 2014
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley. - 1356-1294 .- 1365-2753. ; 20:1, s. 58-65
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectivesThe overall aim of this study was to describe preventive interventions among persons with pressure ulcer (PU) in three nationwide PU prevalence surveys in Sweden.MethodsA cross-sectional research design was used; more than 70 000 persons from different hospitals and nursing homes participated in the three prevalence surveys conducted in March 2011, October 2011 and March 2012.The methodology used was that recommended by the European Pressure Ulcers Advisory Panel.ResultsThe overall prevalence of PU categories I–IV in hospitals was 16.6%, 14.4% and 16.1%, respectively. Corresponding figures for nursing homes were 14.5%, 14.2% and 11.8%, respectively. Heel protection/floating heels and sliding sheets were more frequently planned for persons with PU category I.ConclusionsDespite the three prevalence studies that have showed high prevalence of PU the use of preventing interventions is still not on an acceptable level. Heel protection/floating heels and sliding sheets were more frequently planned for persons with PUs, and individual-planned repositioning also increased. However, when persons already have a PU they should all have pressure-reducing preventive interventions to prevent the development of more PUs. Preventing PUs presents a challenge even when facilities have prevention programmes. A PU prevention programme requires an enthusiastic leader who will maintain the team's focus and direction for all staff involved in patient care.
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| 26. |
- Bååth, Carina, 1959-, et al.
(författare)
-
Pressure Ulcer Prevention
- 2024. - 2
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Ingår i: Fragility Fracture and Orthogeriatric Nursing. - : Springer. - 9783031334849 ; , s. 147-157
-
Bokkapitel (refereegranskat)abstract
- Preventing pressure ulcers is fundamental in managing and caring for the patient following a fragility fracture. Patients who have sustained a hip fracture and have had associated surgery are at high risk as ageing skin, frailty, immobility, and multiple comorbidities are significant factors in skin injury.The causes of pressure ulcers are complex, and their prevention is the responsibility of the entire multidisciplinary team. Accessing evidence and education for practitioners is vital to making a difference in all aspects of care.
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| 27. |
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| 28. |
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| 29. |
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| 30. |
- Bååth, Carina, 1959-, et al.
(författare)
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Prevention of heel pressure ulcers among older patients - from ambulance care to hospital discharge : a multi-centre randomized controlled trial
- 2016
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Ingår i: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 30, s. 170-175
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the effect of an early intervention, a heel suspension device boot, on the incidence of heel pressure ulcers among older patients (aged 70 +). Background: Pressure ulcers are a global healthcare issue; furthermore, the heel is an exposed location. Research indicates that preventive nursing interventions starting during the ambulance care and used across the acute care delivery chain are seldom used. Methods: A multi-centre randomized control study design was used. Five ambulance stations, two emergency departments and 16 wards at two Swedish hospitals participated. Altogether, 183 patients were transferred by ambulance to the emergency department and were thereafter admitted to one of the participating wards. Results: Significantly fewer patients in the intervention group (n=15 of 103; 14.6%) than the control group (n=24 of 80; 30%) developed heel pressure ulcers during their hospital stay (p=0.017). Conclusions: Pressure ulcer prevention should start early in the acute care delivery chain to increase patient safety.
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| 31. |
- Bååth, Carina, 1959-, et al.
(författare)
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Registered nurses and enrolled nurses assessment of postoperative pain and risk for malnutrition and pressure ulcers in patients with hip fracture
- 2010
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier BV. - 1878-1241 .- 1878-1292. ; 14:1, s. 30-39
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe and compare registered (RNs’) and enrolled nurses’ (ENs’) assessments of postoperative pain, risk for malnutrition and pressure ulcers in patients with hip fracture. Furthermore, the aim was to describe and compare their perceptions of using assessment tools. Thirty-four (34) RNs and forty-three (43) ENs, working on orthopaedic wards in Sweden, took part in the study. The assessments were carried out on 82 patients with hip fracture. The assessment tools included the numerical rating scale (NRS), short-form nutritional assessment tool (MNA-SF), modified Norton scale (MNS) and pressure ulcer card. Many patients were assessed to be in postoperative pain and at possible risk for malnutrition. Around 50% were assessed as being at risk for pressure ulcer formation (PU). There is a difference between RNs and ENs assessments of patients’ postoperative pain, risk for malnutrition and PU. ENs assessed to a greater degree that patients were in intense pain currently. RNs assessed to a greater degree that patients had been in intense pain in the past 24 h. Single items on the tools showed differences. However, there was no statistically difference for MNA-SF screening score and MNS total score. ENs found it easier to assess postoperative pain with the NRS compared to RNs.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Bååth, Carina, 1959-
(författare)
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Vara steget före : Bedömning av patienters smärta, näringstillstånd och hudkostym
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet var att beskriva och jämföra sjuksköterskors och undersköterskors bedömningar av patienters smärta, näringstillstånd och hudkostym samt deras uppfattningar om att använda bedömningsinstrument. Vidare att beskriva sjuksköterskors och undersköterskors uppfattningar om hur de bedömer patienters smärta, näringstillstånd och hudkostym. Metod: Etthundrasjuttio patientjournaler granskades. Intervjuer med sjuksköterskor (n=9) och undersköterskor (n=9) genomfördes. Resultatet av sjuksköterskors (n=34) och undersköterskors (n=43) bedömningar jämfördes. Interbedömarreliabilitet undersöktes när sjuksköterskor (n=50) och undersköterskor (n=61) använde bedömningsinstrument. Resultat: Sextio procent av patientjournalerna vid inskrivningen och 78 % vid utskrivningen innehöll dokumentation om patientens hudstatus. Det fanns dokumentation om trycksår i 15 % respektive 20 % av patientjournalerna. Patienter som var i risk för trycksårutveckling enligt Modifierad Nortonskala (MNS) erhöll i medeltal 4,6 omvårdnadsåtgärder och patienter som ej var i risk erhöll i medeltal 3,8. Det var inte några tydliga gränser för hur sjuksköterskor och undersköterskor genomförde bedömningar, vem som gjorde vad och på vilket sätt det gjordes. Det var inga skillnader mellan sjuksköterskors och undersköterskors bedömningar av risk för undernäring och trycksår när det gäller poäng för initial bedömning och totalpoäng. Det var dock skillnader i deras bedömningar av enskilda delskalor och smärta. Sjuksköterskors och undersköterskors uppfattning om hur det var att använda bedömningsinstrument varierade. Interbedömarreliabiliteten avseende MNS, Short- Form Mini Nutritional Assessment och trycksårkortet varierade mellan och inom sjuksköterskegruppen och undersköterskegruppen. Konklusioner: Sjuksköterskor dokumenterar inte alltid bedömning av patienters hudkostym och risk för trycksårutveckling. Det är såväl likheter som skillnader mellan sjuksköterskor och undersköterskor när det gäller hur de genomför bedömningar och resultatet av deras bedömningar. Interbedömarreliabiliteten mellan och inom sjuksköterske- och undersköterskegruppen varierar vid deras bedömning med olika bedömningsinstrument och trycksårkort. Ett viktigt led i arbetet med att säkerställa patientsäkerhet och hög vårdkvalitet är att vara steget före och fortlöpande bedöma patienters smärta, näringstillstånd och hudkostym.
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| 37. |
- Bååth, Carina, 1959-, et al.
(författare)
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Wound Management
- 2024. - 2
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Ingår i: Fragility Fracture and Orthogeriatric Nursing. - : Springer. - 9783031334849 ; , s. 159-170
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Bokkapitel (refereegranskat)abstract
- Wound healing is the process by which the function of damaged tissue is restored following surgery, trauma or other sources of tissue damage. The management of wounds is a fundamental aspect of the management of the patient following a fragility fracture, especially following a hip fracture and associated surgery. Ageing skin and multiple comorbidities are significant factors in skin injury and wound healing problems.The effective evidence-based management of surgical wounds following surgery after a fragility fracture can be challenging as ageing and comorbidities affect wound healing. Skin and wound care involves careful skin and wound assessment and attention to infection prevention measures while managing the factors affecting wound healing. Clinical considerations in wound management also include maintaining adequate nutrition, moisture, treating oedema and preventing further injury.This chapter aims to provide an overview of skin and wound assessment and evidence-based care interventions that can optimise wound healing in older people with fragility fractures.
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| 38. |
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| 39. |
- Deprez, Julie, 1996-, et al.
(författare)
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What are the prognostic factors for the development of incontinence-associated dermatitis (IAD) : a protocol for a systematic review and meta-analysis
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research. Methods and analysis This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Prospective and retrospective observational studies or clinical trials in which prognostic factors associated with the development of IAD are described are eligible. There are no restrictions on study setting, time, language, participant characteristics or geographical regions. Reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports are excluded. MEDLINE, CINAHL, EMBASE and The Cochrane Library will be searched from inception until May 2023. Two independent reviewers will independently evaluate studies. The Quality in Prognostic Studies tool will be used to assess the risk of bias, and the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies-Prognostic Factors checklist will be used for data extraction of the included studies. Separate analyses will be conducted for each identified prognostic factor, with adjusted and unadjusted estimated measures analysed separately. Evidence will be summarised with a meta-analysis when possible, and narratively otherwise. The Q and I 2 statistics will be calculated in order to quantify heterogeneity. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guidance. Ethics and dissemination No ethical approval is needed since all data is already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.
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| 40. |
- Duhalde, Henrik, et al.
(författare)
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Missed nursing care in emergency departments : A scoping review
- 2023
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 69
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Forskningsöversikt (refereegranskat)abstract
- Background: Patient safety is a global health priority. Errors of omission, such as missed nursing care in hospitals, are frequent and may lead to adverse events. Emergency departments (ED) are especially vulnerable to patient safety errors, and the significance missed nursing care has in this context is not as well known as in other contexts. Aim: The aim of this scoping review was to summarize and disseminate research about missed nursing care in the context of EDs. Method: A scoping review following the framework suggested by Arksey and O’Malley was used to (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; (5) collate, summarize, and report the results; and (6) consultation. Results: In total, 20 themes were derived from the 55 included studies. Missed or delayed assessments or other fundamental care were examples of missed nursing care characteristics. EDs not staffed or dimensioned in relation to the patient load were identified as a cause of missed nursing care in most included studies. Clinical deteriorations and medication errors were described in the included studies in relation to patient safety and quality of care deficiencies. Registered nurses also expressed that missed nursing care was undignified and unsafe. Conclusion: The findings from this scoping review indicate that patients’ fundamental needs are not met in the ED, mainly because of the patient load and how the ED is designed. According to registered nurses, missed nursing care is perceived as undignified and unsafe.
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| 41. |
- Falk-Brynhildsen, Karin, 1959-, et al.
(författare)
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Swedish translation, cultural adaptation and psychometric evaluation of the pressure ulcer knowledge assessment tool for use in the operating room
- 2023
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Ingår i: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 20:5, s. 1534-1543
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to psychometrically evaluate the Swedish operating room version of PUKAT 2.0. In total, 284 Swedish operating room nurses completed the survey of whom 50 completed the retest. The item difficulty P-value of 14 items ranged between 0.38 and 0.96 (median 0.65). Three items were found to be too easy (0.90-0.96). The D-value of 14 items ranged between 0.00 and 0.42 (median 0.46). Three items had a D-value lower than 0.20 (0.11-0.16) and eight items scored higher than 0.40 (0.45-0.61). The quality of the response alternatives (a-value) ranged between 0.00 and 0.42. This showed that nurses with a master's degree had a higher knowledge than nurses with a professional degree (respectively 9.4/14 versus 8.6/14; t = -2.4, df = 199, P = 0.02). The ICC was 0.65 (95% CI 0.45-0.78). The ICCs for the domains varied from 0.12 (95% CI = -0.16-0.39) to 0.59 (95% CI = 0.38-0.75). Results indicated that 11 of the original items contributed to the overall validity. However, the low participation in the test-retest made the reliability of the instrument low. An extended evaluation with a larger sample should be considered in order to confirm aspects of the psychometric properties of this instrument.
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| 42. |
- Falk-Brynhildsen, Karin, 1959-, et al.
(författare)
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The Swedish version of the attitude towards pressure ulcer prevention instrument for use in an operating room context (APUP-OR) : A nationwide psychometric evaluation
- 2022
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Ingår i: JOURNAL OF TISSUE VIABILITY. - : Elsevier. - 0965-206X .- 1876-4746. ; 31:1, s. 46-51
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: To assess operating room (OR) nurses' attitudes towards pressure ulcer prevention, the Attitude towards Pressure Ulcer Prevention (APuP) instrument was developed. Aim: The aim of this study was to psychometrically evaluate the Attitude towards Pressure Ulcer Prevention (APuP) instrument in a Swedish OR context. Materials and methods: A psychometric evaluation study was conducted, using a convenience sample, between February and August 2020. Validity (content, construct, discriminatory power) and reliability (stability and internal consistency) were evaluated. Results: The first survey (test) was completed by 284 Swedish OR nurses, of whom n = 50 (17.6%) completed the second survey (retest). A Principal Component Analysis was conducted for the 13-item instrument. The KMO value for this model was 0.62. Bartlett's test for sphericity was statistically significant (p 0.001). Five factors were identified which accounted for 56% of the variance in responses related to attitudes toward pressure ulcer prevention. The Cronbach's a for the instrument "attitude towards Pressure Ulcer Prevention" was 0.66. The intraclass correlation coefficient was 0.49 (95% CI = 0.25-0.67). Conclusion: This Swedish version of the APuP- OR is the first step in the development of an instrument to measure OR nurses' attitudes towards PU prevention in a Swedish OR context. The reliability of the instrument was low and the validity moderate. A larger sample and the revision or addition of items related to the context of the operating room should be considered in order to confirm aspects of the psychometric properties.
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| 43. |
- Florin, Jan, 1956-, et al.
(författare)
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Attitudes towards pressure ulcer prevention : a psychometric evaluation of the Swedish version of the APuP instrument
- 2016
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Ingår i: International Wound Journal. - : Wiley. - 1742-4801 .- 1742-481X. ; 13:5, s. 655-662
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim was to conduct a psychometric evaluation of the Attitude towards Pressure ulcer Prevention (APuP) instrument in a Swedish context. A further aim was to describe and compare attitudes towards pressure ulcer prevention between registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs). In total, 415 RNs, ANs and SNs responded to the questionnaire. In addition to descriptive and comparative statistics, confirmatory factor analyses were performed. Because of a lack of support for the instrument structure, further explorative and consecutive confirmatory tests were conducted. Overall, positive attitudes towards pressure ulcer prevention were identified for all three groups, but SNs reported lower attitude scores on three items and a higher score on one item compared to RNs and ANs. The findings indicated no support in this Swedish sample for the previously reported five-factor model of APuP. Further explorative and confirmative factor analyses indicated that a four-factor model was most interpretable: (i) Priority (five items), (ii) Competence (three items), (iii) Importance (three items) and (iv) Responsibility (two items). The five-factor solution could not be confirmed. Further research is recommended to develop a valid and reliable tool to assess nurses' attitudes towards pressure ulcer prevention working across different settings on an international level.
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| 44. |
- Gesar, Berit, 1959-, et al.
(författare)
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Hip fracture; an interruption that has consequences four months later : A qualitative study
- 2017
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier. - 1878-1241 .- 1878-1292. ; 26, s. 43-48
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Effects following a hip fracture often lead to functional disabilities and increased dependence on others. Although persons sustaining a hip fracture constitute a heterogeneous group in Swedish health care, they tend to be treated as a homogenous one.AIM: The aim of this study was to reveal how previously healthy people, aged 65 years and older, described how they had adapted to daily life four months after a hip fracture.METHOD: The follow-up interviews were performed by the first author four months after the hip fracture. Data were analysed using conventional inductive content analysis.FINDINGS: The results from the interviews highlight that sustaining a hip fracture - even four months later - was seen by the participants as an interruption leading to lasting consequences for everyday life. The recovery process during this period was complex and consisted of both physical and psychological strain. Some were resigned, some strived in order to regain independence and some handled the situation by means of self-confidence and self-efficacy.CONCLUSION: Previous healthy and independently-living participants described, in different ways that the hip fracture was an interruption that still affected everyday life. The absence of psychological support may be one of the reasons for dependency after four months.
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| 45. |
- Gesar, Berit, et al.
(författare)
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Older patients' perception of their own capacity to regain pre-fracture function after hip fracture surgery – an explorative qualitative study
- 2017
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier BV. - 1878-1292 .- 1878-1241. ; 24, s. 50-58
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives To explore healthy older patients' perceptions of their own capacity to regain pre-fracture function in the acute phase following hip fracture surgery. Background The incidence of hip fractures is expected to increase. In Sweden, of the patients who sustain a hip fracture, 40 per cent are healthy and lived independently pre fracture. However, a hip fracture often results in declined functional outcomes for 40 per cent of these patients. Design The study had an explorative inductive qualitative design. Methods Semi-structured interviews (n = 30) were conducted two to five days after hip fracture surgery. Data were analysed using manifest inductive content analysis. Results As a description of patients' perception of their own capacity to regain pre-fracture function after a hip fracture, one main category emerged: To end up in a new situation with or without control. Patients expressed that they believed in recovery and thought nothing would be altered. However, since they had to adapt to the ward culture at the acute hospital, they became passive and became insecure about their future life situation. Conclusion The attitudes of staff at the acute hospital can influence the outcome for hip fracture patients. Patients believe in recovery but do not receive psychological support to regain physical capacity.
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| 46. |
- Gesar, Berit, et al.
(författare)
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Patient-reported outcomes at acute hospital stay and four months after hip fracture surgery. A register and questionnaire study
- 2018
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Ingår i: European Journal for Person Centered Healthcare. - : University of Buckingham Press. - 2052-5648 .- 2052-5656. ; 6:1, s. 119-127
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The large and increasing number of hip fracture patients, in combination with the large impact that this is having on daily living activities, is emphasizing the importance of identifying factors that have a detrimental impact on post-operative outcomes. There are benefits to planning the ward in a way that prevents a steep decline in recovery after hip fracture surgery. Adding the patient`s perspective into the healthcare assessment, via shared healthcare decision-making, allows the patient’s needs and preferences to be taken fully into account. The aim of this study was to identify factors that predict how patients recover after hip fracture surgery.Methods: A descriptive quality register/questionnaire study in acute orthopaedic wards, 2 to 5 days after surgery, with a follow-up 4 months later. The patients included were ≥65 years of age and had been previously healthy and living independently before the hip fracture.Results: The participants in this study had returned to their own homes after 4 months, but only 21% reported themselves as being fully or almost fully recovered. In several domains of recovery, all 3 age groups (65-74, 75-84 and 85-97) reported different challenges both during their acute hospital stay and at the 4 months follow-up. The recovery phase is heterogeneous and requires individual care. The way that this is planned has an influence on patient outcome.Conclusion: Patients sustaining a hip fracture are heterogeneous and different age groups experience different challenges. At 4 months follow-up, one fifth of the participants reported themselves fully or almost fully recovered and most of them had returned to their own homes. The Swedish National Hip Fracture Register and the patient-reported questionnaires employed in this study are appropriate tools to audit further development of healthcare to improve quality of life after hip fracture surgery.
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| 47. |
- Granrud, Marie Dahlen, et al.
(författare)
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Health Care Personnel's Perspectives on Quality of Palliative Care During the COVID-19 Pandemic - A Cross-Sectional
- 2023
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press. - 1178-2390. ; 16, s. 2893-2903
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The provision of high-quality palliative care is challenging, especially during a pandemic like COVID-19. The latter entailed major consequences for health care systems and health care personnel (HCP) in both specialist and community health care services, in Norway and worldwide. The aim of this study was to explore how the HCP perceived the quality of palliative care in nursing homes, medical care units, and intensive care units during the COVID-19 pandemic. Methods: This study had a cross-sectional design. A total of 290 HCP from Norway participated in the study (RR = 25.8%) between October and December 2021. The questionnaire comprised items concerning respondents' demographics and quality of care, the latter measured by the short form of the Quality from the Patient's Perspective-Palliative Care instrument, adapted for HCP. The STROBE checklist was used. Results: This study shows that the HCP scored subjective importance as higher in all dimensions, items and single items than their perception of the actual care received. This could indicate a need for improvement in all areas. Information about medication, opportunity to participate in decisions about medical and nursing care and continuity regarding receiving help from the same physician and nurse are examples of areas for improvement. Conclusion: Study results indicate that HCP from nursing homes, medical care units, and intensive care units perceived that quality of palliative care provided was not in line with what they perceived to be important for the patient. This indicate that it was challenging to provide high-quality palliative care during the COVID-19 pandemic.
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| 48. |
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| 49. |
- Granrud, MD, et al.
(författare)
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Health Care Personnel's Perspectives on Quality of Palliative Care During the COVID-19 Pandemic : A Cross-Sectional Study
- 2023
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press. - 1178-2390. ; 16, s. 2893-2903
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The provision of high-quality palliative care is challenging, especially during a pandemic like COVID-19. The latter entailed major consequences for health care systems and health care personnel (HCP) in both specialist and community health care services, in Norway and worldwide. The aim of this study was to explore how the HCP perceived the quality of palliative care in nursing homes, medical care units, and intensive care units during the COVID-19 pandemic. Methods: This study had a cross-sectional design. A total of 290 HCP from Norway participated in the study (RR = 25.8%) between October and December 2021. The questionnaire comprised items concerning respondents' demographics and quality of care, the latter measured by the short form of the Quality from the Patient's Perspective-Palliative Care instrument, adapted for HCP. The STROBE checklist was used. Results: This study shows that the HCP scored subjective importance as higher in all dimensions, items and single items than their perception of the actual care received. This could indicate a need for improvement in all areas. Information about medication, opportunity to participate in decisions about medical and nursing care and continuity regarding receiving help from the same physician and nurse are examples of areas for improvement. Conclusion: Study results indicate that HCP from nursing homes, medical care units, and intensive care units perceived that quality of palliative care provided was not in line with what they perceived to be important for the patient. This indicate that it was challenging to provide high-quality palliative care during the COVID-19 pandemic.
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| 50. |
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