| 1. |
- Carlsson, Eva, 1952-, et al.
(författare)
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Accuracy and continuity in discharge information for patients with eating difficulties after stroke
- 2012
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 21:1-2, s. 21-31
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the accuracy and continuity of discharge information for patients with eating difficulties after stroke.Design: Prospective, descriptive.Methods: The study investigated a sample of 15 triads, each including one patient with stroke along with his patient record and discharge summary and two nursing staff in the municipal care to whom the patient was discharged. Data were collected by observations of patients' eating, record audits and interviews with nurses. Data were analysed using content analysis and descriptive statistics.Results: Accuracy of recorded information on patients' eating difficulties and informational continuity were poor, as was accuracy in the transferred information according to nursing staff's perceptions. All patients were at risk of undernutrition and in too poor a state to receive rehabilitation. Nevertheless, patients' eating difficulties were described in a vague and unspecific language in the patient records. Co-ordinated care planning and management continuity related to eating difficulties were largely lacking in the documentation. Despite their important role in caring for patients with eating difficulties, little information on eating difficulties seemed to reach licensed practical nurses in the municipalities.Conclusions: Comprehensiveness in the documentation of eating difficulties and accuracy of transferred information were poor based on record audits and as perceived by the municipal nursing staff. Although all patients were at risk of undernutrition, had multiple eating difficulties and were in too poor a state for rehabilitation, explicit care plans for nutritional problems were lacking.Relevance to clinical practice: Lack of accuracy and continuity in discharge information on eating difficulties may increase risk of undernutrition and related complications for patients in continuous stroke care. Therefore, the discharge process must be based on comprehensive and accurate documentation.
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| 2. |
- Carlsson, Eva, 1959-, et al.
(författare)
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Information transfer and continuity of care for stroke patients with eating difficulties from the perspectives of nursing staff in Swedish elderly care
- 2012
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Ingår i: Nursing informatics ... : proceedings of the ... International Congress on Nursing Informatics. - Montreal, Kanada. ; 2012, s. 61-
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Konferensbidrag (refereegranskat)abstract
- Continuity of care is a key issue in the care for elderly people, for example, those having experienced stroke, particularly with regards to informational and managerial continuity based on patient record data. The study aim was to explore municipal nursing staff's (n=30) perceptions of discharge information provided to them for stroke patients with eating difficulties. Structured interviews were used and data were analysed by content analysis and descriptive statistics. Results showed that nursing staff perceived informational continuity and accuracy of information on patients' eating difficulties as poor and that little information on eating difficulties reached licensed practical nurses, who instead relied on their own assessments of patients' eating ability. Co-ordinated care planning and management continuity were largely lacking, increasing the risk for undernutrition and related complications for the patients.
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| 3. |
- Ehnfors, Margareta, 1941-, et al.
(författare)
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Applicability of the International Classification of Nursing Practice (ICNP) in the areas of nutrition and skin care
- 2003
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Ingår i: International Journal of Nursing Terminologies and Classifications. - Hoboken, USA : Wiley-Blackwell. - 2047-3087 .- 2047-3095. ; 14:1, s. 5-18
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate completeness, granularity, multiple axial content, and clinical utility of the beta version of the ICNP in the context of standardized nursing care planning in a clinical setting.Methods: An 35-bed acute care ward for infectious diseases at a Swedish university hospital was selected for clinical testing. A convenience sample of 56 patient records with data on nutrition and skin care was analyzed and mapped to the ICNP.Findings: Using the ICNP terminology, 59%-62% of the record content describing nursing phenomena and 30%-44% of the nursing interventions in the areas of nutrition and skin care could be expressed satisfactorily. For about a quarter of the content describing nursing phenomena and interventions, no corresponding ICNP term was found.Conclusions: The ICNP needs to be further developed to allow representation of the entire range of nursing care. Terms need to be developed to express patient participation and preferences, normal conditions, qualitative dimensions and characteristics, nonhuman focus, and duration.Practice implications: The practical usefulness of the ICNP needs further testing before conclusions about its clinical benefits can be determined.
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| 4. |
- Ehnfors, Margareta, 1941-, et al.
(författare)
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Mapping VIPS concepts for nursing interventions to the ISO reference terminology model for nursing actions : A collaborative Scandinavian analysis
- 2006
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Ingår i: Consumer-Centered Computer-Suppported Care for Healthy People. - Amsterdam, Netherlands : IOS Press. - 9781586036225 ; , s. 401-5, s. 401-5
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Konferensbidrag (refereegranskat)abstract
- The aims of this study were to analyze the coherence between the concepts for nursing interventions in the Swedish VIPS model for nursing recording and the ISO Reference Terminology Model for Nursing Actions and to identify areas in the two models for further development. Seven Scandinavian experts analyzed the VIPS model's concepts for nursing interventions using prototypical examples of nursing actions, involving 233 units of analyses, and collaborated in mapping the two models. All nursing interventions in the VIPS model comprise actions and targets, but a few lack explicit expressions of means. In most cases, the recipient of care is implicit. Expressions for the aim of an action are absent from the ISO model. By this mapping we identified areas for future development of the VIPS model and the experience from nursing terminology work in Scandinavia can contribute to the international standardization efforts.
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| 5. |
- Ehnfors, Margareta, 1941-, et al.
(författare)
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Nursing care as documented in patient records
- 1993
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Ingår i: Scandinavian Journal of Caring Sciences. - Oslo, Norway : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 7:4, s. 209-20
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Tidskriftsartikel (refereegranskat)abstract
- A review of 106 nursing records from 12 wards was conducted to categorize and quantify the content of the documentation and to consider the comprehensiveness of the recording for individual nursing problems. Audit instruments, based on a model for nursing documentation were developed and applied. The results show that admission assessment was missing in slightly less than half of all records, two-thirds had no nursing care plan and about one-third had no documentation on nursing outcome. About 90% of the records had no nursing diagnosis, no objective or no nursing discharge note. Notes on nursing status and nursing interventions were most common. Only one-third of the nursing problems identified had recording that gave information about the progress of the patient's problem. The analyses performed give information on the quality of nursing records which may be used to evaluate the quality of nursing care.
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| 6. |
- Ehnfors, Margareta, 1941-
(författare)
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Nursing documentation practice on 153 hospital wards in Sweden as described by nurses
- 1993
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Ingår i: Scandinavian Journal of Caring Sciences. - Oslo, Norway : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 7:4, s. 201-7
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Tidskriftsartikel (refereegranskat)abstract
- According to Swedish laws and regulations, registered nurses are required to document nursing care in the patient's record. In this exploratory study, nurses were asked to describe how they made their nursing records. The nursing process model was used as a framework. The findings show that a system for admission assessment was fairly common, regarding objectives and a nursing care plan together with a nursing discharge note; more than half of the wards studied recorded these aspects at least occasionally. Nursing diagnoses were seldom recorded in practice. The results reveal serious limitations and deficiencies in the practice of nursing documentation and the implementation of current laws and regulations. This underlines the importance of emphasizing nursing knowledge and nursing documentation in nursing training and practice.
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| 7. |
- Ehnfors, Margareta, 1941-, et al.
(författare)
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Towards basic nursing information in patient records
- 1991
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Ingår i: Vård i Norden. - : SAGE Publications. - 0107-4083 .- 1890-4238. ; 11:3-4, s. 12-31
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Forskningsöversikt (refereegranskat)abstract
- Four key concepts for good nursing care and a list of key words for nursing documentation in patient records were established and to some extent tried in clinical practice in Sweden. The method consisted of the following steps: extensive literature review, review of nursing records, development of a list of key words on two levels, a first level corresponding to the nursing process, and a second level consisting of subdivisions for possible use in practice, use and assessment in clinical practice by nurses and students, expert panel judgement and refinement of the key words including an examination of semantic accuracy of the Swedish key words by an expert in Nordic languages. The proposed key words are presented both in English and Swedish and explanations, comments and references are given. The version of key words presented here is subject to further testing for possible modifications.
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| 8. |
- Ehrenberg, Anna, 1957-, et al.
(författare)
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Nursing documentation in patient records : experience of the use of the VIPS model
- 1996
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Ingår i: Journal of Advanced Nursing. - Oxon, United Kingdom : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 24:4, s. 853-67
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Tidskriftsartikel (refereegranskat)abstract
- The VIPS model for the documentation of nursing care in patient records was scientifically developed and published in 1991, with the aim of supporting the systematic documentation of nursing care and promoting individualized care. As the model seemed to be accepted and used in many parts of Sweden, a study was conducted in order to gather further information on the validity of the model, to describe the clinical and educational experience of its use and to refine it. Experience of the use of the model was gathered from a review of the scientific papers and other reports on it, from questionnaires addressed to nurses (n = 514), from comments by key informants, and from interviews with faculty members at all the nursing schools in the country. The findings showed that an intense process of change and development was occurring regarding nursing documentation. However, there were limitations in the use of the entire nursing process, especially in the specification of patient problems and the formulation of nursing diagnoses and nursing interventions. The keywords (Swedish spelling) of the VIPS model had good content validity in different areas of nursing care. The findings also indicated the need for further elaboration and revision of some of the keywords. A revised version of the VIPS model based on these findings is presented.
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| 9. |
- Ehrenberg, Anna, et al.
(författare)
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Nursing informatics in Sweden : the agenda for the future
- 2009
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Ingår i: Connecting health and humans. - Helsinki : Australian Computer Society. - 9781607500247 ; , s. 866-867, s. 866-867
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- With the purpose of getting an overview of the current research and development in information systems and terminology for nursing practice and outline strategies for the future, an initiative for a workshop was taken at the national level in Sweden by the Section for Nursing Informatics, the Society of Nursing and the Association of Health Professionals in 2007. For the workshop around 30 nurses were invited, representing clinical practice, education, and research. The workshop resulted in recommendations for future strategies to support the development of nursing informatics in Sweden. © 2009 The authors and IOS Press. All rights reserved.
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| 10. |
- Ehrenberg, Anna, 1956-, et al.
(författare)
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Older patients with chronic heart failure within Swedish community health care : a record review of nursing assessments and interventions
- 2004
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Ingår i: Journal of Clinical Nursing. - Oxon, United Kingdom : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 13:1, s. 90-6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older patients with chronic heart failure constitute a large group within community home care that is at high risk for re-hospitalization. However, hospital readmission can be prevented if early signs of deterioration are recognized and proper interventions applied.Aims and objectives: The aim of the study was to audit nursing care for older chronic heart failure patients within the Swedish community health care system.Design: The study adopted a retrospective descriptive design.Methods: In a Swedish urban municipality nursing documentation from 161 records on patients diagnosed with chronic heart failure was collected retrospectively from community nursing home care units. Patient records were reviewed for characteristics of nursing care and assessed for comprehensiveness in recording.Results: The main results showed that medical care of patients with chronic heart failure was poorly recorded, making it possible only to follow fragments of the care process. The nursing notes showed poor adherence to current clinical guidelines. Only 12% of the records contained notes on patients' body weight and only 4% noted patients' knowledge about chronic heart failure. When interventions did occur, they largely consisted of drug administration.Conclusions: The findings revealed flaws in the recording of specific assessment and interventions as well as poor adherence to current international clinical guidelines.Relevance to clinical practice: Supportive guidelines available at the point of care are needed to enhance proper community-based home health care for older patients with chronic heart failure.
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| 11. |
- Ehrenberg, Anna, 1956-, et al.
(författare)
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Patient problems, needs, and nursing diagnoses in Swedish nursing home records
- 1999
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Ingår i: Nursing diagnosis : ND : the official journal of the North American Nursing Diagnosis Association. - Hoboken, USA : Wiley-Blackwell. - 1046-7459. ; 10:2, s. 65-76
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe the main problems, needs, risks, and nursing diagnoses and to examine the descriptions of some common and serious patient problems in nursing home records.Methods: A retrospective audit of a stratified, random sample (N = 12O) of patient records from eight nursing homes in six Swedish municipalities.Findings: Results showed major deficiencies in nursing documentation in the patient records. Only one record contained a comprehensive description of one patient problem that corresponded to the requirements of Swedish laws and regulations. No record was found that contained a systematic and comprehensive assessment of any of the selected problems based on established criteria or the use of an assessment instrument.Conclusions: Nursing documentation in patient records does not reflect the use of systematic assessment and research-based instruments for determining patient care needs. Nurses need skills in assessment in the care of the elderly to be able to set priorities in care and deliver adequate care.
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| 12. |
- Ehrenberg, Anna, 1956-, et al.
(författare)
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Patient records in nursing homes : Effects of training on content and comprehensiveness
- 1999
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Ingår i: Scandinavian Journal of Caring Sciences. - Oslo, Norway : Scandinavian University Press. - 0283-9318 .- 1471-6712. ; 13:2, s. 72-82
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to describe the effects on the contents and comprehensiveness of the nursing-care documentation in the patient records at nursing homes following an educational intervention. A review was made of records (n = 120) from nursing homes in six Swedish municipalities, allocated to a study group and a reference group. All the nursing home nurses in three municipalities received education concerning the nursing process and how to document according to the VIPS model. A retrospective audit of all nursing notes in the records from the nursing homes was made before and after the intervention. Improvements were found in the contents of the records in the study group. The number of notes on nursing history more than doubled. The occurrence of the recording of nursing diagnoses, goals and discharge notes increased. No corresponding changes were observed in the reference group. In the study group, an increase in the number of acceptable notes with contents on nursing history, status, nursing diagnosis, planned and implemented interventions, and nursing discharge notes was found. This increase was significant. The comprehensiveness in the documentation of single nursing problems was only slightly improved in the study group. No record met the requirements of the national regulations on nursing documentation or followed the nursing process thoroughly.
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| 13. |
- Ehrenberg, Anna, 1956-, et al.
(författare)
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The accuracy of patient records in Swedish nursing homes : congruence of record content and nurses' and patients' descriptions
- 2001
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Ingår i: Scandinavian Journal of Caring Sciences. - Oxon, United Kingdom : Blackwell Publishing. - 0283-9318 .- 1471-6712. ; 15:4, s. 303-10
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Tidskriftsartikel (refereegranskat)abstract
- Data from patient records will increasingly be used for care planning, quality assessment, research, health planning and allocation of resources. Knowledge about the accuracy of such secondary data, however, is limited and only a few studies have been conducted on the accuracy of nursing recording. The aim of this study was to analyse the concordance between the nursing documentation in nursing homes and descriptions of some specific problems of nurses and patients. Comparisons were made between wards where nurses had received training in structured recording based on the nursing process (study group) and wards where no intervention had taken place (reference group). Data were collected from the patient records of randomly selected nursing home residents (n=85). The methods used were audits of patient records and structured interviews with residents and nurses. The study revealed considerable deficiencies in the accuracy of the patient records when the records were compared with the reports from nurses and residents. The overall agreement between the interview data from nurses and from the patient records was low. Concordance was better in the study group as compared with the reference group in which the recorded data were structured only following chronological order. The study unequivocally demonstrates that there are major limitations in using records as a data source for the evaluation, planning and development of care.
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| 14. |
- Ekman, Inger, 1952, et al.
(författare)
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Feasibility of a nurse-monitored, outpatient-care programme for elderly patients with moderate-to-severe, chronic heart failure
- 1998
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Ingår i: European Heart Journal. - London, United Kingdom : W. B. Saunders Co. Ltd.. - 0195-668X .- 1522-9645. ; 19:8, s. 1254-60
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To evaluate the feasibility of a nurse-monitored, outpatient-care program for elderly patients previously hospitalized with chronic heart failure.Methods and results: Patients with chronic heart failure hospitalized in the medical wards were screened to find those eligible for a randomized study to compare the effect of a nurse-monitored, outpatient-care programme aiming at symptom management, with conventional care. The inclusion criteria were patients classified in New York Heart Association classes III-IV, age 65 years, and eligibility for an outpatient follow-up programme. The total in-hospital population of patients discharged with a heart-failure diagnosis was surveyed. Eighty-nine per cent of all the hospitalized patients (n=1541) were 65 years old. Of these, 69% (n=1058) were treated in the medical wards which were screened. The study criteria were met by 158 patients (15%). No visits to the nurse occurred in 23 cases among the 79 patients randomized to the structured-care group (29%), mainly on account of death or fatigue. The numbers of hospitalizations and hospital days did not differ between the structured-care and the usual-care groups.Conclusions: Given the selection criteria and the outline of the interventions, the outpatient, nurse-monitored, symptom-management programme was not feasible for the majority of these elderly patients with moderate-to-severe, chronic heart failure, mainly because of the small proportion of eligible patients and the high drop-out rate. Management of these patients would have to be more adjusted to their home situation.
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| 15. |
- Ekman, Inger, et al.
(författare)
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Outpatient care programmes for the elderly
- 1999
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Ingår i: European Heart Journal. - London, United Kingdom : W. B. Saunders Co. Ltd.. - 0195-668X .- 1522-9645. ; 20:5, s. 393-4
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Tidskriftsartikel (refereegranskat)
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| 16. |
- Ekman, Inger, 1952, et al.
(författare)
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The meaning of living with severe chronic heart failure as narrated by elderly people
- 2000
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Ingår i: Scandinavian Journal of Caring Sciences. - Oslo, Norway : Taylor & Francis. - 0283-9318 .- 1471-6712. ; 14:2, s. 130-6
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Tidskriftsartikel (refereegranskat)abstract
- The meaning of elderly patients' experiences of living with chronic heart failure was studied. Narrative interviews were analysed using a phenomenological hermeneutic approach. 'Feeling imprisoned in illness' and 'feeling free despite illness' constituted the themes. These themes were interpreted as describing variations in awareness of the relationship between the self and the body. In theme 'feeling imprisoned in illness' the body's illness and disability hindered the subjects from being themselves. In the theme 'feeling free despite illness' the disabled body was not experienced as limiting, but rather as a part of the self. The patients' understanding of the illness must be interpreted by the caregiver, who also needs to be aware of different modes of communicating feeling about the illness.
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| 17. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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A comparison of the concept of patient participation and patients' descriptions as related to healthcare definitions
- 2010
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Ingår i: International Journal of Nursing Terminologies and Classifications. - Malden, USA : Wiley-Blackwell. - 2047-3087 .- 2047-3095 .- 1744-618X. ; 21:1, s. 21-32
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To depict what patients describe as patient participation and whether descriptions of patient participation are affected by gender, age, healthcare contact, and duration of disease.Data sources: Current patients (n= 362) responded to a questionnaire on participation.Data synthesis: Patients' descriptions focused on having knowledge, rather than being informed, and on interacting with health professionals, rather than merely partaking in decision making.Conclusions: Patients' descriptions of participation correspond with the International Classification of Functioning, Disability and Health's definition, which includes "being involved in a life situation." Healthcare legislation and professionals employ a narrower concept of patient participation as defined by, e.g., Medical Subject Headings.Practice implications: Findings suggest that health professionals need to embrace what patients describe as participation.
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| 18. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
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The development and initial validation of a clinical tool for patients' preferences on patient participation : The 4Ps
- 2015
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Ingår i: Health Expectations. - : Wiley-Blackwell. - 1369-6513 .- 1369-7625. ; 18:6, s. 2522-2535
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care.Background: While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences.Methods: Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability.Results: 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout.Conclusions: A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required.
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| 19. |
- Florin, Jan, et al.
(författare)
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A comparison between the VIPS model and the ICF for expressing nursing content in the health care record
- 2013
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Ingår i: International Journal of Medical Informatics. - Clare, Ireland : Elsevier. - 1386-5056 .- 1872-8243. ; 82:2, s. 108-17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multi-professional standardized terminologies are needed that cover common as well as profession-specific care content in order to obtain a full coverage and description of the contributions from different health professionals' perspectives in health care. Implementation of terminologies in clinical practice that do not cover professionals' needs for communication might jeopardize the quality of care.Purpose: The aim of the study was to compare the structure and content of the Swedish VIPS model for nursing documentation and the international classification of function, disability and health (ICF).Method: Mapping was performed between key words and prototypical examples for patient status in the VIPS model and terms in the ICF and its framework of domains, chapters and specific terms. The study had two phases. In the first phase 13 key words for patient status in the VIPS model and the 289 terms (prototypical examples) describing related content were mapped to comparable terms in the ICF. In phase two, 1424 terms on levels 2-4 in the ICF were mapped to the key words for patient status in the VIPS model.Results: Differences in classification structures and content were found, with a more elaborated level of detail displayed in the ICF than in the VIPS model. A majority of terms could be mapped, but several essential nursing care concepts and perspectives identified in the VIPS model were missing in the ICF. Two-thirds of the content in the ICF could be mapped to the VIPS' key words for patient status; however, the remaining terms in the ICF, describing body structure and environmental factors, are not part of the VIPS model.Conclusion: Despite that a majority of the nursing content in the VIPS model could be expressed by terms in the ICF, the ICF needs to be developed and expanded to be functional for nursing practice. The results have international relevance for global efforts to implement unifying multi-professional terminologies. In addition, our results underline the need for sufficient coverage and level of detail to support different professional perspectives in health care terminologies.
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| 20. |
- Florin, Jan, 1956-, et al.
(författare)
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Developing a national integrated classification of health care interventions in Sweden
- 2005
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Ingår i: International Journal of Medical Informatics. - Clare, Ireland : Elsevier. - 1386-5056 .- 1872-8243. ; 74:11-12, s. 973-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Existing classifications in Sweden of health care interventions used for quality assurance issues and for decisions on resource allocation does not capture all types of health care interventions. The work of professional groups like nurses, physiotherapists, and occupational therapists is partly invisible. There is a need to develop a classification of health care interventions that comprise all activity within the health care sector.Aim: To describe a multi-professional collaborative work on classification development and to provide suggestions for an organizing structure that can capture interventions in the health care services incorporating different professional perspectives.Results: The professional groups reached a common understanding about the use of the classification of The International Classification of Functioning, Disability and Health (ICF) as a unifying framework in the classification of health care interventions. Proposal was made for a revised structure of a current classification of interventions using ICD as unifying framework.Conclusion: The use of ICF as a unifying framework is seen as a fruitful way of overcoming professional differences, and by that supporting the process of reaching a common understanding and use of a common language when describing interventions in health care.
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| 21. |
- Fossum, Mariann, 1970-, et al.
(författare)
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Clinical decision support systems to prevent and treat pressure ulcers and under-nutrition in nursing homes
- 2009
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Ingår i: Studies in Health Technology and Informatics. - Amsterdam : I O S PRESS. - 9781607500247 ; , s. 877-878
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Konferensbidrag (refereegranskat)abstract
- Clinical decision support systems (CDSSs) are believed to have the potential to improve care and change the behavior of health personnel. The project has focused on developing a CDSS to support prevention of pressure ulcer and undernutrition that is completely integrated in the electronic health record in nursing homes. Nursing staff have been involved in all phases in the development of the CDSS, which at present is ready to be implemented and systematically evaluated. © 2009 The authors and IOS Press. All rights reserved.
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| 22. |
- Fossum, Mariann, 1970-, et al.
(författare)
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The experiences of using a computerized decision support system
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim was to describe the facilitators and barriers influencing the ability of nursing personnel to effectively use a CDSS for planning and treating pressure ulcers and malnutrition in nursing homes. Usability evaluations and group interviews were conducted. Facilitators were ease of use, usefulness and a supportive work environment. Lack of training, resistance to using computers and limited integration of the CDSS with the electronic health record system were reported.
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| 23. |
- Goossen, William T. F., et al.
(författare)
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Development of a provisional domain model for the nursing process for use within the Health Level 7 reference information model
- 2004
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Ingår i: JAMIA Journal of the American Medical Informatics Association. - Philadelphia, USA : Hanley & Belfus Inc.. - 1067-5027 .- 1527-974X. ; 11:3, s. 186-94
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Since 1999, the Nursing Terminology Summits have promoted the development, evaluation, and use of reference terminology for nursing and its integration into comprehensive health care data standards. The use of such standards to represent nursing knowledge, terminology, processes, and information in electronic health records will enhance continuity of care, decision support, and the exchange of comparable patient information. As part of this activity, working groups at the 2001, 2002, and 2003 Summit Conferences examined how to represent nursing information in the Health Level 7 (HL7) Reference Information Model (RIM).Design: The working groups represented the nursing process as a dynamic sequence of phases, each containing information specific to the activities of the phase. They used Universal Modeling Language (UML) to represent this domain knowledge in models. An Activity Diagram was used to create a dynamic model of the nursing process. After creating a structural model of the information used at each stage of the nursing process, the working groups mapped that information to the HL7 RIM. They used a hierarchical structure for the organization of nursing knowledge as the basis for a hierarchical model for "Findings about the patient." The modeling and mapping reported here were exploratory and preliminary, not exhaustive or definitive. The intent was to evaluate the feasibility of representing some types of nursing information consistently with HL7 standards.Measurements: The working groups conducted a small-scale validation by testing examples of nursing terminology against the HL7 RIM class "Observation."Results: It was feasible to map patient information from the proposed models to the RIM class "Observation." Examples illustrate the models and the mapping of nursing terminology to the HL7 RIM.Conclusion: It is possible to model and map nursing information into the comprehensive health care information model, the HL7 RIM. These models must evolve and undergo further validation by clinicians. The integration of nursing information, terminology, and processes in information models is a first step toward rendering nursing information machine-readable in electronic patient records and messages. An eventual practical result, after much more development, would be to create computable, structured information for nursing documentation.
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| 24. |
- Göransson, Katarina E., et al.
(författare)
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Thinking strategies used by Registered Nurses during emergency department triage
- 2008
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 61:2, s. 163-172
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper is a report of a study to describe and compare thinking strategies and cognitive processing in the emergency department triage process by Registered Nurses with high and low triage accuracy. BACKGROUND: Sound clinical reasoning and accurate decision-making are integral parts of modern nursing practice and are of vital importance during triage in emergency departments. Although studies have shown that individual and contextual factors influence the decisions of Registered Nurses in the triage process, others have failed to explain the relationship between triage accuracy and clinical experience. Furthermore, no study has shown the relationship between Registered Nurses' thinking strategies and their triage accuracy. METHOD: Using the 'think aloud' method, data were collected in 2004-2005 from 16 RNs working in Swedish emergency departments who had previously participated in a study examining triage accuracy. Content analysis of the data was performed. FINDINGS: The Registered Nurses used a variety of thinking strategies, ranging from searching for information, generating hypotheses to stating propositions. They structured the triage process in several ways, beginning by gathering data, generating hypotheses or allocating acuity ratings. Comparison of participants' use of thinking strategies and the structure of the triage process based on their previous triage accuracy revealed only slight differences. CONCLUSION: The wide range of thinking strategies used by Registered Nurses when performing triage indicates that triage decision-making is complex. Further research is needed to ascertain which skills are most important in triage decision-making.
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| 25. |
- Göransson, Katarina, 1974-, et al.
(författare)
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The use of qualitative data analysis software (QDAS) to manage and support the analysis of think aloud (TA) data
- 2006
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Ingår i: Consumer-Centered Computer-Suppported Care for Healthy People. - Amsterdam, Netherlands : IOS Press. - 9781586036225 ; , s. 143-6, s. 143-6:122, s. 143-6
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Konferensbidrag (refereegranskat)abstract
- This methodological paper describes how qualitative data analysis software (QDAS) is being used to manage and support a three-step protocol analysis (PA) of think aloud (TA) data in a study examining emergency nurses' reasoning during triage. The authors believe that QDAS program QRS NVivo will greatly facilitate the PA and will allow them to identify and describe the information that triage nurses concentrate on during triage, and how they structure this information to make a triage decision. These findings could assist in designing and creating decision support systems to guide nurses' triaging. Additionally, details about how to use QRS NVivo for PA of TA data may assist and guide future informatics research using similar methodology are presented here. This innovative use of QDAS holds great promise for future nursing informatics research.
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| 26. |
- Hagvall, Monica, et al.
(författare)
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Experiences of parenting a child with medical complexity in need of acute hospital care
- 2016
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Ingår i: Journal of Child Health Care. - London, United Kingdom : Sage Publications. - 1367-4935 .- 1741-2889. ; 20:1, s. 68-76
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Tidskriftsartikel (refereegranskat)abstract
- Parents of children with medical complexity have described being responsible for providing advanced care for the child. When the child is acutely ill, they must rely on the health-care services during short or long periods of hospitalization. The purpose of this study was to describe parental experiences of caring for their child with medical complexity during hospitalization for acute deterioration, specifically focussing on parental needs and their experiences of the attitudes of staff. Data were gathered through individual interviews and analyzed using qualitative content analysis. The care period can be interpreted as a balancing act between acting as a caregiver and being in need of care. The parents needed skilled staff who could relieve them of medical responsibility, but they wanted to be involved in the care and in the decisions taken. They needed support, including relief, in order to meet their own needs and to be able to take care of their children. It was important that the child was treated with respect in order for the parent to trust the staff. An approach where staff view parents and children as a single unit, as recipients of care, would probably make the situation easier for these parents and children.
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| 27. |
- Källström Karlsson, Inga-Lill, 1947-, et al.
(författare)
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Five nurses' experiences of hospice care in a long-term perspective
- 2008
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Ingår i: Journal of Hospice and Palliative Nursing. - Philadelphia, PA : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 10:4, s. 224-232
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Tidskriftsartikel (refereegranskat)abstract
- In this study, five nurses’ experiences of regularly having to face the incurable illness and death of dying patients were explored. Qualitative interviews were conducted on two occasions with an interval of 11 years. An interpretive method was used to discern the nurses’ thoughts, feelings, and attitudes over the years toward death and dying. The main finding was that working in hospice care and facing the dying and death of many patients had an impact both on daily work and private life. Narrations from the first occasion were conceptualized as the theme “Death as an Agent of Change.” Eleven years later the presence of death took a less dominant place in the nurses’ lives and the theme became “Death as a Companion in Life“. In the long term nurses emphasized that their professional and personal growth was fostered by their relationship with the dying patients.
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| 28. |
- Källström Karlsson, Inga-Lill, 1947-, et al.
(författare)
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Making sense of life close to death
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This study’s aim was to find out how dying patients experience living near impending death. Eleven patient interviews were conducted via a palliative care unit that included a hospice ward and palliative home care. A qualitative, inductive design enabled descriptions of this complex situation. Analysis followed the Thorne et al. interpretive description approach. The findings revealed that when death became a reality, life took on new meanings and values (not in clear focus before) that were important to preserve or protect. This triggered need for feeling secure within this situation. These revelations were manifest in three subthemes that conceptualised the main theme Making sense of life close to death: (1) when possible death becomes a reality; (2) living with death as a reality and (3) a need for a feeling of security. How life can seem to dying patients demonstrates clinical relevance and complexity, which ensues when death is understood. Nurses must be aware of and respond to that complexity. Responding to patients who protect themselves from existential insight is a particular challenge; preserving their dignity requires being open to how life appears to them and following them as they give meaning to their existence. Dying patients have the right to be cared for according to their understanding of what it means to be dying.
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| 29. |
- Källström Karlsson, Inga-Lill, 1947-, et al.
(författare)
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Nurses’ perspectives on caring for hospice patients with weakening bodies
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aim. To deepen the understanding of how nurses experience their care of dying patients with weakening bodies.Background. A socio-cultural context that emphasizes healthy bodies might have consequences for attitudes toward sickness and weakness. Physical disease-based deterioration puts limits on opportunities to achieve a fit body. When dying patients’ bodies are deteriorating, they must rely on and receive body-care assistance. Few nursing studies explore nurses’ perceptions about caring for the body.Method. Data were collected over a 3-month period in 2004-2005. Qualitative, conversational-style interviews were done to gather personal reflections of 19 nurses in a Swedish hospice ward. The approach of interpretative description was used to analyze the interviews.Findings. A main theme – struggling to acknowledge and unveil the person within the weakening body – was synthesized from four subthemes, i.e., nurses: (1) striving to understand patients’ experiences of bodily losses; (2) encouraging patients to uphold bodily functions and daily habits; (3) acknowledging and balancing patients’ need of bodily control; and (4) providing tender body care.Conclusion. Ways in which nurses interpret and care for bodies of dying patients influence how dying patients perceive their embedded selves at life’s end. Nurses struggled to promote person-oriented care by being flexible and creative and by using various strategies for body care that was aligned with the individual patient’s progression toward death. Person-oriented care was sometimes challenged when patients could not express their preferences or when the body became very deformed.
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| 30. |
- Källström Karlsson, Inga-Lill, 1947-, et al.
(författare)
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Patient characteristics of women and men cared for during the first 10 years at an inpatient hospice ward in Sweden
- 2006
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 20:2, s. 113-121
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Tidskriftsartikel (refereegranskat)abstract
- The hospice philosophy with focus on the patient's autonomy and the ideal of a good death are the overall objectives of palliative care. Often-raised questions, when discussing hospice, are for which of the incurable ill inpatient hospice is the most optimal care alternative together with who are making use of hospice. The aim of the present study was to describe patient characteristics such as age, marital status, diagnosis, referral source and length of stay (LoS) in relation to gender, during the first decade at an inpatient hospice ward (1992–2001). Data, obtained from medical register, were analysed by using descriptive statistics and the chi-square test. The number of patients was 666 women and 555 men, and most of them were elderly. In some respects significant differences were observed between women and men. More women than men were single, had cancer with relatively rapid trajectory and were referred from the oncology department. Men, more often than women, were diagnosed with cancers with a somewhat longer trajectory. Despite the longer trajectory, the LoS was shorter for men (median =13 days) than for women (median = 17 days). The most frequent referral source was hospital, though men, younger men in particular, were more often referred from home-based hospice care than women. During the last 3 years self-referrals were documented. Self-referrals can be seen as one distinct expression from a standpoint of one's own active choice compared with other referrals. Altogether, self-referrals were less frequent among women than men but in relation to age, self-referrals were more common among the youngest (<60 years) and the oldest women (>85 years) than men in the same age groups. Further studies illuminating a gender perspective can broaden the understanding of what these differences may imply for women and men.
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| 31. |
- Odencrants, Sigrid, et al.
(författare)
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Nutritional status and patient characteristics for hospitalised older patients with chronic obstructive pulmonary disease
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:13, s. 1771-1778
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to describe and compare nutritional status and social and medical characteristics among older patients with chronic obstructive pulmonary disease admitted to an acute care hospital ward for respiratory medicine. BACKGROUND: Chronic obstructive pulmonary disease is a condition associated with risk of developing malnutrition. A body mass index <20 is predictive of hospitalisation for acute exacerbations of chronic obstructive pulmonary disease. Knowledge about patient characteristics is crucial for the identification of malnourished patients and the development of nursing care for these patients. DESIGN: Quantitative descriptive study. METHODS: Thirty-three hospitalised women and 17 men with a mean age of 75.7 years (SD 6.9) were consecutively included. A very severe case of chronic obstructive pulmonary disease was indicated in 28 out of 39 patients who underwent a lung function test. Data were collected with measurement of nutritional status using Mini Nutritional Assessment, anthropometry and lung function. RESULTS: Nearly half of the patients (48%) were identified as malnourished, an equal part as at risk for malnutrition and two patients as well nourished. The mean Mini Nutritional Assessment score of 17.2 (SD 3.99) for all patients was near the Mini Nutritional Assessment cut-off score (i.e. 17) for malnutrition. Patients identified as malnourished had a mean body mass index of 18.9 and those at risk for malnutrition had a mean of 23.4. It was more common for those identified as malnourished to live singly, to not live in own property and to be dependent on daily community service. Seven patients identified as malnourished died during the data collection period. CONCLUSIONS: This study provides important knowledge about further risks of impaired nutritional status among older patients with chronic obstructive pulmonary disease. RELEVANCE TO CLINICAL PRACTICE: This knowledge can provide registered nurses with the necessary knowledge to make them aware of certain patients needing particular kinds of attention.
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| 32. |
- Prenkert, Frans, 1969-, et al.
(författare)
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A measure of organizational effectiveness in nursing management in relation to transactional and transformational leadership : a study in a Swedish county hospital.
- 1997
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Ingår i: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 5:5, s. 279-287
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents an empirical study of the influences of transactional (TA) and transformational (TF) leadership on organizational effectiveness (OE), measured as the degree of goal attainment and the quality of nursing care (NQ). The study subjects were all head-nurses and assistant head-nurses at a medium-sized hospital in Sweden (n = 23). The methods used were questionnaires and interviews. The multi-leadership questionnaire earlier developed by Bass was modified and named the Leadership Nursing-Effectiveness Questionnaire (LNEQ), comprising 84 items using Likert-type scales. The study showed low mean scores on OE (2.19) and TA (1.05) but high mean scores on NQ (3.17) and TF (3.84). The results suggest that the degree of TA and TF leadership had a low and insignificant connection with OE in this hospital organization. The study did not support the statement that organizational units exposed to a higher degree of TA and TF leadership at the same time show a high degree of OE, as has been shown in studies in other cultural contexts and organizations.
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| 33. |
- Prenkert, Malin, 1967-, et al.
(författare)
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Growth data of underprivileged children living in rural areas of Chin State, Burma/Myanmar, compared to the WHO reference growth standards : an observational study
- 2016
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Ingår i: BMJ Open. - : BMJ Publishing Group. - 2044-6055. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore growth data (height-for-age, weight-for-age and BMI-for-age) of children living in poor socioeconomic conditions in rural areas of Chin State, Burma/Myanmar; and to compare these data with the growth and development z-score (GDZ) values for school-aged children and adolescents, provided by the WHO.Setting: A support and educational programme, run by the Swedish association Chin Development and Research Society (CDRS), was carried out among underprivileged school-aged children, unable to attend school without economic and practical support, living in villages and remote areas in Chin State.Participants: Community leaders who were well familiar with the citizens in the community identified children in need of this support. Other community members could also suggest or apply for this. The sample includes all participating children in the CDRS programme at the time of the data collection in six townships. The children were placed in host families, close to a suitable school. Two samples with a total of 639 children from 144 villages and remote areas were obtained:1. Children in the CDRS Chin Programme (CCP) (20072010) comprised 558 children: 50% girls and boys.2. Children in the Chin Society (CCS) (2010) comprised 81 children: 44% girls and 56% boys. Primary outcome measures: Growth data.Results: All growth data from both groups deviated significantly from the WHO standard references (p=0.001). The prevalence of stunting (height-for-age <=-2SD) was 52% among girls and 68% among boys. High levels of wasting (weight-for-age <=-2SD) were found among girls 29% and boys 36% aged 5-10 years. In addition, severe thinness (BMI-for-age <=-2SD) was found among girls 31% and boys 44%, all results to be compared to the expected 2.27%.Conclusions: Many more than expected-according to the WHO reference values-in CCP and CCS suffered from stunting, wasting and thinness.
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| 34. |
- Thoroddsen, Asta, 1953-, et al.
(författare)
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Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - Hoboken, USA : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 27:1, s. 84-91
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe the accuracy, completeness and comprehensiveness of information on pressure ulcers documented in patient records.Design and setting: A cross-sectional descriptive study performed in 29 wards at a university hospital in Iceland. The study included skin assessment of patients and retrospective audits of records of patients identified with pressure ulcers.Participants: A sample of 219 patients was inspected for signs of pressure ulcers on 1 day in 2008. Records of patients identified with pressure ulcers were audited (n = 45) retrospectively.Results: The prevalence of pressure ulcers was 21%. Information in patient records lacked accuracy, completeness and comprehensiveness. Only 60% of the identified pressure ulcers were documented in the patient records. The lack of accuracy was most prevalent for stage I pressure ulcers.Conclusions: The purpose of documentation to record, communicate and support the flow of information in the patient record was not met. The patient records lacked accuracy, completeness and comprehensiveness, which can jeopardise patient safety, continuity and quality of care. The information on pressure ulcers in patient records was found not to be a reliable source for the evaluation of quality in health care. To improve accuracy, completeness and comprehensiveness of data in the patient record, a systematic risk assessment for pressure ulcers and assessment and treatment of existing pressure ulcers based on evidence-based guidelines need to be implemented and recorded in clinical practice. Health information technology, including the electronic health record with decision support, has shown promising results to facilitate and improve documentation of pressure ulcers.
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| 35. |
- Udén, Giggi, et al.
(författare)
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Use of initial risk assessment and recording as the main nursing intervention in identifying risk of falls
- 1999
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Ingår i: Journal of Advanced Nursing. - Oxon, United Kingdom : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 29:1, s. 145-52
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Tidskriftsartikel (refereegranskat)abstract
- The consequences of falls among hospital patients are a great problem, for the patient, the family and society, and cost billions of dollars. In Sweden, almost one-third of all hip fractures occur in the hospital population. Despite this, very few prevention strategies have been developed and tested. In this study, a risk assessment and recording programme in relation to the risk of falling among patients in a geriatric department at a Swedish hospital was implemented. The records of all patients admitted to a geriatric unit during one year, and a stratified random sample of patient records, constituting the control group from the year before, were reviewed. No recording of assessments regarding the patients' risk of falling, and no preventive nursing interventions, were found in the records of the control group. The study group, however, increased the recording of risk assessment to 96%. Only implemented nursing interventions were found in the patients' records, despite the fact that Swedish law makes it obligatory for the registered nurse to record both the planning and implementation of nursing care. In the study group there were explicit descriptions of problems of concern for nursing regarding the patients' risk of falling in less than one-third of the records, the nursing care plans were rare, and the evaluations were not satisfactory. Nursing interventions consisted mostly of information or education, promotion of patient participation, and structuring of the environment. There was no agreement on any standard-care plan. Recording of falls was found more often in the study group than in the control group (probably due to more careful recording), but the proportion of injuries in relation to falls was higher in the control group. The results of this study may be used as a baseline for developing a nursing strategy and documentation relating to falls.
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