| 1. |
|
|
| 2. |
- Berg, Lena, et al.
(författare)
-
Avbrott på akutmottagning
- 2011
-
Ingår i: 6:e nationella konferensen om patientsäkerhet. - Stockholm.
-
Konferensbidrag (refereegranskat)
|
|
| 3. |
|
|
| 4. |
- Berg, Lena M, et al.
(författare)
-
An observational study of activities and multitasking performed by clinicians in two Swedish emergency departments
- 2012
-
Ingår i: European journal of emergency medicine. - London : Chapman & Hall. - 0969-9546 .- 1473-5695. ; 19:4, s. 246-251
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore the type and frequency of activities and multitasking performed by emergency department clinicians.Methods: Eighteen clinicians (licensed practical nurses, registered nurses and medical doctors), six from each occupational group, at two Swedish emergency departments were followed in their clinical work for 2 h each to observe all their activities and multitasking practices. Data were analysed using qualitative and quantitative content analysis.Results: Fifteen categories of activities could be identified based on 1882 observed activities during the 36 h of observation. The most common activity was information exchange, which was most often performed face-to-face. This activity represented 42.1% of the total number of observed activities. Information exchange was also the most common activity to be multitasked. Registered nurses performed most activities and their activities were multitasked more than the other clinicians. The nurses’ and doctors’ offices were the most common locations for multitasking in the emergency department.Conclusion: This study provides new knowledge regarding the activities conducted by clinicians in the emergency department. The most frequent activity was information exchange, which was the activity most often performed by the clinicians when multitasking occurred. Differences between clinicians were found for activities performed and multitasked, with registered nurses showing the highest frequencies for both.
|
|
| 5. |
- Berg, Lena M, et al.
(författare)
-
Associations between crowding and ten-day mortality among patients allocated lower triage acuity levels without need of acute hospital care on departure from the emergency department
- 2019
-
Ingår i: Annals of Emergency Medicine. - : Elsevier BV. - 0196-0644 .- 1097-6760. ; 74:3, s. 345-356
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVE: We describe the association between emergency department (ED) crowding and 10-day mortality for patients triaged to lower acuity levels at ED arrival and without need of acute hospital care on ED departure.METHODS: This was a registry study based on ED visits with all patients aged 18 years or older, with triage acuity levels 3 to 5, and without need of acute hospital care on ED departure during 2009 to 2016 (n=705,699). The sample was divided into patients surviving (n=705,076) or dying (n=623) within 10 days. Variables concerning patient characteristics and measures of ED crowding (mean length of stay and ED occupancy ratio) were extracted from the hospital's electronic health records. ED length of stay per ED visit was estimated by the average length of stay for all patients who presented to the ED during the same day and shift and with the same acuity level. The 10-day mortality after ED discharge was used as the outcome measure. Multivariable logistic regression analyses were conducted.RESULTS: The 10-day mortality rate was 0.09% (n=623). The event group had larger proportions of patients aged 80 years or older (51.4% versus 7.7%) and triaged with acuity level 3 (63.3% versus 35.6%), and greater comorbidity (age-combined Charlson comorbidity index median interquartile range 6 versus 0). We observed an increased 10-day mortality for patients with a mean ED length of stay greater than or equal to 8 hours versus less than 2 hours (adjusted odds ratio 5.86; 95% confidence interval [CI] 2.15 to 15.94) and for elevated ED occupancy ratio. Adjusted odds ratios for ED occupancy ratio quartiles 2, 3, and 4 versus quartile 1 were 1.48 (95% CI 1.14 to 1.92), 1.63 (95% CI 1.24 to 2.14), and 1.53 (95% CI 1.15 to 2.03), respectively.CONCLUSION: Patients assigned to lower triage acuity levels when arriving to the ED and without need of acute hospital care on departure from the ED had higher 10-day mortality when the mean ED length of stay exceeded 8 hours and when ED occupancy ratio increased.
|
|
| 6. |
- Berg, Lena M, et al.
(författare)
-
Factors influencing clinicians' perceptions of interruptions as disturbing or non-disturbing : a qualitative study
- 2016
-
Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 27, s. 11-16
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Emergency departments consist of multiple systems requiring interaction with one another while still being able to operate independently, creating frequent interruptions in the clinical workflow. Most research on interruptions in health care settings has focused on the relationship between interruptions and negative outcomes. However, there are indications that not all interruptions are negatively perceived by those being interrupted. Therefore, this study aimed to explore factors that influence when a clinician perceives interruptions as non-disturbing or disturbing in an emergency department context.METHOD: Explorative design based on interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. Data were analyzed using qualitative content analysis.RESULT: Factors influencing whether emergency department clinicians perceived interruptions as non-disturbing or disturbing were identified: clinician's constitution, external factors of influence and the nature of the interrupted task. The clinicians' perceptions were related to a complex of attributes inherent in these three factors at the time of the interruption. Thus, the same type of interruption could be perceived as either non-disturbing or disturbing contingent on the surrounding circumstances in which the event occurred.CONCLUSION: Emergency department clinicians' perceptions of interruptions as non-disturbing or disturbing were related to the character of identified influencing factors.
|
|
| 7. |
- Berg, Lena M
(författare)
-
Patient safety at emergency departments : challenges with crowding, multitasking and interruptions
- 2018
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Several challenges with patient safety in the emergency department (ED) context have beenpreviously identified, and some commonly mentioned are crowding, multitasking, andinterruptions. The ED is a complex, high-risk work environment where multiple clinicians(physicians, registered nurses [RNs], and licensed practical nurses [LPNs]) are constantlyworking in parallel work processes, in an often crowded ED, while conducting tasksinvolving cognitively demanding decision-making processes. ED crowding has for the past20 years been identified as a problem internationally, resulting in extended ED length of stay(LOS) and increased morbidity and mortality for patients. ED crowding is also considered tohave negative effects on the clinicians' workload and work satisfaction.Both multitasking and interruptions have been identified as risk factors for patient safety byhaving negative effects on a clinician's decision-making processes and thus increasing therisk of forgetting important details and events because of memory overload. However,information has been lacking about what specific work assignments ED clinicians conduct,and thus there is little information about the types of assignments they perform whilemultitasking and being exposed to interruptions. Further, because not all interruptions lead toerrors and because they are not all preventable, a more refined account of interruptions iscalled for. Moreover, it seems that previous studies have not identified which specific factorsinfluence the ED clinicians' perceptions of interruptions. The work environment has beenreferred to as a possible influencing factor, but specific details on the relationship between thework environment and negative effects from interruptions are pending.The overall aim of the thesis was to describe ED crowding, and its influence on EDclinicians' work processes (activities, multitasking, and interruptions) and patient outcomes,from a patient safety perspective. The thesis addressed six research questions: 1) How has EDcharacteristics, patient case mix and occurrence of ED crowding changed over time? 2) Whatwork activities are performed by ED clinicians? 3) What kind of multitasking situations areclinicians exposed to during ED work? 4) What kind of interruptions are clinicians exposedto during ED work? 5) How do ED clinicians perceive interruptions? 6) Is there anassociation between ED crowding and mortality for stable patients without the need for acutehospital care upon departure from the ED?The data in the thesis were generated from two data collections: 1) registry data containingpatient characteristics and measures of ED crowding (ED occupancy ratio [EDOR], ED LOS,and patient/clinician ratios) extracted from the patients' electronic health records (paper I andIV) and 2) observations and interviews with ED clinicians (physicians, RNs, and LPNs)(paper II and III). Nonparametric statistics were used in paper I and III, quantitative and qualitative content analysis were used in paper II and III, and multivariate logistic regressionanalysis was used in paper IV.The main results in the thesis are presented based on Asplin's conceptual model of EDcrowding, from the aspect of input-throughput-output, and how parts of a sub-optimalthroughput influence patient safety through ED clinicians' work processes and patientoutcomes. During 2009 – 2016 there has been a change in patient case mix at the EDs at thestudy hospital, primarily with an increase in unstable patients (input) and a decrease in thenumber of patients admitted to in-hospital care (output). The median for ED LOS over thestudy period increased, and the largest increases occurred among the subgroups of unstablepatients, patients ≥80 years of age, and those admitted to in-hospital care (throughput).Further, an increase in crowding, in terms of median EDOR and median patients per RNratios, was identified, with an increase in EDOR from 0.8 in 2009 to 1.1 in 2016 and anaverage increase of 0.164 patients/RN/year (throughput). The ED clinicians' workassignments consisted of 15 categories of activities, and information exchange was found tobe the most common activity (42.1%). In contrast, the clinicians only spent 9.4% of theiractivities on direct interaction with patients and their families (ED clinicians' workprocesses). The clinicians multitasked during 23% of their total number of performedactivities, and there was an overall interruption rate of 5.1 interruptions per hour. Themajority of the observed multitasking situations and interruptions in the ED clinicians' workoccurred during demanding activities that required focus or concentration (ED clinicians'work processes). Finally, an association was identified between an increase in ED LOS andEDOR and 10-day mortality for stable patients without the need for acute hospital care upondeparture from the ED (patient outcomes).This thesis illustrates how a sub-optimal throughput, affected by conditions in both the inputand output components, negatively influence the ED clinicians' work processes as well aspatient outcomes.
|
|
| 8. |
- Berg, Lena M, et al.
(författare)
-
Reasons for interrupting colleagues during emergency department work : A qualitative study
- 2016
-
Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 29, s. 21-26
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Emergency department team members frequently need to interact with each other, a circumstance causing multiple interruptions. However, information is lacking about the motives underlying these interruptions and this study aimed to explore clinicians' reasons to interrupt colleagues during emergency department work.Method: Semi-structured interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. The interviews were analyzed inductively using content analysis.Results: The working conditions to some extent sustained the clinicians' need to interrupt, for example different routines. Another reason to interrupt was to improve the initiator's work process, such as when the initiators perceived that the interruption had high clinical relevance. The third reason concerns the desire to influence the work process of colleagues in order to prevent mistakes and provide information for the person being interrupted to improve patient care.Conclusion: The three identified categories for why emergency department clinicians interrupt their colleagues were related to working conditions and a wish to improve/influence the work processes for both initiators and recipients. Several of the reasons given for interrupting colleagues were done in order to improve patient care. Interruptions perceived as negative to the recipient were mostly related to the working conditions.
|
|
| 9. |
- Berg, Lena M, et al.
(författare)
-
Significant changes in emergency department length of stay and case mix over eight years at a large Swedish University Hospital
- 2019
-
Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 43, s. 50-55
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Describe the longitudinal development of crowding and patient/emergency department (ED) characteristics at a Swedish University Hospital.METHODS: A retrospective longitudinal registry study based on all ED visits with adult patients during 2009-2016 (N = 1,063,806). Patient characteristics and measures of ED crowding (ED occupancy ratio, length-of-stay [LOS], patients/clinician's ratios) were extracted from the hospital's electronic health record. Non-parametric analyses were conducted.RESULTS: The proportion of unstable patients (triage level 1-2) increased while the proportion of admitted patients decreased. All crowding variables were stable, except for LOS, which increased by 9 min/visit/year (95% CI: 8.8-9.1). LOS for visits by patients ≥ 80 years increased more compared to those 18-79 (248 min vs. 190 min, p < 0.001). Unstable patients increased their median LOS compared to stable patients (triage level 3-5). LOS for discharged patients increased with an average of 7.7 min/year (95% CI: 7.5-7.9) compared to 15.5 min/year (95% CI: 15.2-15.8) for those being admitted.CONCLUSION: Fewer admissions, despite an increase of unstable patients, is likely related to lack of in-hospital beds and contributes to ED crowding. The increase in median ED LOS, especially for patients in the subgroups unstable, ≥80 years and admitted to in-hospital care reflects this problem.
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Gardulf, A., et al.
(författare)
-
The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation
- 2016
-
Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 36, s. 165-171
-
Tidskriftsartikel (refereegranskat)abstract
- Background: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. Objectives: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. Methods and participants; The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1[20-56] years, 87.3% women) from 11 universities/university colleges participated. Results: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27 years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (932% vs 875% of NSPGs). Summary and conclusion: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs. (C) 2015 Elsevier Ltd. All rights reserved.
|
|
| 14. |
- Källberg, Ann-Sofie, et al.
(författare)
-
Contributing factors to errors in Swedish emergency departments
- 2015
-
Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 23:2, s. 156-161
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The Emergency Department (ED) is a complex and dynamic environment, often resulting in a somewhat uncontrolled and unpredictable workload. Contributing factors to errors in health care and in the ED are largely related to communication breakdowns. Moreover, the ED work environment is predisposed to multitasking, overcrowding and interruptions. These factors are assumed to have a negative impact on patient safety. Reported errors from care providers are mainly related to diagnostic procedures in Swedish EDs. However, there is a lack of knowledge and national oversight regarding contributing factors. The aim of this study was therefore to describe contributing factors in regards to errors occurring in Swedish EDs. Method: Descriptive design based on registry data from the Lex Maria database of the Swedish National Board of Health and Welfare. Results: The results indicate that factors contributing to errors in Swedish EDs are multifactorial in nature. The most common contributing factor was human error followed by factors in the local ED environment and teamwork failure. Conclusion: Factors contributing to ED errors were multifactorial and included both organizational and teamwork failure in which human error was implicated. To reduce errors, further research is needed to develop methods that disclose latent working conditions such as high workload and interruptions. Patient safety research needs to include understanding of human behaviour in complex organizational systems and the impact of working conditions on patient safety and quality of care.
|
|
| 15. |
- Källberg, Ann-Sofie, et al.
(författare)
-
Medical errors and complaints in emergency department care in Sweden as reported by care providers, health care staff and patients : a national review
- 2013
-
Ingår i: European journal of emergency medicine. - London : Chapman & Hall. - 0969-9546 .- 1473-5695. ; 20:1, s. 33-38
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Despite an increase in research, there is still a lack of knowledge about patient safety in emergency departments (EDs) in many European countries. The aim of this study was therefore to describe the incidence and types of reported medical errors and complaints in ED care in Sweden.Methods: Data reported in 2009 were gathered from national authorities, including the National Board of Health and Welfare, the Medical Responsibility Board, the Patients Advisory Committees, and local incident-reporting systems. Data were analyzed by content analysis.Results: Among 428 cases reported by care providers to the National Board of Health and Welfare, 64 (15.0%) were related to ED care. As several cases contained more than one medical error, 92 errors were identified, out of which 39 (42.4%) were related to diagnostic procedures. Among the 4628 cases of complaints reported by patients to the Medical Responsibility Board, 306 (6.6%) were related to ED care. In total, 437 complaints regarding perceived medical errors were identified (several cases contained more than one error), with 189 (43.2%) pertaining to diagnostic procedures. A total of 1341 complaints about ED care were made by patients to the Patients Advisory Committees (n=21), of which 655 (48.8%) were related to care and treatment. There were 7434 medical errors reported to local incident-reporting systems at the EDs (n=45). Of these, 1450 (19.5%) referred to care and treatment.Conclusion: Medical errors and complaints at Swedish EDs, as reported by both patients and care providers, were related mainly to diagnostic procedures and treatments.
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
|
|
| 19. |
|
|
| 20. |
|
|
| 21. |
- Källberg, Ann-Sofie, et al.
(författare)
-
Physicians' and nurses' perceptions of patient safety risks in the emergency department
- 2017
-
Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 33, s. 14-19
-
Tidskriftsartikel (refereegranskat)abstract
- The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians' perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians' experiences with regard to patient safety risks.METHOD: Semi-structured interviews were conducted with 10 physicians and 10 registered nurses from two emergency departments. Interviews were analysed by inductive content analysis.RESULTS: The experiences reflect the complexities involved in the daily operation of a professional practice, and the perception of risks due to a high workload, lack of control, communication and organizational failures.CONCLUSION: The results reflect a complex system in which high workload was perceived as a risk for patient safety and that, in a combination with other risks, was thought to further jeopardize patient safety. Emergency department staff should be involved in the development of patient safety procedures in order to increase knowledge regarding risk factors as well as identify strategies which can facilitate the maintenance of patient safety during periods in which the workload is high.
|
|
| 22. |
- Nilsson, Jan, et al.
(författare)
-
A short version of the nurse professional competence scale for measuring nurses' self-reported competence
- 2018
-
Ingår i: Nurse Education Today. - Amsterdam : Elsevier BV. - 0260-6917 .- 1532-2793. ; 71, s. 233-239
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The Nurse Professional Competence (NPC) Scale with 88-items has been used to measure self-reported competence among nursing students and registered nurses in many national and international nursing research projects. However, a shorter version of the scale with maintained quality has been requested to further enhance its usability.Objectives: To develop and evaluate the construct validity and internal consistency of a shorter version of the NPC Scale. Design: A developmental and methodological design. Participants and Settings: The study was based on a sample of 1810 nursing students at the point of graduation from 12 universities in Sweden.Methods: The number of items in the original NPC Scale was reduced using several established research steps and then evaluated for data quality and construct validity using principal component analysis and confirmatory factor analysis. Reliability was measured as internal consistency using Cronbach's alpha.Results: The extensive process of reducing the number of items resulted in a version with 35 items. Principal component analysis resulted in six factors explaining 53.6% of the variance: “Nursing Care” “Value-based Nursing Care” “Medical and Technical Care” “Care Pedagogics” “Documentation and Administration of Nursing Care” and “Development, Leadership, and Organization of Nursing Care”. All factors showed Cronbach's alpha values of >0.70. The confirmative factor analysis goodness-of-fit indexes were for root mean square error of approximation 0.05 and for comparative fit index 0.89.Conclusions: The NPC Scale Short Form (NPC Scale-SF) 35-items revealed promising results with a six-factor structure explaining 53.6% of the total variance. This 35-item scale can be an asset when used alone and together with other instruments it can provide the possibility of more complex analyses of self-reported competence among nursing students and registered nurses.
|
|
| 23. |
- Nilsson, Jan, 1963-, et al.
(författare)
-
Development and validation of a new tool measuring nurses self-reported professional competence — The nurse professional competence (NPC) Scale
- 2014
-
Ingår i: Nurse Education Today. - Midlothian, Scotland : Elsevier BV. - 0260-6917 .- 1532-2793. ; 34:4, s. 574-580
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines. Design: A methodological study including construction of a new scale and evaluation of its psychometric properties. Participants and settings: 1086 newly graduated nurse students from 11 universities/university colleges. Results: The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: “Nursing care”, “Value-based nursing care”, “Medical/technical care”, “Teaching/ learning and support”, “Documentation and information technology”, “Legislation in nursing and safety planning”, “Leadership in and development of nursing care” and “Education and supervision of staff/students”. All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: “Patient-related nursing” and “Nursing care organisation and development”. In addition, evidence of known-group validity for the NPC Scale was obtained.
|
|
| 24. |
- Nilsson, Jan, et al.
(författare)
-
Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters
- 2016
-
Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 17, s. 102-108
-
Tidskriftsartikel (refereegranskat)abstract
- The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events. (C) 2015 Elsevier Ltd. All rights reserved.
|
|
| 25. |
- Nilsson, Jan, 1963-, et al.
(författare)
-
Nursing in a globalized world : Nursing students with international study experience report higher competence at graduation
- 2014
-
Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; :4, s. 848-858
-
Tidskriftsartikel (refereegranskat)abstract
- Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 Universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas; “Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were; living alone, not having children or other commitments, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
- Theander, Kersti, et al.
(författare)
-
Adjusting to future demands in healthcare : Curriculum changes and nursing students' self-reported professional competence
- 2016
-
Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 37, s. 178-183
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Nursing competence is of significant importance for patient care. Newly graduated nursing students rate their competence as high. However, the impact of different designs of nursing curricula on nursing students' self-reported nursing competence areas is seldom reported. Objectives: To compare newly graduated nursing students' self-reported professional competence before and after the implementation of a new nursing curriculum. The study had a descriptive comparative design. Nursing students, who graduated in 2011, having studied according to an older curriculum, were compared with those who graduated in 2014, after a new nursing curriculum with more focus on person-centered nursing had been implemented. Setting: A higher education nursing program at a Swedish university. Participants: In total, 119 (2011 n = 69, 2014 n = 50) nursing students responded. Methods: Nursing students' self-reported professional competencies were assessed with the Nurse Professional Competence (NPC) scale. Results: There were no significant differences between the two groups of nursing students, who graduated in 2011 and 2014, respectively, with regard to age, sex, education, or work experience. Both groups rated their competencies as very high. Competence in value-based nursing was perceived to be significantly higher after the change in curriculum. The lowest competence, both in 2011 and 2014, was reported in education and supervision of staff and students. Conclusions: Our findings indicate that newly graduated nursing students- both those following the old curriculum and the first batch of students following the new one - perceive that their professional competence is high. Competence in value-based nursing, measured with the NPC scale, was reported higher after the implementation of a new curriculum, reflecting curriculum changes with more focus on person-centered nursing. (C) 2015 Elsevier Ltd. All rights reserved.
|
|
| 29. |
- Zhou Hagström, Nanna, 1993-, et al.
(författare)
-
Megahertz-rate Ultrafast X-ray Scattering and Holographic Imaging at the European XFEL
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The advent of X-ray free-electron lasers (XFELs) has revolutionized fundamental science, from atomic to condensed matter physics, from chemistry to biology, giving researchers access to X-rays with unprecedented brightness, coherence, and pulse duration. All XFEL facilities built until recently provided X-ray pulses at a relatively low repetition rate, with limited data statistics. Here, we present the results from the first megahertz repetition rate X-ray scattering experiments at the Spectroscopy and Coherent Scattering (SCS) instrument of the European XFEL. We illustrate the experimental capabilities that the SCS instrument offers, resulting from the operation at MHz repetition rates and the availability of the novel DSSC 2D imaging detector. Time-resolved magnetic X-ray scattering and holographic imaging experiments in solid state samples were chosen as representative examples, providing an ideal test-bed for operation at megahertz rates. Nevertheless, our results are relevant and applicable to any other non-destructive XFEL experiments in the soft X-ray range.
|
|
| 30. |
- Zhou Hagström, Nanna, 1993-, et al.
(författare)
-
Megahertz-rate ultrafast X-ray scattering and holographic imaging at the European XFEL
- 2022
-
Ingår i: Journal of Synchrotron Radiation. - : International Union of Crystallography (IUCr). - 0909-0495 .- 1600-5775. ; 29, s. 1454-1464
-
Tidskriftsartikel (refereegranskat)abstract
- The advent of X-ray free-electron lasers (XFELs) has revolutionized fundamental science, from atomic to condensed matter physics, from chemistry to biology, giving researchers access to X-rays with unprecedented brightness, coherence and pulse duration. All XFEL facilities built until recently provided X-ray pulses at a relatively low repetition rate, with limited data statistics. Here, results from the first megahertz-repetition-rate X-ray scattering experiments at the Spectroscopy and Coherent Scattering (SCS) instrument of the European XFEL are presented. The experimental capabilities that the SCS instrument offers, resulting from the operation at megahertz repetition rates and the availability of the novel DSSC 2D imaging detector, are illustrated. Time-resolved magnetic X-ray scattering and holographic imaging experiments in solid state samples were chosen as representative, providing an ideal test-bed for operation at megahertz rates. Our results are relevant and applicable to any other non-destructive XFEL experiments in the soft X-ray range.
|
|
| 31. |
- Acharya, B. S., et al.
(författare)
-
Introducing the CTA concept
- 2013
-
Ingår i: Astroparticle physics. - : Elsevier BV. - 0927-6505 .- 1873-2852. ; 43, s. 3-18
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The Cherenkov Telescope Array (CTA) is a new observatory for very high-energy (VHE) gamma rays. CTA has ambitions science goals, for which it is necessary to achieve full-sky coverage, to improve the sensitivity by about an order of magnitude, to span about four decades of energy, from a few tens of GeV to above 100 TeV with enhanced angular and energy resolutions over existing VHE gamma-ray observatories. An international collaboration has formed with more than 1000 members from 27 countries in Europe, Asia, Africa and North and South America. In 2010 the CTA Consortium completed a Design Study and started a three-year Preparatory Phase which leads to production readiness of CTA in 2014. In this paper we introduce the science goals and the concept of CTA, and provide an overview of the project. (C) 2013 Elsevier B.V. All rights reserved.
|
|
| 32. |
- Actis, M., et al.
(författare)
-
Design concepts for the Cherenkov Telescope Array CTA : an advanced facility for ground-based high-energy gamma-ray astronomy
- 2011
-
Ingår i: Experimental astronomy. - : Springer. - 0922-6435 .- 1572-9508. ; 32:3, s. 193-316
-
Tidskriftsartikel (refereegranskat)abstract
- Ground-based gamma-ray astronomy has had a major breakthrough with the impressive results obtained using systems of imaging atmospheric Cherenkov telescopes. Ground-based gamma-ray astronomy has a huge potential in astrophysics, particle physics and cosmology. CTA is an international initiative to build the next generation instrument, with a factor of 5-10 improvement in sensitivity in the 100 GeV-10 TeV range and the extension to energies well below 100 GeV and above 100 TeV. CTA will consist of two arrays (one in the north, one in the south) for full sky coverage and will be operated as open observatory. The design of CTA is based on currently available technology. This document reports on the status and presents the major design concepts of CTA.
|
|
| 33. |
- Andersson, Jan, et al.
(författare)
-
Fisk- och skaldjursbestånd i hav och sötvatten 2015 : Resursöversikt
- 2015
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES).De bestånd som förvaltas nationellt baseras på de biologiska underlagen och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser (SLU Aqua) vid Sveriges lantbruksuniversitet (SLU) samt yrkesfiskets rapportering.Rapporten omfattar 40 fiskarter uppdelade i olika bestånd, samt sex skal-och blötdjursarter.Nytt för årets upplaga är en beskrivning av hur de provfisken som ligger till grund för analys och rådgivning utförs.Översikten är utarbetad av Sveriges lantbruksuniversitet (SLU), Institutionen för akvatiska resurser (SLU Aqua), på uppdrag av Havs- och vattenmyndigheten.
|
|
| 34. |
- Berg, Lena M, et al.
(författare)
-
Interruptions in emergency department work : an observational and interview study
- 2013
-
Ingår i: BMJ Quality and Safety. - : BMJ. - 2044-5415 .- 2044-5423. ; 22:8, s. 656-663
-
Tidskriftsartikel (refereegranskat)abstract
- Objectiv.e Frequent interruptions are assumed to have a negative effect on healthcare clinicians’ working memory that could result in risk for errors and hence threatening patient safety. The aim of this study was to explore interruptions occurring during common activities of clinicians working in emergency departments.Method. Totally 18 clinicians, licensed practical nurses, registered nurses and medical doctors, at two Swedish emergency departments were observed during clinical work for 2 h each. A semistructured interview was conducted directly after the observation to explore their perceptions of interruptions. Data were analysed using non-parametric statistics, and by quantitative and qualitative content analysis.Results. The interruption rate was 5.1 interruptions per hour. Most often the clinicians were exposed to interruptions during activities involving information exchange. Calculated as percentages of categorised performed activities, preparation of medication was the most interrupted activity (28.6%). Face-to-face interaction with a colleague was the most common way to be interrupted (51%). Most common places for interruptions to occur were the nurses’ and doctors’ stations (68%). Medical doctors were the profession interrupted most often and were more often recipients of interruptions induced by others than causing self-interruptions. Most (87%) of the interrupted activities were resumed. Clinicians often did not regard interruptions negatively. Negative perceptions were more likely when the interruptions were considered unnecessary or when they disturbed the work processes.Conclusions. Clinicians were exposed to interruptions most often during information exchange. Relative to its occurrence, preparation of medication was the most common activity to be interrupted, which might increase risk for errors. Interruptions seemed to be perceived as something negative when related to disturbed work processes.
|
|
| 35. |
- Bergenius, Mikaela, et al.
(författare)
-
Report of the Baltic Fisheries Assessment Working Group (WGBFAS) : 14-21 April 2015, ICES HQ, Copenhagen, Denmark
- 2015
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The ICES Baltic Fisheries Assessment Working Group (WGBFAS) met 14-21 April 2015 (Chair: Mare Storr-Paulsen, Denmark), with 28 participants and 9 countries represented. The objective of WGBFAS was to assess the status of the following stocks:1 ) Sole in Division IIIa, SDs 20-222 ) Cod in Kattegat, Cod in SD 22-24, Cod in SD 25-323 ) Herring in SD 25-27, 28.2, 29 and 32, Herring in SD 28.1 (Gulf of Riga), Herring in SD 30, Herring SD 31.4 ) Sprat in SD 22-325 ) Plaice 21-23, Plaice 24256 ) Flounder 22-23; 24-25; 26+28 and 27+29-32, Brill 2232, Dab 2232, and Turbot 2232 (survey trends)WGBFAS also identified the data needed, for next year’s data call with some suggestions for improvements in the data call as well as in InterCatch. The report contains an introduction with the summary of other WGs relevant for the WGBFAS, country specific fishery description, the methods used, and ecosystem considerations. The results of the analytical stock assessment or survey trends for the species listed above are then presented with all the stocks with the same species in the same sections. The report ends with references, list of Working Documents, recommendations and Stock Annexes. In first quarter 2015 the Baltic cod stocks and the plaice stocks were benchmarked. As a result the Baltic cod stocks now have to apply a splitting key in SD 24 were both stocks are present. This has changed the assessment from being an area based assessment to now being a stock based assessments and has implications for the advice. The principle analytical models used for the stock assessments were XSA and SAM. For most flatfishes, CPUE trends from bottom trawl surveys were presented (except plaice 2425 and her31 using relative SSB from SAM and XSA, respectively). Ecosystem changes have been analytically considered in the following stock assessments: Herring in SD 25-27, 28.2, 29 and 32, and Sprat in SD 22-32, in form of cod predation mortality. Last year a very large retrospective pattern in the Eastern Baltic cod stock caused that the WG rejected the analytic assessment. Several uncertainties in the data lead to this conclusion i.a age reading problems with large inconsistency between and within nations as well as a change in growth and natural mortality. However, even though a data compilation workshop and a benchmark have been conducted in the intermediate time it was not possible to solve the main issue on growth. The lack of knowledge on growth caused to that even the length based data required in the data call was very uncertain for the models and in the end the WG was not able to produce a better model than was presented last year which is based on survey trends. The Her-30 (Herring in the Botnian Sea) was by the working group down scaled from a category 1 stock to a category 3 stock due to the commercial tuning fleet used in the assessment having very uncertain estimates in the last couples of years. However, during the Baltic ADG an alternative assessment was suggested were the stock is still considered a category 1 stock but the last 8 years of the commercial tuning fleet was terminated. This assessment was conducted after the working group but has been included in the report.
|
|
| 36. |
- Borregales, Manuel, et al.
(författare)
-
Robust iterative schemes for non-linear poromechanics
- 2018
-
Ingår i: Computational Geosciences. - Dordrecht : Springer. - 1420-0597 .- 1573-1499. ; 22:4, s. 1021-1038
-
Tidskriftsartikel (refereegranskat)abstract
- We consider a non-linear extension of Biot's model for poromechanics, wherein both the fluid flow and mechanical deformation are allowed to be non-linear. Specifically, we study the case when the volumetric stress and the fluid density are non-linear functions satisfying certain assumptions. We perform an implicit discretization in time (backward Euler) and propose two iterative schemes for solving the non-linear problems appearing within each time step: a splitting algorithm extending the undrained split and fixed stress methods to non-linear problems, and a monolithic L-scheme. The convergence of both schemes are shown rigorously. Illustrative numerical examples are presented to confirm the applicability of the schemes and validate the theoretical results.
|
|
| 37. |
- Both, Jakub W., et al.
(författare)
-
Iterative Methods for Coupled Flow and Geomechanics in Unsaturated Porous Media
- 2017
-
Ingår i: Poromechanics VI. - : American Society of Civil Engineers (ASCE). - 9780784480779 ; , s. 411-418
-
Konferensbidrag (refereegranskat)abstract
- This work concerns the linearization of a three-field discretization of generalized Biot's equations describing coupled fluid flow and mechanical deformation in unsaturated porous media. The model of interest employs the effective stress based on the so-called equivalent pore pressure and can be interpreted as linear mechanics nonlinearly coupled with Richards' equation. As linearization, we apply simultaneously the L-scheme and the Fixed Stress Splitting scheme, which have been established and analyzed for Richards' equation and the linear Biot's equations, respectively. Numerical results demonstrate robustness and mesh independent convergence rates, whereas the popular, locally convergent Newton's method does not display robust convergence for the numerical examples we present.
|
|
| 38. |
- Both, Jakub Wiktor, et al.
(författare)
-
Robust fixed stress splitting for Biot’s equations in heterogeneous media
- 2017
-
Ingår i: Applied Mathematics Letters. - Amsterdam, Netherlands : Elsevier. - 0893-9659 .- 1873-5452. ; 68, s. 101-108
-
Tidskriftsartikel (refereegranskat)abstract
- We study the iterative solution of coupled flow and geomechanics in heterogeneous porous media, modeled by a three-field formulation of the linearized Biot's equations. We propose and analyze a variant of the widely used Fixed Stress Splitting method applied to heterogeneous media. As spatial discretization, we employ linear Galerkin finite elements for mechanics and mixed finite elements (lowest order Raviart Thomas elements) for flow. Additionally, we use implicit Euler time discretization. The proposed scheme is shown to be globally convergent with optimal theoretical convergence rates. The convergence is rigorously shown in energy norms employing a new technique. Furthermore, numerical results demonstrate robust iteration counts with respect to the full range of Lame parameters for homogeneous and heterogeneous media. Being in accordance with the theoretical results, the iteration count is hardly influenced by the degree of heterogeneities.
|
|
| 39. |
- Bousquet, Jean, et al.
(författare)
-
ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice
- 2021
-
Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 76:1, s. 168-190
-
Forskningsöversikt (refereegranskat)abstract
- Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
|
|
| 40. |
- Bousquet, J. Jean, et al.
(författare)
-
Next-generation ARIA care pathways for rhinitis and asthma : a model for multimorbid chronic diseases
- 2019
-
Ingår i: Clinical and Translational Allergy. - : BMC. - 2045-7022. ; 9
-
Forskningsöversikt (refereegranskat)abstract
- Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care.Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
- Eger, Katrien, et al.
(författare)
-
The effect of the COVID-19 pandemic on severe asthma care in Europe : will care change for good?
- 2022
-
Ingår i: ERJ Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 8:2
-
Tidskriftsartikel (refereegranskat)abstract
- Background The coronavirus disease 2019 (COVID-19) pandemic has put pressure on healthcare services, forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care. Methods In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021. Results 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%). Conclusions Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.
|
|
| 44. |
|
|
| 45. |
|
|
| 46. |
- Ehnfors, Margareta, 1941-, et al.
(författare)
-
Applicability of the International Classification of Nursing Practice (ICNP) in the areas of nutrition and skin care
- 2003
-
Ingår i: International Journal of Nursing Terminologies and Classifications. - Hoboken, USA : Wiley-Blackwell. - 2047-3087 .- 2047-3095. ; 14:1, s. 5-18
-
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.
|
|
| 47. |
- Ehrenberg, Anna, et al.
(författare)
-
Nursing informatics in Sweden : the agenda for the future
- 2009
-
Ingår i: Connecting health and humans. - Helsinki : Australian Computer Society. - 9781607500247 ; , s. 866-867, s. 866-867
-
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.
|
|
| 48. |
|
|
| 49. |
- Elf, Marie, et al.
(författare)
-
Yes we can do Quality in eLearning
- 2013
-
Ingår i: Proceedings : The Open and Flexible Higher Education Conference 2013. - : European Association of Distance Teaching Universities. - 9789079730131 ; , s. 114-119
-
Konferensbidrag (refereegranskat)abstract
- Introduction: Dalarna University and the Nursing programme have performed eLearning for a long time and our feeling was that we are good in providing high quality eLearning. However, we wanted to benchmark the education against quality standards for a more objective quality assessment and thus as one of the first Nursing programme in Europe we performed an analysis of the education with support of European Association of Distance Education Universities (EADTU) system. Background and aim: Today, e-learning becomes more established in higher education providing new pedagogical possibilities and support for competence development. This has impacts on students’ and teachers’ roles and responsibility for learning, creation of learning content and activities and forms for interaction. However, it is necessary to assure the quality of eLearning environment and experience provided to the students. The aim of this paper is to describe a quality improvement process regarding eLearning of a Nursing Programme conducted in a blended learning environment. Methods: A systematic Benchmarking process with a bottom-up approach developed by EADTU was used to assess the quality of eLearning. Results: A need of strategies and work processes regarding management, development, implementation and evaluation of eLearning was identified as well as directions regarding teachers’ competence and continuing learning. The awareness of strengths and weaknesses in the nursing programme in relation to eLearning has provided incitement for a continuous quality work. Conclusions: It is essential to have knowledge about the quality of higher education concerning structures, processes and results. Benchmarking can function as a tool to initiate a process of heightened awareness and ongoing quality work. Benchmarking with a bottom-up approach could be a fruitful way of enforcing and maintaining high quality in higher education.
|
|
| 50. |
|
|
