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- Gustafsson, Margareta, 1952-, et al.
(författare)
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Identifying clinically relevant groups of hip fracture patients at risk of adverse outcomes by using classification tree analysis
- 2012
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - London, United Kingdom : Elsevier. - 1878-1241 .- 1878-1292. ; 17:1, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify groups of hip fracture patients at risk of adverse utcome by investigating interactions between previously reported risk factors.Methods: A consecutive sample of 338 hip fracture patients was included at admission to the orthopaedic department and followed up 4 months later. Outcomes measured were mortality, failure to regain pre-injury mobility and failure to return home. Data were collected about previously reported risk factors for adverse outcomes in those respects.Results: The highest risk of death occured in males living in institutions for the elderly before the fracture (48%). Lowest risk of death had patients admitted from their own home, without malignancy and below 80 years of age (1%). The overall risk of failure to regain pre-injury mobility at the 4 month follow up was 30%. In patients walking independently before the fracture and age above 85 years, the risk increased to 88%. In patients walking with devices before the fracture, the risk of being confined to bed or wheelchair increased from 10% to 20% if the patient was confused. Confusion also increased the risk of relocation from their own home to an institution for the elderly from 19% to 53%.Conclusion: The results of the study can help nurses in making realistic discharge plans based on risk analyses, employing more than just age as risk factor. Using this information nurses can meet the patient’s individual needs in an improved way.
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| 3. |
- Hälleberg-Nyman, Maria, 1968-, et al.
(författare)
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Intermittent versus indwelling urinary catheterisation in hip surgery patients : a randomised controlled trial with cost-effectiveness analysis
- 2013
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 50:12, s. 1589-1598
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Tidskriftsartikel (refereegranskat)abstract
- Background Hip surgery is associated with the risk of postoperative urinary retention. To avoid urinary retention hip surgery patients undergo urinary catheterisation. Urinary catheterisation, however, is associated with increased risk for urinary tract infection (UTI). At present, there is limited evidence for whether intermittent or indwelling urinary catheterisation is the preferred choice for short-term bladder drainage in patients undergoing hip surgery.Objectives The aim of the study was to investigate differences between intermittent and indwelling urinary catheterisation in hip surgery patients in relation to nosocomial UTI and cost-effectiveness.Design Randomised controlled trial with cost-effectiveness analysis.Setting The study was carried out at an orthopaedic department at a Swedish University Hospital.Methods One hundred and seventy hip surgery patients (patients with fractures or with osteoarthritis) were randomly allocated to either intermittent or indwelling urinary catheterisation. Data collection took place at four time points: during stay in hospital, at discharge and at 4 weeks and 4 months after discharge.Results Eighteen patients contracted nosocomial UTIs, 8 in the intermittent catheterisation group and 10 in the indwelling catheterisation group (absolute difference 2.4%, 95% CI −6.9–11.6%) The patients in the intermittent catheterisation group were more often catheterised (p < 0.001) and required more bladder scans (p < 0.001) but regained normal bladder function sooner than the patients in the indwelling catheterisation group (p < 0.001). Fourteen percent of the patients in the intermittent group did not need any catheterisation. Cost-effectiveness was similar between the indwelling and intermittent urinary catheterisation methods.Conclusions Both indwelling and intermittent methods could be appropriate in clinical practice. Both methods have advantages and disadvantages but by not using routine indwelling catheterisation, unnecessary catheterisations might be avoided in this patient group.
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| 5. |
- Bisholt, Birgitta, 1963-, et al.
(författare)
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Nursing students' assessment of the learning environment in different clinical settings
- 2014
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 14:3, s. 304-310
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings.AIM: The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students.DESIGN: A cross-sectional study with comparative design was conducted.METHOD: Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement.RESULTS: The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives.CONCLUSION: In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.
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| 9. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education
- 2014
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd.. - 0962-1067 .- 1365-2702. ; 23:15-16, s. 2264-2271
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. BACKGROUND: Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. DESIGN: A cross-sectional study with evaluative design. METHODS: Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. RESULTS: Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. CONCLUSIONS: The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. RELEVANCE TO CLINICAL PRACTICE: It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support.
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| 10. |
- Gustafsson, Margareta, 1952-, et al.
(författare)
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Ten years follow-up of health and disability in people with acute traumatic hand injury : pain and cold sensitivity are long-standing problems
- 2011
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Ingår i: Journal of Hand Surgery - British and European Volume. - : SAGE Publications. - 0266-7681 .- 1532-2211. ; 36:7, s. 590-598
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate health and disability in people with acute traumatic hand injury 10 years after the accident. A consecutive sample of patients from the Department of Hand Surgery was followed up by means of a postal questionnaire containing the instruments EQ-5D for assessment of health and DASH for assessment of disability. Questions were added about cold sensitivity, numbness and aesthetic problems. The 97 people with various acute hand injuries had greater problems with impairments of hand function than with limitations of activities and participation in daily life. Pain was more common than among the general Swedish population. Cold sensitivity was reported by 78% and was associated with both worse impairments and greater limitations on activity and participation. Despite problems with pain and cold sensitivity, they reported good health and a low degree of disability.
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