| 1. |
- Bergström, Annika, et al.
(författare)
-
Reduction of Surgical Complications in Dogs and Cats by the Use of a Surgical Safety Checklist
- 2016
-
Ingår i: Veterinary Surgery. - : Wiley. - 0161-3499 .- 1532-950X. ; 45, s. 571-576
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo examine whether the use of a surgical safety checklist (SSC) could reduce the incidence of complications after small animal surgery.Study DesignProspective clinical study. Animals: Client-owned dogs and cats (n=520).MethodsConsecutive cases were enrolled in the study, the first 300 cases without implementation of the surgical checklist (SSC-), followed by 220 cases with implementation of the checklist (SSC+). The checklist was adapted from the WHO surgical checklist and consisted of three different check points: (1) before induction of anaesthesia (sign in), (2) before surgical incision (time out), and (3) before recovery (sign out). In-hospital outcomes were prospectively recorded, and complications within 6 weeks were retrospectively recorded by reviewing medical records and by telephone interviews with owners. The severity of each recorded complication was graded as minor, moderate, or severe. Comparisons were made between SSC- and SSC+ outcomes.ResultsThere were significantly more complications in SSC- animals than SSC+ animals (SSC- 52/300 vs. SSC+ 15/220, P=.0003). There was a significantly higher frequency of SSI (P=.045) and wound healing complications (P=.0006) for SSC- animals than SSC+ animals.ConclusionThe frequency and severity of postoperative complications was significantly decreased after introduction of a surgical checklist. All veterinary hospitals should consider using a surgical checklist. Compliance with implementation of the checklist is important for success.
|
|
| 2. |
|
|
| 3. |
- Hälleberg Nyman, Maria, 1968-, et al.
(författare)
-
Identifying the knowledge to translate : the example of urinary incontinence in older people
- 2015
-
Ingår i: Nordic Conference on Implementation of Evidence-Based Practice.
-
Konferensbidrag (refereegranskat)abstract
- Background: While urinary incontinence (UI) is a common and worrying issue among older people, promoting the use of evidence to prevent UI onset has rarely been studied. An earlier study that was conducted in nursing homes suggests that UI can be better assessed and managed, but the prevention of UI onset requires attention to the issue by staff within acute care settings. Aim: To report on the internal facilitators’ (IF) transition, identifying the 'know-do gap' between evidence and practice in UI prevention in orthopaedic care.Methods: The Onset PrevenTion of Incontinence in Orthopaedic Nursing and rehabilitation (OPTION) pilot was carried out in two Swedish orthopaedic units of different size and location. The pilot project included a programme to support nursing and rehab staff to facilitate knowledge translation (KT). Five IFs were interviewed at baseline, and one and three months after the intervention was completed, and non-participant observations were performed during the KT-intervention. Interviews and observations were triangulated, depicting when and how the IFs identified the present, local UI practice, the evidence on UI, and the know-do gap in preventing UI onset in older patients undergoing hip surgery.Results: Preliminary results indicate that before the study, neither the IFs nor their fellows at the units were aware that they could prevent UI onset. Rather, through mapping their context and matching the evidence provided by the dialogue with the experts in the KTintervention, the IFs became aware of which practice was evidence based and which evidence to implement, and how to facilitate KT and promote evidence use.Conclusion: The OPTION pilot indicates that KT can be promoted by tailored implementation strategies and tailoring evidence, supported by IFs awareness and understanding of the local know-do gap, and strategies to overcome barriers and promote use of evidence.
|
|
| 4. |
- Hälleberg Nyman, Maria, 1968-, et al.
(författare)
-
Promoting evidence-based urinary incontinence management in acute nursing and rehabilitation care : A process evaluation of an implementation intervention in the orthopaedic context
- 2019
-
Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell Publishing Inc.. - 1356-1294 .- 1365-2753. ; 25:2, s. 282-289
-
Tidskriftsartikel (refereegranskat)abstract
- RATIONALE, AIMS, AND OBJECTIVES: The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery.METHODS: A 3-month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed.RESULTS: Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence-based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit.CONCLUSION: To promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI.
|
|
| 5. |
- Hälleberg Nyman, Maria, 1968-, et al.
(författare)
-
Urinary incontinence and its management in patients aged 65 and older in orthopaedic care : what nursing and rehabilitation staff know and do
- 2017
-
Ingår i: Journal of Clinical Nursing. - West Sussex, United Kingdom : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 26:21-22, s. 3345-3353
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To describe what nursing and rehabilitation staff know and do with regards to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery.Background: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent UI, there are indications that these guidelines are not applied in hospital care.Design: A qualitative study with descriptive design was conducted in two orthopaedic units.Methods: 46 interviews and 36 observations of care were conducted from January to October 2014 and analysed with qualitative content analysis.Results: Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures.Conclusions: Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing UI.Relevance and clinical practive: An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team.
|
|
| 6. |
- Larssen, Pia, et al.
(författare)
-
Tracing Cellular Origin of Human Exosomes Using Multiplex Proximity Extension Assay
- 2017
-
Ingår i: Molecular & Cellular Proteomics. - 1535-9476 .- 1535-9484. ; 16:3, s. 502-511
-
Tidskriftsartikel (refereegranskat)abstract
- Extracellular vesicles (EVs) are membrane-coated objects such as exosomes and microvesicles, released by many cell-types. Their presence in body fluids and the variable surface composition and content render them attractive potential biomarkers. The ability to determine their cellular origin could greatly move the field forward. We used multiplex proximity extension assays (PEA) to identify with high specificity and sensitivity the protein profiles of exosomes of different origins, including seven cell lines and two different body fluids. By comparing cells and exosomes, we successfully identified the cells originating the exosomes. Furthermore, by principal component analysis of protein patterns human milk EVs and prostasomes released from prostate acinar cells clustered with cell lines from breast and prostate tissues, respectively. Milk exosomes uniquely expressed CXCL5, MIA and KLK6, while prostasomes carried NKX31, GSTP1 and SRC, highlighting that EVs originating from different origins express distinct proteins. In conclusion, PEA provides a powerful protein screening tool in exosome research, for purposes of identifying the cell source of exosomes, or new biomarkers in diseases such as cancer and inflammation.
|
|
| 7. |
|
|
| 8. |
|
|
