| 1. |
- Nordin Olsson, Inger, 1955-, et al.
(författare)
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Registered nurses’ perception of their professional role regarding medication management in nursing care of the elderly
- 2014
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 4:2, s. 153-161
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Tidskriftsartikel (refereegranskat)abstract
- Background: The role of the registered nurse (RN) in the municipality regarding medication management in care for the elderly is rarely discussed. Organizational issues related to medication management often contribute more to the management than needs of the patients, nursing skills, and collaboration with the physician in primary care.Objective: The aim of this study was to describe RNs’ perceptions of their professional role, especially regarding medication management in nursing of the elderly.Design: The study is descriptive with a qualitative approach. Interviews with 16 RNs working at nursing homes were analysed by content analysis.Results: The findings can be grouped into seven categories showing the RN in different roles while performing different aspects of her or his work: as controller, executer, messenger, supervisor, initiator, visionary and solitary worker. These themes were identified in the interviews and characterized the nurses’ own judgements and actions taken, especially regarding drug treatment. Overall, the RNs described nursing in elderly care as an undefined profession lacking leadership regarding medication management.Conclusions: The study concludes that medication management ought to be promoted in care for the elderly. To handle the challenge and risks of polypharmacy there must be sufficient and adequate reporting based on the RNs’ nursing and skills to monitor and evaluate the drug treatment in teamwork with the physician. This requires leadership with understanding of the integration of services in care for the elderly, and of the medical processes and nursing skills involved.
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| 2. |
- Nordin Olsson, Inger, et al.
(författare)
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Registered nurses’ perceptions of their professional role in medication in elderly care
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The role of the municipal registered nurse (RN) is rarely discussed with regard to multimedication. The aim of this study was to describe RNs’ perceptions of their professional role especially regarding medication management in elderly care. The study is descriptive with a qualitative approach. Interviews with 16 RNs at nursing homes for the elderly were analysed. The RNs described an undefined profession lacking leadership. The findings can be categorized into seven roles showing different aspects of their work: controller, executer, messenger, supervisor, initiator, visionary and solitary worker. Health assessment and medication management should be promoted in elderly care. There must be sufficient and adequate reporting based on the RNs’ nursing and medical skills to monitor and evaluate the drug treatment in teamwork with the physician. This requires leadership with understanding of the integration process in care of the elderly, of the medical processes and nursing skills involved.
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| 3. |
- Olsson, Inger, 1954-, et al.
(författare)
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Social welfare in Singapore and Sweden : Differences in organisational systems of health care, social security and rehabilitation.
- 2008
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Ingår i: International Journal of Disability Mangement Research. - Brisbane : Australian Academic Press. - 1833-8550 .- 1834-4887. ; 2:3, s. 30-38
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study is to describe and compare the health care, social security and rehabilitation systems in Singapore and Sweden. Two fundamental differences can be identified. First, the system in Singapore are strongly oriented towards a free market system, while Sweden’s demonstrates strong public control. Second, following from how the systems are oriented, Singaporeans are expected to have a higher degree of independence and control over their health care, social security and rehabilitation. It appears that Singapore has had greater success in attaining and maintaining a system of health promotion, which influences the three systems. However, the Swedish welfare system provides greater security to those who are in need of health care, social security and rehabilitation.
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| 4. |
- Alharbi, Tariq, 1979, et al.
(författare)
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Experiences of person-centred care – patients’ perceptions: qualitative study
- 2014
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Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 13:28
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Tidskriftsartikel (refereegranskat)abstract
- Background Patient care models have been implemented and documented worldwide. Many studies have focused on features that hinder and facilitate the shift to such models, including the implementation process, staff involvement, resistance to new models and cultural dimensions. However, few studies have identified the potential effects of such new care models from a patient perspective. The aim of the present study was to investigate whether patients did in fact perceive the intentions of partnership in the new care model 1 year after its implementation. Methods Sixteen participants were interviewed, selected from two wards in a medical department where a new care model had been implemented 1 year earlier. A directed deductive content analysis was selected. The aim of the directed approach to content analysis was to investigate to what extent the new care model had been implemented, using patients’ perspectives to describe the level of implementation. A coding framework was developed based on a theoretical paper that described the key features of the new care model. Results The implementation of person-centred care had clearly occurred to a large degree, even if some patients appeared not to have been exposed to the model at all. Aspects of the newly implemented care model were obvious; however, it was also clear that implementation was not complete. The analysis showed that patients felt listened to and that their own perception of the situation had been noted. Patients spontaneously expressed that they felt that the staff saw them as persons and did not solely focus on their disease. It was also stated that not every ailment or aspect of a patient’s illness needed to be addressed or resolved for open listening to be perceived as a positive experience. Conclusions The findings indicate that even though some patients were not interested in participating and playing an active role in their own care, this might relate to a lack of understanding on how to invite them to do so and to increase their confidence. To change healthcare from a paternalistic system to care where patients are seen as partners may require pedagogical skills.
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| 5. |
- Alharbi, Tariq, 1979, et al.
(författare)
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Organizational culture and the implementation of person centered care: Results from a change process in Swedish hospital care
- 2012
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510. ; 108:2-3, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.
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| 6. |
- Alharbi, Tariq, 1979, et al.
(författare)
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The impact of organizational culture on the outcome of hospital care: After the implementation of person-centred care
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:1, s. 104-110
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To measure the effect of organizational culture on health outcomes of patients 3 months after discharge. Methods: a quantitative study using Organizational Values Questionnaire (OVQ) and a health-related quality of life instrument (EQ-5D). A total of 117 nurses, 69% response rate, and 220 patients answered the OVQ and EQ-5D, respectively. Results: The regression analysis showed that; 16% (R2 = 0.02) of a decreased health status, 22% (R2 = 0.05) of pain/discomfort and 13% (R2 = 0.02) of mobility problems could be attributed to the combination of open system (OS) and Human Relations (HR) cultural dimensions, i.e., an organizational culture being dominated by flexibility. Conclusions: The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.
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| 7. |
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| 8. |
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| 9. |
- Angelstam, Per, 1953-, et al.
(författare)
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Two-dimensional gap analysis : a tool for efficient conservation planning and biodiversity policy implementation
- 2003
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Ingår i: Ambio. - : Royal Swedish Academy of Sciences. - 0044-7447 .- 1654-7209. ; 32:8, s. 527-534
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Tidskriftsartikel (refereegranskat)abstract
- The maintenance of biodiversity by securing representative and well-connected habitat networks in managed landscapes requires a wise combination of protection, management, and restoration of habitats at several scales. We suggest that the integration of natural and social sciences in the form of "Two-dimensional gap analysis" is an efficient tool for the implementation of biodiversity policies. The tool links biologically relevant "horizontal" ecological issues with "vertical" issues related to institutions and other societal issues. Using forest biodiversity as an example, we illustrate how one can combine ecological and institutional aspects of biodiversity conservation, thus facilitating environmentally sustainable regional development. In particular, we use regional gap analysis for identification of focal forest types, habitat modelling for ascertaining the functional connectivity of "green infrastructures", as tools for the horizontal gap analysis. For the vertical dimension we suggest how the social sciences can be used for assessing the success in the implementation of biodiversity policies in real landscapes by identifying institutional obstacles while implementing policies. We argue that this interdisciplinary approach could be applied in a whole range of other environments including other terrestrial biota and aquatic ecosystems where functional habitat connectivity, nonlinear response to habitat loss and a multitude of economic and social interests co-occur in the same landscape.
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| 10. |
- Angerås, Oskar, 1976, et al.
(författare)
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Impact of Thrombus Aspiration on Mortality, Stent Thrombosis, and Stroke in Patients with ST-Segment-Elevation Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry
- 2018
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Ingår i: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background-Thrombus aspiration is still being used in a substantial number of patients despite 2 large randomized clinical trials showing no favorable effect of routine thrombus aspiration during primary percutaneous coronary intervention in patients with STsegment- elevation myocardial infarction. The aim of this observational study was to evaluate the impact of thrombus aspiration on mortality, stent thrombosis, and stroke using all available data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Methods and Results--We identified 42 829 consecutive patients registered in SCAAR between January 2005 and September 2014 who underwent percutaneous coronary intervention for ST-segment-elevation myocardial infarction. Thrombus aspiration was used in 25% of the procedures. We used instrumental variable analysis with administrative healthcare region as the treatmentpreference instrumental variable to evaluate the effect of thrombus aspiration on mortality, stent thrombosis, and stroke. Thrombus aspiration was not associated with mortality at 30 days (risk reduction: -1.2; 95% confidence interval [CI] , -5.4 to 3.0; P=0.57) and 1 year (risk reduction: -2.4; 95% CI, -7.6 to 3.0; P=0.37). Thrombus aspiration was associated with a lower risk of stent thrombosis both at 30 days (risk reduction: -2.7; 95% CI, -4.1 to -1.4; P < 0.001) and 1 year (risk reduction: -3.5; 95% CI, -5.3 to -1.7; P < 0.001). In-hospital stroke and neurologic complications did not differ between groups (risk reduction: 0.1; 95% CI, -0.8 to 1.1; P=0.76). Conclusions--Mortality was not different between the groups. Thrombus aspiration was associated with decreased risk of stent thrombosis. Our study provides important evidence for the external validity of previous randomized studies regarding mortality.
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