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- Ekstedt, Mirjam, Professor, et al.
(author)
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Patient safety and sense of security when telemonitoring chronic conditions at home: the views of patients and healthcare professionals : a qualitative study
- 2023
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In: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Journal article (peer-reviewed)abstract
- Background: Chronic diseases are increasing worldwide, and the complexity of disease management is putting new demands on safe healthcare. Telemonitoring technology has the potential to improve self-care management with the support of healthcare professionals for people with chronic diseases living at home. Patient safety threats related to telemonitoring and how they may affect patients’ and healthcare professionals’ sense of security need attention. This study aimed to explore patients’ and healthcare professionals’ experiences of safety and sense of security when using telemonitoring of chronic conditions at home.Methods: Semi-structured interviews were conducted with twenty patients and nine healthcare professionals (nurses and physicians), recruited from four primary healthcare centers and one medical department in a region in southern Sweden using telemonitoring service for chronic conditions in home healthcare.Results: The main theme was that experiences of safety and a sense of security were intertwined and relied on patients´ and healthcare professionals´ mutual engagement in telemonitoring and managing symptoms together. Telemonitoring was perceived to increase symptom awareness and promote early detection of deterioration promoting patient safety. A sense of security emerged through having someone keeping track of symptoms and comprised aspects of availability, shared responsibility, technical confidence, and empowering patients in self-management. The meeting with technology changed healthcare professionals’ work processes, and patients’ daily routines, creating patient safety risks if combined with low health- and digital literacy and a naïve reliance on technology. Empowering patients’ self-management ability and improving shared understanding of the patient’s health status and symptom management were prerequisites for safe care and the patient´s sense of security.Conclusions: Telemonitoring chronic conditions in the homecare context can promote a sense of security when care is co-created in a mutual understanding and responsibility. Attentiveness to the patient’s health literacy, symptom management, and health-related safety behavior when using eHealth technology may enlighten and mitigate latent patient safety risks. A systems approach indicates that patient safety risks related to telemonitoring are not only associated with the patient’s and healthcare professionals functioning and behavior or the human-technology interaction. Mitigating patient safety risks are likely also dependent on the complex management of home health and social care service.
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| 2. |
- Foss, Stein, et al.
(author)
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First Scandinavian Protocol for Controlled Donation After Circulatory Death Using Normothermic Regional Perfusion
- 2018
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In: Transplantation direct. - : LIPPINCOTT WILLIAMS & WILKINS. - 2373-8731. ; 4:7
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Journal article (peer-reviewed)abstract
- Background. Donation after circulatory death (DCD) can increase the pool of available organs for transplantation. This pilot study evaluates the implementation of a controlled DCD (cDCD) protocol using normothermic regional perfusion in Norway. Methods. Patients aged 16 to 60 years that are in coma with documented devastating brain injury in need of mechanical ventilation, who would most likely attain cardiac arrest within 60 minutes after extubation, were eligible. With the acceptance from the next of kin and their wish for organ donation, life support was withdrawn and cardiac arrest observed. After a 5-minute no-touch period, extracorporeal membrane oxygenation for post mortem regional normothermic regional perfusion was established. Cerebral and cardiac reperfusion was prevented by an aortic occlusion catheter. Measured glomerular filtration rates 1 year postengraftment were compared between cDCD grafts and age-matched grafts donated after brain death (DBD). Results. Eight cDCD were performed from 2014 to 2015. Circulation ceased median 12 (range, 6-24) minutes after withdrawal of life-sustaining treatment. Fourteen kidneys and 2 livers were retrieved and subsequently transplanted. Functional warm ischemic time was 26 (20-51) minutes. Regional perfusion was applied for 97 minutes (54-106 minutes). Measured glomerular filtration rate 1 year postengraftment was not significantly different between cDCD and donation after brain death organs, 75 (65-76) vs 60 (37-112) mL/min per 1.73 m(2) (P = 0.23). No complications have been observed in the 2 cDCD livers. Conclusion. A protocol for cDCD is successfully established in Norway. Excellent transplant outcomes have encouraged us to continue this work addressing the shortage of organs for transplantation.
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| 3. |
- Hellström, Amanda, et al.
(author)
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Monitorering i hemmet : Framtidens sjukvård
- 2021
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Reports (pop. science, debate, etc.)abstract
- Digitalisering av hälso- och sjukvårdstjänster ökar, och som ett led i detta har hemmonitorering testats i en förstudie, för att senare om möjligt kunna implementeras i större skala. Hemmonitoreringen har i detta fall inneburit att patienter rapporterat in vitalparametrar samt utförd egenvård till en sjuksköterska, som mottagit och registrerat värdena. Sjuksköterskan och patienten har haft en kontinuerlig kontakt så att värden och justeringar i behandling har kunnat kommuniceras, diskuterats och följas upp. Totalt erbjöds 65 patienter med diabetes, hypertoni eller hjärtsvikt, kopplade till fem olika vårdenheter, att delta i studien. Patienterna genomförde hemmonitoreringen under 6 månader. Syftet med denna rapport var att undersöka hur hemmonitorering genom telemedicin påverkar patienternas situation i hemmet, sjukdomskontroll och vårdkonsumtion samt funktionalitet och användbarhet av hemmonitorering ur patient- och personalperspektiv.Resultatet visar de flesta av patienterna och vårdgivarna ansåg hemmonitoreringen som något positivt. Men för att dra bästa nytta av monitoreringen behövs avsatta personalresurser för att handha inkommande data och kommunikation med patienter kopplade till systemet, samt att patienterna har en god grundförståelse för sin sjuklighet. Tekniska aspekter som förmåga att kunna hantera rapporteringsterminal och medicinsk utrustning medförde inga större problem för patienterna i studien, och många ansåg systemet lätt att lära sig, lätt att integrera i dagliga rutiner samt att det inte tog så mycket tid i anspråk. Hemmonitorering tycks lämpa sig för många olika patientgrupper, men vid utbyggnad av användandet kan det vara hjälpfullt att göra detta genom samskapande processer med patienter, anhöriga och involverad vårdpersonal, så att innehåll och utformning matchar de behov som finns för patientgruppen.I föreliggande rapport har inga aspekter gällande cybersäkerhet undersökts, men detta kan vara en aspekt att ta hänsyn till då känslig information delas trådlöst mellan patient och vårdgivare.
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