| 1. |
- Nilsson, Jan, 1963-, et al.
(författare)
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Development and Validation of the Ambulance Nurse Competence Scale
- 2020
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Ingår i: Journal of Emergency Nursing. - : Elsevier. - 0099-1767 .- 1527-2966. ; 46:1, s. 34-43
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: In recent decades, major competency shifts have taken place in prehospital care in Sweden because staffing ambulances with registered/specialized nurses has become a priority. The aim of this study was to develop and validate a new instrument to measure the self-reported professional competency of specialist ambulance nursing students and registered/specialist nurses working in prehospital care. Methods: This study used a quantitative cross-sectional design to evaluate psychometric properties of a new instrument. The sample included 179 registered/specialist ambulance nurses and 34 specialist ambulance nursing students. Results: The analyses resulted in the Ambulance Nurse Competence (ANC) scale, consisting of 43 items and covering 8 factors: Nursing Care (n = 8), Value-based Nursing Care (n = 5), Medical Technical Care (n = 5), Care Environment's Community (n = 4), Care Environment's Serious Events (n = 8), Leadership Management (n = 3), Supervision and Professional Conduct (n = 4), and Research and Development (n = 6). All factors except Leadership Management achieved a Cronbach's alpha value greater than 0.71, explaining 59.62% of the total variance. Discussion: The ANC scale was systematically tested and showed satisfactory psychometrical properties. The ANC scale can be used in the education programs of future registered/specialist ambulance nurses as a tool for self-reflected learning and could also be of potential use in identifying competence gaps in registered/specialist ambulance nurses, which could direct the design of introductory programs. The scale could also be used as an outcome measure together with other instruments.
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| 2. |
- Amritzer, Maria, et al.
(författare)
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A new perspective of missed nursing care – the emergency department context: a descriptive, cross-sectional study
- 2024
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Ingår i: Journal of Emergency Nursing. - 0099-1767 .- 1527-2966. ; 50:3, s. 392-402
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This descriptive cross-sectional study describes missed nursing care, quality of care, and patient safety rated by nursing staff in emergency departments. Required patient care that is omitted or delayed (missed nursing care) is associated with poorer quality of care and increased risk for adverse events, but studies are scarce in the emergency setting. Methods: Emergency registered nurses and nursing assistants (N=126) at 2 Swedish emergency departments participated in the study. The MISSCARE survey -Swedish version was used for data collection. Results: Emergency nursing staff assessed that nursing care is frequently missed in the emergency department. More than half of the 24 nursing care items were reported as missed by over 50% of the participants, and registered nurses rated most items significantly higher compared to nursing assistants. Half of the nursing staff perceived quality of care to be good, but nearly the same proportion perceived patient safety as poor. Registered nurses viewed both quality and safety worse than nursing assistants. Discussion: The present study found very high levels of missed nursing care in most nursing items. Results indicate that nursing staff in emergency departments need to prioritize between the tasks and that some tasks may not be relevant in the context. The emergency setting focuses primarily on identifying signs of urgency, assessing patients, performing interventions, and diagnostics. However, even items that seemed to be prioritized, such as reassessment of vital signs, had a surprisingly high level of missed nursing care in comparison to in -hospital wards.
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| 3. |
- Andersson, Henrik, 1968, et al.
(författare)
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Questioning nursing competences in emergency health care.
- 2009
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Ingår i: Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association. - : Elsevier BV. - 1527-2966 .- 0099-1767. ; 35:4, s. 305-11
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Medical and technologic developments entail new competence demands in emergency health care, and it follows that head nurses must recognize and create prerequisites, as well as evaluate the competence of registered nurses. The aim of this study is to describe head nurses' conceptions of emergency nursing competence needs and their responsibility for creating prerequisites of competence development in emergency nursing. METHODS: A 24-item questionnaire was sent to all the head nurses (N = 79) of all the existing emergency departments in Sweden. The response rate was 73%, and in the analysis of the data, descriptive statistics were used. RESULTS: According to the head nurses, basic nursing education does not provide sufficient emergency nursing competence. Consequently, there is a need for supplementary formal emergency nursing education. Furthermore, most of the head nurses have inadequate strategies for evaluating competence development, and economic and personnel resources are insufficient to meet the educational needs. A minority of the head nurses consider that they have full responsibility for creating the prerequisites of the competence development of nurses. DISCUSSION: To ensure sufficient nursing competence in emergency health care organizations, there is a need to establish competence demands in emergency nursing and evaluate strategies for competence development. The establishment of a Swedish emergency nurses association would be important for the development of national guidelines of emergency nursing as well as to facilitate the interpretation and concretizing of rules and legislation and to promote questions related to research, development, and education in emergency nursing. With national guidelines and recommendations, the head nurses' responsibilities for the development of nurses' skills would be clarified.
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| 5. |
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| 6. |
- Kristensson Ekwall, Anna
(författare)
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Acuity and Anxiety From the Patient's Perspective in the Emergency Department.
- 2013
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Ingår i: Journal of Emergency Nursing. - : Elsevier BV. - 1527-2966 .- 0099-1767. ; 39:6, s. 534-538
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge of a patient's perception of her medical needs and urgency may make it possible for emergency nurses to communicate the triage decision and make the patient understand the assessment and triage category. The aim of this study was to compare the patients' own assessments of their acuity to the triage nurse's assessment, as well as describe patient satisfaction and levels of anxiety.
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| 7. |
- Muntlin, Åsa, 1971-, et al.
(författare)
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Barriers to change hindering quality improvement : the reality of emergency care
- 2010
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Ingår i: Journal of Emergency Nursing. - : Elsevier. - 0099-1767 .- 1527-2966. ; 36:4, s. 317-323
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to investigate physicians' and nurses' perspectives and prerequisites for quality improvement in the emergency department based on results from a previous patient survey. Method: The study used an explorative design with a qualitative approach and was conducted at the main emergency department of a Swedish university hospital. Interviews were conducted with 5 focus groups. In total, the groups comprised 22 respondents. Results: The respondents suggested goals and quality improvements, such as more patient-centered care, reduced waiting times, and better pain management. However, barriers to quality improvement also were identified and represented 3 themes: the patient is looked upon as an object or a problem; the physicians and nurses belong to different organizational cultures; and the hospital's organization hinders the optimal flow of patients and improvements to quality. Discussion: When assigning priority to the topic areas, most of the focus groups ranked "information, respect, and empathy" as most important to improve. Adequate information, proper care, and treatment within a reasonable time in the emergency department were cited as the goals for patient care, but the health care professionals perceived barriers to change in the hospital culture and organization. To ensure quality care and patient safety, these barriers should be addressed by leaders on all levels in the organization, including the hospital board. Health care professionals' perspectives of quality of care are valuable and should be included in quality improvement work.
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| 8. |
- Sheerin, Fintan, et al.
(författare)
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The Occipital and Sacral Pressures Experienced by Healthy Volunteers Under Spinal Immobilization : A Trial of Three Surfaces
- 2007
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Ingår i: Journal of Emergency Nursing. - : Elsevier BV. - 0099-1767 .- 1527-2966. ; 33:5, s. 447-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The development of a pressure ulcer is of great significance to the life-long rehabilitative management of the person with a spinal cord injury, and may indeed delay and repeatedly interfere with that process. That the period preceding admission to the specialized spinal injury unit is crucial with regard to pressure ulcer development is evident in the professional literature. Both anecdotal and empirical evidence indicates that a significant number of pressure ulcers occur as a result of management provided prior to admission, and that such ulcers are more likely to occur in those patients who have undergone a transfer process from a hospital distal to the specialist unit on a hard spinal board. AIM: In consideration of this and of the fact that, in Ireland, the interhospital transfer of spinal injured patients has usually involved the employment of such spinal boards to achieve immobilization, this study sought to identify whether or not the pressure experienced by individuals at two anatomical locations was dependent on the support surface employed. METHODOLOGY: Pressure under the occiput and sacrum of three healthy volunteers immobilized on three support surfaces was measured using air-filled pressure-measuring sacks. The surfaces employed were an uncovered spinal board; a spinal board with inflatable raft devise; and a full-body vacuum splint. DISCUSSION: Marked reductions in pressure were measured when using the inflatable raft and the vacuum mattress. The results of this study will provide a basis for a larger study and, through that, the formulation of recommendations for standardized practice along a national care pathway.
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| 9. |
- Sterner, Anders, et al.
(författare)
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Ability to Care in Acute Situations : The Influence of Simulation-Based Education on New Graduate Nurses
- 2022
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Ingår i: Journal of Emergency Nursing. - : Elsevier BV. - 0099-1767 .- 1527-2966. ; 48:5, s. 515-524
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Tidskriftsartikel (refereegranskat)abstract
- Introduction:Simulation-based education is frequently used in transition programs for new graduate nurses. Simulation-based education is implemented as a measure to practice nursing skills, gain experience, and prepare nurses for caring in challenging situations, such as acute situations. However, concerns about the data supporting the use of simulation are obtained from small studies that do not use validated measurement scales.Objective:This study aimed to explore the influence of simulation-based education on new graduate nurses’ perceivedability to provide care in acute situations.Methods:A total of 102 new graduate nurses participated in simulation-based education as a mandatory part of an introductory program. They completed a premeasurement and a postmeasurement using the Perception to Care in Acute Situations scale. The Wilcoxon signed-rank test and the paired samples ttest were used to test the statistical significance of outcomes for the simulation-based education, with the alpha set at 0.05.Cohen’s d formula was used to calculate the effect size.Results:The Wilcoxon signed-rank test on the total scale score showed that simulation-based education resulted in a statistically significant change in the nurses’ perceptions of their abilityt o care in acute situations (N ¼ 99; Z ¼ 7877; P < .001). The paired samplest test showed that the mean posteducation scorewas significantly higher (P < .001) in the total score. Cohen’sd formula (-1.24) indicated a large effect size on the total score.Discussion:Simulation-based education can provide an effective means of improving new graduate nurses’ perceivedability to provide care in acute situations.
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| 10. |
- Wireklint Sundström, Birgitta, et al.
(författare)
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Being Prepared for the Unprepared : A Phenomenology Field Study of Swedish Prehospital Care
- 2012
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Ingår i: Journal of Emergency Nursing. - : Mosby, Inc.. - 0099-1767 .- 1527-2966. ; 38:6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This paper presents a study of prehospital care with particular focus on how ambulance personnel prepare themselves for their everyday assignments. Methods: The caring science field study took a phenomenological approach, where data were analyzed for meaning. Two specialist ambulance nurses, three registered nurses, and six paramedics participated. Results: The previously known discrepancy between in-hospital care and prehospital care was further interpreted in this study. The pre-information from an emergency medical dispatch (EMD) center provides ambulance personnel with basic expectations as to what they will have to take care of. At the same time that they maintain their certainty and control, our major findings indicate that prehospital care in emergency medical service requires the personnel to be prepared for an open and flexible encounter with the patient; to be prepared for the unprepared, i.e., to be open and to avoid being governed by predetermined statements. Discussion: Our findings suggest that the outcomes of good prehospital care affect patient security. The seemingly time-consuming dialogue with the patient facilitates understanding and decision-making regarding the patient's medical needs, and it is comforting to the patient. The ambulance personnel need to be well prepared for this task and fully understand that the situation might differ considerably from the information provided by the EMD centers. All objective information is of great value in this care context, but ultimately it is the patient who provides reliable information about her/his own situation.
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