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  • 1.
    Hedenskog, Christina
    et al.
    Department of Anesthesiology and Intensive Care, Faculty of Medicine and Health, Örebro University Hospital, Sweden.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Jaensson, Maria
    Örebro University, School of Health Sciences. School of Health Sciences, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.
    Swedish-Registered Nurse Anesthetists’ Evaluation of Their Professional Self2017In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 32, no 2, p. 106-111Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to explore how the nurse anesthetist values their professional self, compared with their peers, and also to explore whether professional self is affected by age, work experience, and/or gender.

    Design: An explorative and prospective cross-sectional design.

    Methods: During April 2011, a total of 108 registered nurse anesthetists from three different hospitals were surveyed using the Professional Self- Description Form with questions covering 21 items.

    Findings: A total of 87 (80%) responded: 21 men and 66 women with a mean age of 45 years (range, 28 to 64 years) and mean professional experience of 12 years (range, 1 to 41 years). Four factors were found: professionalism, trait of character, scientific knowledge, and empathy, with Cronbach alpha of 0.96 overall. Analysis showed that perceived professional self depends on age and amount of work experience, but not on gender.

    Conclusions: The Professional Self-Description Form exhibits satisfactory internal consistency. Work experience and age influenced the development of professional self of nurse anesthetists

  • 2.
    Jaensson, Maria
    et al.
    Örebro University.
    Falk-Brynhildsen, Karin
    Örebro University.
    Gillespie, Brigid M.
    Menzies Health Institute Queensland (MHIQ), Griffith University, Gold Coast, Australia.
    Wallentin, Fan Y.
    Department of Statistics, Uppsala University, Uppsala, Sweden.
    Nilsson, Ulrica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Psychometric Validation of the Perceived Perioperative Competence Scale-Revised in the Swedish Context2017In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473Article in journal (Refereed)
  • 3.
    Knudsen, Kati
    et al.
    Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden; Centre for Research & Development, Uppsala University, Uppsala, Sweden; County Council of Gävleborg, Gävle, Sweden; Department of Public Health and Caring Sciences, Section for Caring Sciences, Uppsala University, Uppsala, Sweden;.
    Högman, Marieann
    Centre for Research & Development, Uppsala University, Uppsala, Sweden; County Council of Gävleborg, Gävle, Sweden; Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
    Larsson, Anders
    Department of Anesthesiology and Intensive Care, Hedenstierna Laboratory, Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Nilsson, Ulrica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The best method to predict easy intubation: a quasi-experimental pilot study2014In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 29, no 4, p. 292-297Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To facilitate evaluation of the airway before endotracheal intubation, different scores have been developed, mainly to predict difficult airways. However, in anesthesia clinical practice in Sweden, scores would be more useful if they could also predict an easy airway, so that the correct category of anesthesia personnel can be allocated. Therefore, we evaluated whether scoring systems commonly used to predict difficult airways could also predict easy endotracheal intubation.

    DESIGN: This prospective observational study included patients who were scheduled for general anesthesia and required endotracheal intubation.

    METHODS: Airways were evaluated preoperatively by two independent variables, namely Mallampati classification and thyromental distance. After anesthesia induction, the Cormack and Lehane grade was assessed.

    FINDING: Mallampati scores yielded the highest specificity in predicting easy intubation, and Cormack and Lehane grades yielded the highest positive predictive value for predicting easy intubation.

    CONCLUSIONS: Mallampati classification is an appropriate screening test for predicting easy intubation.

  • 4.
    Nilsson, Ulrica G.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Intraoperative positioning of patients under general anesthesia and the risk of postoperative pain and pressure ulcers2013In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 28, no 3, p. 137-143Article in journal (Refereed)
    Abstract [en]

    Purpose: Intraoperative positioning is a crucial component of peri-anesthesia care and can lead to postoperative complications. Therefore, this study explored risk factors for postoperative positioning pain and pressure ulcers that were associated with supine positioning in patients undergoing general anesthesia.

    Design: In this prospective cross sectional exploratory study, 86 ASA I-II, normal BMI patients undergoing elective surgery in the supine position from February to May 2009 were included. Seven different risk factors were examined to detect possible associations between intraoperative positioning and the development of postoperative positioning pain or pressure ulcers.

    Findings: Only one variable was found to be a significant risk factor for postoperative positioning pain, preoperative pain (P = .017) with an odds ratio of 13.1 (95% CI 1.4-23.9). There were no associations found between positioning pain or pressure ulcers and gender, age, duration of surgery, surface of the operation room bed, and number of monitoring devices. Four patients suffered from pain in their heels; of these, two had bilateral Grade I pressure ulcers. Five patients suffered from arm pain and three patients from neck and back pain.

    Conclusion: In conclusion, the risk for positioning pain seems to be greater in patients suffering from preoperative pain. Routine documentation and follow-up of a patient's preoperative pain, intraoperative positioning and overall postoperative pain experience are emphasized.

  • 5.
    Nilsson, Ulrica
    et al.
    Örebro University, School of Health Sciences.
    Göras, Camilla
    Örebro University, School of Health Sciences. Anesthesia and Intensive Care Unit, Falun Hospital, Falun, Sweden.
    Yang Wallentin, Fan
    Department of Statistics, Uppsala university , Uppsala, Sweden.
    Ehrenberg, Anna
    School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Unbeck, Maria
    Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    The Swedish Safety Attitudes Questionnaire - Operating Room Version: Psychometric Properties in the Surgical Team2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473Article in journal (Refereed)
    Abstract [en]

    Purpose: To validate the Swedish Safety Attitudes Questionnaire–operating room (SAQ-OR) version by re-evaluating its psychometric properties for the surgical team.

    Design: Cross-sectional questionnaire study.

    Methods: 541 surgical team members including perioperative nurses, physicians, and licensed practical nurses at three Swedish hospitals were included.

    Findings: For the total sample, the Cronbach’s a for the six factors ranged from 0.51 to 0.76. Goodness-of-fit analyses indicated that the six-factor model was acceptable and the factor loadings were statistically significant. The test of the hypothesized relationships among the factors showed a correlation from 0.936 to 0.042.

    Conclusions: The refined Swedish version of the SAQ-OR is a reasonably reliable and acceptably valid instrument for the measurement of patient safety climate in the surgical team. However, the results related to the different analyses varied among the different professionals and further research, using larger samples, is needed to explore these differences, especially among the physicians.

  • 6.
    Nilsson, Ulrica
    et al.
    Örebro University, School of Health Sciences.
    Jaensson, Maria
    Örebro University, School of Health Sciences.
    Anesthetic Nursing: Keep in Touch, Watch Over, and Be One Step Ahead2016In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 31, no 6, p. 550-551Article in journal (Refereed)
  • 7.
    Rosén, Siv
    et al.
    Örebro University, School of Health and Medical Sciences. Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.
    Svensson, Margita
    Örebro University, School of Health and Medical Sciences. Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.
    Nilsson, Ulrica G.
    Örebro University, School of Health and Medical Sciences. Department of Health Sciences and Department of Cardiothoracic Surgery, Örebro University Hospital, Örebro, Sweden.
    Calm or not calm: the question of anxiety in the perianesthesia patient2008In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 23, no 4, p. 237-246Article in journal (Refereed)
    Abstract [en]

    Preoperative anxiety can be a major problem for the patient. Three distinct dimensions of preoperative anxiety are known: fear of the unknown, fear of feeling ill, and fear for life. The aim of this study was to investigate whether patients feel anxiety (calm or not calm) preoperatively before undergoing an elective day care surgery and also to elucidate the factors contributing to a patient's current state of mind. A prospective study with 161 American Society of Anesthesiologists I-II outpatients scheduled for elective surgery was conducted. In a questionnaire the patients were asked to state if they were feeling calm or not and to describe factors contributing to their current mood. If responding that they did not feel calm, the participants were asked to rate the level of anxiety on a Numeric Rating Scale, 1-10. The results showed that 57% (n = 91) of the participants stated that they did not feel calm. A significantly higher proportion of women did not feel calm (65%), P < .05. Significantly more participants with a previous experience of surgery felt calm (90%), P < .01. In all, 190 statements were submitted. The results show that nearly half of the participants felt calm before surgery. The reasons were earlier positive experiences, feeling of security and caring, being well-informed, and having positive expectations. Furthermore, a higher proportion of women did not feel calm preoperatively. This indicates a need before surgery to routinely document and evaluate the individual patient's state of mind and reasons for the state of mind. This individual preoperative care can make it possible to provide emotional support, decrease anxiety, and give the patient a more positive surgical experience.

  • 8.
    Rönnberg, Linda
    et al.
    Department of Nursing, Umeå University, Umeå, Sweden; Department of Anaesthesia, Östersunds Hospital, Östersund, Sweden.
    Nilsson, Ulrica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Swedish Nurse Anesthetists’ Experiences of the WHO Surgical Safety Checklist2015In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 30, no 6, p. 468-475Article in journal (Refereed)
    Abstract [en]

    Purpose: The World Health Organization (WHO) surgical safety checklist aims to increase communication, build teamwork, and standardize routines in clinical practice in order to reduce complications and improve patient safety. The checklist has been implemented in surgical departments both nationally and internationally. The purpose of this study was to describe the registered nurse anesthetists’ (RNA) experience with the use of the WHO surgical safety checklist.

    Design: This was a cross-sectional study with a descriptive mixed method design, involving nurse anesthetists from two different hospitals in Sweden. Data was collected from a study specific questionnaire.

    Findings: Forty-seven RNAs answered the questionnaire. There was a statistically significant lower compliance to “Sign-in” compared to the other two parts, “Timeout” and “Sign-out.” The RNAs expressed that the checklist was very important for anesthetic and perioperative care. They also expressed that by confirming their own area of expertise, they achieved an increased sense of being a team member Thirty-four percent believed that the surgeon was responsible for the checklist, yet this was not the reality in clinical practice. Although 23% reported that they initiated use of the checklist, only one RNA believed that it was the responsibility of an RNA. Forty-three percent had received training about the checklist and its use.

    Conclusion: The WHO surgical checklist facilitates the nurse anesthetists anesthetic and perioperative care. It allows the nurse anesthetist to better identify each patient’s specific concerns and increased sense of being a team member.

  • 9.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Department of Cardiothoracic and Vascular Surgery.
    Anderzen-Carlsson, Agneta
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 58-68Article in journal (Refereed)
    Abstract [en]

    Purpose: To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective.

    Design: A cross-sectional design was used.

    Methods: First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy.

    Finding: The final PNAS-Swe has 29 items in four subscales. The RNAs reported that they feel that they should provide protective nursing advocacy for their patients. There were no differences in gender, or associations with age, or work experience regarding their advocacy beliefs or actions.

    Conclusions: The PNAS-Swe is valid for use in a Swedish context. Protective nursing advocacy is important to the RNAs, which is in congruence with earlier qualitative studies.

  • 10.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Perioperative Patient Advocacy: An Integrative Review2016In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 31, no 5, p. 422-433Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this review was to identify the characteristics and consequences of perioperative patient advocacy.

    Design: An integrative review method was employed.

    Methods: A database search to identify peer-reviewed articles that focused on perioperative patient advocacy was conducted in PubMed and CINAHL, followed by a manual search for additional articles. Studies were selected if they reported original empirical research findings with regard to perioperative patient advocacy. The data abstraction and synthesis were achieved with an inductive qualitative content analysis.

    Finding: The analysis resulted in seven categories, two subthemes, and one main theme. The main theme, “Doing good for another human being—a balancing act between philanthropy and personal gratification,” was the core of perioperative patient advocacy.

    Conclusion: Perioperative patient advocacy is part of the professional role of the perioperative nurse, and it affects the perioperative nurse emotionally. This advocacy shares similarities with descriptions of patient advocacy in general nursing.

  • 11.
    Tinnfält, Ingrid
    et al.
    Department of Anesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.
    Nilsson, Ulrica
    Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden; Department of Nursing, Umeå University, Umeå, Sweden.
    Patients' experiences of intraoperative care during abdominal aortic aneurysm repair under local anesthesia2011In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 26, no 2, p. 81-88Article in journal (Refereed)
    Abstract [en]

    Abdominal aortic aneurysms can be repaired using endovascular surgery performed under local anesthesia. However; evidence is sparse concerning how patients experience intraoperative care while being "awake" during major surgery The primary aims of this retrospective study were to identify patients' perceptions of the quality of intraoperative care during endovascular surgery for aortic aneurysm under local anesthesia and to identify areas for quality improvement. Retrospectively, 26 patients completed the questionnaire "Quality From the Patient's Perspective." The results showed that 15 of 21 total items received scores above the quality improvement threshold. Patients rated the quality of intraoperative nursing to be very high in terms of how they experienced the situation and nurses' understanding, confidence, commitment; and respect. However; need for improvement was found in four areas: participation, pain, anxiety, and positioning. In conclusion, despite the need for quality improvement in four identified areas, patients undergoing endovascular aneurysm repair under local anesthesia appear to perceive the quality of intraoperative care, especially nursing, as high.

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