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  • 51.
    Göransson, Katarina E.
    et al.
    Örebro University, Department of Health Sciences.
    Ehrenberg, Anna
    Örebro University, Department of Health Sciences.
    Marklund, Bertil
    Ehnfors, Margareta
    Örebro University, Department of Health Sciences.
    Emergency department triage: is there a link between nurses’ personal characteristics and accuracy in triage decisions?2006In: Accident and Emergency Nursing, ISSN 0965-2302, E-ISSN 1532-9267, Vol. 14, no 2, p. 83-88Article in journal (Refereed)
    Abstract [en]

    Introduction

    A common task of registered nurses is to perform emergency department triage, often using an especially designed triage scale in their assessment. However, little information is available about the factors that promote the quality of these decisions. This study investigated personal characteristics of registered nurses and the accuracy in their acuity ratings of patient scenarios.

    Methods

    Using the Canadian Triage and Acuity Scale (CTAS), 423 registered nurses from 48 (62%) Swedish emergency departments individually triaged 18 patient scenarios.

    Results

    The registered nurses’ percentage of accurate acuity ratings was 58%, with a range from 22% to 89% accurate acuity ratings per registered nurse. In total, 60.3% of the registered nurses accurately triaged the scenarios in 50–69% of the cases. No relationship was found between personal characteristics of the registered nurses and their ability to triage.

    Discussion

    The lack of a relationship between personal characteristics of registered nurses and their ability to triage suggests that there might be intrapersonal characteristics, particularly the decision-making strategies used which can partly explain this dispersion. Future research that focuses on decision-making is likely to contribute in identifying and describing essential nursing characteristics for successful emergency department triage.

  • 52.
    Göransson, Katarina
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences. Department of Health and Social Sciences, Dalarna University, Falun.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Fonteyn, Marsha
    Dana-Farber Cancer Center, Boston, MA, United States.
    The use of qualitative data analysis software (QDAS) to manage and support the analysis of think aloud (TA) data2006In: Consumer-Centered Computer-Suppported Care for Healthy People, Amsterdam, Netherlands: IOS Press, 2006, Vol. 122, p. 143-6Conference paper (Refereed)
    Abstract [en]

    This methodological paper describes how qualitative data analysis software (QDAS) is being used to manage and support a three-step protocol analysis (PA) of think aloud (TA) data in a study examining emergency nurses' reasoning during triage. The authors believe that QDAS program QRS NVivo will greatly facilitate the PA and will allow them to identify and describe the information that triage nurses concentrate on during triage, and how they structure this information to make a triage decision. These findings could assist in designing and creating decision support systems to guide nurses' triaging. Additionally, details about how to use QRS NVivo for PA of TA data may assist and guide future informatics research using similar methodology are presented here. This innovative use of QDAS holds great promise for future nursing informatics research.

  • 53.
    Göransson, Katarina
    et al.
    Örebro University, Department of Health Sciences.
    Ehrenberg, Anna
    Örebro University, Department of Health Sciences.
    Marklund, Bertil
    Ehnfors, Margareta
    Örebro University, Department of Health Sciences.
    Accuracy and concordance of nurses in emergency department triage2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 432-438Article in journal (Refereed)
    Abstract [en]

    In the emergency department (ED) Registered Nurses (RNs) often perform triage, i.e. the sorting and prioritizing of patients. The allocation of acuity ratings is commonly based on a triage scale. To date, three reliable 5-level triage scales exist, of which the Canadian Triage and Acuity Scale (CTAS) is one. In Sweden, few studies on ED triage have been conducted and the organization of triage has been found to vary considerably with no common triage scale. The aim of this study was to investigate the accuracy and concordance of emergency nurses acuity ratings of patient scenarios in the ED setting. Totally, 423 RNs from 48 (62%) Swedish EDs each triaged 18 patient scenarios using the CTAS. Of the 7,550 triage ratings, 57.6% were triaged in concordance with the expected outcome and no scenario was triaged into the same triage level by all RNs. Inter-rater agreement for all RNs was kappa = 0.46 (unweighted) and kappa = 0.71 (weighted). The fact that the kappa-values are only moderate to good and the low concordance between the RNs call for further studies, especially from a patient safety perspective.

  • 54.
    Hagvall, Monica
    et al.
    Department of Paediatric Care, Örebro University Hospital, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Health Care Sciences, Region Örebro County, Örebro, Sweden.
    Experiences of parenting a child with medical complexity in need of acute hospital care2016In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 20, no 1, p. 68-76Article in journal (Refereed)
    Abstract [en]

    Parents of children with medical complexity have described being responsible for providing advanced care for the child. When the child is acutely ill, they must rely on the health-care services during short or long periods of hospitalization. The purpose of this study was to describe parental experiences of caring for their child with medical complexity during hospitalization for acute deterioration, specifically focussing on parental needs and their experiences of the attitudes of staff. Data were gathered through individual interviews and analyzed using qualitative content analysis. The care period can be interpreted as a balancing act between acting as a caregiver and being in need of care. The parents needed skilled staff who could relieve them of medical responsibility, but they wanted to be involved in the care and in the decisions taken. They needed support, including relief, in order to meet their own needs and to be able to take care of their children. It was important that the child was treated with respect in order for the parent to trust the staff. An approach where staff view parents and children as a single unit, as recipients of care, would probably make the situation easier for these parents and children.

  • 55.
    Johansson [Tinnfält], Agneta
    et al.
    Örebro University, Department of Health Sciences.
    Ehnfors, Margareta
    Örebro University, Department of Health Sciences.
    Mental health-promoting dialogue of school nurses from the perspective of adolescent pupils2006In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 26, no 4, p. 10-13, 19Article in journal (Refereed)
    Abstract [en]

    Mental health is a major public health issue in Sweden, especially concerning children and adolescents. School plays a primary role as a health-promoting arena, where school nurses use the health dialogue to promote mental health. The aim of this study was to describe the prerequisites of a mental health-promoting dialogue with the school nurse from the perspective of young people. A further aim was to explore what adolescents believe are important dimensions for achieving such a desired dialogue. Twenty-six 15-year-olds in Sweden were interviewed after being assigned to five focus groups. Inductive qualitative content analysis was used. The findings show that the prerequisites for a mental health-promoting dialogue with the school nurse include what issues to discuss in the dialogue and where the dialogue should take place. The dimensions of the dialogue include what the adolescents think is most important in the dialogue with the school nurse: trustiness, attentiveness, respectfulness, authencity, accessibility during school hours and continuity.

  • 56.
    Källström Karlsson, Inga-Lill
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ternestedt, Britt-Marie
    Department of Health Care Sciences, Ersta Skondahl University College, Stockholm, Sweden.
    Five nurses' experiences of hospice care in a long-term perspective2008In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 10, no 4, p. 224-232Article in journal (Refereed)
    Abstract [en]

    In this study, five nurses’ experiences of regularly having to face the incurable illness and death of dying patients were explored. Qualitative interviews were conducted on two occasions with an interval of 11 years. An interpretive method was used to discern the nurses’ thoughts, feelings, and attitudes over the years toward death and dying. The main finding was that working in hospice care and facing the dying and death of many patients had an impact both on daily work and private life. Narrations from the first occasion were conceptualized as the theme “Death as an Agent of Change.”  Eleven years later the presence of death took a less dominant place in the nurses’ lives and the theme became “Death as a Companion in Life“. In the long term nurses emphasized that their professional and personal growth was fostered by their relationship with the dying patients.

  • 57.
    Källström Karlsson, Inga-Lill
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ternestedt, Britt-Marie
    Enheten för fors Department of Health Care Sciences, Ersta Skondahl, University College, Stockholm, Sweden.
    Patient characteristics of women and men cared for during the first 10 years at an inpatient hospice ward in Sweden2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 2, p. 113-121Article in journal (Refereed)
    Abstract [en]

    The hospice philosophy with focus on the patient's autonomy and the ideal of a good death are the overall objectives of palliative care. Often-raised questions, when discussing hospice, are for which of the incurable ill inpatient hospice is the most optimal care alternative together with who are making use of hospice. The aim of the present study was to describe patient characteristics such as age, marital status, diagnosis, referral source and length of stay (LoS) in relation to gender, during the first decade at an inpatient hospice ward (1992–2001). Data, obtained from medical register, were analysed by using descriptive statistics and the chi-square test. The number of patients was 666 women and 555 men, and most of them were elderly. In some respects significant differences were observed between women and men. More women than men were single, had cancer with relatively rapid trajectory and were referred from the oncology department. Men, more often than women, were diagnosed with cancers with a somewhat longer trajectory. Despite the longer trajectory, the LoS was shorter for men (median =13 days) than for women (median = 17 days). The most frequent referral source was hospital, though men, younger men in particular, were more often referred from home-based hospice care than women. During the last 3 years self-referrals were documented. Self-referrals can be seen as one distinct expression from a standpoint of one's own active choice compared with other referrals. Altogether, self-referrals were less frequent among women than men but in relation to age, self-referrals were more common among the youngest (<60 years) and the oldest women (>85 years) than men in the same age groups. Further studies illuminating a gender perspective can broaden the understanding of what these differences may imply for women and men.

  • 58.
    Källström Karlsson, Inga-Lill
    et al.
    Örebro University, School of Health and Medical Sciences.
    Sunvisson, Helena
    Örebro University, School of Health and Medical Sciences. Hälsoakademin.
    Ehnfors, Margareta
    Enheten för forskning om vård i livets slutskede, Ersta-Sköndal, Stockholm, Sverige.
    Ternestedt, Britt-Marie
    Enheten för forskning om vård i livets slutskede, Ersta, Stockholm, Sverige.
    Nurses’ perspectives on caring for hospice patients with weakening bodiesManuscript (preprint) (Other academic)
    Abstract [en]

    Aim. To deepen the understanding of how nurses experience their care of dying patients with weakening bodies.

    Background. A socio-cultural context that emphasizes healthy bodies might have consequences for attitudes toward sickness and weakness. Physical disease-based deterioration puts limits on opportunities to achieve a fit body. When dying patients’ bodies are deteriorating, they must rely on and receive body-care assistance. Few nursing studies explore nurses’ perceptions about caring for the body.

    Method. Data were collected over a 3-month period in 2004-2005. Qualitative, conversational-style interviews were done to gather personal reflections of 19 nurses in a Swedish hospice ward. The approach of interpretative description was used to analyze the interviews.

    Findings. A main theme – struggling to acknowledge and unveil the person within the weakening body – was synthesized from four subthemes, i.e., nurses: (1) striving to understand patients’ experiences of bodily losses; (2) encouraging patients to uphold bodily functions and daily habits; (3) acknowledging and balancing patients’ need of bodily control; and (4) providing tender body care.

    Conclusion. Ways in which nurses interpret and care for bodies of dying patients influence how dying patients perceive their embedded selves at life’s end. Nurses struggled to promote person-oriented care by being flexible and creative and by using various strategies for body care that was aligned with the individual patient’s progression toward death. Person-oriented care was sometimes challenged when patients could not express their preferences or when the body became very deformed.

  • 59.
    Källström Karlsson, Inga-Lill
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ternestedt, Britt-Marie
    Enheten för forskning om vård i livets slutskede, Ersta, Stockholm, Sverige.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Sunvisson, Helena
    Örebro University, School of Health and Medical Sciences.
    Making sense of life close to deathManuscript (preprint) (Other academic)
    Abstract [en]

    This study’s aim was to find out how dying patients experience living near impending death. Eleven patient interviews were conducted via a palliative care unit that included a hospice ward and palliative home care. A qualitative, inductive design enabled descriptions of this complex situation. Analysis followed the Thorne et al. interpretive description approach. The findings revealed that when death became a reality, life took on new meanings and values (not in clear focus before) that were important to preserve or protect. This triggered need for feeling secure within this situation. These revelations were manifest in three subthemes that conceptualised the main theme Making sense of life close to death: (1) when possible death becomes a reality; (2) living with death as a reality and (3) a need for a feeling of security. How life can seem to dying patients demonstrates clinical relevance and complexity, which ensues when death is understood. Nurses must be aware of and respond to that complexity. Responding to patients who protect themselves from existential insight is a particular challenge; preserving their dignity requires being open to how life appears to them and following them as they give meaning to their existence. Dying patients have the right to be cared for according to their understanding of what it means to be dying.

  • 60.
    Odencrants, Sigrid
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences. Högskolan Dalarna.
    Nutritional status and patient characteristics for hospitalised older patients with chronic obstructive pulmonary disease2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 13, p. 1771-1778Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to describe and compare nutritional status and social and medical characteristics among older patients with chronic obstructive pulmonary disease admitted to an acute care hospital ward for respiratory medicine. BACKGROUND: Chronic obstructive pulmonary disease is a condition associated with risk of developing malnutrition. A body mass index <20 is predictive of hospitalisation for acute exacerbations of chronic obstructive pulmonary disease. Knowledge about patient characteristics is crucial for the identification of malnourished patients and the development of nursing care for these patients. DESIGN: Quantitative descriptive study. METHODS: Thirty-three hospitalised women and 17 men with a mean age of 75.7 years (SD 6.9) were consecutively included. A very severe case of chronic obstructive pulmonary disease was indicated in 28 out of 39 patients who underwent a lung function test. Data were collected with measurement of nutritional status using Mini Nutritional Assessment, anthropometry and lung function. RESULTS: Nearly half of the patients (48%) were identified as malnourished, an equal part as at risk for malnutrition and two patients as well nourished. The mean Mini Nutritional Assessment score of 17.2 (SD 3.99) for all patients was near the Mini Nutritional Assessment cut-off score (i.e. 17) for malnutrition. Patients identified as malnourished had a mean body mass index of 18.9 and those at risk for malnutrition had a mean of 23.4. It was more common for those identified as malnourished to live singly, to not live in own property and to be dependent on daily community service. Seven patients identified as malnourished died during the data collection period. CONCLUSIONS: This study provides important knowledge about further risks of impaired nutritional status among older patients with chronic obstructive pulmonary disease. RELEVANCE TO CLINICAL PRACTICE: This knowledge can provide registered nurses with the necessary knowledge to make them aware of certain patients needing particular kinds of attention.

  • 61.
    Odencrants, Sigrid
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ehrenberg, Anna
    Department of Health and Social Sciences, Dalarna University, Falun, Sweden.
    The relationship between nutritional status and body composition among persons with chronic obstructive pulmonary disease2008In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824Article in journal (Refereed)
  • 62. Prenkert, Frans
    et al.
    Ehnfors, Margareta
    Örebro University, Department of Nursing and Caring Sciences.
    A measure of organizational effectiveness in nursing management in relation to transactional and transformational leadership: a study in a Swedish county hospital.1997In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 5, no 5, p. 279-87Article in journal (Refereed)
    Abstract [en]

    This paper presents an empirical study of the influences of transactional (TA) and transformational (TF) leadership on organizational effectiveness (OE), measured as the degree of goal attainment and the quality of nursing care (NQ). The study subjects were all head-nurses and assistant head-nurses at a medium-sized hospital in Sweden (n = 23). The methods used were questionnaires and interviews. The multi-leadership questionnaire earlier developed by Bass was modified and named the Leadership Nursing-Effectiveness Questionnaire (LNEQ), comprising 84 items using Likert-type scales. The study showed low mean scores on OE (2.19) and TA (1.05) but high mean scores on NQ (3.17) and TF (3.84). The results suggest that the degree of TA and TF leadership had a low and insignificant connection with OE in this hospital organization. The study did not support the statement that organizational units exposed to a higher degree of TA and TF leadership at the same time show a high degree of OE, as has been shown in studies in other cultural contexts and organizations.

  • 63.
    Prenkert, Malin
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Growth data of underprivileged children living in rural areas of Chin State, Burma/Myanmar, compared to the WHO reference growth standards: an observational study2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 1, article id e009119Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore growth data (height-for-age, weight-for-age and BMI-for-age) of children living in poor socioeconomic conditions in rural areas of Chin State, Burma/Myanmar; and to compare these data with the growth and development z-score (GDZ) values for school-aged children and adolescents, provided by the WHO.

    Setting: A support and educational programme, run by the Swedish association Chin Development and Research Society (CDRS), was carried out among underprivileged school-aged children, unable to attend school without economic and practical support, living in villages and remote areas in Chin State.

    Participants: Community leaders who were well familiar with the citizens in the community identified children in need of this support. Other community members could also suggest or apply for this. The sample includes all participating children in the CDRS programme at the time of the data collection in six townships. The children were placed in host families, close to a suitable school. Two samples with a total of 639 children from 144 villages and remote areas were obtained:

    1. Children in the CDRS Chin Programme (CCP) (20072010) comprised 558 children: 50% girls and boys.

    2. Children in the Chin Society (CCS) (2010) comprised 81 children: 44% girls and 56% boys.

    Primary outcome measures: Growth data.

    Results: All growth data from both groups deviated significantly from the WHO standard references (p=0.001). The prevalence of stunting (height-for-age <=-2SD) was 52% among girls and 68% among boys. High levels of wasting (weight-for-age <=-2SD) were found among girls 29% and boys 36% aged 5-10 years. In addition, severe thinness (BMI-for-age <=-2SD) was found among girls 31% and boys 44%, all results to be compared to the expected 2.27%.

    Conclusions: Many more than expected-according to the WHO reference values-in CCP and CCS suffered from stunting, wasting and thinness.

  • 64.
    Thoroddsen, Asta
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 10, p. 1826-1838Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the change in documentation of the nursing process in all inpatient wards in a 900-bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process?

    BACKGROUND: Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well-being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages.

    DESIGN AND METHOD: A cross-sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post-test (n = 349 nursing records) to obtain data on nursing documentation. The year-long intervention comprised planned work in groups, and educational and supporting efforts.

    RESULTS: A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients.

    CONCLUSION: At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.

  • 65.
    Thoroddsen, Asta
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences.
    Content and completeness of care plans after implementation of standardized nursing terminologies and computerized records2011In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 29, no 10, p. 599-607Article in journal (Refereed)
    Abstract [en]

    The nursing process and standardized nursing terminologies are essential elements to structure nursing documentation in daily nursing information management. The aim of this study was to describe sustainability and whether and how standardized nursing terminologies, in handwritten versus preprinted versus computerized nursing care plans, changed the content and completeness of documented nursing care. Three audits of patient records were performed: a pretest (n = 291) before a yearlong implementation of standardized nursing terminologies in nursing care plans followed by two posttests: (1) 3 weeks after implementation of nursing terminologies (n = 299) and (2) 22 months after implementation of nursing terminologies and 8 months after implementation of a computerized system (n = 281) in a university hospital. Content and completeness of documented nursing care improved after implementation of standardized nursing terminologies. Documentation of nursing care plans, signs and symptoms, related factors, and nursing interventions increased, whereas mean number of nursing diagnoses per patient did not change between audits. Computerized nursing care plans had the biggest impact, with more variety of nursing diagnoses and increased documentation of signs and symptoms, related factors, and nursing interventions. The use of standardized nursing terminologies improved nursing content in the nursing care plans. Moreover, computerized nursing care plans, in comparison with handwritten and preprinted care plans, increased documentation completeness.

  • 66.
    Thoroddsen, Asta
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences. School of Health and Social Sciences, Dalarna University, Falun, Sweden.
    Nursing specialty knowledge as expressed by standardized nursing languages2010In: International Journal of Nursing Terminologies and Classifications, ISSN 1541-5147, Vol. 21, no 2, p. 69-79Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe how nursing specialty knowledge is demonstrated in nursing records by use of standardized nursing languages.

    Methods: A cross-sectional review of nursing records (N = 265) in four specialties.

    Findings: The most common nursing diagnoses represented basic human needs of patients across specialties. The nursing diagnoses and related interventions represented specific knowledge in each specialty. Sixty-three nursing diagnoses (nine appeared in four specialties) and 168 nursing interventions were used (24 appeared in four specialties).

    Conclusions: Findings suggest that standardized nursing languages are capable of distinguishing between specialties. Further studies with large data sets are needed to explore the relationships between nursing diagnoses and nursing interventions in order to make explicit the knowledge that nurses use in their nursing practice.

    Practice implications: Nursing data in clinical practice must be stored and retrievable to support clinical decision making, advance nursing knowledge, and the unique perspective of nursing.

  • 67.
    Thoroddsen, Asta
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Landspitali University Hospital, University of Iceland, Reykjavik, Iceland.
    Sigurjónsdóttir, Guðrún
    Landspitali University Hospital, Reykjavik, Iceland .
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ehrenberg, Anna
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 1, p. 84-91Article in journal (Refereed)
    Abstract [en]

    Aim: To describe the accuracy, completeness and comprehensiveness of information on pressure ulcers documented in patient records.

    Design and setting: A cross-sectional descriptive study performed in 29 wards at a university hospital in Iceland. The study included skin assessment of patients and retrospective audits of records of patients identified with pressure ulcers.

    Participants: A sample of 219 patients was inspected for signs of pressure ulcers on 1 day in 2008. Records of patients identified with pressure ulcers were audited (n = 45) retrospectively.

    Results: The prevalence of pressure ulcers was 21%. Information in patient records lacked accuracy, completeness and comprehensiveness. Only 60% of the identified pressure ulcers were documented in the patient records. The lack of accuracy was most prevalent for stage I pressure ulcers.

    Conclusions: The purpose of documentation to record, communicate and support the flow of information in the patient record was not met. The patient records lacked accuracy, completeness and comprehensiveness, which can jeopardise patient safety, continuity and quality of care. The information on pressure ulcers in patient records was found not to be a reliable source for the evaluation of quality in health care. To improve accuracy, completeness and comprehensiveness of data in the patient record, a systematic risk assessment for pressure ulcers and assessment and treatment of existing pressure ulcers based on evidence-based guidelines need to be implemented and recorded in clinical practice. Health information technology, including the electronic health record with decision support, has shown promising results to facilitate and improve documentation of pressure ulcers.

  • 68.
    Thoroddsen, Ásta
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences.
    Content and completeness of care plans after implementation of standardized nursing terminologiesManuscript (preprint) (Other academic)
  • 69.
    Udén, Giggi
    et al.
    Centre of Caring Sciences, Lund University, Lund.
    Ehnfors, Margareta
    Örebro University, Department of Nursing and Caring Sciences.
    Sjöström, Kerstin
    Department of Internal Medicine, Malmö University Hospital, Malmö.
    Use of initial risk assessment and recording as the main nursing intervention in identifying risk of falls1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 29, no 1, p. 145-52Article in journal (Refereed)
    Abstract [en]

    The consequences of falls among hospital patients are a great problem, for the patient, the family and society, and cost billions of dollars. In Sweden, almost one-third of all hip fractures occur in the hospital population. Despite this, very few prevention strategies have been developed and tested. In this study, a risk assessment and recording programme in relation to the risk of falling among patients in a geriatric department at a Swedish hospital was implemented. The records of all patients admitted to a geriatric unit during one year, and a stratified random sample of patient records, constituting the control group from the year before, were reviewed. No recording of assessments regarding the patients' risk of falling, and no preventive nursing interventions, were found in the records of the control group. The study group, however, increased the recording of risk assessment to 96%. Only implemented nursing interventions were found in the patients' records, despite the fact that Swedish law makes it obligatory for the registered nurse to record both the planning and implementation of nursing care. In the study group there were explicit descriptions of problems of concern for nursing regarding the patients' risk of falling in less than one-third of the records, the nursing care plans were rare, and the evaluations were not satisfactory. Nursing interventions consisted mostly of information or education, promotion of patient participation, and structuring of the environment. There was no agreement on any standard-care plan. Recording of falls was found more often in the study group than in the control group (probably due to more careful recording), but the proportion of injuries in relation to falls was higher in the control group. The results of this study may be used as a baseline for developing a nursing strategy and documentation relating to falls.

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