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  • 1.
    Arvidsson, Malin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Jakobsson, Tobias
    Mälardalen University, School of Health, Care and Social Welfare.
    Patientens upplevelser av intensivvårdsdelirium: En litteraturstudie2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
  • 2.
    Bjurling-Sjöberg, Petronella
    et al.
    Uppsala universitet, Sweden.
    Wadensten, Barbro
    Uppsala universitet,Sweden.
    Pöder, Ulrika
    Uppsala universitet, Sweden.
    Jansson, Inger
    Göteborgs universitet, Sweden.
    Nordgren, Lena
    Uppsala universitet, Sweden.
    Struggling for a feasible tool - the process of implementing a clinical pathway in intensive care: A grounded theory study2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 831Article in journal (Refereed)
    Abstract [en]

    Background: Clinical pathways can enhance care quality, promote patient safety and optimize resource utilization. However, they are infrequently utilized in intensive care. This study aimed to explain the implementation process of a clinical pathway based on a bottom-up approach in an intensive care context.

    Methods: The setting was an 11-bed general intensive care unit in Sweden. An action research project was conducted to implement a clinical pathway for patients on mechanical ventilation. The project was managed by a local interprofessional core group and was externally facilitated by two researchers. Grounded theory was used by the researchers to explain the implementation process. The sampling in the study was purposeful and theoretical and included registered nurses (n31), assistant nurses (n26), anesthesiologists (n11), a physiotherapist (n1), first- and second-line managers (n2), and health records from patients on mechanical ventilation (n136). Data were collected from 2011 to 2016 through questionnaires, repeated focus groups, individual interviews, logbooks/field notes and health records. Constant comparative analysis was conducted, including both qualitative data and descriptive statistics from the quantitative data.

    Results: A conceptual model of the clinical pathway implementation process emerged, and a central phenomenon, which was conceptualized as 'Struggling for a feasible tool,' was the core category that linked all categories. The phenomenon evolved from the 'Triggers' ('Perceiving suboptimal practice' and 'Receiving external inspiration and support'), pervaded the 'Implementation process' ('Contextual circumstances,' 'Processual circumstances' and 'Negotiating to achieve progress'), and led to the process 'Output' ('Varying utilization' and 'Improvements in understanding and practice'). The categories included both facilitating and impeding factors that made the implementation process tentative and prolonged but also educational.

    Conclusions: The findings provide a novel understanding of a bottom-up implementation of a clinical pathway in an intensive care context. Despite resonating well with existing implementation frameworks/theories, the conceptual model further illuminates the complex interaction between different circumstances and negotiations and how this interplay has consequences for the implementation process and output. The findings advocate a bottom-up approach but also emphasize the need for strategic priority, interprofessional participation, skilled facilitators and further collaboration.

  • 3. Harlid, R.
    et al.
    Enlund, Mats
    Mälardalen University, Department of Caring and Public Health Sciences.
    Handbok i intravenös anestesi2006Book (Other academic)
  • 4.
    Hällkvist, Ylva
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Lundblad, Torbjörn
    Mälardalen University, School of Health, Care and Social Welfare.
    Att vårda med fingertoppskänsla: Anestesisjuksköterskors erfarenheter av att möta patienter inför och under anestesi2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: All the patients are apprehensive prior to anesthesia, due to the fact that they lose control of their bodies. The patients desire good contact with the nurse anesthetist, in order to convey their needs. The need for information vairy for all the patients. Some require detailed information, while others only sparingly need information. Aim: The aim of the study is to describe nurse anesthetists experience in meeting the patients prior and during anesthesia. Method: A systematic qualitative literature study of published materials was conducted. Results: The nurse anesthetists believe that it is important to see the patients needs, in order to be able to build a sense of security, in addition to good communication. The common obstacle is shortage of time, which affects contact with the patient. Conclusion: The nurse anesthetists feel a need to perform good work. But the patienten och the administration often make conflicting demands, which means that a constant consideration is needed to decide what’s best here and now.

  • 5.
    Malm Wikström, Emil
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Selerup, Kristian
    Mälardalen University, School of Health, Care and Social Welfare.
    INTENSIVVÅRDSSJUKSKÖTERSKORS BEHOV AV STÖD OCH RESURSER: Vid vård av patienter med lätt eller ingen sedering i respirator2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 6.
    Martin-Boglind, Lene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Sabbatsberg Hospital, Sweden.
    Graves, Adrienne
    Sabbatsberg Hospital, Sweden.
    Wanger, Peter
    Sabbatsberg Hospital, Sweden.
    The effect of topical antiglaucoma drugs on the results of high-pass resolution perimetry1991In: American Journal of Ophthalmology, ISSN 0002-9394, E-ISSN 1879-1891, Vol. 11, no 6, p. 711-714Article in journal (Refereed)
    Abstract [en]

    We conducted a randomly assigned, double-masked, crossover study of the effects of betaxolol, epinephrine, pilocarpine, and timolol on the high-passresolution perimetry results in normal subjects. The influence of topical administration of these intraocular pressure reducing drugs was negligible, which confirmed the reliability of high-pass resolution perimetry results. The method seems appropriate for the diagnosis of glaucoma and the follow-up ofpatients with glaucoma.

  • 7.
    Nymark, Alexander
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Lundh, Johan
    Mälardalen University, School of Health, Care and Social Welfare.
    Postoperativ uppföljning - Anestesisjuksköterskans uppfattning2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
  • 8.
    Sjöö, Emmalisa
    Mälardalen University, School of Health, Care and Social Welfare.
    Att lämna intensivvården: En kvalitativ litteraturstudie2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    A patient who has been critically ill and starts to recover, will be discharged from the intensive care unit (ICU) to a general ward. A high demand of intensive care facilities can result in quick discharges causing higher risk of inadequate planning and preparation. This may result with negative consequences for the patient including readmission to the ICU, longer hospital stays and increased mortality. The intensive care nurse has the responsibility to fulfill a safe and coherent discharge. A transition is the way people respond and react to change from one place to another. The aim of this study was to describe patients experiences of their discharge from ICU to general ward. A qualitative literature study with descriptive synthesis was chosen as method. The results showed that inadequate information and preparation can create anxiety. The patients who received good support during the discharge experienced, found that it was a positive step in the right direction. The conclusion is that patients who are going to be discharged from ICU need individual information and preparation. There’s a need for routines to reduce patient concerns, facilitating communication and information and ensuring patient safety.

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