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  • 1.
    Gusdal, Annelie K
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Johansson-Pajala, Rose-Marie
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Zander, Viktoria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    von Heideken Wågert, Petra
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Prerequisites for a healthy and independent life among older people: a Delphi studyInngår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people’s independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65–79, older persons aged ⩾80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one’s own situation, and to have the possibility to choose independently one’s type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one’s personal control.

  • 2.
    Johansson-Pajala, Rose-Marie
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Conditions for the Successful Implementation of Computer-Aided Drug Monitoring from Registered Nurses' Perspective: A Case Site Analysis2019Inngår i: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 37, nr 4, s. 196-202Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This research addressed the introduction of a computerized decision support system for drug monitoring to be used by registered nurses in nursing homes. The system was introduced, and its effects were evaluated over the period of 1 year; however, at the end of 1 year, the implementation was not successful in all the participating settings. The aim of this study was to identify the conditions needed for the successful implementation of a computerized decision support system from the registered nurses' perspective. Two case sites were purposively selected based on the implementation's success in one nursing home, but not in the other. Focus group discussions were performed, one in each setting, with eight registered nurses. An inductive thematic analysis was conducted. The findings revealed six themes illustrating the registered nurses' views about the conditions needed: need to see benefits, have the time and take the time, curb administrative hassle, collaboration at all levels, stated responsibility, and requirements set from managerial positions. The most outstanding findings, when compared with the previous implementations of nursing informatics, involved collaboration and the view of drug monitoring responsibility in relation to themselves and the physicians.

  • 3.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Gustafsson, Lena-Karin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Fastbom, Johan
    Stockholm University, Stockholm.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Nurses' use of computerised decision support systems affects drug monitoring in nursing homes2017Inngår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, nr 1, s. 56-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To describe variations in nurses' perceptions of using a computerised decision support system (CDSS) in drug monitoring. Background: There is an increasing focus on incorporating informatics into registered nurses' (RNs) clinical practice. Insight into RNs’ perceptions of using a CDSS in drug monitoring can provide a basis for further development of safer practices in drug management. Method: A qualitative interview study of 16 RNs. Data were analysed using a phenomenographic approach. Results: The RNs perceived a variety of aspects of using a CDSS indrug monitoring. Aspects of ‘time’ were evident, as was giving a ‘standardisation’ to the clinical work. There were perceptions of effects of obtained knowledge and ‘evidence’ and the division of ‘responsibilities’ between RNs and physicians of using the CDSS. Conclusion: The RNs perceived a CDSS as supportive in drug monitoring, in terms of promoting standardised routines, team-collaboration and providing possibilities for evidence-based clinical practice. Implications: Implementing a CDSS seems to be one feasible strategy to improve RNs’ preconditions for safe drug management. Nurse managers’ engagement and support in this process are vital for a successful result.

  • 4.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bastholm-Rahmner, P.
    Karolinska Institutet, Stockholm.
    Fastbom, J.
    Karolinska Institutet, Stockholm.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. City University London, United Kingdom.
    Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: A qualitative study of medication management2016Inngår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 34, nr 1, s. 37-45Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore registered nurses experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities. Design: A qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis. Setting: Five focus groups in five different long-term care settings in two regions in Sweden. Subject: A total of 21 registered nurses (RNs), four men and 17 women, aged 27-65 years, with 4-34 years of nursing experience. Results: The findings reveal that RNs in municipal long-term care settings can be regarded as "vigilant intermediaries" in the patients drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking. Conclusion: The RNs play a central but also complex role as "vigilant intermediaries" in the medication monitoring process, including the issue of responsibility. Improving RNs possibility to monitor their patients drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs pharmacovigilant activities. Key points This study contributes to the understanding of registered nurses (RNs) role in medication management in municipal care of the elderly (i.e. detecting, assessing, and preventing adverse drug events or any drug-related problems).RNs can be considered to be "vigilant intermediaries" in elderly patients drug treatments, working at a distance from staff, physicians, and patients. RNs occasionally take on responsibilities that exceed their formal competence, with the patients best interests in mind. In order to prevent adverse drug events in municipal care of the elderly, new strategies are justified to facilitate RNs pharmacovigilant activities. 

  • 5.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Registered nurses’ use of computerised decision support in medication reviews: Implications in Swedish nursing homes2018Inngår i: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 31, nr 6, s. 531-544Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this paper is to explore the implications of registered nurses’ (RNs) use of a computerized decision support system (CDSS) in medication reviews. Design/methodology/approach: The paper employs a quasi-experimental, one-group pre-test/post-test design with three- and six-month follow-ups subsequent to the introduction of a CDSS. In total, 11 RNs initiated and prepared a total of 54 medication reviews. The outcome measures were the number of drug-related problems (DRPs) as reported by the CDSS and the RNs, respectively, the RNs’ views on the CDSS, and changes in the quality of drug treatment. Findings: The CDSS significantly indicated more DRPs than the RNs did, such as potential adverse drug reactions (ADRs). The RNs detected additional problems, outside the scope of the CDSS, such as lack of adherence. They considered the CDSS beneficial and wanted to continue using it. Only minor changes were found in the quality of drug treatments, with no significant changes in the drug-specific quality indicators (e.g. inappropriate drugs). However, the use of renally excreted drugs in reduced renal function decreased. Practical implications: The RNs’ use of a CDSS in medication reviews is of value in detecting potential ADRs and interactions. Yet, in order to have an impact on outcomes in the quality of drug treatment, further measures are needed. These may involve development of inter-professional collaboration, such as established procedures for the implementation of medication reviews, including the use of CDSS. Originality/value: This is, to the best of the authors’ knowledge, the first study to explore the implications of medication reviews, initiated and prepared by RNs who use a CDSS. The paper adds further insight into the RNs’ role in relation to quality of drug treatments.

  • 6.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter-Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Implications of computer-supported medication reviews in Swedish nursing homes, led by nursesManuskript (preprint) (Annet vitenskapelig)
  • 7.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Thommes, K.
    Paderborn University, Paderborn, Germany.
    Hoppe, J. A.
    Paderborn University, Paderborn, Germany.
    Tuisku, O.
    Lappeenranta University of Technology, Lahti, Finland.
    Hennala, L.
    Lappeenranta University of Technology, Lahti, Finland.
    Pekkarinen, S.
    Lappeenranta University of Technology, Lahti, Finland.
    Melkas, H.
    Lappeenranta University of Technology, Lahti, Finland.
    Gustafsson, Christine
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Improved Knowledge Changes the Mindset: Older Adults’ Perceptions of Care Robots2019Inngår i: Lecture Notes in Computer Science, vol. 11592, Springer Verlag , 2019, s. 212-227Konferansepaper (Fagfellevurdert)
    Abstract [en]

    This paper explores Finnish, German and Swedish older adults’ perceptions of a future welfare service with increased use of welfare technologies, specifically care robots. The issues are the rapid digitalization and development of health and welfare technology, which presently is mainly technology driven (not need or user driven), and the demographic challenge. The aim of the study was to explore older adults’ perception of the future use of welfare technology or care robots. A qualitative approach with focus group discussions was employed, followed by thematic analysis. The results are presented in four overall themes: the impact on daily life for older adults and professional caregivers, codes of practice and terms of use, dissemination of information and knowledge, and conditions for successful implementation. There were significant differences in the informants’ attitudes toward and knowledge about care robots. However, the informants’ attitudes appeared to change during the focus groups and in general, became more positive. Authentic needs, which care robots could support, refer to independence, safety and security, and the ability to manage or ease daily life or working life. The results suggest that older adults, after receiving relevant information, were open to the idea of being supported by care robots in their daily lives. 

  • 8.
    Martin, Lene
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Johansson-Pajala, Rose-Marie
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Fastbom, Johan
    Karolinska Institutet, Sweden.
    Nurses' self-reported medication competence in relation to their pharmacovigilant activities in clinical practice2015Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 21, nr 1, s. 145-152Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Rationale, aims and objectives

    Adverse drug reactions (ADRs) represent a major health problem and previous studies show that nurses can have an active role in promoting medication safety. The aim of this study was to describe and evaluate nurses' self-reported competence and pharmacovigilant activities in clinical practice and also to explore the impact of age, education, workplace and nursing experience on these matters.

    Methods

    This cross-sectional study was based on a questionnaire covering areas related to nurses' medication competence, including knowledge, assessment and information retrieval, and pharmacovigilant activities within these areas, for example, the detection and assessment of ADRs. A 45-item questionnaire was 2013 sent out to 296 nurses in different settings and counties in Sweden. They were selected on the basis of having applied to a university course including pharmacovigilance during 2008–2011. One hundred twenty-four had participated in the courses (exposed) and 172 had applied to the courses but not participated (unexposed).

    Results

    Completed questionnaires were obtained from 75 exposed (60%) and 93 unexposed (54%) nurses. Overall nurses rated themselves high in medication competence but low in pharmacovigilant activities. Significant (P ≤ 0.001) differences between groups were observed regarding medication competence. The exposure of completed dedicated courses in pharmacovigilance was the strongest factor for self-reported medication competence when adjusted for age, other education, workplace and experience. No significant differences between the groups were found regarding the number of pharmacovigilant activities during the 6 months prior to answering the questionnaire.

    Conclusion

    Dedicated university courses improved nurses' self-reported competence in pharmacovigilance but did not increase the number of related activities. Education per se seems to be not sufficient to generate pharmacovigilant activities among nurses.

  • 9.
    Zander, Viktoria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Johansson-Pajala, Rose-Marie
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Gustafsson, Christine
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Methods to evaluate perspectives of safety, independence, activity, and participation in older persons using welfare technology. A systematic review2019Inngår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To conduct a systematic review of existing methods to evaluate the individual aspects of welfare technology from the perspectives of independence, safety, activity, and participation. Furthermore, the study aimed to describe outcomes that have been the focus of previous research to evaluate individual aspects of welfare technology in older persons living in ordinary housing. Materials and methods: A systematic literature review in PubMed, CINAHL Plus, PsycINFO, Scopus, and Web of Science. Studies selected were those that explored the use of assistive and welfare technology devices from older persons’ perspectives, and which considered the concepts of independence, safety, activity and participation, and quality of life. Results: A broad spectrum of instruments was applied in the studies. For independence, three questionnaires were used in the identified studies. For safety, one instrument was used in two versions. To study activity and participation as well as quality of life, several scales were used. Additionally, several studies included qualitative approaches for evaluation, such as interviews, or posed one or more questions regarding the effects of welfare technology. Conclusions: The integration of digital assistive and welfare technology should be based on the needs of older persons, and those needs must be assessed using reliable and relevant instruments. The heterogeneity of the target group, i.e., older persons, together with the fact that assessments must give consideration to identifying goals, obstacles, and risks as well as users’ preferences, implies a person-centred approach.

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