Bakgrund: Vårdronden genomförs dagligen av vårdpersonal tillsammans medpatienter inneliggande på slutenvårdsavdelning. Syftet med vårdronden är att tillgodose patientens behov av vård och behandling och kan inkluderaundersökningar, prognos, planering och undervisning av personal. Den digitalautvecklingen sker även inom sjukvården och ställer nya krav på vården och erbjudersamtidigt nya tekniska möjligheter. Syfte: Syftet med denna kartläggande litteraturöversikt är att identifiera typer av eHälsointerventioner som används i vårdronden inom slutenvården samt att studera hur vårdronden inom slutenvården har utvecklats med hjälp av eHälsointerventioner. Metod: För att svara på studiens frågeställning genomfördes en scoping review för att kartlägga litteratur inom detta område. Data hämtades från två olika databaser där sexton artiklar svarade på studiens syfte och uppfyllde inklusionskriterierna. En tematisk analys genomfördes därefter för att analysera artiklarna. Resultat: Fyra teman samt åtta underteman identifierades: konsulter på distans, deltagande i virtuella vårdronder, ny teknik och utbildning. eHälsointerventioner har medfört ökad patientsäkerhet, minskat bristen på specialistkompetens, minskat avståndet mellan patient/specialist, ökat delaktigheten för anhöriga, minskat smittspridning och stärkt det interprofessionella samarbetet i samband medvårdronden. Slutsats: Vårdronden har utvecklats genom nya arbetssätt vilka möjliggjorts av ny teknik med exempelvis robotar och virtuella glasögon. Geografiska avstånd kan minskas med hjälp av virtuella vårdronder, vilket även ställer höga krav på tillgången på internetuppkoppling och personal med uppgift att koordinera de nya arbetssätten. eHälsointerventioner har potential att stärka patientsäkerheten, bidra till en mer jämlik vård och minska resursbristen inom slutenvården. / Background: Wardrounds are carried out daily by healtcare staff in the inpatient ward. The purpose of the wardround is to meet the patient´s needs for care and treatment and include examinations, prognosis, planning and teaching of staff. The digital development also takes place in healthcare and places new demands on care and at the same time offers new technical opportunities. Purpose: The purpose is to identify types of eHealth interventions that are used in the wardround in inpatient care and to study how the wardround in inpatient care has developed with the help of eHealth interventions. Method: To answer the study´s question a scoping review was carried out to survey literature in this field. Data were retrieved from two different databases where sixteen articles responded to the purpose of the study and met the inclusion criteria. A thematic analysis was then carried out to analyze the articles. Results: Four themes and eight subthemes were identified. Consultants ondistance, participation in virtual wardrounds, new technology and education. eHealthinterventions have resulted in increased patient safety, reduced the lack of specialistcompetence, reduced the distance between patient/specialist, increased the participation of relatives, reduced the spread of infection and strength enedinterprofessional cooperation in connection with the wardround. Conclusion: The wardround has developed through new working methodsmade possible by new technology, for example robots and virtual glasses. Geographical distances can be reduced with the help of virtual wardrounds, which also places high demands on the availability of an internet connection and staff with coordinating the new working methods. eHealth interventions have the potential to strengthen patient safety, contribute to more equal care and reduce resource shortagesin inpatient care.

Abstrakt Trots att det i Sverige finns lagar som säger att patienten så långt det är möjligt ska vara delaktig i sin egen vård, så verkar inte det vara fallet. Inom den psykiatriska tvångsvården är det ofta en obalans mellan personalen och patientens makt, därav vikten av att arbeta mot patientens delaktighet. Syftet med den integrerade litteraturöversikten var att sammanställa kunskap om patientdelaktighet vid sluten psykiatrisk tvångsvård. Följande frågor besvarades: Vilka förutsättningar för delaktighet finns i den slutna psykiatriska tvångsvården? Vilka hinder för delaktighet finns i den psykiatriska tvångsvården? Metod Integrerad litteraturstudie. Sökningar gjordes i tre databaser utifrån tre sökblock. Det resulterade i sexton artiklar som svarade mot syftet, två kvantitativa, en mixad metod och tretton kvalitativa. Inklusions kriterier: peer-review, engelska och inte äldre än tio år. Detta resulterade i sexton artiklar. Artiklar lästes igenom både enskilt och tillsammans, därefter vidtog dataextraktion där enheter togs ut som svarade mot syftet. Resultat: Analysen resulterade i elva kategorier, varav attityd, engagemang, relation och tvångsvård var mest framträdande. Det som kom fram är att för att det ska kunna jobbas utifrån patient delaktighet krävs det att personalen har en öppen, engagerad och ärlig attityd. Detta gör det möjligt att bygga en god relation mellan patient och personal, vilket i sin tur kan leda till patientdelaktighet. Slutsats Vad behövs för patientdelaktighet beror på vilken attityd man har. Är man som personal öppen, engagerad och ärlig då kan man bygga en relation till patienten och lägga grunden för patientdelaktighet

No description available.

Bakgrund: Covid-19 pandemin som orsakades av Sars-Cov-2-viruset innebar en betydande utmaning för världen. I synnerhet påverkades hälso- och sjukvården av dess framfart. Sjuksköterskor som arbetade inom slutenvården under denna tid var särskilt utsatta och föremål för en rad olika upplevelser både positiva och negativa. Dessa erfarenheter är värdefulla att analysera för att bättre kunna hantera kommande pandemier. Syfte: Att undersöka sjuksköterskors upplevelser inom slutenvården under covid-19 pandemin. Metod: Litteraturöversikt genomförd i enlighet med Fribergs metod. Elva kvalitativa originalartiklar valdes från databaserna PubMed och Cinahl Complete för analys. Resultat: Tre huvudteman identifierades vilka var: Rädsla, Osäkerhet och Sjuksköterskans upplevelser rörande yrkesrollen. Slutsats: Rädsla var en dominerande upplevelse bland sjuksköterskor och antog ett flertal olika former. Sjuksköterskor upplevde även osäkerhet relaterat till det oklara kunskapsläget, föränderlig information, den egna kompetensen samt brist på material och personal. Sjuksköterskor upplevde både positiva och negativa känslor relaterade till yrkesrollen. Förberedelse i form av utbildning av sjuksköterskor och allmänhet, genomtänkta rutiner och riktlinjer samt förbättrad lagerhållning av skyddsmaterial är viktigt för att minska negativa effekter under kommande pandemier. / Background: The Covid-19-pandemic caused by the Sars-Cov-2-virus constituted a significant challenge for the world. In particular the healthcare systems were affected during its course. Nurses working within inpatient care were especially vulnerable and might have had several different experiences, which could be either negative or positive. These experiences are valuable and worth analyzing in order to be better prepared for forthcoming pandemics. Aim: To analyze nurses´experiences in inpatient care during the Covid-19 pandemic. Method: A literary overview conducted in accordance with the method of Friberg. Eleven qualitative original articles were selected from the databases PubMed and Cinahl Complete and analyzed. Results: Three main themes were identified which were: Fear, uncertainty and nurses experiences related to the profession. Conclusions: Fear was a dominant experience among nurses and took a variety of forms. Nurses also experience uncertainty related to the unclear state of knowledge, changing information, their own competence and due to a shortage of materials and other staff. Nurses experienced both positive and negative emotions in relation to their profession. Preparation in the form of eduaction for both nurses and the general public, well-thought-out routines and guidelines as well as improved stockpiling of protective equipment is essential to reduce the negative effects of future pandemics.

Qualitative case study research on Physician Assistants / Background: The Ministry of Health and Long Term Care (MOHLTC) introduced Physician Assistants (PAs) into the Ontario health care system in 2006 to help increase patient access to care, decrease wait times, and improve continuity of care. As a new addition to Ontario, little research exists to describe the roles and contributions of PAs. The aim of this dissertation is to explore PA role integration through an in-depth analysis of setting and role descriptions, barriers and facilitators of role integration, and healthcare provider perceptions. Methods: An exploratory, multiple-case study was used to examine PA role integration in four clinical settings: family medicine, emergency medicine, general surgery, and inpatient medicine. Inductive thematic analysis was used within each of the four cases and for the cross-case thematic analysis. Results: Forty-six health care providers and administrators were interviewed across 19 different healthcare sites. Support for PA contributions across various health care settings, the importance of role awareness, supervisory relationship attributes, and role vulnerability (in relation to sustainability and funding) are interconnected and dynamic in general surgery, inpatient medicine, emergency department and family medicine settings. These findings demonstrate how the flexible and adaptable nature of the PA role and the PAs ability to build relationships allows for the establishment of interprofessional, collaborative, and person-centered care. Conclusions: This dissertation provides a rich understanding of the role of PAs in the Ontario healthcare system through an exploration of role definition, impact on patient care, and professional perceptions. The findings from this dissertation are important from a broad systems perspective as the results help fill existing knowledge and practice gaps regarding the role of PAs, and will help inform the design of human health resource research in order to optimize health care system efficiencies. / Thesis / Doctor of Philosophy (PhD) / Physician Assistants (PAs) are a new health care profession in Ontario, and were introduced by the Ministry of Health and Long Term Care (MOHLTC) in 2006 to help increase access to care and decrease wait times for patients. PAs are trained to work with physicians to extend healthcare services. This research study was undertaken to explore how the PA role has been integrated into number of health care settings, including family practices, emergency departments, general surgery and inpatient medicine settings. The research design is a qualitative case study, which allows for an in-depth exploration of the PA role. Findings revealed that PAs are flexible, collaborative, and adaptable members of healthcare teams in Ontario, who have an interest in enhancing patient care. Despite these benefits, role optimization is often limited by factors such as lack of funding and resistance from other healthcare providers. The findings from this study help fill research gaps around the PA profession in Ontario, and will help inform stakeholders interested in optimizing the impact of PAs in the Ontario healthcare system.

Bakgrund: Stödjande samtal är ett verktyg inom den psykiatriska heldygnsvården som används i behandlande och lindrande syfte med suicidnära patienter. Det konstateras att samtalet var specialistsjuksköterskans viktigaste verktyg inom psykiatrisk omvårdnad. Vid granskning inom ämnet kunde det fastställas att det fanns sparsamt med forskning gällande stödjande samtal med suicidnära patienter i psykiatrisk heldygnsvård i Sverige utifrån specialistsjuksköterskans perspektiv. Syfte: Studiens syfte var att belysa specialistsjuksköterskans erfarenheter av att genomföra stödjande samtal med suicidnära patienter som vårdas i psykiatrisk heldygnsvård. Metod: Studien tillämpar en kvalitativ metod med induktiv ansats och baseras på åtta semistrukturerade intervjuer enligt Graneheims och Lundmans (2004) kvalitativa innehållsanalys. För att inkluderas i studien skulle specialistsjuksköterskan med inriktning psykiatrisk vård ha erfarenhet av stödjande samtal med suicidnära patienter inom psykiatrisk heldygnsvård. Verksamheter bestående av rättspsykiatri samt barn -och ungdomspsykiatri exkluderades ur studien. Resultat: Analysen av datainsamlingen presenterades med temat vikten av ett ömsesidigt möte i samtalet och kategorierna; att vara inkännande, att vara tillgänglig samt samspelets betydelse. Slutsats: För att uppnå möjlighet till ett ömsesidigt möte och ett vårdande stödjande samtal krävs att specialistsjuksköterskor har tid för att kunna bedriva en personcentrerad och patientsäker vård samt för att skapa allianser med patienter inom psykiatrisk heldygnsvård. Det stödjande samtalet styrs av specialistsjuksköterskors erfarenhet och intuition, vilket bidrar till att det stödjande samtalet blir olika för varje individ. Det stödjande samtalet inom psykiatrisk heldygnsvård drabbas om specialistsjuksköterskor inte har någon erfarenhet samt om personalbrist eller tidsbrist förekommer. / Background: Supportive conversations are a tool within the inpatient psychiatric care that is used for the treatment and relieving purpose of suicidal patients. It is established that dialogues were the specialist nurse's most important tool in psychiatric nursing. When examining the subject, it was determined that there was sparingly research regarding supportive conversations with suicidal patients in psychiatric inpatient care in Sweden from the specialist nurse's perspective.Aim: The aim of the study was to shed light on the psychiatric nurse's experiences of carrying out supportive conversations with suicidal patients who are cared for in psychiatric inpatient care. Method: The study applies a qualitative method with an inductive approach and is based on eight semi-structured interviews according to Graneheim and Lundman's (2004) qualitative content analysis. To be included in the study, the specialist nurse specializing in psychiatric care had to have experience of supportive conversations with suicidal patients in psychiatric inpatient care. Departments consisting of forensic psychiatry and child- and adolescent psychiatry were excluded from the study.Result: The analysis resulted in the theme of the importance of a mutual meeting in the conversation with the categories; to be empathetic, to be available and the importance of interaction.Conclusion: In order to achieve the opportunity for a mutual meeting and a caring supportive conversation, the psychiatry nurses must have time to be able to conduct person-centered and patient-safe care and to create alliances with patients in psychiatric inpatient care. The supportive conversation is guided by the psychiatry nurses experience and intuition, which contributes to the supportive conversation being individual. The supportive conversation within psychiatric inpatient care is affected if the psychiatry nurse has no experience and if there is a shortage of staff or a lack of time.

Annotation: The purpose of this Master's thesis is to describe objectively topic of medical social workers' communication in centers of post-acute care, to highlight importance and difficulty of social work with senior citizens and to propose eventual changes leading to eventual communication improvement. Social work here is complicated because senior citizens are often lonely or may have problematic family relationships or may suffer from dementia and quite often are polymorbid patients. For the thesis were used statistics from The Centre of Postacute Care - Motol University Hospital, then method of questionnaire realized with medical social workers from centers of post-acute care in Czech Republic, and method of structured interview with patients in Center of Postacute Care - Motol University Hospital.

No description available.

In the thesis I examine current legislative anchoring of healthcare and social care of mental health. In the second chapter of theoretical part I write about classification of mental illnesses. Third chapter, which is very important from my point of view, describe transformation of healthcare and social care in the foreign countries. Practical part contains pilot survey for the Ministry of Health. The purpose was to find out the satisfaction of the clients with social and health services, which are part of the treatment of mental health. Satisfaction was detected by questionnaires, which patients had available with their ambulant psychiatrist. Those questionnaires were created at round tables by experts, patients and service providers in a hospital. Social care and healthcare do not connect. Experts do not communicate with each other. Tragical finding was that ambulant psychiatrist has in average thirteen minutes for examination of a client. Definitely Czech Republic need Centre for Mental Healthcare for complex care of the patient.

Indicadores de qualidade hospitalar correspondem a medidas que contém informações relevantes sobre determinados atributos e dimensões que caracterizam a qualidade de diferentes instituições de saúde. Tais medidas são capazes de sinalizar eventuais deficiências ou práticas de sucesso associadas à qualidade dos serviços de saúde. O presente estudo teve por finalidade desenvolver uma ferramenta computacional de análise, voltada para o gerenciamento hospitalar, com o objetivo de se obter um instrumento que possa ser utilizado para monitorar e avaliar a qualidade dos serviços oferecidos por instituições hospitalares através da análise e gerenciamento de indicadores de qualidade hospitalar. Os indicadores alvo para avaliar a qualidade dos serviços representaram um subconjunto de indicadores de qualidade denominados Inpatient Quality Indicators (IQIs) da Agency for Healthcare Research and Quality (AHRQ). A partir da revisão bibliográfica de textos científicos na área e com base nas dimensões de processo e resultado do Modelo Donabediano, foram selecionados vinte e dois indicadores da AHRQ, que avaliam a mortalidade por determinadas afecções e procedimentos cirúrgicos, bem como a quantidade e a qualidade dos procedimentos realizados nas instituições de saúde. A ferramenta foi construída em dois módulos: um módulo responsável pela geração dos indicadores a partir de dados coletados de um banco de dados relacional; e outro destinado ao estudo e análise das séries temporais dos indicadores, permitindo o acompanhamento da evolução dos mesmos de forma histórica. Os dados utilizados para a geração dos indicadores são oriundos da base de dados do Observatório Regional de Atenção Hospitalar (ORAH), que consiste numa entidade responsável pelo processamento de dados de internação de quarenta hospitais públicos e privados, distribuídos ao longo de vinte e seis municípios da região de Ribeirão Preto, São Paulo, Brasil, que compõem a Departamento Regional de Saúde XIII (DRS-XIII). A ferramenta computacional foi concluída e validade com êxito e suas funcionalidades foram disponibilizadas para gestores de saúde e acadêmicos através do portal web de conteúdo vinculado ao ORAH. Em adição, os resultados obtidos através do uso da ferramenta foram utilizados para analisar a situação da assistência hospitalar na região de Ribeirão Preto através da comparação histórica dos indicadores entre as três microrregiões de saúde que compõem a DRS-XIII: Aquífero Guarani, Vale das Cachoeiras e Horizonte Verde. A análise destes resultados também foi essencial para verificar a capacidade da ferramenta em prover informações relevantes para a gestão hospitalar. A partir da análise dos resultados obtidos, concluímos que a ferramenta permite a definição de um panorama geral da assistência hospitalar na região de Ribeirão Preto. De acordo com os achados deste estudo, também verificamos que os indicadores de qualidade hospitalar da AHRQ cumpriram seu papel como medidas sentinela e foram capazes de identificar certos aspectos associados à realidade. Entretanto, a análise dos resultados também remeteu à necessidade de introduzir novas variáveis que permitam conhecer o real estado dos pacientes e as condições estruturais das diferentes instituições de saúde, visto que os indicadores selecionados, por si só, não fornecem aos gestores de saúde uma avaliação final da qualidade das instituições hospitalares. / Inpatient quality indicators are measures that provide relevant inforrnation on the level of quality of care delivered by hospitals and healthcare services. These measures are capable of signaling eventual problems or successful practices associated with the quality of care provided by health services. This project was aimed to create an instrument to assess the quality of care delivered by hospitals by developing a web application whose functionalities focused on monitoring a subset of inpatient quality indicators (IQIs), extracted from the Agency for Healthcare Research and Quality (AHRQ). Based on literature review and on the components of process and outcomes defined by the Donabedian model, there were selected twenty-two AHRQ\'s inpatient quality indicators that are commonly used to evaluate the mortality associated with certain conditions and procedures, as well as the quantity and quality of certain medical procedures. The software is composed by two components: one is responsible for calculating the indicators using admission data extracted from an operational database; the other one is meant for the study and analysis of time series of the indicators, which allows the monitoring of its values over the years. The indicators were ca1culated using administrative data from the Observatory for Hospital Care\'s database (ORAH, from the acronyrn in Portuguese \"Observatório Regional de Atenção Hospitalar\"). The Observatory for Hospital Care is responsible for processing admission data collected from forty hospitals located throughout Ribeirao Preto region, in the Brazilian state of Sao Paulo. The management of hospitals located in the Ribeirao Preto region is conducted by the Regional Department of Health XIII (DRS-XIII, from the acronyrn in Portuguese \"Departamento Regional de Saúde XIII). The web application\'s services were made available to health service administrators and academic personnel through the ORAH\'s website. The results provided by this computational tool were also used to analyze the situation of care delivered by the hospitals in Ribeirao Preto region, which is subdivided into three microregions: Aquifero Guarani, Horizonte Verde e Vale das Cachoeiras. The historic values of the indicators were compared between these three microregions. The analysis of these results was also important to verify whether the web application is actually able to provi de enough inforrnation to acknowledge the reality of the hospitals in Ribeirao Preto region. According to the results, we verified that the AHRQ\'s inpatient quality indicators have fulfilled their role in signalizing certain aspects related to the quality of care of the hospitals, but they do not provi de enough inforrnation to establish a defini tive quality assessment of hospital services. Therefore, we verified the need of introducing new attributes in order to understand and acknowledge the clinical condition of the hospitalized patients, as well as the structure and resources available in the hospitals.