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1	Patienter som förts till närakut : en deskriptiv studie / Patients admitted to walk-in centres : a descriptive study Segerblad, Fredrik January 2016 (has links) Riktlinjer har senaste åren tagits fram i syfte att erbjuda patienter som omhändertas av ambulanssjukvården en alternativ vårdnivå i stället för den sjukhusanslutna akutmottagningen, i syfte att ge patienten god vård utifrån dennes behov. Riktlinjer har sedan 2013 på projektbasis upprättats i en storstadsregion i Sverige där ambulanssjuksköterskan i samråd med patient kan erbjuda patienten ett adekvat och i många fall snabbt omhändertagande på fyra av regionens närakutmottagningar utifrån en rad kriterier. Under 2013 har 566 patienter enligt regionens journalsystem förts enligt detta arbetssätt till närakut. Syftet med denna studie var att beskriva patienter som av ambulanssjuksköterskan styrts till en närakut, samt styrningsprocessen för patienterna. Den valda metoden var retrospektiv journalgranskning behandlad med deskriptiv samt inferentiell statistik. Resultatet pekar på genusskillnader bland patienterna som förts till närakut, såväl i utlarmningsprioritet som i bedömd allvarlighetsgrad hos patienterna. Resultatet tyder även på skillnader i orsak till kontakt med närakut i mellan könen. Ambulanssjuksköterskan visade sig även göra avsteg från de kriterier som riktlinjerna för närakutstyrning baseras på. Studien ger en inblick i en förhållandevis ny patientgrupp, som visar på variationer i så väl demografiska data som orsak till vårdkontakt. Skillnader förelåg rörande jämställdhet mellan könen, såväl från alarmeringstjänstens och från ambulanssjukvårdens sida, men bakomliggande orsaker till dessa kräver fördjupad forskning. De riktlinjer som ligger till grund för detta nya arbetssätt följs inte till fullo av ambulanssjukvården vilket tyder på att ytterligare forskning kring beslutstödens utformning och ambulanssjuksköterskors attityder behöver bedrivas. / In recent years, regional guidelines have implemented to provide patients’ cared for by Emergency Medical Services [EMS] care alternatives to the traditional transport to the closest hospital. The purpose for this is to provide the most appropriate level of care based on the patients’ needs. Since 2013, these guidelines have been tested on a project basis in a region in Sweden. Providing that certain criteria are met, the ambulance specialist nurse, in agreement with the patient, is able to offer the patient an adequate level of care, often with a quicker admittance at four walk-in centers in the region, During 2013, 566 patients have been brought by EMS to these walk-in centers, according to the EMS journal system. The purpose was to describe the patient that has been brought to walk-in centers by the EMS and describe the management process. The study was a retrospective journal review where results were presented by descriptive and inferential statistics. The results indicate differences among patient demographics concerning gender, as well as differences in priority set by emergency dispatch and severity of the patients’ condition according to the EMS. Furthermore, the EMS was shown to deviate from the criteria that the regulatory guidelines were founded on. The study gives insight to a relatively new patient group, illustrating variations in demographic data as well as reasons contact with the EMS. There were differences concerning equality between genders, both from emergency dispatch as well as the EMS. The cause for these differences requires further research. The guidelines providing the basis for this new approach were not followed to the full extent, motivating further research into the content of these guidelines, as well as attitudes of the EMS personnel. Ambulance Alternative level of care Walk-in centre Journal review Ambulans Alternativ vårdnivå Närakutmottagning Journalgranskning Nursing Omvårdnad
2	Ontario’s Home First Approach, Care Transitions, and the Provision of Care: The Perspectives of Home First Clients and Their Family Caregivers English, Christine 23 May 2013 (has links) Home First is an Ontario transition management approach that attempts to reduce the pressure on hospital and Long Term Care (LTC) beds through early discharge planning, the provision of timely and appropriate home care, and the delay of LTC placement. The purpose of this qualitative descriptive study was to obtain descriptions from South Eastern Ontario Home First clients and their family caregivers of their experiences with and thoughts about care transitions, the provision of care, and the Home First approach. The goal was to enable insight into the Home First approach, care transitions, and the provision of care through access to the perspectives of study participants. Nine semi structured interviews (and one or more follow-up calls for each interview) with Home First clients discharged from hospitals in South East Ontario and their family caregivers were conducted and their content analyzed. All participating Home First clients were pleased to be home from hospital and did not consider LTC placement a positive option. All had family involved with their care and used a mix of formal and informal services to meet their care needs. Four general themes were identified: (a) maintaining independence while responding (or not) to risks, (b) constraints on care provision, (c) communication is key, and (d) relationship matters. Although all Home First clients participating in the study were discharged home successfully, a sense of partnership between health care providers, families, and clients was often lacking. The Home First approach may be successfully addressing hospital alternative level of care issues and getting people home where they want to be, but it is also putting increasing demands on formal and informal community caregivers. There is room for improvement in how well their needs and those of care recipients are being met. Health professionals and policy makers must ask caregivers and recipients about their concerns and provide them with appropriate resources and information if they want them to become true partners on the care team. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-05-23 16:10:53.323 home support workers home health care community care older home support clients elder care discharge planning relationships family relationships nursing home Ontario health care Canadian health care placement Home First transition management care transitions aging in place maintaining independence caregiving community health and support services community long-term care family carers frail seniors client satisfaction hospital discharge health care older people aged frail elderly aging elderly supportive home care client perspectives long-term care quality of care evaluation of services care planning risk decisions case management communication independence home care constraints on care provision maintaining independence qualitative research family caregivers nursing home placement qualitative description program evaluation alternative level of care patient discharge self-care formal care aged care informal care post-discharge care home support community support services health services research

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Patienter som förts till närakut : en deskriptiv studie / Patients admitted to walk-in centres : a descriptive study

Ontario’s Home First Approach, Care Transitions, and the Provision of Care: The Perspectives of Home First Clients and Their Family Caregivers