: Bakgrund och problemformulering: Extubation är ett avgörande moment inom anestesi. När patienten har tillfredsställande andningsmönster så kan trakealtuben tas ut ur patientens luftväg. Inga hundraprocentiga kriterier finns för hur extubationens utfall blir, utan utförs ofta utefter situation. Det är en komplex process som kräver noga övervakning och anpassning till varje patients individuella behov. Att bedöma, etablera och kontrollera luftvägen kräver att anestesisjuksköterskan har kunskap och erfarenhet av multidisciplinärt samarbete och etisk medvetenhet. För att undvika patientlidande är personcentrerad vård nödvändigt och kräver ett förhållningsätt baserat på omtanke. Riskerna för komplikation har inte tydligt minskat under åren och det upplevs svårt att planera och utföra en extubation. Syfte: Syftet var att undersöka anestesisjuksköterskan och anestesiologens erfarenheter av extubation. Metod: En systematisk litteraturöversikt med integrativ metod baserat på kvalitativa och kvantitativa artiklar. Artikelsökningen utfördes i databaser och webbsökning. Totalt inkluderades nio artiklar publicerade mellan år 2006–2022. Kvalitetsgranskning genomfördes utifrån CASP checklista av kvalitativa och randomiserad kontrollerad studie. Resultat: I resultatet framkommer det att erfarenhet är en betydande roll som ger bättre förutsättning för extubationen. Kommunikationsbrist, tidspress och bristande respekt påverkade anestesipersonal under utförandet. Planering och förberedelser är två viktiga faktorer för att underlätta handhavandet av extubation. Diskussion: Erfarenhet har en betydande roll för att skapa förutsättningar för trygghet, respekt och evidensbaserad vård. Anestesisjuksköterskor och anestesiologer har olika erfarenheter om extubation. Genom att öka kunskap gällande upplevelser av anestesipersonalens erfarenheter kan praktiska och teoretiska momentet kring extubering förbättras. / Background and Problem Statement: Extubation is a crucial step in anaesthesia. When the patient has a satisfactory breathing pattern, the tracheal tube can be removed from the patient's airway. There are no one-hundred- precent criteria for the outcome of extubation; it is often preformed based on the situation. It is a complex process that requires careful monitoring and adaptation to each patient’s individual needs. Assessing, establishing and controlling the airway require that the anaesthesia nurse possesses knowledge and experience with multidisciplinary collaboration and ethical awareness. To avoid patient suffering, person-centred care is necessary, which requires an approach based on compassion. The risk of complications has not clearly decreased over the years, and planning and preforming an extubation are often perceived as challenging. Aim: The aim was to examine the anesthesia nurse and the anesthesiologist's experiences with extubation. Method: A systematic literature review using an integrative method based on qualitative and quantitative articles. Articles searches were conducted in the databases Cinahl, PubMed and Scopus, as well through web searches. A total of nine articles published between 2006 and 2022 were included. Quality assessment was preformed using CASP checklist for qualitative and randomised controlled studies. Results: The results indicate that experience is a significant factor that provides better conditions for successful extubation. Communication problems, time pressure and lack of respect affected anaesthesia personnel during the procedure. Planning and preparing are two important factors that facilitate the management of extubation. Discussion: Experience plays a significant role in creating conditions for safety, respect and evidence-based care. Anaesthesia nurses and anaesthesiologist have mixed options about extubations. By increasing knowledge about the experiences of anaesthesia personnel, both the practical and theoretical aspects of extubation can be improved.

Communication errors are frequent during the perioperative period and cause clinical incidents and adverse events. The overall aim of the thesis was to study communication – the transfer of information, especially the postoperative handover – between healthcare personnel in an anaesthetic clinic and the effects of using the communication tool SBAR (Situation-Background-Assessment-Recommendation) from a patient safety perspective. The thesis is based on studies using a correlational (Paper I), quasi-experimental (Paper II and III) and descriptive (Paper IV) design. Data were collected using digitally recorded and structured observations of handovers, anaesthetic records, questionnaires, incident reports and focus group interviews. The results from baseline data showed that lack of structure and long duration of the verbal postoperative handover decreased how much the receiver of postoperative handover remembered; the item most likely not to be remembered by the receiver was anaesthetic drugs. The variation in remembered information showed that there were room for improvement (Paper I). Implementing the communication tool SBAR increased memorized information among receivers following postoperative handover. Interruptions were frequent during postoperative handover, which negatively affected memorized information (Paper III). Furthermore, after implementation of SBAR, the personnel’s perception of communication between professionals and the safety climate improved, and the proportion of incident reports related to communication errors decreased in the intervention group (Paper II). The results of the focus group interviews revealed that the nurse anaesthetists, anaesthesiologists and post-anaesthesia care unit nurses had somewhat different focuses and views of the postoperative handover, but all professional groups were uncertain about having all information needed to secure the quality of postoperative care (Paper IV). The findings indicate that using a predictable structure during postoperative handover may improve the information memorized by the receiver, perception of communication between professionals and perception of safety climate. Incidents related to communication errors may also decrease. Long duration of the handover and interruptions may negatively affect the information memorized by receiver. To ensure high quality and safe care, there is a need to achieve a shared understanding across professionals of their work in its entirety.