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Barriärer och möjligheter i det prehospitala omhändertagandet av akut sjuka barn / Barriers and anablers in the prehospital care for acutely ill childrenBelfrage, Joneta, Stark, Nathalie January 2022 (has links)
Bakgrunden visar att den prehospitala sjukvården kan vara hektisk med många olika faktorer som sjuksöterskan måste hantera. Att omhänderta barn i ambulansen kan vara utmanande, då antalet uppdrag med akut sjuka barn är få och det kan fortlöpa lång tid mellan dessa jobb. Statistiken visar att endast cirka 10 procent av uppdragen i ambulansen är med barn och ännu färre är akut sjuka barn. För att underlätta omhändertagandet av denna patientegruppen är det därför viktigt att undersöka vilka barriärer och möjligheter som finns. Syftet var att belysa barriärer och möjligheter i det prehospitala omhändertagandet av akut sjuka barn. Som metod användes litterarturöversikt med systematisk metod där totalt 17 artiklar av kvalitativa, kvantitativa och mixed-method design ingick. Resultatet delades in i två teman; Upplevelser hos ambulanspersonalen samt Organsiatoriska förutsättningar, med tillhörande subteman. Slutsatsen var att omhändertagnadet av akut sjuka barn är komplext och måste ske mångfacetterat. Det finns en rad barriärer som kan påverka ett patientsäkert omhändertagande men även en mängd möjligheter till förbättring. Även om ambulanspersonalen har utbildning och erfarenhet kan kombinationen av stress och utmaningarna i omhändertagandet leda till en ökad risk i patientsäkerheten, eftersom stressen kan hindra dem från att agera snabbt och korrekt. Genom att organisationer och arbetsgivare vidareutbildar ambulanspersonalen i pediatriskt omhändertagande kan omhändretagandet av akut sjuka barn optimeras. Eftersom uppdraget med akut sjuka barn skapar stress behövs det även strategier för att ambulanspersonalen ska kunna hantera det efteråt. Detta för att få en hållbar personalhälsa och långvariga anställningar. / Prehospital care can be hectic, with many factors that the nurse needs to consider. Caring for children in the ambulance can be challenging, mostly because these types of calls are few and far between. Statistics show that about 10 percent of all calls are with children, and fewer are calls with acutely ill children. It is therefore necessary to understand what barriers and enablers that exist to better take care of these patients. The aim of this study was to highlight barriers and enablers in the prehospital care of acutely ill children. The method chosen was an integrated literature review; 17 articles were included in the result; they were of qualitative, quantitative, and mixed-method design. The results were divided into two themes: Experiences of ambulance staff and Organizational prerequisites, with associated subthemes. The conclusion was that the care of the acutely ill child is complex and has to be conducted multifaceted. There are several barriers that can affect patient-safety but also a number of enablers to improve the care. The combination of stress and the challenges the ambulance staff face when caring for the acute ill child could lead to a risk of the patient-safety even if they had education and work experience. Stress could be a hindrance in swift and accurate care. The organization and employer of the ambulance staff could help optimize the care of these patients by giving the ambulance staff further education in the care of the acutely ill child. There also needs to be strategies in place for the ambulance staff on how to handle the sometimes traumatizing events that these types of jobs can lead to. This to ensure that the staff remain healthy, and a good sustainability can be achieved within the personal group.
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A Review of Drivers and Barriers for Demand Side Flexibility : The perspective of electric grid customersBöris, Karin, Berg, Maria January 2020 (has links)
The thesis aims to obtain a holistic perspective of opportunities, drivers and barriers that different grid customers experience when enabling demand side flexibility. Due to the increasing problems of capacity shortage of electricity in large cities in Sweden, solutions on the demand side of the electric power grid have become increasingly interesting. Demand side flexibility is a voluntary change of demanded electricity from the grid due to some kind of incentive, which can help support balancing the electric power grid to avoid capacity shortages. Furthermore, the energy transition towards a decentralised power system with an increasing share of variable renewable energy requires a changed demand profile. In this research, a qualitative research methodology was applied. Eleven semi-structured interviews were conducted with case companies within the industry and property company segment. Interviews were also conducted with three actors on the electric power market providing services to aggregate the potential of smaller flexibility resources, as well as with an expert from the Swedish Energy Market Inspectorate. A State of the Art review was completed in order to collect theory and draft previously identified aspects of demand side flexibility. The result shows that the concept is not unknown amongst electricity customers. However, there is a limited knowledge and interest in enabling demand side flexibility. The knowledge gap includes the awareness of potential flexibility resources as well as business opportunities of providing flexibility services. Conflicting priorities within organisations also presents an important barrier, where other easier and more profitable measures may be prioritised. There is also a fear of disrupting core business by causing loss of quality, comfort or production, which proposes a barrier. To overcome mentioned barriers and increase flexibility the financial benefits have to be distinctive and clear. Further, case companies express an ambition of contribution to the environment and sustainable development. By increasing the awareness of the benefits which increased flexibility induces, electricity consumers can become more motivated in adapting a flexible consumption. In addition, case companies express a desire of being early adopters in order to prevent future forced participation or termination of business. In order to enable demand side flexibility the knowledge and interest of the concept must increase. This should be done by providing clear, comprehensible information about the business opportunities of demand side flexibility as well as showcasing successful examples of implementation. Furthermore, it should include suggestions of easy, economical measures different grid customers could carry out to increase their flexibility. By providing this information the interest in flexibility can increase, thus increase the implementation and participation.
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