Bakgrund: I Sverige pågår för närvarande stora projekt för att utforma och införa framtidens vårdinformationssystem. Dessa system utvecklas för att effektivisera hälso- och sjukvårdens processer och IT-miljöer. Elektroniska patientjournalsystem är den mest använda typen av vårdinformationssystem. Andra exempel är system för prover och svar, patientadministration och läkemedelsförskrivning. Trots att vårdinformationssystem har visat sig kunna bidra till ökad patientsäkerhet och kvalitet har implementering av nya system i hälso- och sjukvården en historia av att ofta misslyckas. Enligt ramverket Technology, People, Organizations and Macroenvironmental factors (TPOM), påverkar ett antal områden hur väl implementering av vårdinformationssystem faller ut.  Sjuksköterskor är den största legitimerade yrkeskåren inom hälso- och sjukvård. De ansvarar för omvårdnaden av en individ och hela dennes situation vilket bidrar till att sjuksköterskor är de som använder vårdinformationssystem mest frekvent. För att bidra till lyckad utveckling, implementering och förvaltning av vårdinformationssystem behöver sjuksköterskors upplevelser av utmaningar och möjligheter med vårdinformationssystem och vårddokumentation beskrivas.   Syfte: Studiens syfte är att beskriva sjuksköterskors upplevelser av utmaningar och möjligheter med vårdinformationssystem och vårddokumentation utifrån tekniska, personliga, organisatoriska och samhälleliga områden.  Metod: Kvalitativa semistrukturerade intervjuer genomfördes med tio legitimerade sjuksköterskor från olika verksamheter. Analys av insamlad data skedde genom kvalitativ innehållsanalys med deduktiv ansats utifrån huvudkategorierna i ramverket TPOM.  Resultat: Utmaningar och möjligheter inom områdena teknik, person, organisation och samhälle identifierades och beskrevs. Totalt tio subkategorier identifierades under huvudkategorierna. Respondenternas upplevelser av liknande utmaningar och möjligheter oavsett arbetsplats och vårdinformationssystem tyder på att resultatet kan appliceras och tas i beaktande vid utveckling, implementering och förvaltning oavsett vårdinformationssystem. / Background: Currently in Sweden, there are a number of ongoing extensive projects aiming towards development and adoption of futures’ health information technology (HIT). These systems are formed to make the processes and IT environment of health care more effective. Electronic health records are the most used type of health information technology. Other examples are systems for laboratory testing, patient administration and prescription of medications. Even though HIT has proven to contribute to effectiveness and quality of care, the implementations of such systems has a history of failing. According to the Technology, People, Organizations and Macroenvironmental factors framework (TPOM), a number of dimensions has an impact to determine the success of HIT implementation.  Nurses are the largest group of registered health care practitioners in Sweden. Nursing care include caring for the individual in whole, which leads to nurses extensive, and frequent use of HIT. To contribute to successful development, implementation and continuous management of HIT, nurses’ experiences of challenges and possibilities in HIT and documentation must be described further.  Aim: This study aims to describe nurses’ experiences of challenges and possibilities in Health information technology and documentation in the perspective of Technology, People, Organizations and Macroenvironmental factors.  Method: Qualitative, semistructured interviews was conducted with ten registered nurses coming from different types of care. Data was analyzed based on deductive approached qualitative content analysis, using the TPOM framework.  Results: Challenges and possibilites within technology, people, organizations and macroenvironmental domains were identified and described. A total of ten subcategories were identified. The respondendts experienced similar challenges and possibilites, regardless of workplace and health information technology. This implicates that the result of this study might be considered in development, implementation and management of HIT.

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs. Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple search terms used and these included "neonate OR newborn OR infant", "CLABSI OR central line-associated bloodstream infection", "intervention OR prevention" and "bundle". The search solely focused on the outcome of infant patients. Therefore studies were excluded for the following criteria: being non-peer reviewed, being published before 2008, and being a case in which CLABSI was assessed in patients outside the NICU. See Table 4 and 5 for further information. Results: Eight articles were eligible for inclusion all of which CDC's guidelines were implemented in their strategy of intervention. The systematic review showed that adherence to care bundles decreases infection rates drastically. All eight articles reported a significant decrease in CLABSI rates following the implementation of the bundle set by CDC with two studies achieving a CLABSI rate of zero. Author's Conclusion: Implementation of care bundles showed a success in reducing CLABSI rates in the NICUs; however none of the studies endorsed a specific bundle application utilized to achieve its intended goal. Some practices adopted CDC's guidelines more than others and those showed a greater decrease in infection rate. In addition, it is evident that nurses deliver the best care when preventing an infection. Further research is needed to assess the effectiveness of a specific bundle element.