Introduction: Preventing healthcare professionals from acquiring occupational infectious diseases is very important in maintaining healthcare delivery systems. For protection in the work place, healthcare professionals use PPE which helps prevent exposure to pathogens during patient care. N95 respirators protect healthcare workers against airborne pathogens that are known to be associated with different respiratory diseases. Since previous studies have shown that viruses can survive on PPE surfaces, it is important to examine the survival of viruses on respirators to determine if reuse of the same N95 respirator is possible when PPE shortages occur. Goal: The goal of this research is to determine the inactivation of bacteriophage Φ6 on the surface of N95 respirators at ambient temperature and two different relative humidity levels, 40 and 60%. Result: The linear regression showed that rate of inactivation was much lower in 40% than 60% RH (40%: Slope= -0.046± 0.007040; 60%: Slope= -0.20± 0.006136). Over 24 hours, there was a ~1 Log10 reduction in virus at 20°C and 40% RH, while there was a ~4 Log10 reduction at 20°C and 60% RH. Within the timeframe of a single patient encounter, there was a <0.02 Log10 reduction in virus at 40% RH and a <0.1 Log10 reduction at 60% RH. Conclusion: Bacteriophage Φ6 survives on N95 respirators for up to 24 hours at ambient temperature and 40 and 60% relative humidity levels. Inactivation rate was lower in 40% than 60% RH. The results showed that enveloped viruses survive on the surface of N95 respirators for longer than a single patient encounter. Therefore, this should be taken into consideration when doing a risk assessment of reusing N95 respirators when shortages occur.

Social science research on third sector organisations in the last two decades has emphasised their growing presence and importance in healthcare. This has occurred alongside significant reorganisation of health systems in the UK, including a continued policy emphasis on partnership-working between the public sector and the third sector. However, unanswered questions in the literature remain with regard to the specific roles that these organisations fulfil within partnership arrangements. This thesis examines the role of third sector organisations within Scottish services for the chronic, neurodegenerative condition Huntington’s disease (HD). The closely connected nature of Scottish healthcare and the multitude of professionals involved in HD mean these services are an important, but currently understudied, example of professional interaction around complexity. A multi-methods qualitative research framework was used to gather perspectives of key individuals working in the Scottish HD and wider health scene. Making use of the key concepts of expertise and boundary work, this thesis argues that third sector organisations have an extensive shaping role in 1) the positioning of healthcare organisations, 2) the identities of healthcare professionals, and 3) the meanings around illness and the remit of support. The research findings revealed that organisations and professionals in HD partnership arrangements engaged in processes of boundary work in the negotiation of the roles of themselves and others. Third sector professionals occupied many positions within services, as both experts and supporters of patients. In the process they and other professionals often took on identities as ‘key, committed professionals’. Understanding around HD was also shaped by these professionals as the wider aspects of illness and its support were brought into focus. Building on these findings, it is argued that third sector professionals in coordination roles are well placed to develop a type of expertise that I term ‘aggregate know-how’ (Pols 2014), based around both their professional skills and their extensive contact with patient experiential knowledge. The research builds on and extends influential previous models of third sector ‘partnership’ in healthcare (Rabeharisoa 2003), emphasising the key role of third sector organisations in knowledge production. It also offers insights of both theoretical and practical use with regard to service delivery in healthcare, showing the potential for genuine third sector/public sector partnership around expertise when there is adequate cultural support and resources.

Bakgrund: I Sverige är dödshjälp inte lagligt men ämnet debatteras utifrån olika synsätt samt etiska aspekter. Sjukvårdspersonalens uppgift är att vårda patienter genom att lindra, trösta samt bota men om patienten inte längre vill leva samt efterfrågar dödshjälp ställs sjuksköterskan inför en utmaning. All vård skall bygga på en respekt för patientens autonomi enligt lag. Syfte: Syftet är att beskriva sjukvårdspersonalens upplevelser samt erfarenheter kring dödshjälp inom palliativ vård. Metod: En litteraturöversikt gjordes enligt Fribergs (2017) metod. De databaser författarna använde inför sökningen av vetenskapliga artiklar var följande: CINAHL Complete, PsycINFO samt PubMed . I arbetet inkluderades tio stycken kvalitativa, då författarna bedömde dessa svara på syftet. De utvalda artiklarna analyserades med hjälp av Fribergs analysmetod. Resultat: Författarna kunde identifiera tre teman genom sina valda artiklar. Sjukvårdspersonalens upplevelser samt erfarenheter av dödshjälp. Sjukvårdspersonalens teamwork. Sjukvårdspersonalens relation med patienten. Diskussion: Resultatdiskussionen delades in i tre delar, “Sjukvårdspersonalens upplevelser samt erfarenheter kring dödshjälp”, “Sjukvårdspersonalens teamwork inom dödshjälp” samt “Sjukvårdspersonalens relation med patienten”. Samt en metoddiskussion om styrkor samt svagheter om arbetets gång. / Background: In Sweden euthanasia isn't legal but the subject is still debated from different points of views and ethicals aspects. Health care professionals primary mission is to take care of patients by lindering and cure diseases. However if the patient no longer wants to live and asks for euthanasia the nurse is put in front of a challenge. All of the health care shall be built on respect for the patient's autonomy according to law. Aim: The purpose is to describe the healthcare professional’s experiences about euthanasia in palliative care. Method: A literature review was done according to Friberg's (2017) method. The databases the authors used for the search of scientific articles were as follows: CINAHL Complete, PsycINFO and PubMed. The work included ten qualitative articles, the authors assessed these to respond to the purpose of the study. The selected articles were analyzed using Friberg's method of analysis. Results: The authors was able to identify three themes through their selected articles. healthcare professional’s experience and experiences of euthanasia. Healthcare professionals teamwork. And the healthcare professionals relationship with the patients. Discussion: The discussion about the results was, divided into three parts, "Health care professional´s experience and experiences regarding euthanasia", “Health care professional´s teamwork within euthanasia” and "Health care professional´s relationship with the patient". We also did a method discussion about strengths and weaknesses of the process.

Working in medical profession is stressful, and stress can affect performance, indirectly affecting patient care. Mindfulness has shown to decrease stress, which may improve patient care. At the East Tennessee State University Family Physicians of Bristol, there are no resources for learning mindfulness, so our goal was to educate all the medical professionals in our practice to learn mindfulness and evaluate the effect on their stress levels. First, a stress survey (Perceived Stress Scale) was administered to clinic providers. We presented instruction to clinic providers how to engage in mindfulness meditation. The technique of mindfulness meditation was taught by an expert through an audio clip. Six weeks after implementing the mindfulness meditation program, the Perceived Stress Scale was administered to the providers again to determine if their stress level had been reduced. Statistical analysis consisted of a t test. Higher scores on the Perceived Stress Scale indicate higher levels of experienced stress. The mean score in the pre-meditation condition was 16.71, and the mean score for the post-meditation condition was 12.62. The t test indicated that this difference was statistically significant, t(1,32)=2.14, p<05. The results of this study demonstrate that teaching healthcare providers skills regarding mindfulness meditation can significantly reduce their feelings of stress in the workplace. Future research should focus on examining if reducing stress has a measurable effect on patient outcomes.

No description available.

Medicines optimisation requires healthcare professionals to work collaboratively to meet the medication needs of patients. A grounded theory was produced which explains how doctors, nurses and pharmacists work to optimise the use of medicines in acute hospital settings in Northern Ireland. Seventeen semi-structured, one-to-one interviews were conducted with doctors, nurses and pharmacists. Concurrent data collection and analysis was carried out using coding, particular to grounded theory, adopting a constant comparative approach, writing memos and using theoretical sampling as described by Strauss and Corbin (1998). The core category was managing risk. Participants had an implicit understanding of the need to continually manage risk when working with the complex and the routine. They used personal and systemic checks and balances which could be viewed either as duplication of effort or indicative of a culture of safety. Multi-professional interdependencies and support for new, professional, non-medical roles were highlighted. Working together was a further strategy to ensuring each patient gets the right medicine. Establishing an agreed framework for working with medicines at ward level could support the safer use of medicines. It is anticipated that this theory will contribute to the design of systems involved in medicines use in acute hospitals in Northern Ireland. / Part-funded by: Northern Ireland Centre for Pharmacy Postgraduate Learning and Development (NICPLD), Western Health and Social Care Trust

Background: Approximately 56,000 persons with dementia are admitted to hospitals annually and 75% of them experience responsive behaviours. Responsive behaviours are words/actions used to make one's needs known (e.g. wandering, yelling, hitting, and restlessness) and are perceived by healthcare professionals to be a challenging aspect of dementia care. Aims: This study explores the perceptions of nurses about: (a) caring for older adults with dementia experiencing responsive behaviours in acute medical settings and (b) an educational intervention in dementia care called P.I.E.C.E.S. (Physical, Intellectual, Emotional, Capabilities, Environmental, and Social assessment). Methods: Thorne's interpretive description approach was used. In-person, semi-structured interviews were conducted with 15 nurses and allied health professionals from acute medical settings in a hospital in Ontario. Data were analyzed using experiential thematic analysis. Findings: Themes related to caring for individuals with responsive behaviours included the following: (a) providing nursing care for older adults with responsive behaviours of dementia is a complex experience, (b) there are many barriers to dementia care within acute medical settings, (c) nurses use a combination of pharmacological and non-pharmacological strategies to care for older adults with dementia, (d) there is limited continued use of P.I.E.C.E.S. education although the program and its approaches were seen as relevant for dementia care, and (e) participants viewed organizations as responsible for improving dementia care in acute medical settings. Conclusions: Findings provide guidance for improved support for nurses who provide care to persons experiencing responsive behaviours in acute medical settings such as increasing staffing. Strategies should be implemented to provide continuous educational reinforcements to help staff apply P.I.E.C.E.S such as interdisciplinary rounds focusing on responsive behaviours. / Thesis / Master of Science (MSc)

No / In response to a recent report published by the Royal College of Nursing, Bryan McIntosh, Uduak Archibong and Louise Donaghy discuss the impact of motherhood, part-time hours and career breaks on the cultural perceptions and experiences of female healthcare professionals.

Knowledge gaps exist related to the care and education of pregnant teens. This project study addressed the problem of an inadequate amount of professional development (PD) and training for healthcare professionals (HCPs) caring for pregnant teens at a maternity clinic in the Southeastern United States. Unless HCPs are appropriately trained, the ability to meet the needs of pregnant teens is deficient and negative health outcomes for these patients are likely to be exacerbated. The humanistic learning theory was used in this phenomenological exploratory study to explore perception of 9 HCPs who had the responsibility for patient teaching, clinical care, and were full time employees at a maternity clinic. The research questions focused on the perceptions of the HCPs regarding their experiences of PD as it relates to the care of pregnant and parenting teens, strengths and weaknesses of their current PD, and how their PD could impact the health outcomes of pregnant and parenting teens. The themes developed from the interview data revealed a need for an expansion of HCP knowledge and skills to improve the healthcare of pregnant and parenting teens, as well as challenges associated with the current PD plan. The resulting project consisted of a 3-day workshop to increase the HCPs' proficiency and efficacy in caring for pregnant and parenting teens. Evaluation of the project will be through formative and summative assessment. The project contributes to positive social change at the local clinic by reinforcing the HCPs' skills in in educating, caring for, and supporting the teen parent population.

Sjuksköterskans ansvar är att lindra lidande. Vårdverksamheten och vårdforskningens största utmaningar är att förstå hur lidande bäst kan lindras. Lidande som orsakas av vården kallas vårdlidande. Den systematiska litteraturstudiens syfte var att pröva Katie Erikssons teori om vårdlidande inom omvårdnad. En deduktiv ansats användes vid genomförandet av studien. Studien genererade tolv resultatartiklar som analyserades enligt Erikssons följande kategorier om vårdlidande kränkning av värdighet, fördömelse och straff, maktutövning och utebliven vård. De mest förekommande kategorierna som identifierades utifrån resultatet var kränkning av värdighet och utebliven vård. En ytterligare kategori som framkom benämdes vårdens prioriteringar. Den kan ses som en utveckling av Erikssons kategori utebliven vård. Resultatet bekräftade Erikssons teori om vårdlidande. Rekommendationer för klinisk verksamhet är att patienten ska få möjlighet att utvärdera vården i efterhand, för att skapa en medvetenhet hos vårdpersonalen kring patientens upplevelse. Vidare rekommenderas forskning om vårdens prioriteringar. / Nurses’ responsibility is to alleviate suffering. The main challenge for healthcare organisation and the science of caring and nursing is to understand how suffering could be alleviated. Suffering caused by care is called suffering related to care. The aim of the study was to test and imply Katie Erikssons theory about suffering related to care in nursing. The systematic review was performed with a deductive research method. Twelve articles was analysed according to Erikssons theory about suffering related to care. The theory includes three themes: violating the patients dignity, condemnation and punishment, exert of power and absence of care. The themes that occurred the most in the results were violating the patients’ dignity and absence of care. Another theme was developed through the results was healthcare priorities. The theory can be interpreted as a subtheme to absence of care. Erikssons theory was validated by the results of the study. One implication for clinical practice is to give the patients ability to evaluate their received healthcare. The purpose of the evaluation is to make the health care professionals aware of the patients’ experience. Further research about healthcare priorities are suggested.