Bakgrund: Tidigare forskning visar på en stressig arbetsmiljö för sjuksköterskor med flera komplexa arbetsuppgifter. Behovet av att delegera arbetsuppgifter ökar i och med detta och kraven på att delegera patientsäkert beskrivs som centralt. Den tidigare forskningen ger ingen klar bild över vem som har vilket ansvar i delegeringsfrågan. Syfte: Syftet med examensarbetet var att undersöka sjuksköterskors ansvar vid delegering av hälso- och sjukvårdsinsatser i kommunal verksamhet. Metod: Studien följer en kvalitativ ansats med en innehållsanalys. Insamlingen av data skedde via inspelade semistrukturerade intervjuer. För examensarbetet blev sex sjuksköterskor intervjuade. Resultat: Tre kategorier utformades av resultatet: ansvar gentemot patienten vid delegering, ansvar under delegeringstillfället och ansvar efter utförd delegering. Gemensamt hade informanterna ett standardiserat – webbaserad – delegeringsrutin. Dock fanns det lite till ingen uppföljning på delegeringar. Slutsats: delegeringsprocessen är komplex med oklar ansvarsbild. Sjuksköterskan ansvarar för att patienten i slutänden får god och säker vård även om det är helg, kväll eller sjukdomsfall i personalgruppen. / Background: Previous studies show a stressful work environment for nurses with complex job assignments. The demand to delegate job assignments is increasing as an aftermath and the requirement to delegate job assignments with patient safety in mind is described as a central factor. The previous studies gave no clear image of who has the responsibility in delegations. Objectives: The aim of this study was to examine the registered nurses’ experiences of responsibility during delegations. Method: The study has a qualitative approach and is assembled in content analysis. Data has been collected through semi structured interviews. For the study six nurses have been interviewed. Result: The manifested results formed up in three categories: responsibility towards patients when delegating, responsibility during the delegation and responsibility after the delegation. The informants had in common that they were following a standardized web-based delegation routine. Though there was slight to no follow up on the delegations. Conclusion: The delegation process is complex with unclear responsibility. The nurse is responsible for ensuring that the patient receives good and safe care in the end, even if it is weekend, evening or illness in the staff group.

<p><strong>Introduction</strong></p><p>This thesis explores how we can increase patient safety through medicine management and administration in inpatient care units in somatic hospitals in Sweden and Norway by combining tools and systems which allows nurses to work safely, precicely, and efficiently whenever they are managing or administering medication to patients. </p><p></p><p><strong>Background</strong></p><p>Nurses have the formal, academic, and moral responsibility in medicine management and administration in hospitals (1). The nurse must ensure that the medication is given to the correct patient, that it is the correct kind of medication, correct form, correct strength, correct dose, correct administration method, and that it is given at the correct time (1). Regardless of these 7 points of control, adverse drug events still happen.</p><p></p><p><strong>Methodology</strong> </p><p>Through a human centered design approach this thesis explores design challenges and opportunities to how we can improve the medicine managment and administration process within somatic hospitals in Sweden and Norway.</p><p></p><p></p><p><strong>Result</strong></p><p>The final design proposal, Memo, suggests an ecosystem which make all medication traceable by incorporating a closed loop medicine management approach, making information accessible and consistent across digital and physical platforms, and having a  precise, accessible, and informative electronic medicine list. Memo eliminates risks of medicine errors by designing barriers within the system which make it harder for the nurse to make an error. The aim is to increase patient safety.</p><p>Memo is developed together with nurses and pharmacists from 3 different hospitals in Sweden and Norway.</p>

Made available in DSpace on 2016-04-27T16:57:42Z (GMT). No. of bitstreams: 1 dissertacao_cicera_maria_dos_santos_xavier.pdf: 3183146 bytes, checksum: 180c319ac6fe463a4f9d492e4bb0f443 (MD5) Previous issue date: 2006-05-25 / Secretaria da Educação / The relevance of this research is base don the issues related to the possibility of deepening into discussions and reflections on how to use the problem-situations which involve the proportion and reason concepts and they were arisen and elaborated from observations of nursing-professional practice that may be applied to technical course student graduation as well in elementary school course: in order to stimulate the practice in mathematics through investigation and reflection and would turn the learning into a more meaningful matter. This research is concerned with a qualitative approach and I have chosen, as methodology: non-directed interviews, analysis of the documents and participant s observations. Based on the data, I have built up four problem-situations and one of them was applied, not only to a beginner student; but also to one who had been carrying out the nursing profession, making possible the result comparisons. The application results were observed in terms of Conceptual Field Theories, some aspects of Learning Social Theory and Activity Theory. They revealed that the theory does not provide access to the practice and neither does the opposite. In spite of this, it is possible to elaborate meaningful problems which approach the health transverse theme and come the mathematics near to its nursing context applications. It was shown that it was necessary to organize not only the elementary school but also the nursing technical course, concerning concepts of mathematics, so that the dichotomy between theory and practice may be lessened; making sense and giving interpretation of the context where these concepts are applied / A relevância deste estudo centra-se nas questões concernentes à possibilidade de se aprofundar as discussões e reflexões sobre a utilização de situações-problema, que envolvam os conceitos de Razão e Proporção, criadas e elaboradas a partir da observação da prática do profissional de enfermagem, que podem ser utilizadas na formação dos alunos do curso técnico, bem como na possibilidade de estendê-las ao ensino fundamental, contribuindo para que a Matemática praticada na escola estimule a investigação e a reflexão, tornando a aprendizagem desta disciplina mais significativa. Trata-se de uma abordagem qualitativa e optei por utilizar, como metodologia, a entrevista não-diretiva, análise documental e observação participante. Com base nos dados, criei quatro situações-problema, e uma delas foi aplicada tanto para uma aluna iniciante quanto para uma profissional atuante na área, permitindo comparar os resultados. Os resultados da aplicação foram analisados sob o ponto de vista da Teoria dos Campos Conceituais e alguns aspectos da Teoria Social do Aprendizado e da Teoria da Atividade. Os resultados revelaram que a teoria não fornece acesso à prática e o contrário também não acontece. Entretanto é possível elaborar-se problemas significativos abordando o tema transversal saúde, aproximando a Matemática e suas aplicações do contexto da enfermagem. Mostrou-se necessário uma organização tanto do ensino fundamental quanto do curso técnico de enfermagem na abordagem dos conceitos matemáticos, minimizando a dicotomia entre teoria e prática, dando sentido e interpretação ao contexto em que esses conceitos são aplicados

This study analysed the learning environment of undergraduate medical and health sciences students of the School of Medicine University of Zambia who were studying at the Ridgeway Campus. Premised on the theory that learner’s perception of the learning environment determines approach to learning and learning outcome, the study utilized a descriptive, quantitative, and non-experimental design to articulate the issues that characterise the learning environment of the programmes. The aim was to provide framework based on these, and use it to propose a strategy for improving the learning environment of the School. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was administered to 448 participants from year 2 to year 7 classes of medicine, pharmacy, and physiotherapy programmes. Total DREEM, subscale, and individual items’ scores were analysed statistically and compared by analysis of variance among the programmes. The issues determined formed the framework for strategy development, and strategic options were proposed based on evidence obtained from literature. With a global DREEM score of 119.3 ± 21.24 (59.7 %), the students perceived their learning environment as “more positive than negative.” One sample binomial test of hypothesis for categorical variables returned a p value <0.05, with a verdict to ‘reject the null hypothesis,’ thereby confirming a more positive than negative perception. Subscale scores also showed ‘more positive’ perception. There were no significant differences between scores from the different programmes when compared by Games Howell test, P> 0.05, thereby upholding the second hypothesis. Analysis of individual items revealed problems in six items, which were summarised into four strategic ssues: inadequate social support for stressed students, substandard teaching and mentoring, unpleasant accommodation, and inadequate physical facilities. The implications of the findings for theory and practice were discussed and strategic options proposed to address the issues. The study concludes that analysis of the learning environment of medical schools provides more insight for strategic planning and management. / Health Studies / D.Litt. et Phil. (Health Studies)