Syftet var att granska sjuksköterskans dokumentation avseende intagningsorsak, andra identifierade problem/behov utefter CGA och vilka åtgärder det ledde till samt beskriva sjuksköterskans erfarenheter av att använda instrumentet CGA. Metod: Studien har en beskrivande design med kvantitativ och kvalitativ ansats. Totalt granskades 50 bedömningsinstrument och datajournaler. Frågeformulär utformades och 13 sjuksköterskor valde att delta. Journalgranskningarna utfördes med kvantitativ retrospektiv analys och frågeformulären analyserades enligt kvalitativ manifest innehållsanalys. Resultat: Under journalgranskningen framkom 11 olika intagningsorsaker där försämrat allmäntillstånd var den största gruppen. Totalt identifierades 205 problem/behov och 186 initierade åtgärder varav 7 åtgärder/person var högsta antal. Flest initierade åtgärder fanns inom nutrition, social bakgrund och fallrisk. Sjuksköterskornas erfarenheter av att använda CGA var att det fanns behov av tydliga arbetsrutiner gällande CGA, att CGA fungerade bra som checklista men var tidskrävande. De upplevde att CGA gav dubbelarbete men viljan fanns att använda CGA men däremot svårt att få det att fungera i arbetet samt att sjuksköterskorna identifierade problem/behov utan att använda CGA. Sjuksköterskorna upplevde inte att omhändertagandet förändrades men däremot fick teamet helhetsperspektiv på patientens livssituation. Samverkan med anhöriga och kommunen var viktigt. Slutsats: Studiens resultat visade att förutom inskrivningsorsak fanns även andra identifierade problem/behov utefter CGA som hade stor betydelse för att den äldre skulle uppleva hälsa. Sjuksköterskorna upplevde brister inom rutinen runt CGA samt erfor att sjuksköterskornas omhändertagande av den geriatriska patienten inte förändrades efter implementeringen av CGA. / Aim was to examine nurses documentation regarding admission cause, other identified problems/needs by the CGA and the actions that led to and describe nurses experiences of using the instrument CGA. Method: The study has a descriptive design with quantitative and qualitative approach. Total audited 50 assessment instruments and data records. Questionnaires were designed and 13 nurses chose to participate. Journal audits performed by quantitative retrospective analysis and the questionnaires were analyzed by the inspiration of qualitative manifest content analysis. Results: In the journal audit identified 11 different admission causes which reduced general condition was the largest group. Total identified 205 problems/needs and 186 initiated measures which 7 action/person was the highest number. Most measures were initiated in nutrition, social background and risk of falling. Nurses experiences of using the CGA was that there was a need for clear work procedures regarding the CGA, the CGA worked well as a checklist but was time consuming. They felt that the CGA gave duplication but the desire was to use the CGA but hard to make it work at work and the nurses identified problems / needs without using the CGA. The nurses did not feel that the care was changed but got the team holistic view of the patients life situation. Collaboration with families and the municipality was important. Conclusion: The study results showed that in addition the cause enrollment were other identified problems/needs along the CGA that had great importance for the elderly would experience health. The nurses experienced deficiencies in routine around the CGA and required that the nurses taking care of the geriatric patient did not change after the implementation of CGA.

Requirements for changes in nursing care on the part of top management Abstract At present, nursing care has been experiencing a great progress. Implementation of the nursing process as a working method has been striven for. The educational system for non-medical workers has been changing. Nurses holding top managerial posts should have competence to lead and manage people effectively in the ever changing nursing environment. To acquire information necessary for achievement of the set goals, a quantitative research was employed. Within the framework of the quantitative research, the questioning method using a questionnaire was selected. The questionnaires concerned were sent to top managers among nurses and doctors working in medical centres all over the Czech Republic. The thesis had three objectives defined. First, to discover what prerequisites top managers miss to be able to implement the changes concerned in the area of nursing care. Second, to discover top managers´ opinions on the system of nursing care provision. Third, to identify differences between requirements for the nursing process method on the part of top managers {--} nurses and top managers {--} doctors. Based on these objectives, four hypotheses were formulated. The hypothesis no. I: The current situation does not allow top managers operating in health service to implement changes in nursing care in practice. This hypothesis has been confirmed. The hypothesis no. 2: Top managers do not require group nursing care as a prerequisite for the implementation of nursing care changes. This hypothesis has not been confirmed. The hypothesis no. III: Representatives of nurses in managerial posts promote the nursing process application as a prerequisite for changes concerning nursing care. This hypothesis has been confirmed. The hypothesis no. IV: Representatives of medicine doctors in managerial posts do not promote the nursing process application as a method of nurses´ work. This hypothesis has not been confirmed. As far as the results of this diploma thesis are concerned, we were trying to outline possible solutions of the issues concerning changes in nursing care. Top managers are recommended to stimulate critical thinking in their employees in the course of work in the nursing process. It is beneficial to improve communication on the managerial level in hospitals, and in addition, to obtain feedback from subordinates with respect to continuing education, to identify effectiveness and needs relating to education on the part of employees and to enable them to participate in the process of the respective changes implementation. To train function nurses in such changes management. To implement a programme aiming at continual quality improvement.

An estimated 215,000 children and adolescents younger than 20 years old were diagnosed with Type 1 or Type 2 diabetes in 2011. Management of children with Type 2 diabetes requires 24-hour care provided by health care providers, parents, and school nurses. Guided by the health belief model (HBM), the purpose of this qualitative case study was to explore and describe beliefs, attitudes, and practices of school nurses who manage children with Type 2 diabetes. A pilot study with 2 nurses was conducted to finalize interview guide. Volunteer school nurses were recruited through an e-mail announcement from their school district. Face-to-face, in-depth interviews with 10 female school nurses were conducted. School nurse work experience ranged from 4 to 20 years, selected from 4 school districts, including 8 European, 1 Asian, and 1 Hispanic American. Transcripts from digitally recorded interviews were analyzed using NVivo software version 11. Thematic analysis led to 5 themes of communication, education, management, perceived barriers (multiple schools assigned/student demand), and enablers (school aides). Individually and collectively, themes reflect a synergistic positive attitude in management of children with Type 2 diabetes. HBM constructs elucidated school nurses' behaviors and attitudes regarding severity and susceptibility to illness, benefits students received from preventive care, and barriers they encountered. The positive implications for social change include recommendations for increasing the number of school nurses per district to meet the demand in managing children with chronic diseases, and intensification of positive attitude interventions in diabetes management.