MSc (Nursing), Faculty of Health Sciences, University of the Witwatersrand / The purpose of this study was to determine the knowledge of nurses working in ICU with respect to evidence based guidelines for prevention of ventilator associated pneumonia. A non experimental, descriptive, correlational and contextual two phase research design was used. The first phase of the study consisted in validating the data collection instrument for applicability to the South African context. The second phase of the study used the instrument validated in phase one to test the knowledge of nurses working in ICU. Data analysis was done by means of descriptive and inferential statistics using frequency distributions, cross-tables, means, standard deviations and Pearson correlation coefficient. The knowledge of 83 nurses working in ICU from two hospitals of the private health sector and one hospital of the public health sector in Gauteng was tested using the data collection instrument validated by ICU nursing experts. Knowledge of ICU trained and non ICU trained nurses working in ICUs of the three hospitals was found to be lacking in the evidence based guidelines for prevention of ventilator associated pneumonia. Of the 83 participants, 18 (21.69%; CI 95% 13.4% ; 32.1%) achieved a pass mark of 70% on the multiple choice part of the questionnaire and were considered to have adequate knowledge on the evidence based guidelines for prevention of VAP. The mean score of participants was 4.25 (SD 1.537 CI 95% 3.92; 4.59) on nine questions. The difference in the mean average score of ICU trained nurses and non ICU trained nurses was very similar demonstrating no statistically significant difference in the knowledge of the two groups of nurses. A weak correlation between years working in ICU and knowledge was found, but this correlation may be clinically insignificant. Recommendations to address this lack of knowledge of ICU nurses were given for clinical nursing practice, nursing education as well as for nursing research.

Bakgrund: Västvärlden har hög medellivslängd vilket inte bara innebär att människor är friska utan att de också finns många som lever med svåra sjukdomar och stort lidande. I Australien startades den Mobila Intensivvårds Gruppen, MIG-team för att minska dödlighet av akut sviktande patienter, som sedan infördes runt om i världen.   Syfte: Syftet med denna litteraturstudie var att beskriva sjuksköterskornas upplevelser av den mobila intensivvårdgruppen (MIG-team) samt National Early Warning Score (NEWS), samt beskriva de inkluderade artiklarnas datainsamlingsmetod.   Metod: Beskrivande litteraturstudie. De inkluderade vetenskapliga artiklarna söktes fram i databasen PubMed. Elva artiklar inkluderades som svarade på syftet. Artiklarna inkluderade både kvalitativ och kvantitativ ansats.   Huvudresultat: Många sjuksköterskor ansåg att kommunikationen var viktig. NEWS – National Early Warning Score sågs som ett viktigt verktyg för att effektivisera patientvården då kommunikationen blev snabb och exakt mellan sjuksköterskan och MIG-team. Detta ökade även patientsäkerheten genom att både hjärtstoppslarm och dödsfall har minskat. Sjuksköterskorna önskar överlag mer utbildning för att stärka den egna kompetensen. Det har påvisats att en del av sjuksköterskorna känner sig osäkra att hantera NEWS samt att de känner sig osäkra vid vilken tidpunkt de bör kontakta MIG-team. Osäkerheten skulle med största sannolikhet minska om de fick tillgång till mer utbildning samtidigt som det skulle stärka teamarbetet kring patienten. Datainsamlingsmetoderna i de inkluderade studierna var ett flertal intervjuer, en observationsstudie och datainsamlingar från olika dataprogram.   Slutsats: Kommunikation har visat sig ha stor betydelse både för att säkerhetsställa patientarbete och främja teamarbete i personalgruppen. Införande av NEWS och MIG-team runt om i världen har visats minska hjärtstopplarm och dödligheten på sjukhus, vilket skulle kunna motivera till ytterligare utbildning för sjuksköterskor i NEWS och MIG-team. / Background: In the west world it is a high life expectancy, which not only means thatpeople are healthy but that they also are many who are living with serious illnesses andgreat suffering. The Mobile Intensive Care Group (MIG team) started in Australia toreduce mortality from acute fragile patients, who then introduced around the world. Aim: To describe the nurse´s experiences of Rapid Response Team (MIG-team), andthe National Early Warning Score (NEWS), and to describe the data collection of theincluded articles. Methods: A literature study with descriptive design. The included scientific articleswere sought out in the PubMed database. Eleven articles were included who answeredthe aim. The articles included both qualitative and quantitative approach. Results: Many of the nurse´s concider that the communication was important. NEWSseen as an important tool to streamline patient care when communication was fast andaccurately between the nurse and the MIG- team. This also increased patient safety,which showed that both cardiac arrest alarm and deaths have declined. Nurses wishgenerally more education to enhance their skills. It has been demonstrated that some ofthe nurses feel insecure dealing with NEWS and that they feel uncertain when theyshould contact MIG -Team. The uncertainty would most likely decrease if they hadaccess to more education while it also would strengthen the teamwork around thepatient. Data collection methods in the included studies were several interviews, oneobservational study and data collection from various data programs. Conclusion: Communication has proved to be very important both to the collateralpatient work and promote teamwork in the personnel group. Introduction of NEWS andMIG teams around the world have been shown to reduce cardiac alarms and mortality inhospitals, which could warrant additional training in the MEWS and MIG team for thenurse´s.

Bakgrund: I sjuksköterskans arbete ingår varierande arbetsuppgifter. Omvårdnad är ett omsorgsyrke där patientens olika behov ska tillgodoses samtidigt som de administrativa uppgifterna och den medicinska disciplinen ska skötas. Sjuksköterskan konfronteras med stressade situationer dagligen i sitt omvårdnadsarbete. Syfte: Syftet med studien var att beskriva sjuksköterskans upplevelse av stressrelaterade konsekvenser i omvårdnadsarbetet. Metod: En litteraturstudie gjordes som grundats på tolv vetenskapliga artiklar. Resultat: Tre huvudteman av sjuksköterskans upplevelser hittades. Fysiska konsekvenser för sjuksköterskan, psykiska konsekvenser för sjuksköterskan och sjuksköterskans upplevelse av direkta konsekvenser för patientsäkerheten. Slutsats: Sjuksköterskorna upplevde att stress i omvårdnadsarbetet gav negativa konsekvenser. Patientsäkerheten minskar då sjuksköterskor stressar i sitt arbete och inte får tid att tillämpa individuell patientomvårdnad. Teoretisk kunskap om och hur arbetsrelaterad stress påverkar omvårdnadskvalitén bör inhämtas för att minska konsekvenserna för både sjuksköterskor och patienter. / Background: The nurse's work includes varied duties. Nursing is a caring profession where the patient's different needs should be met while the administrative data and the medical discipline must be maintained. Nurses are confronted with stressful situations in their daily nursing work. Aim: The aim of the study was to describe the nurse's experience of stress-related consequences of nursing care. Method: A literature review was made, based on twelve scientific articles. Results: Three main themes of the nurses' experience was found. Psychological consequences for nurses, mental health consequences for nurses and nurses' experience of direct consequences for patient safety. Conclusion: The nurses felt that stress in nursing gave negative consequences. Patient safety is reduced when nurses stress in their work and when they don´t have the time to apply individual patient care. Theoretical knowledge and how work-related stress affects the quality of care should be obtained to reduce the consequences for both nurses and patients.

Sverige har blivit ett mångkulturellt land vilket innebär att sjuksköterskan möter patienter från olika kulturer som är i behov av palliativ vård. Detta gör det viktigt att belysa i vilken grad sjuksköterskan har förmåga att hantera svårigheter som kan förekomma vid vård av patienter med olika kulturella bakgrunder i palliativ vård. Syftet med arbetet är att beskriva sjuksköterskans upplevelse av transkulturell palliativ vård. Metoden som används är en kvalitativ litteraturöversikt grundad på 11 artiklar som beskriver sjuksköterskans upplevelser av transkulturell palliativ vård. Artiklarna har eftersökts i databaserna CINAHL, Medline och PubMed. Resultatet visar att kommunikation är en viktig del för att kunna erbjuda vård och omsorg med kvalitet till patienter med olika kulturella bakgrunder. Förståelse för patientens verbala och icke-verbala kommunikation är väsentlig för att kunna skapa en bra relation mellan sjuksköterskan och patienten inom palliativ vård. Att använda tolk kräver att sjuksköterskans har kompetens och kunskap om hur man kommunicerar genom tolk för att kunna överbrygga kommunikationshinder. Resultatet visar att olika kulturella föreställningar skapar utmaningar vid transkulturell omvårdnad inom palliativ vård. Sjuksköterskans kunskap om kulturella skillnader är viktigt för att kunna undvika missförstånd och konflikter.  Resultatet visar också att medvetenhet, kulturell sensibilitet, patientens autonomi och familjen, är de faktorer som har betydelse för att kunna ge en god transkulturell omvårdnad inom palliativ vård. Uppsatsen visar att sjuksköterskans generella kunskap om kulturell känslighet, respekt och öppenhet för olika kulturella skillnader och empati kan vara viktiga förutsättningar för att undvika kulturella utmaningar i transkulturell omvårdnad inom palliativ vård. Sjuksköterskans förmåga att ge vård som är individanpassad med ett holistiskt synsätt för patientens situation och god kommunikation är viktigt för att kunna utföra god transkulturell omvårdnad inom palliativ vård. / Sweden has become a multicultural country which means that nurses encounter patients from diverse cultural backgrounds that in need of palliative care, this makes it important to examine the ability of nurse on how to deal with difficulties that may occur in the caring for patients in transcultural palliative care.The purpose of this study is to describe nurse’s experience in transcultural palliative care. A literature review based on 11 articles describing nurse’s experiences in transcultural palliative care. The articles used in the study are qualitative articles and has been researched in the database CINAHL, Medline and PubMed.The results show that communication has a vital part in providing a quality care for patients with different cultural backgrounds. An understanding of the patient's verbal and non-verbal communication is essential in order to create a good relationship between the nurse and the patient in palliative care. Using an interpreter requires that the nurse has the skills and knowledge of how to communicate through an interpreter in order to overcome communication barriers. The results show that different cultural beliefs can create challenges in transcultural nursing in palliative care. The nurse's knowledge of cultural differences is important in order to avoid misunderstandings and conflicts. The result also shows that awareness, cultural sensitivity, patient autonomy and the family, are the factors that are important to give a good transcultural nursing in palliative care.The thesis shows that nurses' general knowledge about cultural sensitivity, respect and openness to different cultural differences and empathy may be important prerequisites for avoiding cultural challenges in transcultural nursing in palliative care. The nurse's ability to provide care that is personalized with a holistic view of the patient's situation and good communication is essential in order to perform good transcultural nursing in palliative care.

Background. In Canadian baccalaureate nursing education, many schools pair their nursing students with a nurse preceptor to complete a consolidation placement in their final year of studies. The preceptor plays an important role in students’ learning and their success in the program. Although there are many factors that may influence preceptors’ ability to be successful in the role, the literature suggests that self-efficacy may affect their performance as a preceptors and may have an impact on students’ learning and their preceptorship experience. Self-efficacy is defined as a person’s confidence in their abilities to complete a task or goal. As such, preceptors with greater self-efficacy may be more effective in their role and may have a positive impact on students’ learning. Therefore, it is important to assess factors that influence preceptors’ self-efficacy as this knowledge could help inform and target the development of preceptor training programs, preceptor selection criteria and preceptor supports. Objectives. The purpose of this thesis is to explore the factors that affect the self-efficacy of preceptors. Five factors were investigated, including: (1) nursing experience, (2) preceptor experience, (3) vicarious preceptor experience, (4) preceptor training, and (5) the personality trait neuroticism. These variables are derived from Bandura’s (1986) theory of self-efficacy. Design. This study was conducted using a cross-sectional, non-experimental study design. Methods. A total of 95 nurse preceptors participated in the study by completing an online survey and were recruited using multiple strategies, including social media. The survey was comprised of demographic questions, a measure of the Big-Five personality traits, and a measure of clinical teaching self-efficacy. Correlation, independent t-tests and ANOVAs were done to analyze the data. Results. A statistically significant correlation was found between self-efficacy and two independent variables: nursing experience (r = 0.33, p < 0.01) and the personality trait of neuroticism (r = -0.21, p = .05). Additionally, self-efficacy was correlated with agreeableness (r = 0.22, p = .03) and age (r = 0.41, p < 0.01). A statistically significant difference in self-efficacy was found between diploma and bachelor degree nurses (mean difference = 0.37, p = .02), and bachelor degree and graduate degree nurses (mean difference = -0.45, p = .02). Conclusion. Three key results were found to influence the self-efficacy of nurse preceptors. This knowledge can be incorporated into preceptor training, preceptor support and the preceptor selection process.

Språkliga hinder kan vara en utmaning för sjuksköterskor i mötet med patienter som talar ett annat språk än svenska. Vårdrelationen kan bli lidande på grund av språkliga hinder och sjuksköterskor får det svårare att vårda patienterna utifrån deras unika behov. Att vårdrelationen blir lidande kan vara förödande för patienten då vårdrelationen mellan sjuksköterska och patient är av avgörande betydelse för en patients hälsoprocesser. Syftet var att beskriva sjuksköterskors erfarenheter och upplevelser av möten med patienter som talar ett annat språk än svenska. Examensarbetet är en litteraturstudie som grundar sig på elva vetenskapliga studier som beskriver sjuksköterskors upplevelse av språkliga hinder i vården. Resultatet visar att sjuksköterskors erfarenheter är att det kan vara svårare att skapa en god vårdrelation med patienter som inte talar samma språk som sjuksköterskan själv gör. Dessa språkliga hinder gör att patienterna inte kan uttrycka sina behov och sjuksköterskor får svårt med att göra adekvata bedömningar av patientens hälsa. Därmed anses denna patientgrupp vara svårare att vårda. Språkliga hinder kan upplevas som en barriär mellan sjuksköterska och patient och därmed blir det svårare att bygga en vårdrelation tillsammans. Patienters hälsoprocesser beror till stor del på vårdrelationen och att kunna uttrycka sina behov. Tolkanvändning i vården är däremot ett bra exempel på hjälpmedel som kan göra att vårdrelationen kan byggas trots språkliga hinder. Icke-verbala kommunikationsuttryck har också visat sig fungera bra för att göra det möjligt för sjuksköterskan att ge den vård som varje patienten har rätt till, trots språkliga hinder dessa emellan.

BAKGRUND: Meticillinresistenta Staphylococcus aureus (MRSA) är ett växande problem globalt. I Sverige är cirka 30 procent av befolkningen ovetandes bärare av MRSA. Bakterien kan ställa till problem när de kommer till antibiotikabehandling eftersom bakterien är resistent. Sjuksköterskor kan uppleva MRSA som skrämmande vilket leder till att patienten upplever stigmatisering. SYFTE: Syftet med studien varatt beskriva sjuksköterskans erfarenhet av att vårda patienter med MRSA. METOD: En kvalitativ intervjustudie har genomförts. Datainsamlingen har bestått av semistrukturerade intervjuer och materialet från intervjuerna har analyserats med en kvalitativ innehållsanalys. RESULTAT: Resultatet visar god kunskap om hur basala hygienrutiner används och hur stress påverkar sjuksköterskans arbete. Det framkommer även kunskap om hur de ska bemöta patienter med MRSA för att minska stigmatisering. SLUTSATS: Erfarenheten av att vårda patienter med MRSA var individuellt hos sjuksköterskorna som deltog. En oro som fanns hos alla informanter var att de skulle bidra till smittspridning. Informanterna beskrev även att patientens upplevelse är viktig. FÖRSLAG PÅ FORTSATT FORSKNING: Studien har utförts på en kirurgisk vårdavdelning. Det skulle därför vara intressant att göra en studie på andra vårdavdelningar för att jämföra sjuksköterskornas erfarenhet. / BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a growing global problem. In Sweden, about 30 percent of the population are unaware that they are carriers of MRSA. The bacteria can cause problems when it comes to treatment via antibiotics due to the fact the bacterium is resistant. Nurses may experience MRSA as frightening which can lead to patients feeling stigmatized. AIM: The purpose of this study was to describe the nurse's experience of caring for patients with MRSA. METHOD: A qualitative interview study was conducted, with data collection consisting of semi-structured interviews. The material from the interviews has been analysed with a qualitative content analysis. RESULT: The result shows good knowledge of basic hygiene routines and how stress affect nurses work. They also show good knowledge about how to receive and care for patients with MRSA to reduce stigmatization. CONCLUSION: All participating nurses had individual experiences when it came to caring for patients with MRSA. A concern that existed in all informants was that they would be contributing to the spread of infection. The informants also describe that the patient's experience is important. PROPOSAL FOR CONTINUED RESEARCH:The study has been performed at a surgical care department. It would therefore be interesting for a study to be conducted in another care department to compare experience of the nurses.

Suicide is a worldwide problem that generates both great suffering for the individual and its family as well as a large economic impact for the society. 800 000 people commit suicide each year globally, of whom many have already been in contact with the care system without getting the help they need. The aim of this study was to describe nurses’ experiences of caring for suicidal patients. We conducted a literature study based on analysis of qualitative studies according to Friberg’s five step model. Ten studies, published 2011-2021, were included. When asked about their experiences, nurses empathize the need of patient safety and the importance of forming a close partnership with the patient. They also empathize the emotional impact the caring of these patients put on them. Patient safety for these patients is a matter of both a safe hospital environment and nurses being well educated and aware of suicidal cues. The formation of a partnership is crucial for the nurse’s ability to make a good assessment and is usually facilitated by nurses being open and personal as well as empathic and present in the moment. However, becoming too close to the patient may be emotionally tough if the patient commits suicide. Nurses therefore need support and tools for handling their emotions. Further on, to make a good assessment the nurses also need to be able to tune into the patients verbally unexpressed needs.

No description available.

Aim. The aim of this study was to examine missed nursing care in the context of academic preparedness, years of experience, and job satisfaction and determine predictors of missed nursing care. Background. Patient care that is omitted or delayed is known as missed nursing care. Failure to provide the necessary care interventions on time can lead to decreased patient outcomes. Academic preparation, the number of years of nursing experience, and job satisfaction can also play a pivotal role in patient outcomes. Limited studies have assessed academic preparedness and years of nursing experience on missed nursing care while also examining job satisfaction. It is currently unknown how missed nursing care relates to RN-BSN nurses. Method. The MISSCARE survey was distributed electronically to members of the Academy of Medical Surgical Nurses. Descriptive, inferential analysis and regression analyses were conducted using the electronic survey results. Results. One hundred sixty-eight registered nurses from across the United States were included in the sample for this study. Using the MISSCARE survey, results found there were no significant differences when examining academic preparation, years of experience, or job satisfaction on the amount of care missed at the bedside between ADN, RN-BSN, and traditional BSN nurses. Job satisfaction was the only predictor for missed nursing care, as nurses who are more satisfied are less likely to miss care.