Bakgrund: Antalet personer med obesitas ökar världen över och definieras genom ett Body Mass Index (BMI) över 30. Det ställer ökade krav på sjukvården att möta behovet av vård hos dessa patienter. Att bli sövd är förenat med risker, där ett högt BMI ökar risken vid generell anestesi. En förändrad anatomi och fysiologi hos patienter med obesitas utgör en ökad risk vid generell anestesi, vilket är någonting anestesisjuksköterskan måste vara förberedd på och kunna hantera. Syfte: Studiens syfte var att beskriva anestesisjuksköterskans erfarenhet av generell anestesi av patienter med obesitas för att säkerställa säker vård. Metod: Deskriptiv design med kvalitativ ansats. Totalt fem anestesisjuksköterskor intervjuades individuellt på en operationsavdelning i Mellansverige under perioden december 2023 till januari 2024. Resultat: Anestesisjuksköterskans erfarenheter presenteras i tre kategorier; Skapa egna förutsättningar för säker vård, process av mental och praktisk förberedelse för att hantera olika situationer, samt organisatoriska förutsättningar för säker vård. Vidare framkom åtta subkategorier; Identifiera patientutmaningar, ta stöd i team, erfarenhet medför trygghet, preoperativa förberedelser och använda hjälpmedel, förutse och hantera peroperativa risker, planera och utföra omvårdnadsåtgärder inför väckning och postoperativ vård, planerat operationsprogram påverkar, samt tillgänglighet till resurser. Slutsats: Studien visar att stöd i team samt att vara erfaren medför trygghet och ger goda förutsättningar för att skapa säker vård. Organisatoriska förutsättningar såsom operationsprogram och tillgänglighet till resurser är förutsättningar som påverkar möjlighet att skapa säker vård. / Background: The prevalence of obesity is increasing worldwide, with a Body Mass Index (BMI) above 30 defining the condition. This places increased demands on healthcare providers to meet the care needs of these patients. Being put under anesthesia is associated with risks, with even a high BMI increasing the risk of general anesthesia. An altered anatomy and physiology in obese patients pose an increased risk during general anesthesia, which the nurse anesthetist must be prepared for and be able to handle. Aim: The aim of the study was to describe the nurse anesthetist's experience of general anesthesia in obese patients in order to ensure safe care. Method: A descriptive design with a qualitative approach was employed. A total of five nurse anesthetists were interviewed individually in a surgical ward in central Sweden during the period December 2023 to January 2024. Results: The nurse anesthetists' experiences are presented in three categories: creating one's own conditions for safe care, the process of mental and practical preparation to handle different situations, and organizational conditions for safe care. Furthermore, eight subcategories emerged: identifying patient challenges, taking support in teams, experience brings safety, preoperative preparation and use of aids, anticipating and managing peroperative risks, planning and performing nursing measures for wake-up and postoperative care, planned surgical program affects, and availability of resources. Conclusion: The study indicates that the provision of support within teams and the possession of experience affords security and facilitates the creation of safe care. Organizational conditions, such as the surgical program and the availability of resources, are conditions that affect the possibility to create safe care.

Šiame baigiamajame darbe siekiama ištirti medicinos darbuotojų darbui ir sveikatai darančius ergonominius veiksnius bei įvertinti medicinos darbuotojų sveikatą, darbo kokybę ir ergonomiką. Siekiama rasti ryšį tarp ergonomikos, sveikatos, aplinkos ir medicinos darbuotojų gyvenimo kokybės bei skatinti imtis priemonių rizikos veiksniams šalinti. Darbas sudarytas iš dviejų analitinių (aprašomųjų) ir empirinės (eksperimentinės) dalių. Pirmoje analitinėje dalyje nagrinėjami veiksniai, darantys įtaką darbo ergonomikai, tai mikroklimato parametrai ir jų įtaka žmogui, dulkių poveikis, apšvietimas, taip pat triukšmo bei virpesių poveikis žmogaus organizmui. Antroje dalyje nagrinėjama sveikata bei darbą ir sveikatą lemiantys veiksniai: socialinė aplinka, gyvenimo kokybė, aplinkos tarša. Empirinėje dalyje, atlikus anketinę apklausą, įvertintas darbo įrankių ir prietaisų atitikimas ergonomikos reikavimams, nustatyta, kaip ergonominės naujovės atitinka darbuotojų lūkesčius, kaip jos mažina darbo įtampą. Taip pat buvo įvertintas medicinos darbuotoj�� darbo ergonomiškumas ir sveikata. / The objective of this study is to investigate the factors of ergonomics having the influence upon the medical employee‘s health, work quality and ergonomics. The aim was to find the link among ergononomics, health, environmental and life quality of the medical employees and to include to take measures for the elimination of the risk factors. The paper consist of two analytical (descriptive) and one empirical (experimental) parts. The first analytical part analyses the factors which affect the ergonomics of work, mainly the parameteres of microclimate and their influenc on people, as well as the influence of dust, ligthing, noise and vibration being mad o the human organism. The second part examines the health and such factors as health, social enviroment, life quality,pollution affecting the quality of work and life. The empirical part, according to previous surveys, evaluates the correspondence between hand tools, devices and the requirements of ergonomics, defines the way the innovations of ergonomics conform the expectations of the workers. It also analysed the role of innovations in reducing stress at workplace. Work ergonomics and health of medical employee‘s was analyses, as well.

The industry is facing major challenges today. The challenges are tougher global competition, customers who require individualized products and shorter product lifecycles. The predicted industrial revolution is a way to deal with these challenges. Industry 4.0 includes strategies linked to several technologies that will meet the new needs. Smart factory is a central concept in industry 4.0, which involves connected technologies of various kinds. Such as digital manufacturing technology, network communication technology, computer technology, automation technology and several other areas. In this work, these were defined as smart factory technologies. Implementing such technologies will result in improved flexibility, resource productivity and efficiency, quality, etc. But, implementing smart factory technologies poses major challenges for the companies. Laboratory environments can be utilized to address the challenges. This results in a new problem, how to transfer a smart factory technology developed in a laboratory environment to a full-scale production system. In the literature study no, structured approach was identified to handle this challenge. Therefore, the purpose of this work was to: create a work process that supports the technology transfer from a smart factory compliant laboratory environment to a full-scale production system. To justify the purpose, the following research questions were answered: RQ1: What are the differences in the operating environment between the laboratory and the full-scale production system? RQ2: How is a smart factory technology determined ready to be implemented into a full-scale production system? RQ3: What critical factors should a work process for the implementation of smart factory technologies include? The research questions were answered by conducting a multiple-case study in collaboration with Scania CV AB. During the case studies, interviews, observations and other relevant types of data collection were conducted. The results were as follows: RQ1: How difficult it is to transfer a technology from a laboratory environment to a full-scale production system depends on how large the differences between these are. The general difference is that laboratory environments are used to experiment and develop technologies and a full-scale production system is used to produce products. Some want the laboratory environment to be an exact copy of a full-scale production system, but this is not appropriate because it means you lose the freedom of experimentation and it would be much more expensive. RQ2: Determining whether a smart factory technology is ready consists of two parts, laboratory activities and pilot testing. A structured assessment method has been developed. The laboratory operations reduce the risks and contribute to raising the degree of maturity of the technology. In pilot testing, it is important not to interfere with the full-scale production system stability. This is the reason for doing pilot testing in a delimited area first and checking that the technology works as desired. RQ3: The critical factors identified were: competence and knowledge, technology contributing to improvements, considering risks with implementation, cost versus potential improvement, clear goals and reason for implementation and communication.