Att ha ett sår är en belastning och påverkar människors vardag, oavsett om såret är akut efter ett olycksfall eller efter en operation, alternativt svårläkande som vid bensår, diabetesfotsår, trycksår eller maligna tumörsår. Syftet med studien var att undersöka kunskaper hos sjuksköterskor och undersköterskor om sårbehandling inom kirurgisk verksamhet. Metoden utgjordes av en enkätundersökning hos sjuksköterskor (n=56) och undersköterskor (n=38). Resultatet visar att sjuksköterskorna kände sig mer osäkra i sitt val av behandling av svårläkande sår jämfört med undersköterskorna. Kunskaperna om sårbehandling visar att skattade kunskaper inte motsvarar svaren på kunskapsfrågorna. Nitton av 56 sjuksköterskor och 15 av 37 undersköterskor hade genomgått någon form av sårutbildning. Undersköterskorna skattar sina kunskaper om sårbehandling högre än sjuksköterskorna och känner sig mer sällan osäkra i sitt val av behandling av svårläkande sår, jämfört med sjuksköterskorna. Det är också undersköterskorna som oftast utför såromläggningar på avdelningarna. Studien visar att det finns brister i kunskaperna om sårbehandling, hos både sjuksköterskor och undersköterskor och att mer utbildning behövs. / To have a wound is a burden and affect people's everyday lives, whether the wound is acute after an accident or after surgery or difficult healing of the ulcers, diabetic foot ulcers, pressure ulcers or a malignant wound. The purpose of this study was to investigate nurses' and nursing assistant’s knowledge of wound healing in surgical wards. The method was done by using a questionnaire survey among registered Nurses (RNs) (n = 56) and nursing assistants (NAs) (n = 38). The results show that the RNs felt more insecure in their choice of treatment of severe ulcer healing compared with the NAs. Knowledge of wound healing shows that the estimated knowledge does not correspond to the answers to knowledge questions. Of the RNs answered 51 of 56 and of the NAs answered 32 of 37 that they needed more education in wound care/treatment. NAs estimated their knowledge of wound care higher than the RNs and felt less insecure in their choice of treatment of wound healing, compared with the RNs. There are also the NAs who usually perform a change of dressing on the wards. The study shows that there are gaps in knowledge in wound care/treatment, with both RNs and NAs and that more education is needed.

Äldre personer riskerar i stor utsträckning att drabbas av undernäring och sjuksköterskor har en viktig uppgift i nutritionsarbetet kring dessa personer. Studiens syfte var att mäta attityder till äldres ätande och näringstillstånd. Det validerade instrumentet Staff Attitudes to Nutritional Nursing Care Geriatric scale (SANN-G-skalan) användes. I urvalet ingick sjuksköterskor på särskilt boende och korttidsboende i två kommuner. Två påståenden som handlade om kostpolicy och utbildning i nutrition lades till i enkäten, med möjlighet att lämna kommentar. Svarsfrekvensen var knappt 50 %. Resultatet visade att sjuksköterskorna totalt sett hade en positiv attityd. Det delområde som visade högst andel positiv attityd var individualisering som handlade om individanpassade måltider. En tredjedel av sjuksköterskorna ansåg att det sällan förekommer att äldre människor på kommunalt äldreboende är undernärda, trots att forskning visar motsatsen. För att få kunskap om hur de äldres näringstillstånd är i realiteten bör ansvariga inom respektive kommun undersöka hur många bedömningar som gjorts, vilken dokumentation som finns samt vidtagna åtgärder. Det kan vara en god grund för ett utvecklings- och förbättringsarbete där utbildning, reflektion kring arbetssätt och kommunikationsvägar bör ingå. Den positiva attityden och önskan om utbildning är gynnsam för utvecklings- och förbättringsarbete av nutrition och målttidssituation på särskilt boende och korttidsboende. / Elderly people run the risk of undernourishment to a great extent. Registered nurses have an important task in nutritional care. The aim of the study was to measure attitudes to elderly people’s eating and nutritional status. The valid instrument, Staff Attitudes to Nutritional Nursing Care Geriatric scale, (SANN-G-scale) was used. Registered nurses working in nursing homes and short-term care in two communities were selected. Two statements were added to the questionnaire, focussing on nutrition policy and further education. The percentage of answers was almost 50 %. The result showed that registered nurses overall had a positive attitude. The area that showed the highest degree of positive attitude was individualisation about the meal situation. One third of the registered nurses considered that the elderly in municipal care were rarely undernourished, although research findings are showing the opposite. To reveal the elderly´s actual nutritional status the number of assessments, the documentation and what measures have been taken must be investigated. The result could be a good foundation for development work and improvements. In this work further education, reflection about ways of working and ways of communicate should be included. The positive attitude and the registered nurses’ wish for further education are favourable for improvement of nutritional care and meal situations in nursing homes and short-term care.

Denna studies Syfte var att beskriva hur omvårdnadspersonal och sjuksköterskor på två särskilda boenden i en kommun i Mellansverige uppfattar sin egen och varandras yrkesroll, däribland uppfattningen av sjuksköterskors ledarskap. Detta syfte har speglats utifrån designen kvalitativ ansats där resultatet är övergripande beskrivande och Metoden för studien var halvstrukturerade, ämnesfokuserade intervjuer som analyserats genom kvalitativ innehållsanalys. Resultatet som framkommer i studien var att rollerna är svåra att definiera, de generella beskrivningarna är att sjuksköterskans ansvar ligger i det sjuka och förebygga ohälsa samt att omvårdnadspersonalens huvudansvar vilar i den basala omvårdnaden men båda yrkesgrupperna anser sig dela det preventiva arbetet, omvårdnadsteknik är omvårdnadspersonalens arbetsuppgift - men anses valbar och förväntningarna på respektive yrkesgrupp skiljer sig. Varken sjuksköterska eller omvårdnadspersonal anser att sjuksköterskan har några specifika uppgifter som ledare utöver att de ska fungera som handledare och stå för kompetenshöjning på avdelningen, däremot framkommer åsikter om att det finns en naturlig ledarroll inom den medicinska vården vid specifika situationer. Slutsatser i studien var att sjuksköterskorna uppvisar bredare kunskap om arbetsuppgifterna inom yrkesrollerna än vad omvårdnadspersonalen gör, förväntningarna på varandras ansvarsområden skiljer sig och båda grupperna verkar ovetandes om ansvaret sjuksköterskor har i ledanderollen. / The aim of this study was to describe how health care assistants and registered nurses perceive their own and each other’s work roles and also how they perceived registered nurses role as a leader. A qualitative descriptive design was used. The used method was semi-structured, topic-focused interviews that were analyzed through qualitative content analysis. The result of the study shows that it was difficult to define respectively work role, the general description is that the registered nurses responsibility lies within the area of diseases and prevention of illness. The health care assistant’s main responsibility is in the area of basic nursing care and also technical care, but both occupational groups considered preventive work as a shared responsibility and the expectations on respectively occupational group differ. Neither the registered nurses nor the healthcare assistants considered registered nurses as a leader, except in the role of a mentor and the responsibility to increase competence within the healthcare assistants group when needed. But it was found that registered nurse have a natural role as a leader regarding the medical care in specific situations. The conclusions of the study was that the registered nurses has a broader knowledge of the work tasks within the work role of the two professions compared to the health care assistants, the expectations of each other’s responsibilities differ and both groups seem unaware of the leading role that is incorporated in registered nurses responsibility.

BACKGROUND: Stroke survivors fall 7 times more annually than same-aged healthy adults; and most fall within the first 2 to 6 months post stroke after transition of care home from the acute setting. These falls cause hip fractures and other bodily injury, further compounding post-stroke mobility, fear of falling, social isolation, and social dependence while collectively yielding poorer outcomes at greater financial burden. PROBLEM: To date, no fall prevention program has targeted stroke survivors as they prepare for transition of care home from the acute setting. PURPOSE: The purpose of this practice inquiry is to develop an evidence-based fall prevention program aimed at empowering acute stroke survivors preparing for transition of care home from the acute setting. METHODS: An extensive literature review was synthesized to assess post-stroke falls epidemiology, contributing factors, potential consequences, and the current status of ameliorative interventions. A modified conceptual framework based upon the Science of Unitary Human Beings, theories of health empowerment, cognitive plasticity, and cognitive reserve was created to synergistically inform fall prevention program development. Literature review synthesis and modified conceptual framework collectively informed subsequent construction of a mixed theory-outcome-activities approach logic model to systematically guide proposed program implementation and evaluation plans. RESULTS: A novel evidence-based empowerment-focused fall prevention program was developed for acute stroke survivors preparing for transition of care home from the acute setting. CONCLUSION: The multi-interventional Patient Empowerment at Transitions of Care Fall Prevention Program for Stroke Survivors inspires a paradigm shift in the way stroke professionals and survivors view recovery and inherent survivor potential. The proposed fall prevention program is informed by a solid theoretical foundation and rigorous literature review of high-level evidentiary support. Moreover, existing dynamic funding opportunities promote subsequent program implementation and evaluation facilitated by Patient-Centered Outcome Research Institute grant pursuit.

Socialstyrelsen beskriver en kommande brist på operationssjuksköterskor i Sverige, samtidigt visar statistik av antal ansökningar till specialistutbildningen att färre sjuksköterskor väljer inriktningen operationssjuksköterska. I litteraturen beskrivs operationssjuksköterskans yrke som dolt för utomstående, och det kan vara en orsak till det låga intresset att välja yrket. Syftet med denna pilotstudie var att beskriva sjuksköterskors uppfattningar om operationssjuksköterskans yrke. Studien är genomförd med kvalitativ induktiv ansats som en intervju med öppen ingångsfråga. Data är analyserat med manifest innehållsanalys. I resultatet framkom tre kategorier, Osynligt och lågt värderat, Medlem i teamet och Praktiskt arbete. Resultatet stämmer överens med tidigare utförd forskning. En större studie är av värde för att få en djupare förståelse av skillnader i uppfattningar. Kunskap om uppfattningen kan underlätta rekrytering av operationssjuksköterskor. Specialistkompetens på operationsavdelningarna ökar förutsättningarna för patienter att få en säker perioperativ omvårdad / National Board of Health and Welfare describes an upcoming shortage of perioperative nurses in Sweden, and statistics show that the number of nurses applying to specialized training in the perioperative field is declining. In the literature, the perioperative nursing profession is described as non-visible to people in general, and that may be a reason for the lack of interest in choosing the profession. The purpose of this pilot study is to describe nursesʹ perceptions of the perioperative nursing profession. The study was conducted using qualitative inductive approach as an interview with open entry question. Data was analyzed by manifest content analysis. The results revealed three categories; Invisible and low valued, Member of the team and Practical work. The result is consistent with prior research conducted. A larger study is of value to obtain a deeper understanding of differences in perceptions. Knowledge of these perceptions may facilitate the recruitment of perioperative nurses. Specialized competence at the surgical departments increases the chances for patients to receive a safe perioperative care.

Bakgrund: Att bli förälder är en omvälvande och stor förändring i livet och det är vanligt att bli nedstämd den första tiden som förälder. Oftast går det över ganska snabbt efter förloss-ningen men 10-20 procent av alla nyblivna mödrar mår fortsatt dåligt en längre tid och drab-bas av en förlossningsdepression. På grund av känslor som skam och skuld undviker många mödrar att söka vård och därför blir förlossningsdepression ofta oupptäckt och odiagnostise-rat.Syfte: Att beskriva mödrars upplevelser vid förlossningsdepression samt att beskriva upple-velsen av stödet från sjuksköterskan. Syftet var vidare att beskriva de inkluderade artiklarnas urvalsmetod och undersökningsgrupp.Metod: En beskrivande litteraturstudie baserad på 15 vetenskapliga artiklar med kvalitativ ansats. Databaserna PsycINFO och Cinahl användes till litteratursökningen.Huvudresultat: Vanliga upplevelser hos mödrar med förlossningsdepression var rädsla, skuld och ökad sårbarhet för att hantera förändringar. Mödrarna beskrev en frustration kring stödet och rådgivningen som gavs från sjuksköterskan samt deras attityder. Mödrarna beskrev en önskan om att sjuksköterskan skulle lyfta fram och synliggöra förlossningsdepression.Slutsats: Mödrar med förlossningsdepression lever i en känslomässig berg- och dalbana. På grund av skam och dåligt bemötande från sjuksköterskan undviker många mödrar att söka hjälp och de som försöker söka hjälp vet oftast inte var de kan vända sig. Sjuksköterskan ska enligt mödrarna ha ett empatiskt bemötande och vårda relationen mellan dem för att skapa trygghet i vården. / Background: Becoming a parent is revolutionary and a huge change in life and it is normal to become depressed the first time as a parent. The feelings often disappear after giving birth, but 10-20 percent of all new mothers continues to feel depressed for a long time and can result in a postpartum depression. Because of feelings such as shame and guilt many mothers avoid seeking care and therefore postpartum depression often become undiscovered and under-diagnosed. Aim: To describe mothers' experiences at postpartum depression and to describe the experi-ence of support from the nurse. The aim was also to describe the included articles selection method and study group. Method: A descriptive literature study based on 15 scientific articles with qualitative approach. The databases PsycInfo and Cinahl were used for the literature research. Main Results: The most common experiences of mothers with postpartum depression were fear, sense of guilt, increased vulnerability to manage change. The mothers described the frus-tration surrounding the support and advice given by the nurse. What created the most frustra-tion were the poor availability and the nurse's condescending attitude. The mothers described a desire that the nurse would highlight and make postpartum depression more visible. Conclusion: Mothers with postpartum depression lives in an emotional rollercoaster. Because of the feeling of shame and poor treatment from the nurse many mothers avoid to seek help and those who try to seek help often do not know where to turn. According to the mothers the nurse should have an empathetic approach and cherish the relationship between them to create safety in care.

It is a well-known fact that nurses generally work in challenging circumstances. Within the South-African context, a developing country, factors such as shortages of staff, lack of training and crowded hospitals are common occurrences. Large amounts of South-African-born nurses leave the country, or even the profession, with the hope of better career opportunities. The nurses that are left behind, automatically experience more pressure as their already heavy workload increases further. Staff shortages, which is a general problem in the nursing profession, is a great contributing factor to stress, as nurses sometimes need to work outside their scope of practice. A so-called "multi-skill" setup is then created, such as the Level-Two hospital where this research was conducted, where staff members did not necessarily receive formal training to carry out the tasks that are required from them. Multi-tasking from them then results in the nurse having to divide her attention. The above mentioned circumstances cause a great deal of stress for the nurse working within this setup. The aim of this research was to explore and describe the experience of nurses working in the multi-skill setup, as well as to explore and describe the nurses' view of effective coping mechanisms within the multi-skill setup, and to suggest guidelines for enhancing the emotional well-being of the nurse within the multi-skill setup. A purposive sample was conducted according to a list of inclusion criteria. The sample constituted of registered nurses, enrolled nurses, as well as enrolled nursing assistants employed at the particular Level-Two hospital in Gauteng. Semi-structured interviews were used in order to collect the richest data possible. Each of the interviews was recorded on digital compact discs, so that it could be transcribed verbatim. Data saturation was reached after ten interviews and the researcher analyzed the data, together with an independent co-coder. Consensus was reached between the researcher and the co-coder with regards to their individual analyses. Four main categories, each with their own sub-categories, were identified and discussed together with a literature control; namely; the experience of the multi-skill setup as positive, the experience of the multi-skill setup as negative, personal coping mechanisms within the multi-skill setup, as well as suggestions for the enhancing of the emotional well-being of the nurse within the multi-skill setup. Recommendations were formulated by the researcher relating to nursing research, nursing education, as well as to nursing practice. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2009.

It is a well-known fact that nurses generally work in challenging circumstances. Within the South-African context, a developing country, factors such as shortages of staff, lack of training and crowded hospitals are common occurrences. Large amounts of South-African-born nurses leave the country, or even the profession, with the hope of better career opportunities. The nurses that are left behind, automatically experience more pressure as their already heavy workload increases further. Staff shortages, which is a general problem in the nursing profession, is a great contributing factor to stress, as nurses sometimes need to work outside their scope of practice. A so-called "multi-skill" setup is then created, such as the Level-Two hospital where this research was conducted, where staff members did not necessarily receive formal training to carry out the tasks that are required from them. Multi-tasking from them then results in the nurse having to divide her attention. The above mentioned circumstances cause a great deal of stress for the nurse working within this setup. The aim of this research was to explore and describe the experience of nurses working in the multi-skill setup, as well as to explore and describe the nurses' view of effective coping mechanisms within the multi-skill setup, and to suggest guidelines for enhancing the emotional well-being of the nurse within the multi-skill setup. A purposive sample was conducted according to a list of inclusion criteria. The sample constituted of registered nurses, enrolled nurses, as well as enrolled nursing assistants employed at the particular Level-Two hospital in Gauteng. Semi-structured interviews were used in order to collect the richest data possible. Each of the interviews was recorded on digital compact discs, so that it could be transcribed verbatim. Data saturation was reached after ten interviews and the researcher analyzed the data, together with an independent co-coder. Consensus was reached between the researcher and the co-coder with regards to their individual analyses. Four main categories, each with their own sub-categories, were identified and discussed together with a literature control; namely; the experience of the multi-skill setup as positive, the experience of the multi-skill setup as negative, personal coping mechanisms within the multi-skill setup, as well as suggestions for the enhancing of the emotional well-being of the nurse within the multi-skill setup. Recommendations were formulated by the researcher relating to nursing research, nursing education, as well as to nursing practice. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2009.

Clinical research is conducted to advance human medicine by developing efficacious treatments and improving patient outcomes when new therapies are developed and implemented. Clinical trials are a subset of the types of clinical research conducted on human volunteers in the development of new drugs, devices and other therapies. Prior to the start of a trial, a country’s regulatory authority must review the trial to ensure it is scientifically and ethically sound. In Canada, the regulatory authority is Health Canada. The International Conference on Harmonization (ICH) of technical requirements for the registration of pharmaceutics for humans aims to provide ethical and scientific quality standards for design, conduct, data collection and reporting in clinical trials. The Good Clinical Practice (GCP) Guidelines were created by the ICH Steering Committee to assure the public that rights, safety and well being of subjects are protected according to the Declaration of Helsinki, and the clinical data obtained in a ICH/GCP compliant clinical trial will meet regulatory requirements. Health Canada has adopted the ICH/GCP Guidelines and therefore, in Canada, all clinical trials involving humans must comply with these Guidelines. The clinical trial coordinator is an important and central position on the research team executing many trial duties and communications. Regulatory authorities, Research Ethics Boards and the sponsor, overlook the role and responsibilities of a highly trained clinical coordinator, despite their vital and central position. The GCP Guidelines also fail to address the role and responsibilities of a clinical coordinator. Disconnect between guidelines, regulatory expectations and actual trial conduct provides an apparent need to formalize and clearly define the role and scope of a clinical coordinator. The Registered Nurse (RN) brings professionalism, knowledge, skill and a holistic perspective to the expanded role of a clinical coordinator and to the clinical trial. Highly trained health professionals are capable of assuming more responsibilities and executing clinical trial design, setup and management as compared to the traditional administrative roles of the clinical coordinator. The expanded role of the clinical coordinator is especially beneficial for Principal Investigator initiated trials due to limited research personnel and resources. Postoperative adhesions are a common complication following pelvic surgery, therefore, this clinical trial is relevant and a response to a healthcare need. My graduate studies focused on the development and set up of the clinical trial Protocol ADE002-2013 Phase I Trial of L-Alanyl-L-Glutamine for the Reduction of Peritoneal Adhesions in Adult Females Undergoing Myomectomy. My thesis is a discussion of general Canadian clinical trial research information followed by an explanation of how we executed the information to design and set up our PI initiated clinical trial. The value of the expanded role of the clinical coordinator as a member of the research team will also be discussed.

The global trend towards an ageing population presents challenges for health-care professionals, including registered nurses (RNs). In Taiwan, health care policies relating to the aged and to gerontological nursing are still in the early stages of development. Integral to this development is the evolving definition of the clinical role of RNs who make a major contribution to aged care. Using data from in-depth interviews of 29 RNs working across eight nursing homes, this grounded theory study examines the factors that shape the care work of RNs in long-term aged care in Taiwan. The objectives of this study were to: * examine the work-experience perceptions of RNs employed in nursing homes in Taiwan * explore the factors that influence the delivery of nursing care to the aged by RNs * explain the events that constitute nursing practices in aged care provision that have an effect on the roles of RNs, and * develop a theoretical proposition that can guide future nursing practice in aged care. Grounded theory and symbolic interactionism are the complementary methodologies selected to underpin this study. The perspective of grounded theory allows for a critical investigation of the social processes that are integral in shaping the perspectives of RNs who work in Taiwanese nursing homes. The application of the theory of symbolic interactionism facilitates an exploration of the roles of RNs in this context and of the different meanings for individuals in the various situations they confront. Organizational factors and interactions that shape the role of RNs in the working environment of aged care are highlighted in the interaction between the data and the theory. The core category that emerged from the study was searching for an identity. This core process reflects ambivalence in the perceptions of RNs in describing and explaining the nursing role in Taiwanese nursing homes. Five categories that bring some greater understanding of this ambivalence are: coming to know, doing anything and everything, negotiating the work role, dealing with the system, and learning by being there. The specific intention of this study was to extend our understanding of nursing work and the delivery of care to older people in nursing homes in Taiwan. The findings of this study will contribute to the development of an educational framework that may be applied to improve nursing practices in nursing homes. These findings also have the potential to make a positive contribution to aged health care policy-making in Taiwan.