Syfte: Studien syftade till att undersöka nyutexaminerade kvinnliga sjuksköterskors upplevelser avseende rondsituationen och arbetsledarrollen.   Metod: Kvalitativ deskriptiv studie. Åtta semi- strukturerade intervjuer genomfördes och analyserades med innehållsanalys.   Resultat: Nyutexaminerade sjuksköterskor upplever svårigheter att hantera ronden och rollen som arbetsledare. Trots sitt omvårdnadsansvar upplever sjuksköterskan att omvårdnaden prioriteras ner och att mer tid går till att fördela och utföra läkarordinationer i det dagliga arbetet. På arbetsplatserna saknas rondstruktur och praktisk vägledning i hur en rond ska gå till, vilket även upplevs som bristfälligt under utbildningens gång. Det finns otillräcklig kunskap och tid för att förbereda sig för en rond på bästa sätt. Sjuksköterskorna har olika upplevelser, både negativa och positiva, av den kommunikation som finns med läkare under rondsituationer. Att arbetsleda är svårt dels på grund av utbildningens otillfredsställande förberedelser och dels på grund av svårigheterna att som ny personal på arbetsplatsen förväntas ta kommando och för första gången leda en annan yrkesgrupp.   Slutsats: Nyutexaminerade sjuksköterskor upplever svårigheter att hantera rondsituationer på grund av bristande struktur samt problematik i rollen som arbetsledare för omvårdnaden. Kommunikation och samarbete mellan läkare och sjuksköterska har stor betydelse för rondens utgång. Omvårdnad upplevs generellt vara nedprioriterat i förhållande till medicinsk vetenskap. / Objective: The study aims to examine newly qualified female nurses' experiences regarding the ward round and leadership role.   Method: Qualitative descriptive study. Eight semi-structured interviews were conducted and analyzed using content analysis.   Results: Graduate nurses are experiencing difficulties in managing the round and the leadership role. Despite their nursing responsibilities they experience a lack of priority in nursing, and that most time is spent to distribute and perform medical prescriptions in their daily work. The workplace has no structure and practical guidance regarding rounds, which is also perceived as deficient during the education. There is insufficient knowledge and time to prepare for a round in the best way. The nurses have different experiences, both positive and negative, of the communication with doctors during round situations. The leadership role is difficult partly because of inadequate preparation and training. Also because of the difficulties in which the newly graduated nurse in the new workplace is expected to take command, and for the first time take the lead of a different profession.   Conclusion: Newly graduated nurses are experiencing difficulties in managing the ward round due to lack of structure as well as problems in the leadership role of nursing. Communication and cooperation between doctors and nurses are of great importance for the round outcome. Nursing is generally perceived to not be prioritized in relation to medical science.

L’objet de cette thèse est de modéliser et de simuler des écoulements turbulents diphasiques incompressibles à phases non miscibles. La modélisation et la simulation de ce type d’écoulements sont traitées dans le cadre des méthodes de Simulation des Grandes Echelles (SGE) ou Large Eddy Simulation (LES) en anglais qui consistent à calculer directement les plus grandes structures de l’écoulement et à modéliser les plus petites. Ces méthodes adaptées aux écoulements turbulents monophasiques sont étendues au cadre des écoulements turbulents diphasiques. Pour cela, elles sont couplées avec une méthode eulérienne de type ’ Volume Of Fluid’ (VOF) spécifique au caractère diphasique de l’écoulement. La pertinence du couplage entre les modélisations SGE et VOF est testée sur la configuration industrielle proposée par le CEA-CESTA: l’impact d’un jet rond turbulent sur une surface libre eau/air dans une cavité. Des mesures expérimentales de vitesse (Particle Image Velocimetry PIV) réalisées au CEA-CESTA sont disponibles pour valider les résultats numériques issus des simulations. / The scope of this dissertation is to model and simulate non-miscible two-phase turbulent and incompressible flows. The modeling and the simulation of this kind of flows are carried out in the framework of the Large Eddy Simulation (LES) which consists in calculating directly the largest structures of the flow and in modeling the finest ones. These numerical methods, applied usually to the simulation of single-phase turbulent flows, are extended to the simulation of two-phase turbulent flows in this work. Hence, the LES methods are coupled with an Eulerian ’Volume of Fluid’ (VOF) approach which is particularly adapted to interfacial flows. The relevance of this numerical coupling bewtween LES and VOF methods is validated in the following industrial configuration of the CEA-CESTA: the impact of a turbulent round jet on a free water/air surface in a cavity. Some experimental velocity measurements (Particle Image Velocimetry PIV), carried out at the CEA-CESTA, are available to validate the numerical results.

Bakgrund: Ronden är en central punkt gällande planering och utvärdering av patientens vård. Sjukvårdspersonalen ansvarar för att personcentrera omvårdnaden där patienten sätts i fokus, och där vården byggs på respekt för patientens självbestämmande och integritet. Den traditionella ronden utförs i större del utan patientens närvaro. Bedside-rond (BR) syftar till att alla inblandade professioner rondar tillsammans med patienten vid patientens sängkant eller i ett avskilt rum för att göra patienten delaktig i sin egen vård.   Syfte: Litteraturstudiens syfte var att beskriva om BR bidrar till personcentrerad vård, delaktighet och förbättrat teamarbete, ur patienten och sjukvårdspersonalens perspektiv.   Metod: En litteraturstudie baserad på tio vetenskapliga originalartiklar. Databaser som användes i studien var PubMed, CINAHL och SveMed+. Resultatanalysen gjordes utifrån Graneheim och Lundmans (2004) kvalitativa innehållsanalys.   Resultat: Resultatet av denna studie indikerar på att patienten och sjukvårdspersonalen upplever en ökad delaktighet genom BR. Sjukvårdspersonal upplever förbättring i utfallet av vården eftersom hela sjukvårdsteamet får en helhetsbild av patienten. Flera studier styrker att samarbetet i teamet förbättrades, och att BR bidrog till en ökad förståelse för varandras yrkesroller. Oenigheter rörande rondens mål framkom, men även avsaknad av en tydlig struktur försvårade genomförandet. Kommunikationen förbättrades enligt flertal studier, vilket framförallt berodde på den direkta kommunikationen mellan berörda teamdeltagare.   Slutsats: BR skulle kunna införas som arbetsmodell istället för den traditionella ronden. Patienten blir mer delaktig i sin vård och samarbetet förbättras genom en effektivare kommunikation. Resultatet visar att patientens delaktighet ökar men för att kunna säkerhetsställa evidensen att patienten upplever att BR bidrar till en personcentrerad vård, behövs ännu mer forskning ur ett patientperspektiv. / Background: The round is a central part regarding planning and evaluating the patients’ health. Healthcare professional are responsible for the person-centered healthcare where the patient is the center of attention, and where the healthcare is based on the patient’s integrity and autonomy. The traditional round is carried out mainly without the patient’s presence. Bedside-round (BR) aims at all professions involved with the patient at the patient’s bedside or in a separate room to make the patient involved in his or her own care.   Aim: The purpose of the literature study was to describe whether BR contributes to person-centered care, participation and improved teamwork, from the patients’ and the healthcare professionals’ perspective.   Method: A literature study based on 10 scientific original articles. Databases used in the study were PubMed, CINAHL and SveMed +. The results analysis was based on Graneheim and Lundman's (2004) qualitative analysis method.   Results: The result of this study indicates that the patient and healthcare professionals experience increased participation through bedside-round. Healthcare professionals experience improvement in the outcome of care as the entire healthcare team gets an overall picture of the patient. Several studies confirm that team collaboration improved, and bedside-round contributed to an increased understanding of each other's professional roles. Disagreements concerning the goal of the round came true, but lack of a clear structure also complicated implementation. Communication improved according to several studies, mainly due to the direct communication between relevant team participants.   Conclusion: BR could be introduced as a working model instead of the traditional round. The patients becomes more involved in their care and the collaboration is improved through more effective communication. The result shows that the patient's participation increases but in order to ensure the evidence that the patient experiences that BR contributes to a person-centered care, even more research is needed from a patient perspective.

Syftet med studien är att visa hur kommunikation går tillväga under rondarbetet som är den vanligaste plattformen för interkollegialt arbete mellan läkare och sjuksköterskor. Metoden som användes var icke-deltagande ostrukturerade observationer som analyserades med hjälp av innehållsanalys. Observationer gjordes vid sex tillfällen på en infektionsklinik i södra Sverige. Resultaten visar att kommunikationen mellan yrkeskategorierna tyder på att det finns en hierarkisk struktur men visar samtidigt att orsaken till viss del vilar på yrkeskategoriernas åtskilda kompetenser och ansvarsområden. / The aim of this study was to show how communication occurs during ward round which is the most common platform for intercolleagual work between physicians and nurses. The used method was non-participant, unstructured observations and content analysis was used for the analysis. Observations were made at six different occasions at an infection unit in southern Sweden. The results showed that communication between the professions is demonstrating a hierarchical structure; however one cause for this was related to the differences in competence and field of responsibility within the professions.

Syftet med studien var att undersöka kvinnliga patienters upplevelse av ronden. Undersökningen har gjorts som en empirisk studie. Metoden som användes var en kvalitativ intervjustudie med manifest innehållstextanalys. Inklusionskriterierna var kvinna som varit inlagd på vårdavdelningen minst två dygn. Informanten bör kunna förstå och behärska det svenska språket. Resultatet från intervjuer med tio informanter visade att de flesta patienterna tyckte att den givna informationen var tydlig och begriplig. En del av patienterna upplevde dock att ronden var hastig. Det gavs inte tillfälle till att ställa frågor personalen lyssnade inte på patienterna. En utav patienterna hade en känsla av att vara i underläge under ronden. De kände oro över att inte veta något, samt frustration och aggressivitet då ronden fungerade dåligt. All personal har enligt patienten inte samma enhetliga kvalité. Fynden av denna studie visade att majoriteten av patienterna hade positiva upplevelser av ronden. Patienterna upplevde ett bra bemötande från personalen och att tydlig information gavs. Dock visar resultatet att då inte tydlig information ges och då inte öppenhet mellan patient och vårdpersonal finns är det patienten som drabbas. Det är därför viktigt med öppenhet mellan patient och vårdpersonal samt att givandet av information är tydlig. Patienterna upplevde en känsla av trygghet då familjemedlemmar deltog vid ronden. / The aim of the study was to examine the female patient’s experience of the ward round. The survey was done as an empirical study. The method used was qualitative interview with manifest content analysis. The inclusion criteria was woman that has been on the nursing ward at least two days. And could understand and speak the Swedish language. The result from the interviews with ten informants showed that most patients thought that the information was clear and understandable. Some of the patients experienced however that the round was to rapid. There was not given occasion to setting questions and the personal did not listen to the patients. Some patients felt being in a weak position during the round. They experienced frustration and aggressiveness when the round functioned poorly. According to some patients the staffs do not have same uniform quality. The findings of this study showed that the majority of the patients had positive experiences of the ward round. The patients experienced good meetings from the staff and that clear information was given. However, the result shows that when clear information not was given and when openness with the patient and staff did not exist it is the patient that is hit. It is therefore important with openness between patient and staff and that the given information is clear. The patients experienced a feeling of safety when family members during the ward round were present.

Ronden är en marknadsplats för utbyte av kommunikation mellan patienter och sjukvårdspersonal. Tidigare forskning har visat på ett asymmetriskt kommunikationsflöde under ronden där sjukvårdspersonalen och då framförallt läkaren varit den part som kommunicerat mest och patienten minst. Sjuksköterskans roll har beskrivits som tillbakadragen och relativt passiv i rondsammanhang. Asymmetrin återkommer också i den beskrivning av patientrollen där denne således befinner sig längst ned i sjukvårdshierarkin. Kontinuerlig patientanpassad information och ett aktivt lyssnande hos personalen leder enligt studerad litteratur och forskning till ett mer jämlikt kommunikationsflöde och informationsutbyte under ronden. Studies syfte är att undersöka patientens upplevelse av ronden på en onkologisk avdelning. Metoden som har använts är halvstrukturerad kvalitativ intervju. De centrala frågeställningarna har varit att undersöka hur patienten upplever att kommunikationen fungerar under ronden, om patienten upplever delaktighet under ronden samt att söka svar på hur patienten upplever betydelsen av sjuksköterskans närvaro under ronden. Av resultaten framkommer att respondenterna överlag tycker att kommunikationen fungerar väl under ronden. Respondenterna upplever även delaktighet under ronden och från deras sida manifesterades detta i form av frågeställande. Det framgick av resultatet att respondenterna inte upplevde att sjuksköterskan hade någon speciell betydelse för dem personligen under ronden, däremot framkom att respondenterna upplevde att sjuksköterskans roll i allmänhet under ronden var betydelsefull. I resultatet framkom även två intressanta bifynd som berörde integritet och tidsbrist. / The ward round is the marketplace for information and communication exchange between patients and healthcare professionals. Studies have shown an asymmetrical balance in the communication flow during the round. Healthcare professionals, in particular physicians are shown to have the most part of the communication during rounds, whereas patients only contributed with a small part. The role of the nurse during rounds has been described as relatively passive and quiet. Asymmetry has been used to describe the role of the patient leaving him or her in the bottom of the hospital hierarchy. Literature and studies used in the background suggests that continuous patient adjusted information and active listening by professionals would lead to a greater equality when it comes to the balance of communication and the exchange of information during rounds.The aim of this study is to investigate how patients in an oncology ward experience the round. The method used was qualitative semi structured interviews. The central research questions were to investigate the patient’s experience of the communication during the round, if the patients experience participation during the round and how the patient experience meaning of the presence of the nurse during rounds. Our result shows that the respondents felt that the communication was working well during the round. The respondents expressed that they participated during the round by asking questions. The respondents did not feel that the nurse had a special meaning for them personally during the round, but they did feel that the nurse in general had a meaningful role during the round. Other findings in the results concerning the integrity of patients and lack of time on behold of the professionals are also included.

Ronden är en benämning på en arbetsform som sedan länge använts på vårdavdelningar inom sjukhusen. Syftet med studien har varit att undersöka patientens upplevelse av delaktighet vid ronden på en onkologavdelning för att öka förståelsen för individuella uppfattningar om känslan av delaktighet hos patienten. Avdelningens patienter har delats in i en Röd respektive Blå grupp. Den Röda gruppen har fungerat som försöksgrupp för en ny metod att genomföra ronden på. Metoden har inneburit att patienterna i den Röda gruppen personligen varit närvarande under en så kallad socialrond. Varje vecka har nya patienter erbjudits att deltaga i studien, detta har skett under en två veckors period. Metoden vi inspirerats av är innehållsanalys och den teoretiska referensramen har föranletts av omvårdnadsforskaren Katie Erikssons definition av vårdprocessen. Resultatet har presenterats som både kvantitativa och kvalitativa data, i form av korta citat och tabeller. I resultatet har det ej framkommit några tendenser på att införandet av den nya rondmetoden skulle ha påverkat patientens upplevelse av delaktighet. Vad vi dock kunde påvisa var att personalens bemötande var av stor betydelse för samtliga informanter, oavsett rondmetod. / The round is a designation of a work form that for a long time have been used in nursing wards at the hospitals. The aim of the study has been to look into the patient’s experience of participation at the round on an oncology ward to gain understanding around individual opinions of the experience about patient participation. The patients at the ward have been divided into two different groups, a Red and a Blue. The Red group has functioned as the trial group of a new method of how the round could be performed. The method has meant that the patients in red group personally have been participating during a so-called socialround. Every week different patients have been offered to participate in the study, during two weeks. The method of which we have been inspired is content analysis and the theoretical frame has generated from the nursing researcher Katie Eriksson’s definition of the caring process. The result has been presented as both quantitative and qualitative form of data, presented as short quotations and tables. In the result there haven’t been clear tendencies that implicate that the introduction of the new round method has led to any affect on the patient’s experience of participation. We have however been able to point out that the staffs’ treat were of great importance for each and every one of the informants, regardless of what round method that has been used.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-03T20:59:11Z No. of bitstreams: 1 469951 - Texto Completo.pdf: 1648815 bytes, checksum: 0c9de5862ebd223abf629856bef3b63a (MD5) / Made available in DSpace on 2015-06-03T20:59:12Z (GMT). No. of bitstreams: 1 469951 - Texto Completo.pdf: 1648815 bytes, checksum: 0c9de5862ebd223abf629856bef3b63a (MD5) Previous issue date: 2015-03-31 / The objective of this thesis is to analyze the worker profile that came to Rond?nia attracted by the hydropower plants of Rond?nia between the years 2009 and 2012,, perpetrated by labor, beyond the social impact to the community. To understand this reality accessed poured the ontological standard and Marxian methodology, as theoretical framework. Focused categories were the arrival of the plants and its historical process of setting up and subsequent seduction and labor migration, the profile identified through the labor and the likely repercussions predictive. The methodological tool used to access the reality were focused labor demands and its wealth of data on worker qualification as a proponent , through qualitative analysis method, by analyzing the documents of the labor process. / O objetivo desta tese ? analisar o perfil do trabalhador que veio ? Rond?nia atra?do pelas Usinas Hidrel?tricas de Rond?nia entre os anos de 2009 e 2012, atrav?s de a??es trabalhistas perpetradas, al?m do impacto social causado ? coletividade. Para compreender esta realidade acessada serviu-se do padr?o ontol?gico e metodol?gico marxiano, como arcabou?o te?rico. As categorias enfocadas foram a chegada das usinas e seu processo hist?rico de instaura??o e posterior sedu??o e migra??o de trabalhadores, o perfil identificado atrav?s dos processos trabalhistas e as prov?veis repercuss?es preditivas. A ferramenta metodol?gica utilizada para acessar a realidade enfocada foram as demandas trabalhistas e sua riqueza de dados na qualifica??o do trabalhador como proponente, atrav?s do m?todo de an?lise qualitativa, atrav?s da an?lise de documentos constantes do processo trabalhista.

<p>The market for security is one filled with great opportunities. The security services companies are numerous and diverse, the Swedish market is dominated by two large companies: Securitas Bevakning AB and Falck Security AB. In this study we have focused on the bigger of the two, Securitas. </p><p>This report describes and analysis the security service branch and its surroundings in an involved manner. The target group of the result is mainly people within the security branch. However, by making a wide theoretical description the person unacquainted with the business will be able to understand the concept of this interesting trade. Further, those who are familiar with this field will be enabled to broaden their minds. The aim with this project is to create a foundation upon which Securitas can further continue their work. We have not presented any direct solutions, instead we have displayed concrete problems and presented guidelines for further exploration. </p><p>The purpose of the investigation is to discover how modern technology can improve today’s guard services. Moreover, the aim is to show how a change of attitude needs to be present while developing future security services. This change can also be applied to other security services than the time-sharing guarding. </p><p>The methodology used to meet our goals was a qualitative investigation based on interviews and literary studies. In order to form a robust overview of the study area the objects were carefully selected according to set preferences. These were, among others, which function the object has in society, how long they have been customers with Securitas and what kind of business they run. </p><p>In the discussion and analysis four important areas is to be taken into consideration: The change of the market, the adaptation of the service to the needs of the customer, the adaptation of technology, and the assertion to the customer of the profound effects following these amendments. These four areas represent the foundation for the presented model. </p><p>A solid cooperation between the customer and the supplier of the security service is vital. In contemporary society the customers have become more specialised and thereby the delivering company must aim to meet the increasing demands expected of this specialised service. Therefore the demand on the competence of the guard is getting higher. Another conclusion is also that one should introduce a quality measurement system that together with a statistical basis makes reporting and the analysing of the effects of the guarding easier to the customer. </p><p>Technology is the most important corner stone in an effective alarm system. The time for an emergency call response must be reduced. Further qualities that the customer demands are that the security companies possess good knowledge of the object and its surroundings. The effectiveness in the guarding rounds and the learning time for a new object can be reduced by multimedia teaching aids. </p><p>The customer satisfaction is not likely to be long term if they cannot see the results and high quality that they ask for. This is why it will be very important to measure, calculate and point out what both the guard and the security company can contribute with to please the customer. To enhance the dialogue the guard will be presenting solutions rather than static reports, and an acting counsellor strengthen the feeling of professionalism. Any change from the customers that affects the actual risk picture has to be identified promptly by the security service company.</p>

Syfte: Studiens syfte var att beskriva sjuksköterskors upplevelser av gåronden med fokus påinformation, patientens integritet och delaktighet.Metod: Deskriptiv design med kvalitativ ansats. Åtta omvårdnadsansvariga sjuksköterskor påtvå kirurgavdelningar intervjuades. Datainsamlingen gjordes med semistrukturerade intervjuersom bearbetades med kvalitativ innehållsanalys.Resultat: Information var en stor del av gåronden och kunde både lyfta och sänka gåronden.Patienternas delaktighet och möjlighet till ett eget val beskrevs. Sjuksköterskorna beskrev hurpatienternas integritet kan både bevaras och kränkas under gåroden samt vilka fel somuppkommer.Diskussion: Sjuksköterskorna upplevde att information till patienterna som de förstod var enviktig del av gåronden. Att bevara patienternas integritet under gåronden ansågs varavårdpersonalens uppgift och i många fall enbart sjuksköterskornas. Att patienterna blirdelaktiga under gåronden beskrevs av sjuksköterskorna som både patienternas ochvårdpersonalens ansvar.Slutsats: Samtliga intervjuade sjuksköterskor upplevde att informationen under gåronden varviktigt och att patienten förstod den information som ges. Att patienterna gavs och togmöjligheten till att vara delaktiga var både vårdpersonalens och patientens ansvar.Sjuksköterskorna ansåg det viktigt att arbeta för att skydda patienternas integritet och värnaom privat information / Purpose: The purpose of the study was to describe nurses’ experience of the bedside roundfocusing on information, integrity and patients participation.Method: Descriptive design with qualitative approach. Eight nurses in two different surgicaldepartments were interviewed. The data collection was done with semi-structured interviewmethod and analyzed using qualitative content analysis.Findings: Information is a crucial part of the bedside round and could both improve anddegrade it. They describe how patients privacy can both be preserved and impaired during thebedside round, patients participation and opportunity to make a choice.Discussion: The nurses felt that understandable information to the patients was an importantpart of the bedside round. That the patients were involved in the bedside round was describedby nurses as both patients and healthcare staffs’ responsibilities. To preserve patient privacyduring bedside round considered often to be nurses’ task.Conclusion: The nurses felt that information during the bedside round was important and thatthe patient understood the information that was given to them. That patients’ were given andhad the opportunity to be involved were both staffs and the patients’ responsibility. Thenurses felt that it was important to work for the patients' privacy and to protect the patients’private information.