Bakgrund: Överrapportering mellan skiftbyten är en central roll för sjuksköterskan och en viktig del för vårdverksamheten. Dock är den traditionella överrapporteringen identifierad som ett möjligt område för felkommunikation och minskad patientdelaktighet. Bedside överrapportering kan öppna upp för en mer personcentrerad vård och öka delaktigheten för patienten.  Syfte: Att undersöka patientens upplevelser och erfarenheter vid bedside överrapportering. Metod: En litteraturöversikt innehållande tio kvalitativa artiklar. Artiklarna hämtades från PubMed och CINAHL och kvalitetsgranskades med hjälp av SBU:s granskningsmall för bedömning av studier med kvalitativ metodik. Artiklarna analyserades med Graneheim och Lundmans (2004) innehållsanalysmetod.  Resultat: Analysen resulterade i fyra domäner och fyra kategorier där resultatet presenterades. Patientens upplevelser och erfarenheter visade sig till stor del handla om önskan att vara delaktig i sin vård. Vissa patienter uttryckte önskan om delaktighet i större utsträckning än andra och många poängterade fördelar som att kunna korrigera felaktigheter, ställa frågor och tillägga missad information i anslutning till överrapporteringen. Kommunikationen mellan patient och sjuksköterska påpekades vara en viktig del. Förmedlandet av känslig information upplystes som en svårighet och bevarande av patientens integritet ansågs som betydelsefullt.     Slutsats: Patienters upplevelser och erfarenheter av bedside överrapportering visade sig till stor del främja patientdelaktigheten. En del patienter ansåg sig dock vilja vara involverad i en begränsad omfattning. Patienterna ansåg att överlämningen gav en mer personlig relation mellan till sjuksköterskan. Möjligheten att påverka informationsöverföringen ansågs vara positivt. Bevara patientens integritet vid hantering av känslig information ansågs som en svårighet och att patienter ibland ansåg att det var svårt att förstå sjuksköterskornas komplicerade språk. / Introduction: Shift reports between nurses is a central role for the nurses and an important part of health care. The traditional handover has however been identified as a possible source of miscommunication and reduced patient participation. Bedside shift reports can facilitate a more personalized care and increase patient participation. Objective: To examine patient experiences with bedside shift reports. Method: A literary study containing ten qualitative studies. The studies were identified through PubMed and CINAHL and reviewed using SBUs template “assessment of studies with a qualitative method”. The articles were analysed using Graneheim and Lundmans’ (2004) content analysis method. Results: The analysis resulted in four domains and four categories. The results showed that a big part of the patient’s experiences of bedside shift reports was that they wished to participate more in their care. Some patients had a bigger wish to participate than others and a lot of patients emphasized the benefits of bedside shift reports; how they could correct wrong information, ask questions, and add further information. The communication between patients and nurses was another important part of bedside shift reports. The mediation of sensitive information was pointed out as a difficulty, as well as the protection of the patient’s integrity. Conclusion: The patient’s experiences of bedside shift reports has shown increasing patient participation in their care. They said that the handover enabled a more personal relationship between the patient and the nurses, and that this resulted in a feeling of calmness and safety. The opportunity to influence the transfer of information and to correct wrong data or ask questions was a positive aspect of bedside shift reports. The handling of sensitive information was seen as a weakness of bedside shift reports. Patients also had difficulty understanding the nurses' complicated language.

Bakgrund: Bedside-överrapportering är avsedd för att möjliggöra patienternas delaktighet och vara ett personcentrerat tillvägagångssätt där patienternas expertinformation tillvaratas. I tidigare forskning beskriver sjuksköterskorna patienterna som en oanvänd resurs i överrapporteringar (icke bedside). Dessutom erfar sjuksköterskorna tidsbrist och att rapporter var ofullständiga. Patienterna uppskattade i sin tur bedside-överrapportering eftersom de upplever en större kontroll och delaktighet. Dock erfars en utmaning kring känslig information och konfidentialitetsfrågor. Problem: Sjuksköterskorna har en central roll i att möjliggöra patienternas delaktighet och deras erfarenheter anses kunna bidra till en bättre förståelse för utmaningar och möjligheter i bedside-överrapportering. Syfte: Att skapa en kartläggning av sjuksköterskornas erfarenheter av bedside-överrapportering. Metod: Allmän litteraturöversikt för att skapa en översiktlig bild grundad i en analys av 10 artiklar. Resultat: Sjuksköterskorna erfor att patienterna blev mer delaktiga vid bedside-överrapportering och att personcentrerad vård främjades eftersom patienterna hamnade i fokus. Sjuksköterskorna beskrev även utmaningar i bedside-överrapporteringar i huruvida konfidentilitet och integritet röjdes samt avbrott och tidsbrist. Trots detta sågs även förbättringar som att överrapporteringarna erfors bli mer korrekt och komplett och kommunikationen ansågs förbättrad. Utöver detta upplevde sjuksköterskorna sig mer nöjda. Slutsats: Sjuksköterskorna uttryckte en förbättring i patientdelaktighet, personcentrering, kommunikation och rapportering. Dock fanns hinder i patientdelaktighet och problem gällande tidsaspekten och konfidentialitetsfrågor. / Background: Bedside handoff is a person-centred approach that aims to enable patient-participation and ensure the patients’ expert information is utilised. In earlier research nurses describe patients to be an unused resource. Furthermore, nurses find that lack of time and incomplete reports are problems in patient handoffs. Patients appreciate bedside handoffs because they feel more involved and in control. However, there is a perceived challenge concerning sensitive information and confidentiality issues. Problem: Nurses have a crucial role in enabling patient participation and their experiences are considered to help form a greater understanding of the challenges and possibilities relating to bedside handoffs. Purpose: To create an overview of nurses’ experiences of bedside handoff. Method: General literature review to create an overview founded in the analysis of 10 articles. Results: Nurses experienced that patients became more involved with bedside handoffs and that person-centred care was promoted because patients became the focus. Nurses also described challenges with bedside handoff in whether confidentiality and integrity were jeopardised. Moreover, challenges such as interruptions and lack of time were found. Despite this, improvements were also seen such as a more accurate and complete report, and improvements in communication. In addition, nurses felt more satisfied using bedside handoff. Conclusion: Nurses experienced an improvement in patient-participation, person-centred care, communication and in the report itself. However, there were barriers to patient-participation, time limits and confidentiality issues.

There are currently no Swedish norms for the bedside version of the Western Aphasia Battery (B-WAB-R) and the Cognitive Linguistic Quick Test (CLQT). It is unknown whether age, gender, and education influence performance in a Swedish context. Verbal fluency tests measure language and cognition, but semantic and phonemic versions are associated with separate cognitive processes. The aim was to evaluate how non-impaired adults performed on Swedish translations of B-WAB-R and CLQT, and the verbal fluency tests FAS and Animal Naming. Fifty-two participants without linguistic or cognitive impairments aged 21–88 were recruited. Potential differences in performance depending on age, gender, and education were analysed, and how performance on FAS and Animal Naming related to CLQT, and B-WAB-R performance. Performance did not differ depending on gender or education. Some scores fell below previous CLQT cut-offs for mild cognitive impairment. Participants aged 30–49 had better performance than older groups on Animal Naming and the CLQT domains Attention, Executive Functions and Language, and better performance than the youngest group on Attention. Animal Naming was weakly related to both language and cognitive measures. FAS was not related to any other measure. The small and unequally distributed sample limits the generalizability of the results. More research is needed to determine how age and education influence performance on CLQT and B-WAB-R in Sweden. More research is also needed to determine whether phonemic and semantic verbal fluency tests measure the same cognitive processes. / Det finns för närvarande ingen svensk normering för bedside versionen av Western Aphasia Battery (B-WAB-R) och Cognitive Linguistic Quick Test (CLQT). Det är okänt huruvida ålder, kön och utbildning påverkar prestationen i en svensk kontext.Ordflödestest mäter språk och kognition, men semantiska och fonetiska versioner är associerade med skilda kognitiva processer. Syftet var att utvärdera hur icke-nedsatta vuxna presterade på svenska översättningar av B-WAB-R och CLQT, samt ordflödestesten FAS och Djur. Femtiotvå deltagare utan språkliga eller kognitiva nedsättningar i åldrarna 21–88 rekryterades. Potentiella prestationsskillnader beroende på ålder, kön och utbildning analyserades, samt hur prestation på FAS och Djur relaterade till prestation på CLQT och B-WAB-R. Det fanns inga skillnader i prestation beroende på kön eller utbildning. Några poäng hamnade under tidigare satta CLQT gränsvärden för lindrig kognitiv nedsättning. De i åldern 30–49 hade bättre prestation än äldre grupper på Djur och CLQT domänerna Uppmärksamhet, Exekutiv Funktion och Språk, samt bättre prestation än den yngsta gruppen på Uppmärksamhet. Djur var svagt relaterad till både språkliga och kognitiva mått. FAS relaterade inte till några mått. Det lilla och ojämnt fördelade urvalet begränsar resultatens generaliserbarhet. Mer forskning behövs för att avgöra hur ålder och utbildning påverkar prestation på B-WAB-R och CLQT i Sverige. Mer forskning behövs även för att avgöra om fonetiska och semantiska ordflödestest mäter samma kognitiva processer.

Bakgrund: Dagens omvårdnadsforskning lyfter fram patienten som den viktigaste men samtidigt den mest outnyttjade resursen i hälso- och sjukvården. Patienterna måste göras mer delaktiga i sin egen vård och behandling. Historiskt har överrapportering mellan sjuksköterskor skett på sjuksköterskeexpeditionen. I bedsiderapportering sker kommunikationen mellan vårdpersonal och patient, vilket gör informationsöverföringen effektiv och säker. Syfte: Att beskriva patientens upplevelse av delaktighet vid bedsiderapport. Metod: Studien är en litteraturöversikt baserad på kvalitativa och kvantitativa vetenskapliga artiklar. Resultat: Resultatet redovisas utifrån fyra teman: att bli bemött som en person, att förstå och bli förstådd, att bidra till sin egen vård och att känna sig trygg. Det är viktigt att patienten erkänns som en person för att känna sig delaktig och därmed kunna bidra till sin egen vård. När patienten förstår och gör sig förstådd upplevs delaktighet. En bra bedsiderapport skapar trygghet. Slutsats: När sjuksköterskan blir medveten om fördelarna, tar tillvara på möjligheterna med patientens deltagande och samtidigt tar hänsyn till sekretess, språkbruk och patientens personella förutsättningar, blir bedsiderapportering betydelsefull för ökad delaktighet och inflytande för patienterna. / Background : Today nursing science brings forward the patient as the most important, but also the most neglected, resource in healthcare. The patients must be invited to participate in their own care and treatment. Historically, nursing handover has been carried out at the nurses’ expedition. In bedside reporting, care personnel communicate directly with the patient, which makes information exchange more efficient and safer. Purpose: To describe the patient’s experiences of participation in bedside report. Method: The study is a literature review based on quantitative and qualitative articles. Results: The results are presented based on four themes: to be met as a person, to understand and to make oneself understood, to contribute to one’s own care and to feel secure. It’s important that patients are recognized as persons to make them feel that they participate, thereby being able to contribute to their own care. When patients understand and make themselves understood, they feel participation. A good bedsiderapport creates security. Conclusion: Successful bedside report requires that the nurse becomes aware of the benefits and takes advantage of the opportunities that patient participation signifies. Bedside report is important to increase patients’ participation in care.

Background: Society demands increased patient participation in healthcare. One strategy to achieve patient participation during hospital stay in a surgical ward is implementation of handover at the patient’s bedside. The literature discusses the meaning of the concept patient participation, it is therefore important to study if patient participation can be achieved through bedside handover on the clinical ward.Aim: To explore how the bedside handover in nursing was performed on a surgical ward from the patient’s perspective focusing and participation.Method: A qualitative descriptive design with focused observations and informal interviews. A total of 23 observations were done, the analysis was inspired by ethnographic method.Results: Five themes emerged from the analysis: A calm atmosphere, Conditions for participation, To create a sense of “us”, Conversation on equal ground and at last Integrity and secrecy. The patients were active participants during the bedside handovers, they contributed with information and asked questions. The medical vocabulary was simplified and adapted to the patient’s ability. During the interviews the patients stated that the bedside handover created a sense of security and control. The observations showed though, that the patients were not asked to participate nor were they prepared for the report beforehand.Conclusion: This study shows that bedside handover gives the patient a sense of participation in his or her own care and creates a feeling of security and control. The result also shows a need for improvement regarding information, preparation and the opportunity to decline bedside handover, which offers potential to improve the bedside handover’s ability to increase patient participation. / Bakgrund: Samhället efterfrågar ökad patientdelaktighet i vården och ett sätt att möta detta krav är införandet av bedsiderapport på vårdavdelning. Litteraturen förklarar betydelsen av begreppet patientdelaktighet i teorin, det är därför motiverat att genom observation undersöka om patientdelaktighet kan uppnås med hjälp av bedsiderapport i kliniken.Syfte: Att utforska hur bedsiderapportering genomförs på en kirurgisk vårdavdelning med fokus på patientens perspektiv och delaktighet.Metod: En kvalitativ deskriptiv design med fokuserade observationer och informella intervjuer. Totalt genomfördes 23 observationer vilka analyserades med etnografisk data-analysResultat: Studiens resultat mynnade ut i fem teman: En lugn stämning, Förutsättningar för delaktighet, Att skapa en ”vi- känsla”, Samtal på lika villkor samt Integritet och sekretess. Under observationerna sågs att patienterna deltog aktivt i rapporten, de bidrog med information och ställde frågor. Det medicinska språket förenklades och anpassades efter patientens förmåga. Under intervjun uppgav patienterna att bedsiderapporten skapade en känsla av trygghet och kontroll. Dock observerades att patienterna varken tillfrågades om medverkan eller förbereddes inför rapporten.Slutsats: Studien visar att införandet av bedsiderapport får patienten att känna delaktighet i den egna vården och skapar en känsla av trygghet och kontroll. Resultatet påvisar även behov av att genom förbättringsarbete utveckla arbetssättet vidare då brister observerades gällande information, förberedelser och möjlighet att avstå bedsiderapportering. Detta skulle ge potential till förbättring av bedsiderapportens förmåga att skapa patientdelaktighet.

Background: Goal-directed ultrasound protocols have been developed to facilitate efficiency, throughput, and patient care. Hands-on instruction and training workshops have been shown to positively impact ultrasound training. Objectives: We describe a novel undifferentiated chest pain goal-directed ultrasound algorithm-focused education workshop for the purpose of enhancing emergency medicine resident training in ultrasound milestones competencies. Methods: This was a cross-sectional study performed at an academic medical center. A novel goal-directed ultrasound algorithm was developed and implemented as a model for teaching and learning the sonographic approach to a patient with undifferentiated chest pain. This algorithm was incorporated into all components of the 1-day workshop: asynchronous learning, didactic lecture, case-based learning, and hands-on stations. Performance comparisons were made between postgraduate year (PGY) levels. Results: A total of 38 of the 40 (95%) residents who attended the event participated in the chest pain objective standardized clinical exam, and 26 of the 40 (65%) completed the entire questionnaire. The average number of ultrasounds performed by resident class year at the time of our study was as follows: 19 (standard deviation [SD]=19) PGY-1, 238 (SD=37) PGY-2, and 289 (SD=73) PGY-3. Performance on the knowledge-based questions improved between PGY-1 and PGY-3. The application of the novel algorithm was noted to be more prevalent among the PGY-1 class. Conclusion: The 1-day algorithm-based ultrasound educational workshop was an engaging learning technique at our institution.

Many entry-level nurses are not prepared to handle medical emergencies. Although responsible for managing the care of individuals with complex medical conditions, many of these nurses compromise the safety of patients due to a lack of experience and an inability to apply clinical judgment. The purpose of this study was to explore the perceptions of registered nurses about their transition from entry-level to advanced beginner. Bandura's social cognitive theory, along with Colaizzi's descriptive method of data analysis, provided a basis for this phenomenological study. Research questions focused on challenges that entry-level nurses have experienced with problem-solving and complex patient care that requires advanced critical thinking and the application of clinical judgment. Criterion sampling facilitated recruitment of advanced-beginner RNs, with data collected through semistructured, one-on-one interviews. Data analysis occurred in a series of steps, including extracting and developing meanings from interview transcripts, clustering meanings into description lists, and eliminating outliers. Data analysis revealed 12 major themes aligned with behavior, clinical environment, and personal/cognitive factors. Among the findings were that nurses often felt unsupported, unable to manage conflict, unprepared, unseasoned, inefficient, and unable to lead others effectively. This study was necessary because its findings may provide insights leaders in health services can use to develop strategies to better prepare entry-level nurses to care for individuals with complex medical conditions. Among the implications for positive social change are developing a better tool for the training and advancement of entry-level nurses, consequently improving patient safety and reducing health care costs.

There is a lack of quality communication among health care professionals and patients in the hospital setting, which can negatively impact patient satisfaction and increase hospital readmission rates. Interdisciplinary bedside rounding (IBR) is a method of rounding that uses direct communication and discussion of the patient at the bedside, and the use of IRB may improve the quality communication among health care professionals and patients. The purpose of this program outcomes evaluation project was to evaluate whether IBR increased patient satisfaction with nursing communication and if IBR decreased hospital readmission rates. The Iowa model of evidence-based practice provided a framework that was used for this project. This program outcomes evaluation used a retrospective pre-post design to collect data 3 months prior to and 3 months following IBR on 1 medical surgical hospital unit. A convenience sample of 42 IBR patient participants was used. HCAHPS scores were used to evaluate patient satisfaction with nursing communication, with a percent of change comparison evaluated. Thirty day readmission rates were evaluated using a hospital based data set and a direct comparison of data was performed. Findings revealed that IBR did not improve patient satisfaction with nursing communication overall. In regards to hospital readmissions, 1% of the hospital readmissions were from the IRB group versus 10% hospital wide. Those who experienced IBR were less likely to return within 30 days. The use of the IBR program and resultant reduced readmission rates show promise for positive social change by improved patient outcomes and decreased health care costs for all.

A stroke is a life-changing event for a patient and his or her family. The acute stroke patient is at risk for developing aspiration pneumonia, whether silent or overt. Prevention of pneumonia in this population requires timely completion and documentation of the bedside swallow screen to identify those patients at risk for aspiration pneumonia; however, anecdotal data from the emergency department at the site of this project suggested that completion and documentation of the screening were inconsistent. Guided by the quality caring model adopted by the project site as well as the logic model, the aim of this project was to evaluate emergency room nurses' compliance with documentation after completing a modified bedside swallow screening. To facilitate documentation compliance, the current bedside screening tool was modified to make it user friendly. Electronic records of stroke patients (n = 104) admitted to the emergency room were monitored for a period of 6 months after implementing the modified bedside swallow screening tool. The findings indicate that implementing the modified bedside swallow screening tool achieved 93% documentation compliance in the electronic records and 100% documentation in patient charts over this 6-month period and clearly identified patients at risk for developing aspiration pneumonia. Further study is recommended to determine the relationship between the results of the modified bedside swallow screening and the development of hospital-acquired pneumonia. Implementation of this modified bedside swallow screening tool can initiate therapeutic measures to reduce the incidence of aspiration pneumonia in the acute stroke patient, resulting in shorter length of hospitalization and reduced health care costs.

The main purpose of this study is to investigate the current status, demands and problems of Kaohsiung hospital bedside teaching in Kaohsiung, expecting to enhance the content and quality of hospital bedside teaching. The theory and research framework was established through literature review which acted as a basis of research tools for the design. And the survey research method and the qualitative research method are the research methods. Hospital bedside teaching teachers of compulsory education years in Kaohsiung, and students¡¦ parents were the subjects of the survey. Also, students¡¦ parents and bedside teaching teachers were the semi-structured interviewees for qualitative research. Descriptive statistical analysis was proceeded after recovering the formal questionaires, and for the data of interviews we also proceeded the process of data processing to analyze the data collected. According to the results of the analyses, the following conclusions have been reach: Firstly, the problems of hospital bedside teaching in Kaohsiung exists in three dimensions: (a) It is urgent to improve the system; (b) For bedside teaching students back to the school, there are no appropriate management measures for case counseling; (c) The rights of bedside teaching teachers are necessary to be improved. Secondly, it shows the following two aspects for the needs of Kaohsiung hospital bedside teaching: (a) the urgent needs of multi-teaching measures and curriculum for bedside teaching; (b) the services that bedside teaching teachers offer can be further enhanced. Thirdly, it proposed six dilemmas for the aspect of " It is urgent to improve the system planning aspect ": (a) lack of teacher preparation; (b) lack of teaching resources; (c) way of teacher professional education is lack; (d) hospital bedside teaching should be widely publicized; (e) the places in the hospitals to support for bedside teaching are not enough; (f) the controversy for student¡¦s GPA. Fourthly, it proposed three problems for the appropriate management measures for case counseling ": (a) it is lack to pay attention to the students of hospital besdide teaching; (b) to strengthen the assistance and concern for the students back to school and cross-education; (c) the case management system for special education students is not exactly implemented. Fifthly, two problems of the rights of bedside teaching teachers: the traffic allowance for the teachers is not corresponding for the actual needs, and the personal safety and protection of the rights and interests for bedside teaching teachers are ignored. Sixthly, for the services of bedside teaching teachers can further enhance, it proposed three items about "offering a variety of services", " strengthening transition and tracking system" and "arranging the opportunity to interact between the case students and the parents". Keywords¡GSpecial education, Itinerant service, Health Impairment, Education for the Health Impaired, Hospital bedside teaching