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Bakgrund: Ordet kejsarsnitt kommer från latin och innebär att barnets tas ut genom livmoderväggen med ett snitt långt ner på buken. Det föds närmare 200 000 barn om året i Sverige och av dessa är 17,3 procent förlösta genom kejsarsnitt. Tidigare forskning beskriver vikten av en fungerande och tydlig kommunikation i operationsteamet kring patienten, för att patientsäkerheten ska uppfyllas och en säker vård ska kunna bedrivas vid ett akut kejsarsnitt. Syfte: Att beskriva operationsteamets erfarenheter av kommunikation under ett akut kejsarsnitt. Metod: En kvalitativ studie där data inhämtades via 14 stycken frågeformulär utformade enligt critical incident technique. Data analyserades enligt en kvalitativ innehållsanalys och redovisas genom tabell, citat och löpande text. Resultat: Kommunikation är viktigt vid akuta kejsarsnitt, men beroende på vilka som ingår i operationsteamet och vilken erfarenhet de har med sig kan kommunikationen vara mer eller mindre uttalad. Aspekter, förutom yrkeserfarenhet, för en välfungerande kommunikation är tid, samarbete och rutiner. Slutsats: I resultatet framkommer att kommunikationen tar sig olika uttryck i olika team, där rutiner och yrkeserfarenhet påverkar hur man kommunicerar. En fungerande kommunikation behöver operationsteamet arbeta aktivt med, då det medför ett positivt teamarbete, bra stämning på sal och en säker vård. / Background: The word caesarean section is Latin and means that the baby is delivered through the uterine wall with an incision far down on the abdomen. Nearly 200,000 babies are born each year in Sweden and of these, 17.3 per cent are delivered by caesarean section. Previous literature describes the importance of clear and well-established communication in the surgical team responsible for the patient, so that patient safety standards are met, and safe care can be provided in an emergency caesarean section. Aim of the study: To describe the operating team's experiences of communication during an emergency caesarean section. Methodology: A qualitative study where data were collected via 14 questionnaires designed according to the critical incident technique and data were analyzed according to a qualitative content analysis and reported by table, citation and running text. Results: Communication is important in acute caesarean sections, though depending on who is part of the surgical team and what experience they have, the quality of the communication can vary. Elements, besides professional experience, for a well-functioning communication were time, attitude, and clarity. Conclusion: The result shows that the communication patterns varies depending on whom is a part of the team, where routines and professional experience form the communication. The operating team needs to work actively with a functioning communication as it is important for a positive team work, a good atmosphere in the ward and safe care.

Bakgrund: Vid ett hjärtstopp slutar hjärtat pumpa runt blod till kroppens olika organ, detta resulterar i att ischemi uppstår och en eventuell död. Hjärtinfarkter är den vanligaste orsaken till hjärtstopp, det kan även orsakas av andra tillstånd samt olyckor. Runt 1300 personer överlever hjärtstopp årligen i Sverige och siffran ökar på grund av bättre sjukvård. Den grundutbildade sjuksköterskan möter patienter som överlevt ett hjärtstopp oavsett vart i vården sjuksköterskan väljer att arbeta. För att kunna förbättra vårdkedjan genom att samverka i team och ge personcentrerad omvårdnad krävs det att sjuksköterskan har förståelse för vilka problem dessa patienter upplever. Syfte: Syftet med denna studie är att sammanställa patienters upplevelse av att överleva ett hjärtstopp samt hur det har påverkat deras välbefinnande. Metod: Detta examensarbete utfördes i form av en litteraturstudie. Arbetet baserades på tio vetenskapliga artiklar med kvalitativ studiedesign. Resultat: Resultatet genererade fyra teman: “Brist i sjukvården”, ”Den nya identiteten”, ”Existentiella frågor”, ”Familj & stöd” och tolv subteman. Konklusion: Slutsatsen är att patienter upplever att deras välbefinnande har försämrats efter ett hjärtstopp. Samtliga av de fysiska, psykiska och emotionella aspekterna av välbefinnandet blev påverkade av bland annat långvariga symtom orsakade av hjärtstoppet. Efter hjärtstoppet uppstod även flera existentiella frågor för patienterna. Patienterna beskriver ett missnöje med vården då de kände att de blivit övergiva vid hemgången samt att sjukvården missade att behandla deras psykiska hälsa. Genom att samverka i team och arbeta personcentrerat hade sjuksköterskan kunnat motverka majoritet av patientens problem och förbättrat deras välbefinnande. / Background: When a cardiac arrest occurs the heart will stop pumping blood to the body's organs, this will lead to ischemia and possible death. Myocardial infarction is the most common cause of cardiac arrest but other conditions and accidents can also cause it. It’s estimated that 1300 persons survive a cardiac arrest annually and the number of survivors is growing due to better healthcare. Regardless of where nurses choose to work they will encounter cardiac arrest patients. To be able to improve the care for the patient as a team and to work person-centered the nurse must understand what type of problems this patient group is experiencing. Aim: The aim of this study was to compile patient ́s experience of surviving a cardiac arrest and how it affected their well-being. Method: A literature study was used as a method for this research paper. The literature study was based on ten articles with qualitative study design. Result: The result generated four themes: “Flaws in the healthcare”,” My new identity”,” Existential questions”, “Family & support” and twelve sub teams. Conclusion: The conclusion is that patients felt that their well-being had deteriorated after surviving a cardiac arrest. The physical, psychical, and emotional aspect of the patient’s well-being had been affected by prolonged symptoms by the cardiac arrest. After the cardiac arrest several existential questions also arose for the patient. A dissatisfaction with the healthcare was described by the patients. This in relation to feeling abandoned after being discharged from the hospital and that the healthcare failed to treat their mental health. By collaborating in teams and working person-centered the nurse would be able to reduce the majority of the patient’s problems and also improve their well- being.

There is minimal research into families where a person who is receiving palliative care has dependent children. In particular, there is a lack of information about the work that palliative care social workers undertake with such families. This study examines the role of the palliative care social worker in safeguarding and promoting the welfare of children of adults receiving specialist palliative care. This is a qualitative study involving the collection of information from a total of 57 palliative care social workers in three ways: focus groups, survey and semi-structured interviews. The analysis demonstrates that palliative care social workers understand the term 'safeguarding children' to mean more than child protection alone. The analysis also focuses on the process of referral, institutional barriers, supports for their work with children, and inter-agency collaboration. An equally important aspect of the analysis, and one generally neglected in psycho-social studies, relates to the socio-economic context of the palliative care social workers' work, including the effects of the immigration status of families on children. In the main, concerns about the present and future care of children come to the attention of palliative care social workers via members of the multidisciplinary team in which they are based. The numbers are reported to be relatively small in contrast to the total number of referrals received. The extent to which support to children is provided varies considerably; some palliative care agencies do not encourage palliative care social workers to work directly with children prior to bereavement and others restrict direct work with children post-bereavement. The main emphasis for all workers, however, is on support to the parents to help them understand their children's needs during the terminal phase of the illness. The well-being of children at this time of emotional stress is included in the palliative care social workers' definition of 'safeguarding children'. In addition, the wide-ranging examination of the palliative care social workers' involvement with the families illustrates the extent of the dedication involved in an under-resourced and little understood area of their work. Whilst palliative care social workers reported receiving basic training on child protection within their agency, with some themselves providing this training, further training on safeguarding children is not always available or known about. The amount and type of professional supervision and support is also varied, particularly in relation to child-care matters; not all have access to supervision from another social work professional. There are a small number of examples given in the study where children are considered to be at risk in some way. Children cared for by lone parents are recognised as being especially vulnerable, particularly if future care plans are not in place before the death of the parent. Also identified as vulnerable are children of parents whose immigration status is in question as their future location may be in doubt, placing children and the surviving parent under additional stress. One of the major difficulties for palliative care social workers is securing support services from local authority children's services. Whilst there are examples of collaboration and co-operation, the findings in this study echo those of others which examine the relationship between adult and children's services. In this study, palliative care social workers speak of frustration and disappointment in the responses they receive, and they are concerned that the needs of children of dying parents are not understood. This study contributes to the debate about the focus of children in care services for adults and how staff may be supported in their task of safeguarding and promoting the welfare of children. This study also adds to the limited existing knowledge about palliative care social work practice.