Dental decay remains a global issue but, in the UK, has become concentrated within the most vulnerable section of society, namely young children and the most deprived. When dental decay and subsequent infection become too severe, teeth may need to be extracted under General Anaesthetic. The aim of this work was to develop a greater understanding of the population of young children referred for a Dental General Anaesthetic (DGA) in the North West of England and to explore possible interventions that may positively impact on this group reducing the high number of children undergoing this procedure. A mixed methods approach was utilised, combining a broad scoping review, quantitative data collection and qualitative interviews. Individually these methods were used to develop a greater understanding of the issue and of the services, processes and patients involved in DGA. The methods were subsequently combined using triangulation to address potential preventative interventions that would be appropriate and acceptable to this group. Differences were observed between hospitals in treatment experiences of children across the North West of England. These included variations in the environment, hospital setting and time from referral to treatment, all of which were shown to impact on the child. The number of children experiencing a repeat DGA was also high and noted as an area that required further intervention. While DGA could be a distressing experience it was considered necessary and resulted in a positive outcome both in terms of oral health and a child’s quality of life. Improving oral health in young children who experience severe decay is a complex and challenging area. A number of interventions were identified that could reduce the need for extraction under DGA. These ranged from targeted interventions, linked to information provision and enablement to support those who are more at risk, to policy change with regard to excessive sugar in food and beverages that could have a broader impact across the population. In addition, DGA service re-designs are discussed including increased provision of prevention that may benefit children referred along this pathway and thereby reduce repeat DGA rates in the future.

<p>The aim of the study was to describe how anaesthetic nurses, within both advanced beginner and expert levels, experience their professional role as they perform a general anaesthetic.</p><p>The study had a descriptive design with a qualitative approach in which ten advanced beginners- and ten expert anaesthetic nurses from an operating theatre and an ambulatory surgical ward at a hospital located in the middle of Sweden, participated. All data was collected in an interview with semi-structured questions which focused on how the anaesthetic nurses experience their work. The data were analysed with qualitative content analysis. The results are presented in categories and themes. The themes were formed from the categories. Themes for the advanced beginners were: <em>support develops self confidence that gives the feeling of satisfaction</em> and <em>lack of support impedes further development of independency and gives the feeling of insecurity</em>. Themes for the experts were: <em>experience and new challenges in a supported environment give satisfaction</em> and <em>lack of support and own insecurity give dissatisfaction</em>. The advanced beginners described their experiences in a more descriptive way, while the experts had more difficult to describe what they experienced. The advanced beginners wanted more support from their colleagues while the experts wanted to be more independent and were also more confident in their professional role.</p> / <p>Syftet med studien var att beskriva hur anestesisjuksköterskor på avancerad nybörjarnivå respektive expertnivå upplever sin yrkesroll vid generell anestesi. Studien hade en deskriptiv design med kvalitativ ansats där tio avancerade nybörjare respektive tio expert anestesisjuksköterskor, från en allmän operations avdelning och en dagkirurgisk avdelning vid ett Mellansvenskt sjukhus, deltog i studien. Data samlades in via halvstrukturerade intervjufrågor som inriktade sig på anestesisjuksköterskors upplevelser av sitt arbete. Data analyserades med kvalitativ innehållsanalys. Resultatet redovisas utifrån kategorier som bildade olika teman. Teman som för avancerade nybörjare var <em>stöd utvecklar självförtroende som ger en känsla av tillfredställelse</em> samt <em>brist på stöd hindrar utvecklingen av självständighet och ger känsla av osäkerhet</em>. Teman för experterna var <em>erfarenhet och nya utmaningar i en stödjande miljö ger tillfredställelse</em> samt <em>bristande stöd och egen osäkerhet ger otillfredsställelse</em>. Avancerade nybörjarna beskrev sina upplevelser på ett mer beskrivande sätt medan experterna hade svårare att beskriva vad de upplevde. Avancerade nybörjarna ville ha mer stöd medan experterna ville vara mer självständiga och var mer trygg i sin yrkesroll.</p>

The aim of the study was to describe how anaesthetic nurses, within both advanced beginner and expert levels, experience their professional role as they perform a general anaesthetic. The study had a descriptive design with a qualitative approach in which ten advanced beginners- and ten expert anaesthetic nurses from an operating theatre and an ambulatory surgical ward at a hospital located in the middle of Sweden, participated. All data was collected in an interview with semi-structured questions which focused on how the anaesthetic nurses experience their work. The data were analysed with qualitative content analysis. The results are presented in categories and themes. The themes were formed from the categories. Themes for the advanced beginners were: support develops self confidence that gives the feeling of satisfaction and lack of support impedes further development of independency and gives the feeling of insecurity. Themes for the experts were: experience and new challenges in a supported environment give satisfaction and lack of support and own insecurity give dissatisfaction. The advanced beginners described their experiences in a more descriptive way, while the experts had more difficult to describe what they experienced. The advanced beginners wanted more support from their colleagues while the experts wanted to be more independent and were also more confident in their professional role. / Syftet med studien var att beskriva hur anestesisjuksköterskor på avancerad nybörjarnivå respektive expertnivå upplever sin yrkesroll vid generell anestesi. Studien hade en deskriptiv design med kvalitativ ansats där tio avancerade nybörjare respektive tio expert anestesisjuksköterskor, från en allmän operations avdelning och en dagkirurgisk avdelning vid ett Mellansvenskt sjukhus, deltog i studien. Data samlades in via halvstrukturerade intervjufrågor som inriktade sig på anestesisjuksköterskors upplevelser av sitt arbete. Data analyserades med kvalitativ innehållsanalys. Resultatet redovisas utifrån kategorier som bildade olika teman. Teman som för avancerade nybörjare var stöd utvecklar självförtroende som ger en känsla av tillfredställelse samt brist på stöd hindrar utvecklingen av självständighet och ger känsla av osäkerhet. Teman för experterna var erfarenhet och nya utmaningar i en stödjande miljö ger tillfredställelse samt bristande stöd och egen osäkerhet ger otillfredsställelse. Avancerade nybörjarna beskrev sina upplevelser på ett mer beskrivande sätt medan experterna hade svårare att beskriva vad de upplevde. Avancerade nybörjarna ville ha mer stöd medan experterna ville vara mer självständiga och var mer trygg i sin yrkesroll.