Approximately 43.4% of medication errors occur at the time of administration despite the use of bar code medication administration (BCMA) System. This trend has prompted a national effort to mitigate this problem in the United States. Implementing BCMA in health care settings is one of those efforts. Studies focusing on the approaches employed by nurses when using this system are scant. The purpose of this qualitative case study was to investigate strategies nurses and their leaders use to ensure BCMA is implemented, maximized, and sustained. The technology acceptance model was used to guide the study. The 2 research questions addressed nurses' perceptions regarding the use and optimization of BCMA, and approaches of clinical nurses and their leaders to ensure that BCMA technology is properly used, optimized, and sustained in acute care units. Data collection included semistructured interviews with 8 participants. Thematic data analysis generated themes including ease of use, reduce errors, time saving, old technology, overreliance on technology, paper backups, and hope for future development. Common barriers to system effectiveness were system errors and inadequate training; intragroup and self-monitoring were important strategies to sustain use of the system. Study results may be used by health care leadership to reduce medication errors by adopting easy to use technology, change policies regarding training of BCMA end users in hospitals, increase the culture of patient safety among nurses, and prompt technology redesign within health care settings that meets the national patient safety goals.

Thoraxkirurgiska ingrepp har väldokumenterade ökade risker för svåra smärtor postoperativt och tidigare forskning visar om den postoperativa smärtlindringen underbehandlas ökar risken att utveckla en kronisk smärta (CPSP) som drabbar 30-50% av alla som genomgår thoraxkirurgi. Detta leder till högre vårdkostnader för samhället, en kraftig försämring av patientens livskvalitet och ett vårdlidande för patienten. Sjukvården borde fokusera på att möta patienternas lidande och ge redskap och möjlighet för vårdarna att lindra lidandet och stärka patientens förmåga till egenvård av smärta i hemmet. Syftet med denna litteraturstudie var att belysa sjuksköterskans upplevelse av vad som behövs för att ge en bra smärtbehandling till patienter som genomgått större kirurgi exempelvis thoraxkirurgi och vilka hinder som måste överstigas för att lyckas. Examensarbetet genomfördes som en systematisk litteraturstudie där innehållet från elva artiklar analyserades och sammanställdes. I analysen av resultatet framkom två teman; Upplevda hinder och sjuksköterskans strategier. De beskriver hur sjuksköterskan på olika sätt arbetar med smärtskattning och vilka hinder som kan uppstå. Resultatet visar på stora problem i smärtbehandling, både vad gäller att smärtskatta som att lindra lidandet och berodde bland annat på bristande kunskap hos både patient och sjuksköterska. Slutsatsen är att sjukvården borde satsa på mer individualiserad patientinformation både preoperativt och innan hemgång, så patienten förstår varför smärtlindring är viktigt. Om detta görs kan man förhindra postoperativa komplikationer och kronisk smärta, som leder till lägre vårdkostnader och minst lika viktigt att bibehålla en patient med god livskvalitet.

The purpose of this multiple case study was to explore strategies that healthcare facility leaders in Central Minnesota use to recruit and retain qualified nurses. Participants were 6 healthcare facility leaders including 2 nursing directors, 2 human resource personnel, 1 nurse supervisor/administrator, and 1 nurse recruiter who had the knowledge and experience in recruitment and retention of Registered Nurses (RNs) in healthcare facilities in Central Minnesota. The Herzberg 2-factor theory was the conceptual framework. Semistructured interviews were used to collect data. Data were analyzed using Morse's 4 steps data analysis process. The major themes were recruitment strategies and retention incentives. The recruitment strategies were the various hiring methods participants used to attract and gain RNs, and the retention incentives were the benefits that motivated and retained RNs. Participants relied on both recruitment strategies and retention incentives to manage the shortages of RNs. The results provide healthcare facility leaders with additional information about how to successfully recruit and retain qualified RNs, which may lead to a larger and potentially satisfied nursing population. Social implications include strengthening the nursing workforce, increasing productivity for healthcare facilities, providing better customer service and increased patient satisfaction, and contributing to more satisfied RNs and families, as well as helping the local communities and the economy.

5 Abstract This diploma thesis is focused on the development of lifelong education of general nurses in the Czech Republic. The duty of lifelong education and its control has been introduced with the admission of the Czech Republic into the European Union. However, the development timeline is possible to follow until the period after the Second World War. The theoretical part describes the term of non-medical occupations, nursing and the roles of general nurses. Within the concept of lifelong education and learning is pursued European development line, as well as its influence in the Czech Republic. There is also a track of professionalism within the nursing occupation, which enables general nurses to take over more responsibilities and this led to the requirement of higher education. The empirical part of the text is dedicated to the analysis of the questionnaire of my own construction, which examined rapport of lifelong learning principles by general nurses. These principles were chosen on the base of nursing strategies which were acquired by the Czech Republic. The interest of the research was to compare two groups of general nurses. The first was represented by nurses educated before adopting the law no. 96/2004, and the second group included nurses with tertiary education level. Key words: general...