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Bakgrund: Antalet personer med obesitas ökar världen över och definieras genom ett Body Mass Index (BMI) över 30. Det ställer ökade krav på sjukvården att möta behovet av vård hos dessa patienter. Att bli sövd är förenat med risker, där ett högt BMI ökar risken vid generell anestesi. En förändrad anatomi och fysiologi hos patienter med obesitas utgör en ökad risk vid generell anestesi, vilket är någonting anestesisjuksköterskan måste vara förberedd på och kunna hantera. Syfte: Studiens syfte var att beskriva anestesisjuksköterskans erfarenhet av generell anestesi av patienter med obesitas för att säkerställa säker vård. Metod: Deskriptiv design med kvalitativ ansats. Totalt fem anestesisjuksköterskor intervjuades individuellt på en operationsavdelning i Mellansverige under perioden december 2023 till januari 2024. Resultat: Anestesisjuksköterskans erfarenheter presenteras i tre kategorier; Skapa egna förutsättningar för säker vård, process av mental och praktisk förberedelse för att hantera olika situationer, samt organisatoriska förutsättningar för säker vård. Vidare framkom åtta subkategorier; Identifiera patientutmaningar, ta stöd i team, erfarenhet medför trygghet, preoperativa förberedelser och använda hjälpmedel, förutse och hantera peroperativa risker, planera och utföra omvårdnadsåtgärder inför väckning och postoperativ vård, planerat operationsprogram påverkar, samt tillgänglighet till resurser. Slutsats: Studien visar att stöd i team samt att vara erfaren medför trygghet och ger goda förutsättningar för att skapa säker vård. Organisatoriska förutsättningar såsom operationsprogram och tillgänglighet till resurser är förutsättningar som påverkar möjlighet att skapa säker vård. / Background: The prevalence of obesity is increasing worldwide, with a Body Mass Index (BMI) above 30 defining the condition. This places increased demands on healthcare providers to meet the care needs of these patients. Being put under anesthesia is associated with risks, with even a high BMI increasing the risk of general anesthesia. An altered anatomy and physiology in obese patients pose an increased risk during general anesthesia, which the nurse anesthetist must be prepared for and be able to handle. Aim: The aim of the study was to describe the nurse anesthetist's experience of general anesthesia in obese patients in order to ensure safe care. Method: A descriptive design with a qualitative approach was employed. A total of five nurse anesthetists were interviewed individually in a surgical ward in central Sweden during the period December 2023 to January 2024. Results: The nurse anesthetists' experiences are presented in three categories: creating one's own conditions for safe care, the process of mental and practical preparation to handle different situations, and organizational conditions for safe care. Furthermore, eight subcategories emerged: identifying patient challenges, taking support in teams, experience brings safety, preoperative preparation and use of aids, anticipating and managing peroperative risks, planning and performing nursing measures for wake-up and postoperative care, planned surgical program affects, and availability of resources. Conclusion: The study indicates that the provision of support within teams and the possession of experience affords security and facilitates the creation of safe care. Organizational conditions, such as the surgical program and the availability of resources, are conditions that affect the possibility to create safe care.

Bakgrund: Sjukvården möter ökade krav på grund av befolkningsökning och avancerade behandlingsmöjligheter. Utlokalisering av patienter innebär att en patient läggs in på en annan avdelning än den som har medicinskt ansvar och specialistkompetens och kan ske på grund av en brist på vårdplatser på hemavdelningen. Swansons teori om vårdande beskriver fem steg som vårdpersonal kan använda för att främja patientens välbefinnande i vården. Sjuksköterskan har omvårdnadsansvaret för patienterna på avdelningen, oavsett vilket medicinskt team de tillhör. Syfte: Att undersöka sjuksköterskans perspektiv på vård av utlokaliserade patienter i slutenvården. Metod: Allmän litteraturöversikt innefattande kvalitativa och kvantitativa data. Resultat: Sjuksköterskorna upplevde brister och utmaningar kopplat till vårdandet av utlokaliserade patienter, inklusive hög arbetsbelastning, tidskrävande insatser, obekant utrustning, bristande kunskap/erfarenhet och kommunikation begränsade dem i deras yrkesroll. Utifrån sjuksköterskans perspektiv skapade detta en utmanade arbetsmiljö och riskerade försämrad vårdkvalité och patientsäkerhet. Konklusion: Utlokalisering leder till en sämre arbetsmiljö och hindrar sjuksköterskan från att kunna ge en god säker vård. Detta kan leda till stress för sjuksköterskan och innebära en risk för patienten. Det bör endast ske om inget annat alternativ finns. Vid utlokalisering bör ansvariga för utlokaliseringen noggrant välja bästa möjliga avdelning samt utarbeta rutiner för att underlätta samarbete mellan avdelningar. / Background: Healthcare faces increased demands due to growth in population and more advanced treatment options. Patient outlying occurs when a patient is placed in a different ward than the one medically responsible, often due to bed shortages. Swanson's Caring Theory outlines five steps that healthcare professionals can utilize to promote patient well-being. Nurses maintain responsibility for patients on their ward, regardless of medical team affiliation. Aim: To investigate the nurse’s perspective on the care of outlying patients in inpatient care Method: General literature review encompassing qualitative and quantitative data. Findings: Nurses experienced deficiencies and challenges related to caring for outlying patients, including high workload, time constraints, unfamiliar equipment, lack of knowledge/ experience and communication constraints limited them in their professional role. From the nurse’s perspective, this created a challenging work environment, risking diminished care quality and patient safety. Conclusion: Outlying leads to a poorer work environment for nurses, hindering them from providing safe, quality care. This can lead to stress for the nurse but also pose a risk to the patient. Therefore, the practice of outlying patients should only occur if no other alternatives exist. If outlying is unavoidable, careful ward selection and collaboration procedure between ward are crucial.

<p dir="ltr">Nursing, deeply rooted in social justice principles, faces the contemporary imperative of achieving health equity. However, the perception of social justice among nurses, particularly newly graduated registered nurses (NGRNs), remains unclear, posing a significant challenge amid high turnover rates in this population, threatening the realization of health equity goals.</p><p dir="ltr">Through this study, I sought to enhance nursing knowledge by delving into the understanding, cocreation, processing, and response to social justice among NGRNs. Utilizing a constructivist grounded theory methodology, I explore NGRNs’ narratives and perceptions concerning social justice, addressing the research question: How do NGRNs understand, cocreate, process, and respond to social justice in their nursing practice?</p><p dir="ltr">Findings from the grounded theory study reveal seven categories with subsequent subcategories, culminating in the development of a proposed theoretical framework. This framework elucidates four overarching global themes: “Best Care for all, No Matter What,” “Novice Emancipators,” “Making the Human Connection,” and “Supportive Organizational Culture.” I used theoretical modeling to delineate a middle-range theory titled “NGRN Evolving Process of Social Justice Transition.”</p><p dir="ltr">The study’s conclusions have significant implications for nursing education, practice, research, and policy. They highlight the importance of shaping future nursing landscapes through a focus on NGRNs’ social justice transition. Emphasizing the pivotal role of social justice identity in NGRNs’ progression to expert nurses, the study underscores the critical need to foster this identity during NGRNs’ transition period. Implications extend to curriculum structure, onboarding programs, leadership, and policy, aiming to promote person-centered care and health equity. This study marks the inception of a journey towards continual support for NGRNs as advocates for social justice, potentially catalyzing substantial societal change with nursing at the forefront of the pursuit of equity.</p>

No / Aims This paper aims to explore and describe how qualified nurses working with in, in-patient surgical areas cope with the daily experiences they are exposed to. It has long been recognised that many aspects of nursing work can result in high levels of stress, with negative consequences for the individual nurse and patient care. Difficulties in coping with nursing work can also result in burnout, as well as raising concerns about cognitive dissonance, emotional labour and the use of emotional barriers. Why some nurses are more prone to experience these phenomena than others, is unclear. Method A descriptive qualitative approach is taken using a purposive, theoretically congruent sample of 16 qualified registered nurses all of whom participated in a semi-structured interview during 2002. All interviews were tape recorded and transcribed verbatim and then analysed using the four stages outlined by Morse and Field [Morse, J.M., Field, P.A., 1996. Nursing Research: The Application of Qualitative Approaches. Chapman & Hall, London]. Findings Three key themes emerged from analysis; relationships with patients, being a person and the effect of experience. All three interlink to describe a process whereby the individual switches off from the environment around them by adopting a working persona which is different but related to their own personal persona and is beneficially enhanced as a consequence of experience. Conclusion Working as a nurse results in exposure to potentially distressing and stressful events from which it is important to protect the self. Participants in this study achieve protection by the development of a working persona which facilitates switching off and is beneficially enhanced by experience.

戶口普查的主旨在於瞭解一個國家或地區的人口及其相關特性，國家的政策制訂及人力規劃需仰賴正確的調查結果。但隨著社會變遷等諸多因素，即使增加費用也無法提高普查的完訪率，資料的品質也因民眾配合意願而降低。為提高資料品質與降低調查成本等因素，部份國家積極發展新的普查方法，預計在2010年普查正式實施，取代傳統的戶口普查。 本研究整理新的普查方法，包括登記式普查、登記式普查結合抽樣調查、滾動式普查等方法。其中也包括行政院計畫預計在2010年以登記式普查結合抽樣調查取代傳統的戶口普查，效法新加坡、北歐四國與荷蘭，整合公務登記系統取得普查短表資料，抽樣調查代替國外長表問卷，希冀獲得較為詳細的教育、生育、居家老人照護等社經議題之統計資料。除了整理資料外，本文也將討論2010年台灣的戶口普查，以常住人口為調查目標，可能衍生的問題。 另外，本研究也將整理美國與法國即將採用的調查方法，包括美國社區調查（American Community Survey）的設計與抽樣方法，用於普查以取代長表問卷的可能，並研究抽樣調查蒐集人口的限制，比較普查及調查蒐集資料的優缺點。 / The objective of the population and housing census is to collect the demographic information on the population in a nation or an area which will be used as a reference for government planning and policy making. Because of the dramatic change in the social environment, some problems were generated as a result, such as the increase in survey cost, non-response rate, and data demand. Although many countries are still using the Traditional Census method for the 2010 census, some are active in developing new methods to improve the quality of data collected and to decrease the survey cost. Following the examples of Singapore, Netherland, and the Nordic countries (Denmark, Finland, Norway, and Sweden), the method for conducting the 2010 Taiwan Census will be different, changing from the traditional census to registered-based census with sampling survey. This method will integrate the official registry system to acquire the basic demographic characteristics, and collect more detailed information on the social and economic topics, including the aspects of education, fertility, and elder care by using sampling methods. Consequently, this research will be separated into two parts. The first part will introduce and analyze several common census methods used, including the Traditional Census method, Registered-Based Census, Registered-Based Census with Sampling Survey, and the Rolling Census. In addition, the target population of 2010 Taiwan Census is De Jure population and we shall also discuss its potential problems. In the second part, the research will further examine the survey methods that will be used for the U.S. and French census, including the design concept and the sampling method executed by the American Community Survey (ACS) to replace the long-form questionnaire for the 2010 U.S. Census. Finally, we will discuss the restrictions of using sampling to collect data, compare the strengths and weaknesses of census and the different sampling methods, as well as analyze the problems related to the registered population and the permanent residents.

This article provides a different approach to the debated issue of the criterion of solution of what has come to be called “property not registered vs. embargo registered”. In it, it argues that all the solutions that has been raised (even the adopted as “binding precedent” in the judgment of the Seventh Civil CassationPlenary) are based on an optical error, because they look at the embargo act of a static way, as if it were an act that creates a final situation, forgetting that the embargo is a procedural act that is not an end in itself, but is inserted into the dynamic of the execution process, a process in which the final situation occurs (the awarding of the asset under seizure to the successful bidder or creditor, that is, the acquisition of a real right). Observed, however, theembargo on the dynamic of the executive procedure, as an act that prepares the forced alienation of the asset, is postulated, as a criterion of solution to the problem, that of priority registration (that is, the contained in the first paragraph of the article 2022 of the Civil Code, but with the tempering of the appreciation of good faith), once the annotation of the embargo “reserve priority” to the act of forced alienation of the asset. / El presente trabajo pretende aportar un enfoque distinto al debatido tema del criterio de solución de lo que ha venido a llamarse “propiedad no inscrita vs. embargo inscrito”. En él, se sostiene que todas las soluciones que se han planteado (incluso la adoptada como “precedente vinculante” en la Sentencia del VII Pleno Casatorio) parten de un error de óptica, pues miran el acto del embargo de manera estática, como si se tratara de un acto que crea una situación final, olvidando así que el embargo es un acto procesal que no es fin en sí mismo, sino que se inserta en la dinámica del proceso de ejecución, proceso en el cual se produce la situación final (la adjudicación del bien embargado al postor adjudicatario o al acreedoradjudicatario, esto es, la adquisición de un derecho real). Observado, en cambio, el embargo en la dinámica del procedimiento ejecutivo, como acto que prepara la enajenación forzada del bien, se postula, como criterio de solución al problema, el de la prioridad registral (esto es, la contenida en el primer párrafo del artículo 2022 del Código Civil, pero con el atemperante de la apreciación de la buena fe), en cuanto la anotación del embargo “reserva prioridad” al acto de enajenación forzada del bien.

The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts. / Health Studies / D.Litt et Phil. (Health Studies)

The purpose of this qualitative study was to explore and describe the extent to which registered nurses’ practice was affected by emergency department overcrowding. Participants were recruited from a tertiary hospital by using the purpose sampling method. Data collection was done using a semi-structured interview guide. Individual interviews were conducted with eight registered nurses working in the paediatric emergency department. Data analysis was conducted using thematic content analysis and Yin’s (2003:178) five-phase cycle. The study findings revealed that the lack of professional nurse leadership and the difficult existing relationship with the physicians were obstacles that had to be obviated if the paediatric ED were to function optimally and best practice were to be achieved. It was revealed that a problematic issue in the setting was that the most critical decisions on allocating where patients should be treated were made by physicians who have more authority than nurses. It was recommended that the ED need to be clearly defined in the policies as an outpatient, emergency care or as an episodic patient care area as “Admission” can mean admission to the ED or admission as an inpatient/boarded patient. / Health Studies / M.A. (Health Studies)

The purpose of this study was to explore and describe the knowledge that a cohort of 40 intensive care unit nurses had of evidence-based practice. It was assumed that they lacked the knowledge to locate, evaluate understand and apply research findings. Quantitative, non-experimental descriptive research was conducted to explore their knowledge and to formulate recommendations for promoting it. Data collection involved administering a structured questionnaire administered to the cohort in an intensive care unit. The findings revealed that, although they were familiar with the basic concept of evidence-based practice, they were reluctant and lacked the skills to adopt it in their practice. It is recommended that they be trained and empowered to develop research expertise from within their own ranks. Finally it is recommended that nursing management should play a more proactive role in identifying cost-effective strategies in overcoming barriers to finding, promoting and integrating evidence-based practice / Health Studies / M.A. (Health Studies)