Text in English / Health Studies / M.A. (Nursing Science)

PURPOSE The purpose of this study was to explore how primary care registered nurses address unmet social needs in patients. SPECIFIC AIMS Explore how RNs in a safety-net, primary care setting develop an awareness of and address patient's unmet social needs. Describe how information about unmet social needs are integrated into nursing assessment and intervention activities, and are shared with other members of the health care team. Describe the challenges primary care RNs face when addressing unmet social needs. FRAMEWORK Critical caring theory provided the framework for this study. DESIGN This study used a descriptive, qualitative design. Semi-structured interviews were conducted with seventeen nurses working in 11 different safety-net primary care clinics within a hospital-based system. RESULTS Three major themes emerged. Key findings included the importance of the nurse-patient relationship, the establishment of trust, and a caring, nonjudgmental approach to patients with unmet social needs. Nurses used knowledge of unmet needs to coordinate patient care, provide social support, and work collaboratively with care team members to refer patients to resources within the health care system and in the community. CONCLUSION Unmet social needs contribute to adverse health outcomes, and addressing social and medical needs is critical to eliminating health inequities and reducing health care costs. In this study, primary care nurses described relationships with patients that allowed for the sharing of sensitive information, leading the nurse to identify and address unmet social needs that could impact patient health.

Bakgrund: Tidigare forskning visar att det finns flera faktorer som bidrar till preoperativ oro, vilket är ett tillstånd som kan orsaka flera negativa konsekvensen både i direkt anslutning till operation som långt senare efter operation. Ett av målen vid ett preoperativt möte mellan anestesisjuksköterskan och patienten är att anestesisjuksköterskan ska minska patientens stress. Därmed är det av värde att göra en översikt avseende aktuell forskning kring omvårdnadsåtgärder som kan vidtas av anestesisjuksköterskor för att lindra preoperativ oro. Syfte: Studiens syfte var att beskriva vilka omvårdnadsåtgärder som kan att vidtas av anestesisjuksköterskor för att lindra preoperativ oro hos patienten. Metod: Metod var integrerad litteraturöversikt bestående av 20 vetenskapliga artiklar, varav 14 kvantitativa och sex kvalitativa. Vid litteratursökning användes databaserna CINAHL och PubMed. Resultat: Analysen resulterade i fyra kategorier som beskriver omvårdnadsåtgärder som anestesisjuksköterskor kan vidta för att lindra preoperativ oro: Individanpassa den preoperativa informationen, Skapa en bekväm miljö, Bemöta individanpassat och empatiskt och Ha en lugnande närvaro och kommunikation. Slutsats: Analysen resulterade i fyra distinkta kategorier gällande omvårdnadsåtgärder mot preoperativ oro. Utifrån komfortteorin är det möjligt att anföra att om anestesisjuksköterskor kombinerar omvårdnadsåtgärder från de fyra kategorierna för att lindra patienters preoperativa oro har patienter större möjlighet att nå total komfort. Framtida forskning behövs avseende effekten av omvårdnadsåtgärder som utförs av just anestesisjuksköterskor samt effekten av patientens egna strategier för att lindra preoperativ oro. / Background: Previous research has identified several factors contributing to patients experiencing preoperative anxiety, which is a condition that can cause several negative consequences both directly in connection with the surgery, as well as long after the surgical procedure. One of the aims during a preoperative meeting between the nurse anesthetist and the patient is for the nurse anesthetist to ease the patient’s stress. Thus, it is of value to conduct and overview of current research regarding nursing interventions that can be conducted by nurse anesthetists to alleviate preoperative anxiety. Aim: The aim of the study was to describe what nursing interventions that nurse anesthetists can conduct to alleviate a patient’s preoperative anxiety. Method: Integrative literature review consisting of 20 scientific articles, of which 14 were quantitative and six qualitative. The literature search was conducted in the databases CINAHL and PubMed. Result: The analysis resulted in four categories describing nursing interventions that nurse anesthetists can conduct to alleviate a patient’s preoperative anxiety: Individualize the preoperative information, Create a comfortable environment, Treat individually and empathically and Have a soothing presence and communication. Conclusion: The integrative literature review with data from the 20 scientific articles resulted in four categories describing nursing interventions to alleviate preoperative anxiety. It is possible to say, based on the theory of comfort, that the patient has a greater chance to reach total comfort if nurse anesthetists combine multiple nursing interventions from the four categories to alleviate the patient’s preoperative anxiety. Future research is suggested to focus on the effect of nursing interventions performed by nurse anesthetists and the effect of the patient’s own strategies to alleviate preoperative anxiety.

Bakgrund: Delegering av omvårdnadsuppgifter blir en allt mer förekommande del av sjuksköterskans arbete, både nationellt som internationellt. Anledningen till att allt mer och mer omvårdnadsarbete delegeras tycks vara en mer komplex omvårdnadsbild kombinerat med en växande population i behov av omvårdnad. Det finns lagar och föreskrifter som begränsar vilka arbetsuppgifter som får delegeras samt vilka som måste utföras av legitimerad personal. Dessa föreskrifter är tänkta att bidra till god omvårdnad och ett patientsäkert arbetsutövande, dock tycks dessa föreskrifter vara aningen otydliga och verkar inte efterföljas till önskad utsträckning. Syfte: Syftet med studien var att sammanställa forskning kring sjuksköterskans erfarenhet av delegering, med fokus på omvårdnaden och patientsäkerheten. Metod: Studien har genomförts som en litteraturstudie som behandlar tio kvalitativa forskningsansatser inhämtade från CINAHL och PubMed. Resultaten av dessa har analyserats och sammanfattats. Resultat: Det framkommer att både organisatoriska och interpersonella aspekter har en påverkan på delegering. Studien visar att brist på resurser, inklusive personal, bristande uppföljning, bristande kommunikation och bristfällig dokumentation har negativ inverkan på resultatet av delegeringen. Otydliga roller i vårdarbetet är en bidragande faktor som påverkar utgången av delegerade arbetsuppgifter. Ett gott samarbete i vårdlaget är en förutsättning för ett välfungerande delegeringsarbete och omvårdnad av patienten. Konklusion: I de fall en omvårdnadsuppgift delegeras felaktigt eller uppfattas fel kan resultatet påverka patientens omvårdnad negativt vilket i sin tur utgör en risk för patientsäkerheten. Det finns uppenbara kunskapsluckor i ämnet och mer vikt bör läggas vid att lära ut säker delegering under sjuksköterskeutbildningen. / Background: Delegation of authority is becoming a more and common way of carrying out work tasks in healthcare settings, both nationally as globally. The reason behind the increase in delegating nursing care is possibly due to an emerging complexity of nursing care and a growing population in need of health care. There are a number of laws and acts that regulates what health care work can be delegated and which tasks needs to be conducted by registered personnel. These acts are thought to contribute to a high standard health care and patient safety, though the acts appears to be unclear in regards to not being complied with. Aim: The aim of the study was to review prior studies undertaken regarding registered nurses experiences of delegating health care work, focusing on health care and patient safety. Method: A literature review was conducted and data from a total of ten qualitative peer reviewed articles obtained via CINAHL and PubMed. The results of the articles were then analyzed and summarized. Results: The result showed that both organizational and communicational faults had a poor effect on the outcome of the delegated care. Lack of understanding of roles differences and responsibility seemed common findings in the articles. Missed communication and missed documentation in delegated work can lead to missed care and therefor jeopardize patient safety. An effective teamwork is required in order to achieve optimal patient outcome regarding the delegated care. Conclusion: Poor delegation or misinterpretation of delegated tasks may lead to a negative outcome for the patient’s care which may further result in lapse of the patient´s safety. There is a certain lack of knowledge regarding delegation of authority and there ought to be more resources put into teaching the subject more frequently in nursing school.

Människor lever längre och det innebär att de allra flesta som dör i Sverige är äldre. Vårdfilosofin palliativ vård definieras som en helhetsvård, där patienten och anhöriga ska göras delaktiga i omvårdnaden. Enligt svensk lag har sjuksköterskan en skyldighet att göra patienten delaktig i sin vård. Vården i livets slutskede blir allt mer avancerad och det är viktigt att patienten görs delaktig, för att främja en god död. Samband i form av delaktighet och en god död har påvisats. Sjuksköterskan kan skapa förutsättningar för patientens delaktighet genom att vara lyhörd och lyssna samt se till att patientens delaktighet finns dokumenterad. Studiens syfte var att beskriva sjuksköterskans upplevelse och möjlighet att göra den äldre patienten delaktig vid vård i livets slutskede inom kommunens hemsjukvård. En kvalitativ intervjustudie med en induktiv ansats genomfördes. Deltagarna var åtta sjuksköterskor med erfarenhet av vård i livets slutskede i kommunens hemsjukvård. Kvalitativa innehållsanalysen gav ett resultat med fyra huvudkategorier: sjuksköterskans roll, teamets betydelse, anhörigas roll samt etiska dilemman. Slutsatsen är att det behövs mer dokumentation om den äldres delaktighet i kommunens hemsjukvård. / People live longer and that means that the vast majority of people who die in Sweden are older. Care philosophy, palliative care is defined as a holistic care, where the patient and relatives must be involved in the care. According to Swedish law, the registered nurse has an obligation to involve the patient in their care. The end of life care is becoming more advanced and it is important that the patient becomes involved in their care, as it can lead to a good death. Relationships in the form of participation and a good death have been demonstrated. The registered nurse can create conditions for the patient's participation by being responsive and listening, and ensuring that the patient's participation is documented. The aim was to describe the registered nurse's experience and opportunity to involved the older patient in care at the end of life within the municipality's home health care. A qualitative study with an inductive approach was conducted. Eight registered nurses with experience in end of life care in municipality's home care. The qualitative content analysis a resulted in four main categories: the registered nurse's role, the importance of the team, the role of relatives and ethical dilemmas. The conclusion is that more documentation is needed about older patient´s participation in municipality's home health care.

Nurses as professionals and front-liners in patient care should possess good knowledge about health research, as this is critical in improving patient outcomes. The purpose of this study was to determine the level of knowledge and attitudes that public health clinic nurses possess regarding health research in Botswana in order to make recommendations to enhance a research culture among nurses. A quantitative study with a cross-sectional study design was used. Twenty-six clinics in Gaborone were sampled and 168 nurses participated in the survey. Data was analysed using Stata version 15.1. Only 51% of the nurses demonstrated satisfactory knowledge of health research. Despite this limited knowledge, nurses had a good attitude towards health research (66%). Degree nurses were more likely to have satisfactory knowledge, as were those who reported research training and experience. Additionally, research training and experience were associated with a good attitude. Recommendations include provision of research training and practicums as part of the nursing education curriculum, as well as in-service training, in order to improve the levels of knowledge of health research among nurses. / Health Studies / M. P. H.

The purpose of this study was to describe the perceptions of the bridging programme graduates regarding their preparedness to manage a nursing unit .Quantitative; descriptive survey design was used with a structured questionnaire as data collection instrument. The sample included 58 bridging programme graduates who had completed their training at a private nursing school and was working at seven private hospitals in KwaZulu Natal. The graduates reported competence in performing some but not all management competencies addressed by this survey. Some graduates reported they were placed in charge of the nursing unit, in spite of not feeling competent, as early as in their first month. Recommendations with regard to nursing education, nursing practice and further research, specifically relating to improvement of management competencies for new graduates, were made / Health Studies / M.A. (Health Studies)

Background: “Nurses provide essential care to the millions of people who are hospitalized each year as a result of illness or injury” (Smith, 2012, p. 172). The Institute of Medicine reported approximately 44,000-98,000 patients die annually resulting from a medical error, and health care errors ranked among the top 10 for the leading causes of death in the United States (Smith, 2012). Problem: Nurse competence impacts safe and quality nursing, and several research studies investigated the measurement of nurse competence among nurses in various nursing settings (Flinkman et al., 2016). However, a review of the research revealed limited studies in the emergency department (ED) setting and in the United States (O’Leary, 2012). Method: This study implemented a quantitative nonexperimental research design using the combination of an instrumental case study and a cross-sectional survey for this study’s sample. An Internet-based SurveyMonkey questionnaire collected data on nurse competence from registered nurses (RNs) working in the ED at a San Francisco Bay Area hospital. Part I of the questionnaire integrated Meretoja, Isoaho, and Leino-Kilpi’s (2004) Nurse Competence Scale (NCS) consisting of 73 closed-ended clinical indicators divided into seven competence areas. Participants rated their level of competence and frequency of use for each clinical indicator. Part II of the questionnaire obtained background information about participants. A total of 21 out of 110 potential participants completed the survey. Results: The data analysis using Statistical Package for Social Sciences (SPSS) provided descriptive and nonparametric correlation statistics. Descriptive statistics described survey respondents. The least and most competent areas were ensuring quality and managing situations, respectively. The most frequent length of nursing experience was at least 60 months and the most frequent number of hours worked was at least 65 hours per 2-week period. Nonparametric correlation statistics, including Kendell’s tau-b and Spearman’s rho, identified significant relationships. A significant relationship existed between the frequency of using clinical skills and level of competence for four of the seven competence areas. A significant relationship existed between the background factor of experience, both as an RN and an ED RN, and level of competence for many clinical indicators. A significant relationship existed between the background factor of hours worked and level of competence for one clinical indicator. Conclusion: Despite the small sample size of 21 survey respondents, this study revealed findings consistent with the existing research on nurse competence. This study offers implications and recommendations for practice relative to nurse competence, nurse competence assessment, and transitions to new settings of nursing practice to support the nursing profession and safe and quality nursing.

No description available.

Bakgrund: Njurdonation är en omfattande process där en individ, efter eget beslut eller i samråd med andra, donerar en av sina friska njurar till en mottagare i behov av den för att förbättra sin överlevnad och hälsa. Som grundutbildad sjuksköterska har man tillgång till flera olika arbetsplatser, vilket innebär att man kommer möta olika patientgrupper i sitt yrke. I omvårdnaden av en njurdonator är den personcentrerade vården en viktig grundsten. Utöver denna princip är sjuksköterskans övriga kärnkompetenser avgörande. Det är nödvändigt att kunna samarbeta i team eftersom patienten inte bara behöver sjuksköterskans stöd utan även hjälp och kontakt med andra vårdpersonal såsom läkare, specialistsjuksköterska samt psykolog och kurator. Den grundutbildade sjuksköterskan spelar rollen som navet i samarbetet, med ansvar för att säkerställa att all samverkan fungerar samtidigt och ingen aspekt av vården försummas. Därför är det av vikt att den grundutbildade sjuksköterskan har kunskap om njurdonatorers upplevelser både pre- och postoperativt. Syfte: litteraturstudiens syfte var att belysa pre- och postoperativa donationsupplevelse för donatorer som frivilligt donerar en njure. Metod: Studien genomfördes som en systematisk litteraturgenomgång med en kvalitativ metod på en grund av tio vetenskapliga peer-reviewed artiklar. Analysen av artiklarna följde en specifik modell för innehållsanalys. Resultat: Tre huvudkategorier definierar donatorernas upplevelser av den pre-och postoperativa donationsprocessen; ”Donatorernas anledningar till att donera”, ”Betydelsefullt med emotionellt stöd och förståelse” och ”Stress och komplikationer”. Konklusion: Njurdonatorers erfarenheter är övervägande positiva men präglas av intensiva känslor såsom glädje och stolthet, samtidigt som de upplever nervositet och stress inför godkännandet som donator. Tillräckligt stöd och förståelse från vårdpersonal och närstående underlättar hanteringen av den emotionella påfrestningen. För sjuksköterskor är insikten om donatorers upplevelser avgörande för att erbjuda personcentrerad vård och förbereda både vårdpersonal och donator för potentiella konsekvenser, vilket främjar högre vård- och livskvalitet för donatorn. Nyckelord: Grundutbildad sjuksköterska, Njurdonation, Njurtransplantation, upplevelser, Personcentrerad vård / Background: Kidney donation is a medical process where an individual, by their own decision or in consultation with others, donates one of their healthy kidneys to a recipient in need, aiming to improve their survival and health. As a registered nurse, one has access to various workplaces and opportunities, meaning they will encounter different types of patients in their profession. In the care of kidney donors, person-centered care stands as a crucial cornerstone. Beyond this principle, the nurse´s other core competencies are paramount. Collaborating within a team is essential since the patient requires not only the nurse´s support but also assistance and interaction with other healthcare professionals such as physicians, specialized nurses, psychologists, and counselors. The bachelor's degree nurse plays a pivotal role in this collaboration, being responsible for ensuring seamless cooperation while no aspect of care is neglected. Therefore, it is crucial for the bachelor's degree nurse to have knowledge of kidney donors´experiences both pre- and post-operatively. Aim: The aim of the literature study was to illustrate the pre-and postoperative donation experience of donors who voluntarily donate a kidney. Method: The research was conducted as an approach to a qualitative systematic literature review, drawing from ten peer-reviewed original articles. The Articles underwent analysis following a specific model for content analysis. Result: Three main categories define the donors' experiences of the pre- and post-operative donation process; “Donors’ reasons for donating”, “Meaningful with emotional support and understanding” and “Stress and complications”. Conclusion: Kidney donors` experiences are predominantly positive but are characterized by intense emotions such as joy and pride, while at the same time they experience nervousness and stress before being accepted as a donor. Sufficient support and understanding from healthcare staff and relatives facilitates the handling of the emotional strain. For nurses, the insight into donors´experiences is essential to provide person-centered care and prepare both health care professionals and donors for potential consequences, promoting higher quality of care and quality of life for the donor. Keywords: Registered nurse, experiences. kidney donation, kidney transplantation, person-centred care.