Bakgrund: Handledning är ett forum där möjlighet ges till reflektion. Reflektion kan handla om att bearbeta situationer som upplevts svåra, att planera inför framtiden samt att sätta ord på tyst kunskap. Studier visar att handledning i grupp kan bidra till bland annat reducerad oro, ökad arbetstillfredsställelse samt ökad kunskap och självinsikt. Omvårdnadshandledning är en modell där sjuksköterskor i grupp handleds av en annan sjuksköterska.Syfte: Syftet med den här studien var att undersöka förekomst och omfattning av samt eventuella hinder till omvårdnadshandledning i klinisk verksamhet. Dessutom var syftet att undersöka förekomst av eventuella andra forum för sjuksköterskor att reflektera kring sin yrkesverksamhet.Metod: Standardiserade telefonintervjuer genomfördes med enhetschefer som var knutna till sjuksköterskeprogrammet på Malmö högskola via samverkansprojektet kliniska lärarpar. I studien ingår 37 av 53 enhetschefer som svarade för 39 avdelningar och mottagningar. Materialet analyserades med deskriptiv statistik samt manifest innehållsanalys.Resultat: Sex av 39 avdelningar och mottagningar erbjöd omvårdnadshandled-ning, främst till nyutexaminerade sjuksköterskor som en del av mentorsprogram-met inom det kliniska basåret. Hindrande faktorer kunde delas in i två teman: organisation och inget intresse. Utöver omvårdnadshandledning fanns flertalet andra forum där sjuksköterskor hade möjlighet att reflektera kring sin yrkesverksamhet. Handledning där handledaren hade en annan profession än sjuksköterska, tvärprofessionella reflektionsträffar, individuellt stöd för nyutexaminerade sjuksköterskor, reflektion vid en specifik händelse, daglig reflektion samt forum där huvudfokus inte var reflektion men där det fanns möjlighet att reflektera. Konklusion: Omvårdnadshandledning, enligt studiens definition, förekom på 15,4 procent av de undersökta avdelningarna och mottagningarna. Handledning där handledaren hade en annan profession än sjuksköterska förekom i lika stor utsträckning (15,4 procent) som omvårdnadshandledning. Utöver detta fanns flera andra forum där möjlighet till reflektion gavs. / Background: Clinical supervision offers an opportunity for job reflection. Reflection can be a way to process difficult situations, plan for the future and visualize tacit knowledge. Studies show that clinical supervision can contribute to reduce worries and to increase job satisfaction, knowledge and self-awareness. Nursing supervision is a model, in which a nurse supervises a group of other nurses.Aim: The aim of this study was to examine the prevalence and the scope of and possible barriers to nursing supervision in clinical occupation. Furthermore, the aim was to examine the prevalence of possible other fora for nurses to reflect upon their work.Method: Standardized telephone interviews were carried out with nurse managers affiliated with Malmö University’s nurse programme through the partnership programme ‘clinical teachers’. The study includes 37 of 53 nurse managers who answered on behalf of 39 wards and outpatient clinics. The data was analyzed using descriptive statistics and a manifest content analysis.Result: Six out of 39 wards and outpatient clinics offered nursing supervision. Furthermore, supervision was generally offered to all newly graduated nurses as part of the mentor programme during the first year of clinical employment. The known reported barriers to supervision could be divided into two themes: organization and no interest. Alternatives to nursing supervision were clinical supervision with a non-nurse supervisor, multidisciplinary reflection meetings, individual support to newly graduated nurses, nurse meetings, debriefing, daily reflection and forum where the main focus was something else but where the nurses got a possibility to reflect.Conclusion: Nursing supervision appeared in 15.4 percent of the examined wards and outpatient clinics. Clinical supervision, in which the supervisor had another education than nurse, appeared to the same extension (15.4 percent) as nursing supervision. Several other fora with possibility for reflection also existed.

Abstract: Health libraries have received relatively little attention, and not much has been studied regarding their operations. Thus the aim of this bachelor thesis is to gain an increased understanding of the placement of health libraries within the health care system, through interviews with managers about their perceptions of what possibilities and challenges that comes with the placement. Methods: The study was conducted on six different health care libraries, through telephone interviews with the managers for said libraries. The interviews were then analysed through deductive thematic analysis, based on elements from Jacobsen & Thorsvik’s Comprehensive organization model. Findings: On the whole, the managers were content with the placement of the health libraries within the organization structure and stated that they found the communication to and from the management of the health care system satisfactory, though with room for improvement. It was also noted that while the managers did think that the health library had received more recognition from both management and health care professionals due to increased need of electronic resources for evidence-based medicine, they still competed with outdated prejudices and ignorance on the duties of health libraries and health librarians. This ignorance, coupled with a lack of law ordained missives, were considered the greatest challenges that the health libraries had to face. However, the managers were despite these challenges hopeful regarding the future role of health libraries within the system, citing both a greater need of their services, as well as a growing understanding of how they can contribute.

<p>En ofullständig eller inaktuell dokumentation av läkemedel i Receptregistret och läkemedelslistorna kan leda till en sämre vetskap om vilka läkemedel som är aktuella att administrera samt till felmedicinering.</p><p>Syftet med denna studie är att hos patienter med diagnosen artros undersöka förekomsten av avvikelser mellan recept i Receptregistret på apotek, vårdcentralens läkemedelslista från ordinationsjournalen samt patienternas egen uppfattning om aktuell läkemedelsbehandling.</p><p>Studien genomfördes dels som registerstudie genom avstämning av journaldata på aktuella läkemedelsordinationer från Stensö Hälsocentral mot sparade recept i Receptregistret och dels som telefonintervju med patienterna om vilka recept som utgör hans/hennes aktuella ordinationer.</p><p>Av artrospatienternas recept i Receptregistret var 89 % aktuella och av artrospatiernas ordinationer i läkemedelslistorna på hälsocentralen var 69 % aktuella. Av alla artrospatienters ordinationer var det 52 % som var aktuella och som förekom i både Receptregistret och läkemedelslistorna.</p><p>Trots att studien är begränsad i storlek och att patienterna bara rekryterades från en vårdcentral indikerar resultaten att det finns betydande skillnader mellan artrospatienternas aktuella medicinering, deras läkemedelslistor på vårdcentral samt Receptregister från apotek. Genom att förbättra och göra regelbundna läkemedelsavstämningar efter ändringar i patientens läkemedelsbehandling, såväl på apotek som inom sjukvården, kan antalet avvikelser reduceras, följsamheten hos patienterna kan ökas genom att det blir lättare för dem att veta vilka läkemedel som är aktuella att administrera och medicineringsfel kan reduceras.</p> / <p>Misuse of drugs is a growing problem and a major cause of both morbidity and mortality in today's society. This may be a result of an incomplete or outdated medication history of patients and it is therefore important that all medical records are updated with the current drugs for the patient to use to prevent medication errors.</p><p>The ultimate effect of any drug therapy depends on the patient's decision to take their medicines as the doctor has prescribed, to have so-called adherence to their prescription medicines, which in turn depends in particular on the patient's knowledge of the drugs at issue. To assist the patient there are two kinds of printing, a list with the doctor’s prescriptions from the electronic patient record (EMR) and also a list from the national prescription repository (NPR) of all the saved prescriptions at pharmacies by the patient. Discrepancies may exist between what is documented in the patient's EMR and that in the pharmacy record, which both also may differ from the drugs that the patient actually is using. These discrepancies between the documents, which can both include valid and outdated prescriptions so as prescription duplicates, can cause a worsening of compliance and medication errors especially in patients with multiple drugs that may have difficult to keep track of their current drug treatment.</p><p>The aim of the study was compare the national prescription repository (NPR), the electronic medical records (EMR) and patient’s knowledge of the prescribed treatment for people with a diagnosis of osteoarthritis.</p><p>The study was conducted both as registry study by reconciliation of journal data on current drug prescriptions from a health centre (HCC) with saved recipes in the Swedish national prescription repository (NPR) and partly by telephone interview with patients about the prescriptions that represent his / her current prescriptions. The participation rate was 58 %. Twenty-nine patients with osteoarthritis were included in the study.</p><p>Of the osteoarthritis patients 89 % the recipes in the NPR were found to be valid and 11 % were outdated. Duplicates of recipes were estimated to 5 %, and double-medication occurred in 1 % of the recipes.</p><p>Of the patients' prescriptions in the medical records at the health centre 69 % were found to be valid. The outdated prescriptions were estimated to 31 % while 4 % was duplicates.</p><p>For all of the osteoarthritis patients' 247 drugs, only 52 % was valid and occurred both in the NPR and in the EMR.</p><p>There were major discrepancies between the prescriptions in the EMR, the NPR and what the patients with osteoarthritis are seeing as their current prescriptions. Through regular medical reconciliations after changes in the patients' treatment, in both health care and pharmacies, the discrepancies can be reduced, the patient can be surer of what to administrate and therefore medication errors can be reduced.</p>

En ofullständig eller inaktuell dokumentation av läkemedel i Receptregistret och läkemedelslistorna kan leda till en sämre vetskap om vilka läkemedel som är aktuella att administrera samt till felmedicinering. Syftet med denna studie är att hos patienter med diagnosen artros undersöka förekomsten av avvikelser mellan recept i Receptregistret på apotek, vårdcentralens läkemedelslista från ordinationsjournalen samt patienternas egen uppfattning om aktuell läkemedelsbehandling. Studien genomfördes dels som registerstudie genom avstämning av journaldata på aktuella läkemedelsordinationer från Stensö Hälsocentral mot sparade recept i Receptregistret och dels som telefonintervju med patienterna om vilka recept som utgör hans/hennes aktuella ordinationer. Av artrospatienternas recept i Receptregistret var 89 % aktuella och av artrospatiernas ordinationer i läkemedelslistorna på hälsocentralen var 69 % aktuella. Av alla artrospatienters ordinationer var det 52 % som var aktuella och som förekom i både Receptregistret och läkemedelslistorna. Trots att studien är begränsad i storlek och att patienterna bara rekryterades från en vårdcentral indikerar resultaten att det finns betydande skillnader mellan artrospatienternas aktuella medicinering, deras läkemedelslistor på vårdcentral samt Receptregister från apotek. Genom att förbättra och göra regelbundna läkemedelsavstämningar efter ändringar i patientens läkemedelsbehandling, såväl på apotek som inom sjukvården, kan antalet avvikelser reduceras, följsamheten hos patienterna kan ökas genom att det blir lättare för dem att veta vilka läkemedel som är aktuella att administrera och medicineringsfel kan reduceras. / Misuse of drugs is a growing problem and a major cause of both morbidity and mortality in today's society. This may be a result of an incomplete or outdated medication history of patients and it is therefore important that all medical records are updated with the current drugs for the patient to use to prevent medication errors. The ultimate effect of any drug therapy depends on the patient's decision to take their medicines as the doctor has prescribed, to have so-called adherence to their prescription medicines, which in turn depends in particular on the patient's knowledge of the drugs at issue. To assist the patient there are two kinds of printing, a list with the doctor’s prescriptions from the electronic patient record (EMR) and also a list from the national prescription repository (NPR) of all the saved prescriptions at pharmacies by the patient. Discrepancies may exist between what is documented in the patient's EMR and that in the pharmacy record, which both also may differ from the drugs that the patient actually is using. These discrepancies between the documents, which can both include valid and outdated prescriptions so as prescription duplicates, can cause a worsening of compliance and medication errors especially in patients with multiple drugs that may have difficult to keep track of their current drug treatment. The aim of the study was compare the national prescription repository (NPR), the electronic medical records (EMR) and patient’s knowledge of the prescribed treatment for people with a diagnosis of osteoarthritis. The study was conducted both as registry study by reconciliation of journal data on current drug prescriptions from a health centre (HCC) with saved recipes in the Swedish national prescription repository (NPR) and partly by telephone interview with patients about the prescriptions that represent his / her current prescriptions. The participation rate was 58 %. Twenty-nine patients with osteoarthritis were included in the study. Of the osteoarthritis patients 89 % the recipes in the NPR were found to be valid and 11 % were outdated. Duplicates of recipes were estimated to 5 %, and double-medication occurred in 1 % of the recipes. Of the patients' prescriptions in the medical records at the health centre 69 % were found to be valid. The outdated prescriptions were estimated to 31 % while 4 % was duplicates. For all of the osteoarthritis patients' 247 drugs, only 52 % was valid and occurred both in the NPR and in the EMR. There were major discrepancies between the prescriptions in the EMR, the NPR and what the patients with osteoarthritis are seeing as their current prescriptions. Through regular medical reconciliations after changes in the patients' treatment, in both health care and pharmacies, the discrepancies can be reduced, the patient can be surer of what to administrate and therefore medication errors can be reduced.

På webbplatsen arbetsliv.org finns webbsidorna branschkunskap och ämneskunskap innehållandes länkar till andra webbsidor, med fakta kring arbetsmiljö. Webbsidorna riktar sig främst till arbetsmiljöingenjörer och medlemmarna inom organisationerna FTF (Föreningen Teknisk Företagshälsovård) Arbetsmiljö och EHSS, Ergonomi och Human Factors Sällskapet Sverige. Arbetsmiljöingenjörer arbetar med frågor relaterade till branscher inom många olika områden. Därför anses det underlätta deras arbete genom att ha en samlad plats för branschspecifik information. Syftet med uppsatsen är att utveckla webbsidor till en egen domän, arbetsmiljowiki.se, och att utifrån organisationsmedlemmarnas åsikter skapa en wiki med bransch- och ämneskunskap inom arbetsmiljö. För att ta reda på användarnas åsikter genomfördes åtta stycken kvalitativa telefonintervjuer med intervjupersoner från olika åldersgrupper. Litteraturstudier skedde kring val och utveckling av teknisk lösning för att få en bild av de möjligheter som finns. Jämförelsen av tekniska lösningar, analysen av telefonintervjuerna och de uppställda kraven utgör tillsammans ett delresultat. Delresultatet ledde fram till en integration av Facebookinloggning, YouTubelänkar, kommentarsfält och att resultatet arbetsmiljowiki.se utformades enligt organisationsmedlemmarnas åsikter. / Located on the website arbetsliv.org is the webpages branschkunskap and ämneskunskap, containing links to other websites with facts about occupational health and safety. The webpages mainly target themselves towards occupational health engineers and members of the two organization’s FTF (Föreningen Teknisk Företagshälsovård) Arbetsmiljö and EHSS, Ergonomi och Human Factors Sällskapet Sverige. Occupational health engineers work with questions related to industries of many different fields. Therefore, it is considered to facilitate their work by providing a collaborative collection of industry-specific information. The purpose of this thesis is to develop the webpages into an independent domain, arbetsmiljowiki.se, and based on the organization members’ opinions create a wiki about industry and subject knowledge related to occupational health and safety. To collect the users’ opinions, eight qualitative telephone interviews were carried out with interviewees from different age-groups. Literature studies regarding choice of and development of technical solutions were performed in order to obtain a greater picture of the available possibilities. The comparison of technical solutions, analysis of the telephone interviews and the specified requirements together make up a part of the result. One part of the result resulted in an integration of Facebook login, embedded YouTube videos, comment fields and that the final result arbetsmiljowiki.se was shaped as per the organization members’ requests.