Bakgrund: Överrapportering av patient mellan vårdpersonal kan utgöra en patientsäkerhetsrisk. Vid överrapportering mellan intensivvårdsavdelning och vårdavdelning skiljer sig vårdmiljö, kommunikation, dokumentation samt sjuksköterskors fokus och kompetens. Syfte: Att beskriva avdelningssjuksköterskors upplevelser av överrapportering från intensivvårdssjuksköterskor av patient från intensivvård till fortsatt vård på vårdavdelning. Metod: Kvalitativ innehållsanalys med beskrivande design. Tio avdelningssjuksköterskor intervjuades via semistrukturerade intervjuer. Huvudresultat: Fyra huvudkategorier framkom: Att ta över ansvaret, Att ha tid och vara förberedd, Att ha kompetens och samarbeta samt Att skapa en bra miljö för överrapportering. Struktur samt tillräcklig och relevant information tillsammans med tydlig dokumentation och planering för den fortsatta vården hade betydelse för avdelningssjuksköterskorna i övertaget av ansvaret för patienten. Att vara förberedd och ha tid för överrapporteringen var också viktigt för ett säkert övertag av vården. Bemötande och samarbete över klinikgränser upplevdes ha betydelse för hur bra en överrapportering blev där trygghet och stöd i den sårbara övergången i vårdnivå var viktigt för att upprätthålla adekvat vård för patienten. Överrapporteringen blev bättre med erfarenhet och ökad trygghet i rollen som sjuksköterska. Att göra patienten delaktig upplevdes betydelsefullt och den fysiska miljön upplevdes ha betydelse för hur informationsutbytet skedde. Slutsats: Planering, förberedelse och tid för överrapporteringen gav viktiga förutsättningar för en patientsäker övergång i vårdnivå och kontinuitet i den fortsatta vården. Erfarenhet hos avdelningssjuksköterskan och samarbete över klinikgränserna har betydelse för hur bra vården upprätthålls i denna sårbara övergång. Att göra patienten delaktig i överrapporteringen och den fysiska miljön har betydelse för hur informationsutbytet sker. / Background: Handover of patient between health care professionals can pose a patient safety risk. Handover between intensive care unit and general ward differs in care environment, communication, documentation and nurses’ focus and competence. Aim: To describe ward nurses’ experiences of handover from intensive care nurses of a patient from intensive care to continued care in a general ward. Method: Qualitative content analysis with descriptive design. Ten ward nurses were interviewed with semi-structured interviews. Result: Four main categories emerged: To take over the responsibility, To have time and be prepared, To have competence and cooperate and To create a good environment for handover. Structure, relevant and enough information with clear documentation and planning of the continued care impacted the transfer for the ward nurses. Being prepared and having time for the handover were also important for a safe transfer of care. Attitude and cooperation over clinic borders were perceived to impact the transfer. Security and support in the vulnerable transfer in level of care were important to maintain adequate care for the patient. The handover became better with experience and accrued security in the role as a nurse. To involve the patient was meaningful and the physical environment had an impact on how information transfer occurred. Conclusion: Planning, preparation and time created important conditions for a safe transfer. Experience and cooperation impacted how care was maintained. To involve the patient was meaningful and the physical environment impacted how information transfer occurred.

Due to the higher migration rates, there is more cultural diffusion. The healthe care personnel will be dealing with patients from different cultures more often. This is why it is important to use an appropriate approach and give competent heathcare considering cultural backround of the patients. The goal of this thesis was to map the cultural differences in care for an underage patient and to trend the minority groups that are being cared for by nurses in the children's ward. To achieve the goal of this thesis, there were four specified questions and to achieve the result, there was a threephase trial, specifically qualitative trial supplemented with quantitative method using a questionnaire. The first phase was the pilot poll and a techniquire "snowball slamping" was used. The second phase of the trial consisted of pre-structured interviews with the nurses. The third phase consisted of pre-structured interviews with the parents. On the basis of this trial, it was concluded that the nurses are caring for Romany and Vietnamese minority groups most often. The other most patiens from Ukraine, Russia, Germany, Poland, Muslims and Jehova witnesses. The most common problems that occur during the care are: language barrier, cultural customs, communication and co-operation. Based on the data collected from interviews with nurses and parents, there are specific variations in expectency of care, such as food, daily regime, differences in behavour, communication, reliability to adhere to given rules and consequent care after the hospital stay. There are other different specifics such as rituals and traditions during child labour or at the time of death, celebration of different festivals, fasting and other spiritual needs. Traditions relating to refusal or demand of specific care were also mentioned. Results of this thesis were presented at the 13th Student conference in Pardubice and will be published in a technical journal.