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Harvey, G., Gifford, W., Cummings, G., Kelly, J., Kislov, R., Kitson, A., . . . Ehrenberg, A. (2019). Mobilising evidence to improve nursing practice: A qualitative study of leadership roles and processes in four countries. International Journal of Nursing Studies, 90, 21-30
Open this publication in new window or tab >>Mobilising evidence to improve nursing practice: A qualitative study of leadership roles and processes in four countries
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2019 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 90, p. 21-30Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The approach and style of leaders is known to be an important factor influencing the translation of research evidence into nursing practice. However, questions remain as to what types of roles are most effective and the specific mechanisms through which influence is achieved.

OBJECTIVES: The aim of the study was to enhance understanding of the mechanisms by which key nursing roles lead the implementation of evidence-based practice across different care settings and countries and the contextual factors that influence them.

DESIGN: The study employed a qualitative descriptive approach.

SETTINGS: Data collection was undertaken in acute care and primary/community health care settings in Australia, Canada, England and Sweden.

PARTICIPANTS: 55 individuals representing different levels of the nursing leadership structure (executive to frontline), roles (managers and facilitators), sectors (acute and primary/community) and countries.

METHODS: Individual semi-structured interviews were conducted with all participants exploring their roles and experiences of leading evidence-based practice. Data were analysed through a process of qualitative content analysis.

RESULTS: Different countries had varying structural arrangements and roles to support evidence-based nursing practice. At a cross-country level, three main themes were identified relating to different mechanisms for enacting evidence-based practice, contextual influences at a policy, organisational and service delivery level and challenges of leading evidence-based practice.

CONCLUSIONS: National policies around quality and performance shape priorities for evidence-based practice, which in turn influences the roles and mechanisms for implementation that are given prominence. There is a need to maintain a balance between the mechanisms of managing and monitoring performance and facilitating critical questioning and reflection in and on practice. This requires a careful blending of managerial and facilitative leadership. The findings have implications for theory, practice, education and research relating to implementation and evidence-based practice.

Keywords
Evidence-based practice, Facilitation, Facilitators, Implementation, Knowledge translation, Leadership, Managers
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29100 (URN)10.1016/j.ijnurstu.2018.09.017 (DOI)30551080 (PubMedID)2-s2.0-85058064165 (Scopus ID)
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2019-01-30Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Anna, F. & Ehrenberg, A. (2019). Oral health and oral care in short-term care: prevalence, related factors, and coherence between older peoples and professionals assessments. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Oral health and oral care in short-term care: prevalence, related factors, and coherence between older peoples and professionals assessments
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2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Oral health is important for well-being and overall health. Older peoples oral health is well described in the residential care context, but remains understudied in short-term care.

Objective: The aim of this study was to describe oral health, daily oral care and related factors among older people in short-term care and to compare self-perceived oral health with professional assessment.

Materials and methods: This cross-sectional study included 391 older people in 36 short-term units in 19 Swedish municipalities. Oral health was assessed professionally by clinical oral assessment and the Revised Oral Assessment Guide (ROAG). The older peoples’ perceptions of their own oral health were measured with a global question on self-perceived oral health. Self-care ability was assessed with Katz Index of Activities of Daily Living (Katz-ADL).

Results: Mean age was 82.9 years, 19% of participants were totally edentulous, and 43% had ≥20 teeth. Almost 60% had coating or food debris on their teeth, but only 19% received help with daily oral care. Those who were dependent on help with self-care had around a sixfold higher risk of having oral problems. There was a low level of agreement between the clinical assessment based on ROAG and self-perceived oral health.

Conclusion: Professionals’ assessments of oral health differed considerably from the older peoples own assessments. A higher risk of oral problems and more occurrence of coating or food debris or broken teeth were seen among those dependent on help with self-care (ADL). This study indicates that in order to improve older peoples oral health and oral care we need to provide person-centred oral care and to develop a close collaboration between nursing and dental staff.

Keywords
oral health, oral care, older people, short-term care, self-perceived, functional ability
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29647 (URN)10.1111/scs.12667 (DOI)30859599 (PubMedID)
Note

Open Access beslut 5/2019

Available from: 2019-03-12 Created: 2019-03-12 Last updated: 2019-03-18Bibliographically approved
Westgård, T., Ottenvall Hammar, I., Holmgren, E., Ehrenberg, A., Wisten, A., Ekdahl, A. W., . . . Wilhelmson, K. (2018). Comprehensive geriatric assessment pilot of a randomized control study in a Swedish acute hospital: a feasibility study. Pilot and Feasibility Studies, 4, Article ID 41.
Open this publication in new window or tab >>Comprehensive geriatric assessment pilot of a randomized control study in a Swedish acute hospital: a feasibility study
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2018 (English)In: Pilot and Feasibility Studies, ISSN 2055-5784, Vol. 4, article id 41Article in journal (Refereed) Published
Abstract [en]

Background: Comprehensive geriatric assessment (CGA) represent an important component of geriatric acute hospital care for frail older people, secured by a multidisciplinary team who addresses the multiple needs of physical health, functional ability, psychological state, cognition and social status. The primary objective of the pilot study was to determine feasibility for recruitment and retention rates. Secondary objectives were to establish proof of principle that CGA has the potential to increase patient safety.

Methods: The CGA pilot took place at a University hospital in Western Sweden, from March to November 2016, with data analyses in March 2017. Participants were frail people aged 75 and older, who required an acute admission to hospital. Participants were recruited and randomized in the emergency room. The intervention group received CGA, a person-centered multidisciplinary team addressing health, participation, and safety. The control group received usual care. The main objective measured the recruitment procedure and retention rates. Secondary objectives were also collected regarding services received on the ward including discharge plan, care plan meeting and hospital risk assessments including risk for falls, nutrition, decubitus ulcers, and activities of daily living status.

Result: Participants were recruited from the emergency department, over 32 weeks. Thirty participants were approached and 100% (30/30) were included and randomized, and 100% (30/30) met the inclusion criteria. Sixteen participants were included in the intervention and 14 participants were included in the control. At baseline, 100% (16/16) intervention and 100% (14/14) control completed the data collection. A positive propensity towards the secondary objectives for the intervention was also evidenced, as this group received more care assessments. There was an average difference between the intervention and control in occupational therapy assessment - 0.80 [95% CI 1.06, - 0.57], occupational therapy assistive devices - 0.73 [95% CI 1.00, - 0.47], discharge planning -0.21 [95% CI 0.43, 0.00] and care planning meeting 0.36 [95% CI-1.70, -0.02]. Controlling for documented risk assessments, the intervention had for falls - 0.94 [95% CI 1.08, - 0.08], nutrition - 0.87 [95% CI 1.06, - 0.67], decubitus ulcers - 0.94 [95% CI 1.08, - 0.80], and ADL status - 0.80 [95% CI 1.04, - 0.57].

Conclusion: The CGA pilot was feasible and proof that the intervention increased safety justifies carrying forward to a large-scale study.

Trial registration: Clinical Trials ID: NCT02773914. Registered 16 May 2016.

Keywords
Discharge plan, Frail older people, Geriatric, Multidisciplinary team, Occupational therapy, Safety
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27208 (URN)10.1186/s40814-018-0228-1 (DOI)29423259 (PubMedID)2-s2.0-85046787910 (Scopus ID)
Available from: 2018-02-14 Created: 2018-02-14 Last updated: 2018-05-28Bibliographically approved
Bjurbo, C., Eriksson, U., Källberg, A.-S., Ehrenberg, A. & Muntlin Athlin, Å. (2018). Early identification of frail older patients by using the FRESH-instrument in the emergency department: a pilot study. In: : . Paper presented at 3rd Global Conference on Emergency Nursing & Trauma Care, Leeuwenhorst, 6-8 October 2018.
Open this publication in new window or tab >>Early identification of frail older patients by using the FRESH-instrument in the emergency department: a pilot study
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29205 (URN)
Conference
3rd Global Conference on Emergency Nursing & Trauma Care, Leeuwenhorst, 6-8 October 2018
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Kislov, R., Cummings, G., Ehrenberg, A., Gifford, W., Harvey, G., Kitson, A., . . . Wilson, P. (2018). From research evidence to "evidence by proxy"?: Organisational enactment of evidence-based healthcare in four high-income countries. In: : . Paper presented at Evidence Live Symposium, Oxford UK.
Open this publication in new window or tab >>From research evidence to "evidence by proxy"?: Organisational enactment of evidence-based healthcare in four high-income countries
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29207 (URN)
Conference
Evidence Live Symposium, Oxford UK
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Kislov, R., Cummings, G., Ehrenberg, A., Gifford, W., Harvey, G., Kitson, A., . . . Wilson, P. (2018). From research evidence to "research by proxy"?: Organisational enactment of evidence-based healthcare in four high-income countries. In: : . Paper presented at International Organizational Behavior in Healthcare Conference, Montreal, May 13-16 2018.
Open this publication in new window or tab >>From research evidence to "research by proxy"?: Organisational enactment of evidence-based healthcare in four high-income countries
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29208 (URN)
Conference
International Organizational Behavior in Healthcare Conference, Montreal, May 13-16 2018
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2018). Munhälsa hos äldre personer inom korttidsvård bedömd ur två perspektiv, självupplevd och professionell. In: : . Paper presented at Tandhygienistdagarna, 22-24 April 2018, Visby.
Open this publication in new window or tab >>Munhälsa hos äldre personer inom korttidsvård bedömd ur två perspektiv, självupplevd och professionell
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2018 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29211 (URN)
Conference
Tandhygienistdagarna, 22-24 April 2018, Visby
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2018). Munhälsa hos äldre personer inom korttidsvård, bedömd ur två perspektiv, självupplevd och professionell. In: : . Paper presented at Forskningens och utvecklingens dag, Örebro universitet.
Open this publication in new window or tab >>Munhälsa hos äldre personer inom korttidsvård, bedömd ur två perspektiv, självupplevd och professionell
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29209 (URN)
Conference
Forskningens och utvecklingens dag, Örebro universitet
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2018). Munhälsorelaterad livskvalitet hos äldre personer inom korttidsvård. In: : . Paper presented at Svensk samhällsodontologisk förening.
Open this publication in new window or tab >>Munhälsorelaterad livskvalitet hos äldre personer inom korttidsvård
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2018 (Swedish)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29204 (URN)
Conference
Svensk samhällsodontologisk förening
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2018). Oral health among elderly people assessed from two perspectives: self-perceived and professional. In: : . Paper presented at 24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018.
Open this publication in new window or tab >>Oral health among elderly people assessed from two perspectives: self-perceived and professional
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29210 (URN)
Conference
24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3964-196X

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