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Orton, M.-L., Andersson, Å., Wallin, L., Forsman, H. & Eldh, A. C. (2019). Nursing management matters for registered nurses with a PhD working in clinical practice. Journal of Nursing Management, 27(5), 955-962
Open this publication in new window or tab >>Nursing management matters for registered nurses with a PhD working in clinical practice
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2019 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 5, p. 955-962Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate what registered nurses (RNs) with a PhD working in clinical practice experience in terms of their role, function and work context.

BACKGROUND: Previous studies have shown that RNs with a graduate degree contribute to better and safer care for patients. However, little is known about what further academic schooling of RNs, at PhD level, means for clinical practice.

METHOD: Qualitative design, with semi-structured interviews and inductive content analysis.

RESULTS: The main areas of responsibilities for RNs with a PhD working in clinical practice were related to practice development and implementation of research results. In their work, they experienced barriers to the full use of their competence; the expectations and prerequisites of the organization were not clearly defined, and they often lacked a mandate to create conditions for quality improvement of nursing care.

CONCLUSIONS: RNs with a PhD can contribute to evidence-based practice (EBP), clinical training as well as the development of clinical research. Their roles and responsibilities need to be clarified and for this, they need support from managers.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should partner with RNs with a PhD to support the EBP process and help structure nursing practice in more efficient ways. 

Keywords
clinical practice, content analysis, doctoral degree, nursing care, qualitative
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29316 (URN)10.1111/jonm.12750 (DOI)30656787 (PubMedID)2-s2.0-85066033400 (Scopus ID)
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-08-23Bibliographically approved
Udo, C., Forsman, H., Jensfelt, M. & Flink, M. (2019). Perceptions of knowledge, research use and evidence-based practice among Swedish medical social workers – a qualitative study. In: : . Paper presented at European Conference for Social Work Research 2019 (ECSWR), 10-12 april, Leuven, Belgium.
Open this publication in new window or tab >>Perceptions of knowledge, research use and evidence-based practice among Swedish medical social workers – a qualitative study
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background and aim: With the intention to do more good than harm, it is important to rely on practice that is rooted in evidence-based guidelines so that clients are given the exact care they need. Thus, from a client safety perspective, the social worker needs to apply evidence-based practice (EBP). Learning more about the medical social workers’ perceptions of EBP has the potential to contribute to an increased understanding of how best available knowledge can be implemented in medical social work settings to provide high quality and safe practice to clients. Therefore the aim of this study was to explore medical social workers’ perceptions of evidence-based practice (EBP), including factors relevant for the successful implementation of evidence into medical social work practice.

Methods: This is a qualitative study. Eight focus group interviews were conducted that included 27 medical social workers. Data were analyzed using qualitative content analysis.

Results: Analysis resulted in two categories: “knowledge in practice” and “challenges in relation to the implementation of EBP” and four subcategories: “practice based on research evidence or experience”, “obtaining new evidence of practice”, “research and the social work context”, and “barriers and facilitating factors”. Participants tended to perceive EBP as theoretical and positivistic while perceiving their own knowledge as eclectic and experience-based. Although they perceived the relevance of research findings to their practice, they expressed a need for support to translate research into policy and practice. They also reported that studies about their specific work were scarce.

Conclusion and implications: The facilitating factors suggested by the medical social workers which concerned, e.g., a specially designated person responsible for supporting the increased use of research findings, support for prioritization of time, increased opportunities for the sharing of knowledge, and time for consultations, need to be considered when promoting the implementation of EBP within medical social work settings. The medical social workers’ suggestion for the facilitation of knowledge exchange needs further investigation.

Keywords
Evidence-based practice, Focus group interviews, Medical social worker
National Category
Social Work
Identifiers
urn:nbn:se:du-29622 (URN)
Conference
European Conference for Social Work Research 2019 (ECSWR), 10-12 april, Leuven, Belgium
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-03-07Bibliographically approved
Hälleberg Nyman, M., Forsman, H., Wallin, L., Ostaszkiewicz, J., Hommel, A. & Eldh, A. C. (2019). Promoting evidence-based urinary incontinence management in acute nursing and rehabilitation care: A process evaluation of an implementation intervention in the orthopaedic context. Journal of Evaluation In Clinical Practice, 25(2), 282-289
Open this publication in new window or tab >>Promoting evidence-based urinary incontinence management in acute nursing and rehabilitation care: A process evaluation of an implementation intervention in the orthopaedic context
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2019 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 25, no 2, p. 282-289Article in journal (Refereed) Published
Abstract [en]

RATIONALE, AIMS, AND OBJECTIVES:

The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery.

METHODS:

A 3-month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed.

RESULTS:

Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence-based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit.

CONCLUSION:

To promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI.

Keywords
evidence-based practice; implementation; incontinence; older people; orthopaedics; research utilization
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-26873 (URN)10.1111/jep.12879 (DOI)000461883800015 ()29411463 (PubMedID)2-s2.0-85063088977 (Scopus ID)
Available from: 2017-12-20 Created: 2017-12-20 Last updated: 2019-04-04Bibliographically approved
Karlberg Traav, M., Forsman, H., Eriksson, M. & Cronqvist, A. (2018). First line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing. Nursing Open, 5(4), 634-641
Open this publication in new window or tab >>First line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing
2018 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 4, p. 634-641Article in journal (Refereed) Published
Abstract [en]

Aim

The aim was to explore first line nurse managers’ experiences of opportunities and obstacles to support evidence‐based nursing.

Design

A qualitative study with a phenomenographical approach.

Method

Data were collected through focus group interviews with 15 first line nurse managers’ in four settings.

Results

The results are presented in four categories of description headed: Manage the everyday work vs. evidence‐based nursing; Uncertainties about evidence‐based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness—towards an active approach to evidence‐based nursing. The overarching category of description has been formulated as follows: The internal relation—how active leadership influences evidence‐based nursing. The outcome space is presented as: The individual path—how to make vision and reality become a working entity around evidence‐based nursing.

National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27932 (URN)10.1002/nop2.172 (DOI)30338109 (PubMedID)2-s2.0-85062111702 (Scopus ID)
Available from: 2018-06-17 Created: 2018-06-17 Last updated: 2019-03-11Bibliographically approved
Granström, T., Forsman, H., Brorsson, A. L., Granstam, E. & Leksell, J. (2018). Patients’ experiences before starting anti-VEGF treatment for sight-threatening diabetic macular oedema: A qualitative interview study. Nordic journal of nursing research, 38(1), 11-17
Open this publication in new window or tab >>Patients’ experiences before starting anti-VEGF treatment for sight-threatening diabetic macular oedema: A qualitative interview study
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2018 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 1, p. 11-17Article in journal (Refereed) Published
Abstract [en]

The diabetic complication macular oedema (DME) is a growing problem worldwide because of the increasing number of patients suffering from diabetes mellitus (DM). DME is treated with injections of anti-vascular endothelial growth factor (anti-VEGF) in the eye. This real-world study aimed to describe patients’ experiences before they received their first injection in the eye. Twenty-one men and women aged 49 to 86 years were interviewed. The interviews were analysed using qualitative content analysis. Two categories and an overall theme ‘to be at a crossroads and a crucial phase in life with an uncertain outcome’ were found. The participants expressed thoughts and concerns at different levels, practical concerns about the treatment procedure, and other existential thoughts regarding hope for improved visual acuity or fear of deterioration. Cooperation between eye clinics and diabetes clinics should be strengthened to clarify who is responsible for providing the information and support required by patients.

Keywords
anti-VEGF treatment, diabetic macular oedema, qualitative research, visual impairment
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-25211 (URN)10.1177/2057158517709409 (DOI)
Available from: 2017-06-16 Created: 2017-06-16 Last updated: 2018-06-07Bibliographically approved
Udo, C., Forsman, H., Jensfelt, M. & Flink, M. (2018). Research use and evidence-based practice among Swedish medical social workers: a qualitative study. Clinical social work journal
Open this publication in new window or tab >>Research use and evidence-based practice among Swedish medical social workers: a qualitative study
2018 (English)In: Clinical social work journal, ISSN 0091-1674, E-ISSN 1573-3343Article in journal (Refereed) Epub ahead of print
National Category
Social Work
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-26947 (URN)10.1007/s10615-018-0653-x (DOI)
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-02-01Bibliographically approved
Hälleberg Nyman, M., Forsman, H., Ostaszkiewicz, J., Hommel, A. & Eldh, A. C. (2017). Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do. Journal of Clinical Nursing, 26(21-22), 3345-3353
Open this publication in new window or tab >>Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do
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2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 21-22, p. 3345-3353Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To describe what nursing and rehabilitation staff know and do with regards to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery.

BACKGROUND:

Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent UI, there are indications that these guidelines are not applied in hospital care.

DESIGN:

A qualitative study with descriptive design was conducted in two orthopaedic units.

METHODS:

46 interviews and 36 observations of care were conducted from January to October 2014 and analysed with qualitative content analysis.

RESULTS:

Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures.

CONCLUSIONS:

Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing UI.

RELEVANCE TO CLINICAL PRACTICE:

An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team.

Keywords
Evidence-based practice; hip surgery; knowledge implementation; older people; orthopaedic care; urinary incontinence
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-23610 (URN)10.1111/jocn.13686 (DOI)000417389400010 ()27982485 (PubMedID)
Available from: 2016-12-19 Created: 2016-12-19 Last updated: 2017-12-29Bibliographically approved
Karlberg, M., Cronqvist, A., Forsman, H., Johansson, G., Möller, M. & Eriksson, M. (2016). Leading for reserach: An intervention to facilitate research utilization. In: : . Paper presented at Nordic Conference in Nursing Research 2016, Methods and Networks for the future,15-17 June, 2016 Stockholm.
Open this publication in new window or tab >>Leading for reserach: An intervention to facilitate research utilization
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2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-22685 (URN)
Conference
Nordic Conference in Nursing Research 2016, Methods and Networks for the future,15-17 June, 2016 Stockholm
Available from: 2016-08-12 Created: 2016-08-12 Last updated: 2016-08-15Bibliographically approved
Granström, T., Forsman, H., Lindholm Olinder, A., Gkretsis, D., Eriksson, J. W., Granstam, E. & Leksell, J. (2016). Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting. Diabetes Research and Clinical Practice, 121, 157-165
Open this publication in new window or tab >>Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting
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2016 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 121, p. 157-165Article in journal (Refereed) Published
Abstract [en]

Aims

To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12 months in a real world setting.

Methods

In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68 years) with type 1 and type 2 diabetes diagnosed with DME were included. Medical data and two questionnaires were collected; an eye-specific (NEI VFQ-25) and a generic health-related quality of life questionnaire (SF-36) were used.

Results

The total patient group had significantly improved visual acuity and reduced retinal thickness at 4 months and remains at 12 months follow up. Thirty patients had significantly improved visual acuity, and 27 patients had no improved visual acuity at 12 months. The patients with improved visual acuity had significantly improved scores for NEI VFQ-25 subscales including general health, general vision, near activities, distance activities, and composite score, but no significant changes in scores were found in the group without improvements in visual acuity.

Conclusions

Our study revealed that anti-VEGF treatment improved visual acuity and central retinal thickness as well as patient-reported outcome in real world 12 months after treatment start.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Patient-reported measurements; Diabetic macular edema; Anti-VEGF treatment; Visual function
National Category
Endocrinology and Diabetes
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-23260 (URN)10.1016/j.diabres.2016.09.015 (DOI)000390460100020 ()27718374 (PubMedID)
Available from: 2016-10-14 Created: 2016-10-14 Last updated: 2017-11-29Bibliographically approved
Hälleberg Nyman, M., Forsman, H., Hommel, A., Rycroft-Malone, J., Wallin, L. & Eldh, A. C. (2015). Identifying the knowledge to translate: the example of urinary incontinence in older people. In: : . Paper presented at Nordic Conference on Implementation of Evidence-Based Practice, Norway, 3-4 Feb. 2015.
Open this publication in new window or tab >>Identifying the knowledge to translate: the example of urinary incontinence in older people
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2015 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: While urinary incontinence (UI) is a common and worrying issue among older people, promoting the use of evidence to prevent UI onset has rarely been studied. An earlier study that was conducted in nursing homes suggests that UI can be better assessed and managed, but the prevention of UI onset requires attention to the issue by staff within acute care settings. Aim: To report on the internal facilitators’ (IF) transition, identifying the 'know-do gap' between evidence and practice in UI prevention in orthopaedic care.

Methods: The Onset PrevenTion of Incontinence in Orthopaedic Nursing and rehabilitation (OPTION) pilot was carried out in two Swedish orthopaedic units of different size and location. The pilot project included a programme to support nursing and rehab staff to facilitate knowledge translation (KT). Five IFs were interviewed at baseline, and one and three months after the intervention was completed, and non-participant observations were performed during the KT-intervention. Interviews and observations were triangulated, depicting when and how the IFs identified the present, local UI practice, the evidence on UI, and the know-do gap in preventing UI onset in older patients undergoing hip surgery.

Results: Preliminary results indicate that before the study, neither the IFs nor their fellows at the units were aware that they could prevent UI onset. Rather, through mapping their context and matching the evidence provided by the dialogue with the experts in the KTintervention, the IFs became aware of which practice was evidence based and which evidence to implement, and how to facilitate KT and promote evidence use.

Conclusion: The OPTION pilot indicates that KT can be promoted by tailored implementation strategies and tailoring evidence, supported by IFs awareness and understanding of the local know-do gap, and strategies to overcome barriers and promote use of evidence.

National Category
Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-19052 (URN)
Conference
Nordic Conference on Implementation of Evidence-Based Practice, Norway, 3-4 Feb. 2015
Available from: 2015-08-26 Created: 2015-08-19 Last updated: 2015-08-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5892-9897

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