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Källberg, Ann-SofieORCID iD iconorcid.org/0000-0002-0681-9768
Publications (10 of 16) Show all publications
Crilly, J., Sweeny, A., Muntlin, Å., Green, D., Malyon, L., Christofis, L., . . . Göransson, K. (2024). Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study. BMC Health Services Research, 24(1), Article ID 235.
Open this publication in new window or tab >>Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study
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2024 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, no 1, article id 235Article in journal (Refereed) Published
Abstract [en]

Background: Identifying factors predictive of hospital admission can be useful to prospectively inform bed management and patient flow strategies and decrease emergency department (ED) crowding. It is largely unknown if admission rate or factors predictive of admission vary based on the population to which the ED served (i.e., children only, or both adults and children). This study aimed to describe the profile and identify factors predictive of hospital admission for children who presented to four EDs in Australia and one ED in Sweden.

Methods: A multi-site observational cross-sectional study using routinely collected data pertaining to ED presentations made by children < 18 years of age between July 1, 2011 and October 31, 2012. Univariate and multivariate analysis were undertaken to determine factors predictive of hospital admission.

Results: Of the 151,647 ED presentations made during the study period, 22% resulted in hospital admission. Admission rate varied by site; the children's EDs in Australia had higher admission rates (South Australia: 26%, Queensland: 23%) than the mixed (adult and children's) EDs (South Australia: 13%, Queensland: 17%, Sweden: 18%). Factors most predictive of hospital admission for children, after controlling for triage category, included hospital type (children's only) adjusted odds ratio (aOR):2.3 (95%CI: 2.2-2.4), arrival by ambulance aOR:2.8 (95%CI: 2.7-2.9), referral from primary health aOR:1.5 (95%CI: 1.4-1.6) and presentation with a respiratory or gastrointestinal condition (aOR:2.6, 95%CI: 2.5-2.8 and aOR:1.5, 95%CI: 1.4-1.6, respectively). Predictors were similar when each site was considered separately.

Conclusions: Although the characteristics of children varied by site, factors predictive of hospital admission were mostly similar. The awareness of these factors predicting the need for hospital admission can support the development of clinical pathways.

Keywords
Emergency departments, Children, Hospital admission, Australia, Sweden
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:du-47629 (URN)10.1186/s12913-023-09403-w (DOI)001174557100001 ()38388438 (PubMedID)2-s2.0-85185678645 (Scopus ID)
Available from: 2023-12-29 Created: 2023-12-29 Last updated: 2024-04-04Bibliographically approved
Gelin, M., Gesar, B., Källberg, A.-S., Ehrenberg, A. & Gustavsson, C. (2023). Introducing a triage and Nurse on Call model in primary health care - a focus group study of health care staff's experiences. BMC Health Services Research, 23(1), Article ID 1299.
Open this publication in new window or tab >>Introducing a triage and Nurse on Call model in primary health care - a focus group study of health care staff's experiences
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2023 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, no 1, article id 1299Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: With the increased demand for health care services and with simultaneous staff shortages, new work models are needed in primary health care. In November 2015, a Swedish primary health care centre introduced a work model consisting of a structured patient sorting system with triage and Nurse on Call. The aim of this study was to describe the staff's experiences of introducing the triage and Nurse on Call model at the primary health care centre.

METHODS: Five focus group discussions with staff (n = 39) were conducted 4 years after the introduction of the work model. Groups were divided by profession: medical secretaries, nursing assistants, physicians, primary health care nurses, and registered nurses. The transcribed text from the discussions was analysed using qualitative inductive content analysis.

RESULTS: The analysis generated one overarching theme: The introduction of triage and Nurse on Call addresses changed preconditions in primary health care, but the work culture, organization, and acquisition of new knowledge are lagging behind. The overarching theme had five categories: (1) Changed preconditions in primary health care motivate new work models; (2) The triage and Nurse on Call model improves teamwork and may increase the quality of care; (3) Unclear purpose and vague leadership make introducing the work model difficult; (4) Difficulties to adopt the work model as it challenges professional autonomy; and (5) The triage and Nurse on Call model requires more knowledge and competence from nurses in primary health care.

CONCLUSIONS: This study contributes with knowledge about implications of a new work model in primary health care from the perspective of health care staff. The work model using triage and Nurse on Call in primary health care was perceived by participants to increase availability and optimize the use of resources. However, before introduction of new work models, it is important to identify barriers to and facilitators for successful improvements in the local health care context. Additional education for the health care staff is important if the transition is to be successful. Complementary skills and teamwork, supported by a facilitator seems important to ensure a well-prepared workforce.

Keywords
Accessibility of health services, Focus groups, Nurse on Call, Primary health care, Qualitative content analysis, Triage
National Category
Nursing
Identifiers
urn:nbn:se:du-47319 (URN)10.1186/s12913-023-10300-5 (DOI)001107663300002 ()38001493 (PubMedID)2-s2.0-85177754687 (Scopus ID)
Available from: 2023-11-28 Created: 2023-11-28 Last updated: 2024-01-15Bibliographically approved
Pellas, U., Ehrenberg, A., Svedbo Engström, M. & Källberg, A.-S. (2023). Omvårdnadsrådets utlåtande gällande förhållandet mellan antal patienter per sjuksköterska och patientsäkerhet inom somatisk slutenvård med internmedicinsk inriktning: Rapport baserad på uttömmande litteratursökning, underlag för beslut i Region Dalarnas Kunskapsstyrningsgrupp-beredningsgrupp.
Open this publication in new window or tab >>Omvårdnadsrådets utlåtande gällande förhållandet mellan antal patienter per sjuksköterska och patientsäkerhet inom somatisk slutenvård med internmedicinsk inriktning: Rapport baserad på uttömmande litteratursökning, underlag för beslut i Region Dalarnas Kunskapsstyrningsgrupp-beredningsgrupp
2023 (Swedish)Report (Other academic)
Publisher
p. 18
National Category
Nursing
Identifiers
urn:nbn:se:du-47211 (URN)
Available from: 2023-11-03 Created: 2023-11-03 Last updated: 2023-11-07Bibliographically approved
Källberg, A.-S., Berg, L. M., Skogli, S., Bjurbo, C., Muntlin, Å. & Ehrenberg, A. (2023). Prevalence of frailty and associated factors in older adults seeking care at Swedish emergency departments. BMC Geriatrics, 23(1), Article ID 798.
Open this publication in new window or tab >>Prevalence of frailty and associated factors in older adults seeking care at Swedish emergency departments
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2023 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 23, no 1, article id 798Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Internationally, prolonged length of stay for older adults in the emergency department (ED) is associated with increased risk of in-hospital adverse events. In Sweden patients 65 years and older account for 35% of emergency visits, and according to consensus from an international expert group, all persons over 70 should be screened for frailty. This is not routinely done in Swedish EDs, and therefore, knowledge about prevalence, characteristics and clinical outcomes associated with frailty is limited.

AIM: To describe the prevalence of frailty and associated factors in older adults seeking care at Swedish EDs.

METHODS: The study has a cross-sectional design. Data was collected at three hospital-based EDs, varying in level and size of setting, for one month. Patients age 70 and older presenting at the EDs and agreed to participate were screened for frailty using the FRail Elderly Support researcH group (FRESH) instrument. Data were analysed using descriptive statistics to assess the distribution of patient characteristics and clinical outcomes. Multivariate logistic regression was used to model the association between frailty and demographic characteristics, and Cox regression was used to model the association between frailty and clinical outcomes.

RESULTS: A total of 3101 patients were eligible for inclusion; of these, 984 (32%) were included and screened for frailty. Of the final sample, 57.3% were assessed as frail. Characteristics significantly associated with frailty were living in a residential care facility, age (> 80 years), being a woman and arriving with emergency medical service (EMS). There was a significant association between frailty and admittance to in-hospital care.

CONCLUSION: Our study shows a high prevalence of frailty in older people. Factors associated with frailty were living in a residential care facility, age ≥ 80 years, being a woman and arriving with EMS to the ED and being admitted to in-hospital care. Frailty screening should be incorporated in the triage system to identify frail patients who need tailored interventions. More studies using the FRESH instrument are needed to further confirm our findings and to develop the methods for screening for frailty in the ED.

Keywords
Emergency service hospital, Frailty, Older adult, Screening
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:du-47464 (URN)10.1186/s12877-023-04545-2 (DOI)001113691600006 ()38049748 (PubMedID)2-s2.0-85178556292 (Scopus ID)
Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2024-07-04Bibliographically approved
Tistad, M., Bergström, A., Elf, M., Eriksson, L., Gustavsson, C., Göras, C., . . . Wallin, L. (2023). Training and support for the role of facilitator in implementation of innovations in health and community care: a scoping review protocol.. Systematic Reviews, 12(1), Article ID 15.
Open this publication in new window or tab >>Training and support for the role of facilitator in implementation of innovations in health and community care: a scoping review protocol.
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2023 (English)In: Systematic Reviews, E-ISSN 2046-4053, Vol. 12, no 1, article id 15Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Implementing and sustaining innovations in clinical practice, such as evidence-based practices, programmes, and policies, is frequently described as challenging. Facilitation as a strategy for supporting implementation requires a facilitator, i.e. an individual with a designated role to support the implementation process. A growing number of studies report that facilitation can help tackle the challenges in implementation efforts. To optimise the potential contribution of facilitation as a strategy to improve the implementation of new practices, there is a need to enhance understanding about what training and support is required for individuals in the facilitator role. The objective of this scoping review is to map how facilitators have been trained for, and supported in, the facilitator role in implementation studies in health and community care. Specifically, the review aims to examine what is reported on training and support of facilitators in terms of learning outcomes, content, dose, mode of delivery, learning activities, and qualifications of the trainers and how the facilitators perceive training and support.

METHODS: This scoping review will follow the guidance of the Joanna Briggs Institute and the PRISMA Extension for Scoping Review checklist. We will include articles in which (a) facilitation is deployed as an implementation strategy, with identified facilitator roles targeting staff and managers, to support the implementation of specified innovations in health or community care, and (b) training and/or support of facilitators is reported. We will exclude articles where facilitation is directed to education or training in specific clinical procedures or if facilitation supports the implementation of general quality improvement systems. All types of peer-reviewed studies and study protocols published in English will be included. A systematic search will be performed in MEDLINE (Ovid), Embase (embase.com), Web of Science Core Collection, and CINAHL (Ebsco).

DISCUSSION: The proposed scoping review will provide a systematic mapping of the literature on the training and support of implementation facilitators and contribute useful knowledge within the field of implementation science to inform future facilitation initiatives.

SYSTEMATIC REVIEW REGISTRATION: Registered at Open Science Framework (registration https://doi.org/10.17605/OSF.IO/M6NPQ ).

Keywords
Community care, Evidence-based practice, Facilitation, Facilitator, Healthcare services, Implementation science, Supervision, Support, Training, i-PARIHS
National Category
Nursing
Identifiers
urn:nbn:se:du-45393 (URN)10.1186/s13643-023-02172-x (DOI)000924318500001 ()36721192 (PubMedID)2-s2.0-85147186976 (Scopus ID)
Available from: 2023-02-07 Created: 2023-02-07 Last updated: 2023-03-02Bibliographically approved
Danesh, V., Sasangohar, F., Källberg, A.-S., Kean, E. B., Brixey, J. J. & Johnson, K. D. (2022). Systematic review of interruptions in the emergency department work environment. International Emergency Nursing, 63, Article ID 101175.
Open this publication in new window or tab >>Systematic review of interruptions in the emergency department work environment
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2022 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 63, article id 101175Article in journal (Refereed) Published
Abstract [en]

Objective: The purpose of this systematic review is to describe the operationalization of interruptions measurement and to synthesize the evidence on the causes and consequences of interruptions in the emergency department (ED) work environment. Methods: This systematic review of studies explores the causes and consequences of interruptions in the ED. Of 2836 abstract/titles screened, 137 full-text articles were reviewed, and 44 articles met inclusion criteria of measuring ED interruptions. Results: All articles reported primary data collection, and most were cohort studies (n = 30, 68%). Conceptual or operational definitions of interruptions were included in 27 articles. Direct observation was the most common approach. In half of the studies, quantitative measures of interruptions in the ED were descriptive only, without measurements of interruptions’ consequences. Twenty-two studies evaluated consequences, including workload, delays, satisfaction, and errors. Overall, relationships between ED interruptions and their causes and consequences are primarily derived from direct observation within large academic hospitals using heterogeneous definitions. Collective strengths of interruptions research in the ED include structured methods of naturalistic observation and definitions of interruptions derived from concept analysis. Limitations are conflicting and complex evaluations of consequences attributed to interruptions, including the predominance of descriptive reports characterizing interruptions without direct measurements of consequences. Conclusions: The use of standardized definitions and measurements in interruptions research could contribute to measuring the impact and influence of interruptions on clinicians’ productivity and efficiency as well as patients’ outcomes, and thus provide a basis for intervention research. © 2022 Elsevier Ltd

Keywords
ED, Emergency department, Human factors, Interruptions, Systematic review, Work environment, adult, article, cohort analysis, concept analysis, emergency ward, female, human, male, outcome assessment, productivity, quantitative analysis, satisfaction, university hospital, workload, hospital emergency service, workplace, Emergency Service, Hospital, Humans
National Category
Nursing
Identifiers
urn:nbn:se:du-42164 (URN)10.1016/j.ienj.2022.101175 (DOI)000836194400008 ()35843150 (PubMedID)2-s2.0-85134294804 (Scopus ID)
Available from: 2022-08-17 Created: 2022-08-17 Last updated: 2023-03-17Bibliographically approved
Bjurling-Sjöberg, P., Göras, C., Lohela-Karlsson, M., Nordgren, L., Källberg, A.-S., Castegren, M., . . . Ekstedt, M. (2021). Resilient performance in healthcare during the COVID-19 pandemic (ResCOV): study protocol for a multilevel grounded theory study on adaptations, working conditions, ethics and patient safety.. BMJ Open, 11(12), Article ID e051928.
Open this publication in new window or tab >>Resilient performance in healthcare during the COVID-19 pandemic (ResCOV): study protocol for a multilevel grounded theory study on adaptations, working conditions, ethics and patient safety.
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2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 12, article id e051928Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Since early 2020, the COVID-19 pandemic has challenged societies and revealed the built-in fragility and dependencies in complex adaptive systems, such as healthcare. The pandemic has placed healthcare providers and systems under unprecedented amounts of strain with potential consequences that have not yet been fully elucidated. This multilevel project aims to explore resilient performance with the purpose of improving the understanding of how healthcare has adapted during the pandemic's rampage, the processes involved and the consequences on working conditions, ethics and patient safety.

METHODS: An emerging explorative multilevel design based on grounded theory methodology is applied. Open and theoretical sampling is performed. Empirical data are gathered over time from written narratives and qualitative interviews with staff with different positions in healthcare organisations in two Swedish regions. The participants' first-person stories are complemented with data from the healthcare organisations' internal documents and national and international official documents.

ANALYSIS: Experiences and expressions of resilient performance at different system levels and times, existing influencing risk and success factors at the microlevels, mesolevels and macrolevels and inter-relationships and consequences in different healthcare contexts, are explored using constant comparative analysis. Finally, the data are complemented with the current literature to develop a substantive theory of resilient performance during the pandemic.

ETHICS AND DISSEMINATION: This project is ethically approved and recognises the ongoing strain on the healthcare system when gathering data. The ongoing pandemic provides unique possibilities to study system-wide adaptive capacity across different system levels and times, which can create an important basis for designing interventions focusing on preparedness to manage current and future challenges in healthcare. Feedback is provided to the settings to enable pressing improvements. The findings will also be disseminated through scientific journals and conferences.

Keywords
covid-19, ethics (see medical ethics), health & safety, human resource management, qualitative research, quality in health care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:du-39051 (URN)10.1136/bmjopen-2021-051928 (DOI)000728888800025 ()34880017 (PubMedID)2-s2.0-85122542619 (Scopus ID)
Available from: 2021-12-14 Created: 2021-12-14 Last updated: 2023-08-28Bibliographically approved
Källberg, A.-S., Brixey, J. J., Johnson, K. D. & Berg, L. M. (2020). Disturbance during emergency department work – A concept analysis. International Emergency Nursing, 53, Article ID 100853.
Open this publication in new window or tab >>Disturbance during emergency department work – A concept analysis
2020 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 53, article id 100853Article in journal (Refereed) Published
National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-32387 (URN)10.1016/j.ienj.2020.100853 (DOI)000596592000011 ()2-s2.0-85082517626 (Scopus ID)
Available from: 2020-04-07 Created: 2020-04-07 Last updated: 2021-11-12Bibliographically 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, Tidig identifiering av sköra äldre på akutmottagning
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: 2021-11-12Bibliographically approved
Källberg, A.-S., Ehrenberg, A., Florin, J., Östergren, J. & Göransson, K. (2017). Physicians' and nurses' perceptions of patient safety risks in the emergency department. International Emergency Nursing, 33, 14-19
Open this publication in new window or tab >>Physicians' and nurses' perceptions of patient safety risks in the emergency department
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2017 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 33, p. 14-19Article in journal (Refereed) Published
Abstract [en]

The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians' perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians' experiences with regard to patient safety risks.

METHOD: Semi-structured interviews were conducted with 10 physicians and 10 registered nurses from two emergency departments. Interviews were analysed by inductive content analysis.

RESULTS: The experiences reflect the complexities involved in the daily operation of a professional practice, and the perception of risks due to a high workload, lack of control, communication and organizational failures.

CONCLUSION: The results reflect a complex system in which high workload was perceived as a risk for patient safety and that, in a combination with other risks, was thought to further jeopardize patient safety. Emergency department staff should be involved in the development of patient safety procedures in order to increase knowledge regarding risk factors as well as identify strategies which can facilitate the maintenance of patient safety during periods in which the workload is high.

Keywords
Emergency service (hospital), Error, Interviews, Patient safety, Qualitative content analysis, Risk
National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-24515 (URN)10.1016/j.ienj.2017.01.002 (DOI)000407530200003 ()28256336 (PubMedID)2-s2.0-85014054824 (Scopus ID)
Available from: 2017-03-09 Created: 2017-03-09 Last updated: 2021-11-12Bibliographically approved
Projects
Triage och task shifting i primärvård
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0681-9768

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