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  • 1. Angsmo, Ewa
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Midböe, Lars
    Nilsson, Gunilla
    Fogelberg-Dahm, Marie
    Ehnfors, Margareta
    Björvell, Catrin
    Wärn-Hede, Gunnel
    Östlinder, Gerthrud
    Nursing informatics in Sweden: the agenda for the future2009Ingår i: Connecting Health and Humans - Proceedings of NI2009, Helsinki, 2009, Vol. 146, s. 866-867Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    With the purpose of getting an overview of the current research and development in information systems and terminology for nursing practice and outline strategies for the future, an initiative for a workshop was taken at the national level in Sweden by the Section for Nursing Informatics, the Society of Nursing and the Association of Health Professionals in 2007. For the workshop around 30 nurses were invited, representing clinical practice, education, and research. The workshop resulted in recommendations for future strategies to support the development of nursing informatics in Sweden.

  • 2. Asplund, Kjell
    et al.
    Castrén, Maaret
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Farrokhnia, Nasim
    Göransson, Katarina
    Jonsson, Håkan
    Lind, Lars
    Oredsson, Sven
    Rognes, Jon
    SBU om "lean": Processorienterat arbetssätt på akuten ger kortare ledtider2010Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, nr 17Artikel i tidskrift (Övrigt vetenskapligt)
  • 3. Asplund, Kjell
    et al.
    Castrén, Maaret
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Farrokhnia, Nasim
    Göransson, Katarina
    Jonsson, Håkan
    Lind, Lars
    Oredsson, Sven
    Rognes, Jon
    Triage och flödesprocesser på akutmottagning2010Bok (Övrigt vetenskapligt)
  • 4.
    Berg, L
    et al.
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Källberg, Ann-Sofie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska Institutet; Department of Emergency Medicine, Falun Hospital.
    Göransson, K
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Östergren, J
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Interruptions in emergency department work: an observational and interview study2013Ingår i: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 22, nr 8, s. 656-663Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectiv.e Frequent interruptions are assumed to have a negative effect on healthcare clinicians’ working memory that could result in risk for errors and hence threatening patient safety. The aim of this study was to explore interruptions occurring during common activities of clinicians working in emergency departments.

    Method. Totally 18 clinicians, licensed practical nurses, registered nurses and medical doctors, at two Swedish emergency departments were observed during clinical work for 2 h each. A semistructured interview was conducted directly after the observation to explore their perceptions of interruptions. Data were analysed using non-parametric statistics, and by quantitative and qualitative content analysis.

    Results. The interruption rate was 5.1 interruptions per hour. Most often the clinicians were exposed to interruptions during activities involving information exchange. Calculated as percentages of categorised performed activities, preparation of medication was the most interrupted activity (28.6%). Face-to-face interaction with a colleague was the most common way to be interrupted (51%). Most common places for interruptions to occur were the nurses’ and doctors’ stations (68%). Medical doctors were the profession interrupted most often and were more often recipients of interruptions induced by others than causing self-interruptions. Most (87%) of the interrupted activities were resumed. Clinicians often did not regard interruptions negatively. Negative perceptions were more likely when the interruptions were considered unnecessary or when they disturbed the work processes.

    Conclusions. Clinicians were exposed to interruptions most often during information exchange. Relative to its occurrence, preparation of medication was the most common activity to be interrupted, which might increase risk for errors. Interruptions seemed to be perceived as something negative when related to disturbed work processes.

  • 5. Berg, Lena
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Göransson, Katarina
    An observational study of activities and multitasking performed by clinicians in two Swedish emergency departments2012Ingår i: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 19, nr 4, s. 246-251Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To explore the type and frequency of activities and multitasking performed by emergency department clinicians.

    Methods: Eighteen clinicians (licensed practical nurses, registered nurses and medical doctors), six from each occupational group, at two Swedish emergency departments were followed in their clinical work for 2 h each to observe all their activities and multitasking practices. Data were analysed using qualitative and quantitative content analysis.

    Results: Fifteen categories of activities could be identified based on 1882 observed activities during the 36 h of observation. The most common activity was information exchange, which was most often performed face-to-face. This activity represented 42.1% of the total number of observed activities. Information exchange was also the most common activity to be multitasked. Registered nurses performed most activities and their activities were multitasked more than the other clinicians. The nurses’ and doctors’ offices were the most common locations for multitasking in the emergency department.

    Conclusion: This study provides new knowledge regarding the activities conducted by clinicians in the emergency department. The most frequent activity was information exchange, which was the activity most often performed by the clinicians when multitasking occurred. Differences between clinicians were found for activities performed and multitasked, with registered nurses showing the highest frequencies for both.

  • 6. Berg, Lena
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Göransson, Katarina
    Avbrott på akutmottagning2011Ingår i: 6:e nationella konferensen om patientsäkerhet, Stockholm, 2011Konferensbidrag (Refereegranskat)
  • 7. Berg, Lena
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Göransson, Katarina
    Multitasking and interruptions of emergency department clinicians' activities2011Ingår i: College of Emergency Nursing Australasia International Conference, Adelaide, Australia, 2011Konferensbidrag (Refereegranskat)
  • 8. Berg, Lena
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Göransson, Katarina
    The presence of emergency department crowding at a Swedish University hospital.: A longitudinal study using two crowding indicators as measures.2018Konferensbidrag (Refereegranskat)
  • 9.
    Berg, Lena
    et al.
    Akutkliniken Karolinska Universitetssjukhuset Solna ; Institutionen för Medicin Solna, Karolinska Institutet.
    Källberg, Ann-Sofie
    kutkliniken, Falu Lasarett ; Institutionen för Medicin Solna, Karolinska Institutet.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Karolinska institutet.
    Göransson, Katarina
    Karolinska institutet.
    Avbrott och störning i arbetet för akutmottagningspersonal - är det någon skillnad?2014Konferensbidrag (Refereegranskat)
  • 10.
    Berg, Lena
    et al.
    Karolinska institutet.
    Källberg, Ann-Sofie
    Karolinska institutet.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Karolinska institutet.
    Göransson, Katarina
    Karolinska institutet.
    Interruptions and disturbances in emergency department work assignments2014Konferensbidrag (Refereegranskat)
  • 11. Berg, Lena M
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karonlinska institutet.
    Östergren, Jan
    Discacciati, Andrea
    Göransson, Katarina E
    Associations between crowding and ten-day mortality among patients allocated lower triage acuity levels without need of acute hospital care on departure from the emergency department2019Ingår i: Annals of Emergency Medicine, ISSN 0196-0644, E-ISSN 1097-6760, Vol. 74, nr 3, s. 345-356Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY OBJECTIVE: We describe the association between emergency department (ED) crowding and 10-day mortality for patients triaged to lower acuity levels at ED arrival and without need of acute hospital care on ED departure.

    METHODS: This was a registry study based on ED visits with all patients aged 18 years or older, with triage acuity levels 3 to 5, and without need of acute hospital care on ED departure during 2009 to 2016 (n=705,699). The sample was divided into patients surviving (n=705,076) or dying (n=623) within 10 days. Variables concerning patient characteristics and measures of ED crowding (mean length of stay and ED occupancy ratio) were extracted from the hospital's electronic health records. ED length of stay per ED visit was estimated by the average length of stay for all patients who presented to the ED during the same day and shift and with the same acuity level. The 10-day mortality after ED discharge was used as the outcome measure. Multivariable logistic regression analyses were conducted.

    RESULTS: The 10-day mortality rate was 0.09% (n=623). The event group had larger proportions of patients aged 80 years or older (51.4% versus 7.7%) and triaged with acuity level 3 (63.3% versus 35.6%), and greater comorbidity (age-combined Charlson comorbidity index median interquartile range 6 versus 0). We observed an increased 10-day mortality for patients with a mean ED length of stay greater than or equal to 8 hours versus less than 2 hours (adjusted odds ratio 5.86; 95% confidence interval [CI] 2.15 to 15.94) and for elevated ED occupancy ratio. Adjusted odds ratios for ED occupancy ratio quartiles 2, 3, and 4 versus quartile 1 were 1.48 (95% CI 1.14 to 1.92), 1.63 (95% CI 1.24 to 2.14), and 1.53 (95% CI 1.15 to 2.03), respectively.

    CONCLUSION: Patients assigned to lower triage acuity levels when arriving to the ED and without need of acute hospital care on departure from the ED had higher 10-day mortality when the mean ED length of stay exceeded 8 hours and when ED occupancy ratio increased.

  • 12. Berg, Lena M
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Göransson, Katarina E
    Significant changes in emergency department length of stay and case mix over eight years at a large Swedish University Hospital2019Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 43, s. 50-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Describe the longitudinal development of crowding and patient/emergency department (ED) characteristics at a Swedish University Hospital.

    METHODS: A retrospective longitudinal registry study based on all ED visits with adult patients during 2009-2016 (N = 1,063,806). Patient characteristics and measures of ED crowding (ED occupancy ratio, length-of-stay [LOS], patients/clinician's ratios) were extracted from the hospital's electronic health record. Non-parametric analyses were conducted.

    RESULTS: The proportion of unstable patients (triage level 1-2) increased while the proportion of admitted patients decreased. All crowding variables were stable, except for LOS, which increased by 9 min/visit/year (95% CI: 8.8-9.1). LOS for visits by patients ≥ 80 years increased more compared to those 18-79 (248 min vs. 190 min, p < 0.001). Unstable patients increased their median LOS compared to stable patients (triage level 3-5). LOS for discharged patients increased with an average of 7.7 min/year (95% CI: 7.5-7.9) compared to 15.5 min/year (95% CI: 15.2-15.8) for those being admitted.

    CONCLUSION: Fewer admissions, despite an increase of unstable patients, is likely related to lack of in-hospital beds and contributes to ED crowding. The increase in median ED LOS, especially for patients in the subgroups unstable, ≥80 years and admitted to in-hospital care reflects this problem.

  • 13. Berg, Lena M
    et al.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Djärv, Therese
    Göransson, Katarina E
    Reasons for interrupting colleagues during emergency department work: a qualitative study2016Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 29, nr SI, s. 21-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Emergency department team members frequently need to interact with each other, a circumstance causing multiple interruptions. However, information is lacking about the motives underlying these interruptions and this study aimed to explore clinicians' reasons to interrupt colleagues during emergency department work.

    METHOD: Semi-structured interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. The interviews were analyzed inductively using content analysis.

    RESULTS: The working conditions to some extent sustained the clinicians' need to interrupt, for example different routines. Another reason to interrupt was to improve the initiator's work process, such as when the initiators perceived that the interruption had high clinical relevance. The third reason concerns the desire to influence the work process of colleagues in order to prevent mistakes and provide information for the person being interrupted to improve patient care.

    CONCLUSION: The three identified categories for why emergency department clinicians interrupt their colleagues were related to working conditions and a wish to improve/influence the work processes for both initiators and recipients. Several of the reasons given for interrupting colleagues were done in order to improve patient care. Interruptions perceived as negative to the recipient were mostly related to the working conditions.

  • 14. Berg, Lena M
    et al.
    Källberg, Ann-Sofie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Department of Medicine Solna, Karolinska Institutet; Department of Emergency Medicine, Falun Hospital.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Östergren, Jan
    Djärv, Therese
    Brixey, Juliana J
    Göransson, Katarina E
    Factors influencing clinicians' perceptions of interruptions as disturbing or non-disturbing: a qualitative study2016Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 27, s. 11-16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Emergency departments consist of multiple systems requiring interaction with one another while still being able to operate independently, creating frequent interruptions in the clinical workflow. Most research on interruptions in health care settings has focused on the relationship between interruptions and negative outcomes. However, there are indications that not all interruptions are negatively perceived by those being interrupted. Therefore, this study aimed to explore factors that influence when a clinician perceives interruptions as non-disturbing or disturbing in an emergency department context.

    METHOD: Explorative design based on interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. Data were analyzed using qualitative content analysis.

    RESULT: Factors influencing whether emergency department clinicians perceived interruptions as non-disturbing or disturbing were identified: clinician's constitution, external factors of influence and the nature of the interrupted task. The clinicians' perceptions were related to a complex of attributes inherent in these three factors at the time of the interruption. Thus, the same type of interruption could be perceived as either non-disturbing or disturbing contingent on the surrounding circumstances in which the event occurred.

    CONCLUSION: Emergency department clinicians' perceptions of interruptions as non-disturbing or disturbing were related to the character of identified influencing factors.

  • 15. Bjurbo, Camilla
    et al.
    Eriksson, Ulrika
    Källberg, Ann-Sofie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Muntlin Athlin, Åsa
    Early identification of frail older patients by using the FRESH-instrument in the emergency department: a pilot study2018Konferensbidrag (Refereegranskat)
  • 16. Bostrom, Anne-Marie
    et al.
    Rudman, Ann
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Jens Petter
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Nursing, Huddinge, Sweden.
    Factors associated with evidence-based practice among registered nurses in Sweden: a national cross-sectional study2013Ingår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, artikel-id 165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation.

    Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models.

    Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0).

    Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

  • 17. Boström, Anne-Marie
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Wallin, Lars
    Registered nurses' application of evidence based practice - A national survey2010Ingår i: The 2010 Knowledge Utilization Colloquium, Halifax, Kanada, 2010Konferensbidrag (Refereegranskat)
  • 18. Boström, Anne-Marie
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska Institutet.
    Registered nurses' application of evidence based practice: a national survey2009Ingår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 15, nr 6, s. 1159-1163Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work.

    Objectives. To examine the application of EBP in clinical practice by registered nurses (RNs) 2 years post graduation and to explore whether the application of EBP differed with regard to the clinical settings where RNs were working.

    Method. A cross-sectional design using a national sample. Data were collected in 2007 from 987 RNs (response rate 76%). Six items measuring respondents' self-reported extent of applying EBP were used.

    Results. Of the 987 RNs, 19% formulated questions and performed searches in data bases, 56% used other information sources, 31% appraised the literature, 30% participated in practice development and 34% participated in evaluating clinical practice. A greater proportion of the RNs working in elder care applied EBP compared with the RNs working in hospitals, psychiatric care and primary care.

    Conclusions. The RNs applied the components of EBP to a rather low extent 2 years post graduation despite EBP being an important objective in Swedish health care and educational programmes since the 1990s. These findings support other studies reporting the implementation of EBP in organizations as a complex and often slow process. The differences in the RNs extent of applying EBP in relation to their workplace indicate that contextual factors and the role of the RN in the organization are of importance for getting EBP into practice.

  • 19. Carlsson, E
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehnfors, M
    Long term experiences of living with eating difficulties after stroke2004Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, s. 825-834Artikel i tidskrift (Refereegranskat)
  • 20. Carlsson, E
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehnfors, M
    Long-term experiences of living with eating difficulties after stroke2004Ingår i: The Tenth Annual Qualitative Health Research Conference, Banff, Alberta, Canada, 2004Konferensbidrag (Övrigt vetenskapligt)
  • 21. Carlsson, Eva
    et al.
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Multidisciplinary recording and continuity of care for stroke patients with eating difficulties2010Ingår i: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 24, nr 3, s. 298-310Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Eating difficulties after stroke are common and can, in addition to being a risk for serious medical complications, impair functional capability, social life and self-image. Stroke unit care entails systematic multidisciplinary teamwork and continuity of care. The purpose of this study was to describe (i) multidisciplinary stroke care as represented in patient records for patients with eating difficulties, and (ii) the written information that was transferred from hospital to elderly care. Data from 59 patient records were analysed with descriptive statistics and by categorization of phrases. Signs of multidisciplinary collaboration to manage eating problems were scarce in the records. While two notes from physiotherapists were found, nurses contributed with 78% of all notes (n=358). Screening of swallowing and body weight was documented for most patients, whereas data on nutritional status and eating were largely lacking. The majority of notes represented patients' handling of food in the mouth, swallowing and lack of energy. Care plans were unstructured and few contained steps for managing eating. Discharge summaries held poor information on care related to eating difficulties. The language of all professionals was mostly unspecific. However, notes from speech-language therapists were comprehensive and entailed information on follow-up and patient participation.

  • 22. Carlsson, Eva
    et al.
    Ehnfors, Margareta
    Eldh, Ann Catrine
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet, Örebro university.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Accuracy and continuity in discharge information for patients wtih eating difficulties after stroke2012Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 2, s. 21-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims. To describe the accuracy and continuity of discharge information for patients with eating difficulties after stroke. Design. Prospective, descriptive. 

    Methods. The study investigated a sample of 15 triads, each including one patient with stroke along with his patient record and discharge summary and two nursing staff in the municipal care to whom the patient was discharged. Data were collected by observations of patients' eating, record audits and interviews with nurses. Data were analysed using content analysis and descriptive statistics. 

    Results. Accuracy of recorded information on patients' eating difficulties and informational continuity were poor, as was accuracy in the transferred information according to nursing staff's perceptions. All patients were at risk of undernutrition and in too poor a state to receive rehabilitation. Nevertheless, patients' eating difficulties were described in a vague and unspecific language in the patient records. Co-ordinated care planning and management continuity related to eating difficulties were largely lacking in the documentation. Despite their important role in caring for patients with eating difficulties, little information on eating difficulties seemed to reach licensed practical nurses in the municipalities. 

    Conclusions. Comprehensiveness in the documentation of eating difficulties and accuracy of transferred information were poor based on record audits and as perceived by the municipal nursing staff. Although all patients were at risk of undernutrition, had multiple eating difficulties and were in too poor a state for rehabilitation, explicit care plans for nutritional problems were lacking. Relevance to clinical practice. Lack of accuracy and continuity in discharge information on eating difficulties may increase risk of undernutrition and related complications for patients in continuous stroke care. Therefore, the discharge process must be based on comprehensive and accurate documentation.

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