du.sePublikasjoner
Endre søk
Begrens søket
1234 51 - 100 of 180
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 51.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Friberg, Febe
    Wallin, Lars
    Wijk, Helle
    Öhlén, Joakim
    Omvårdnadens grunder: En specialutgåva för sjuksköterskor2010Bok (Annet vitenskapelig)
  • 52.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Förberg, Ulrika
    Karolinska institutet.
    Unbeck, Maria
    Karolinska institutet.
    Johansson, Eva
    Karolinska institutet.
    Ygge, Britt-Marie
    Karolinska institutet.
    Petzold, Max
    Göteborgs universitet.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Electronic reminders as an implementation strategy for the uptake of clinical practice guidelines for peripheral venous catheters in pediatric care: A cluster randomized study2014Inngår i: Welcome to KU 14, The 14th annual Knowledge Utilization (KU), June 25-27 2014, at the Quality Spa and Resort Dalecarlia in Tällberg, Sweden., 2014Konferansepaper (Fagfellevurdert)
  • 53.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Boström, Anne-Marie
    Rudman, Ann
    New graduate nurses' developmental trajectories for capability beliefs concerning core competencies for healthcare professionals: A national cohort study on patient-centered care, teamwork and evidence-based practice.2016Inngår i: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 13, nr 6, s. 454-462Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    This study aimed to describe the developmental trajectories of registered nurses' capability beliefs during their first 3 years of practice. The focus was on three core competencies for health professionals-patient-centered care, teamwork, and evidence-based practice.

    Methods:

    A national cohort of registered nurses (n = 1,205) was recruited during their nursing education and subsequently surveyed yearly during the first 3 years of working life. The survey included 16 items on capability beliefs divided into three subscales for the assessment of patient-centered care, teamwork, and evidence-based practice, and the data were analyzed with linear latent growth modeling.

    Results:

    The nurses' capability beliefs for patient-centered care increased over the three first years of working life, their capability beliefs for evidence-based practice were stable over the 3 years, and their capability beliefs for teamwork showed a downward trend.

    Linking evidence to action:

    Through collaboration between nursing education and clinical practice, the transition to work life could be supported and competence development in newly graduated nurses could be enhanced to help them master the core competencies. Future research should focus on determining which factors impact the development of capability beliefs in new nurses and how these factors can be developed by testing interventions.

  • 54.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Häggblom, M
    Problem-based learning in clinical nursing education: Integrating theory and practice.2007Inngår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 7, s. 67-74Artikkel i tidsskrift (Fagfellevurdert)
  • 55.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Oredsson, Sven
    Anttila, Sten
    Dahlin Ivanoff, Synneve
    Davidsson, Thomas
    Ekdahl, Anne
    Eklund Grönberg, Annika
    Odeberg, Jenny
    Sahlin, Nils-Eric
    Sjöstrand, Fredrik
    Stavenow, Lars
    Wisten, Aase
    Wårdh, Inger
    Omhändertagande av äldre som inkommer akut till sjukhus - med fokus på sköra äldre: En systematisk litteraturöversikt2013Bok (Fagfellevurdert)
  • 56.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, LarsHögskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Omvårdnadens grunder: Ansvar och utveckling2014Collection/Antologi (Annet (populærvitenskap, debatt, mm))
  • 57.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Nyexaminerade sjuksköterskors användning av forskningsresultat och tillämpning av evidensbaserad vård2013Inngår i: Verksamhetsförlagd utbildning i högskolans vårdutbildningar – Att stödja lärande den 13-14 november 2013 i Skövde: Sammanfattningar av föredrag, 2013Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 58.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Wallin, LarsHögskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.Friberg, FebeEdberg, Anna-KarinWijk, HelleÖhlén, Joakim
    Omvårdnadens grunder: Ansvar och utveckling2009Bok (Annet vitenskapelig)
  • 59.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Karolinska institutet.
    Rudman, Ann
    Karolinska institutet.
    Boström, Anne-Marie
    Karolinska institutet.
    Registered nurses' application of the principles of evidnece-based practice the five years after graduation2014Konferansepaper (Fagfellevurdert)
  • 60. Ekdahl, Anne
    et al.
    Dahlin-Ivanoff, Synneve
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Oredsson, Sven
    Sjöstrand, Fredrik
    Stavenow, Lars
    Wisten, Aase
    Vård av sköra äldre patienter: evidensbaserad metod finns2014Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, nr 7Artikkel i tidsskrift (Annet vitenskapelig)
  • 61. Ekdahl, Anne
    et al.
    Sjöstrand, Fredrik
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Oredsson, Sven
    Stavenow, Lars
    Wisten, Aase
    Wårdh, Inger
    Dahlin-Ivanoff, Synneve
    Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting: a systematic review and meta-analysis2015Inngår i: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 6, nr 6, s. 523-540, artikkel-id 6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care. 

    Objective: To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings. 

    Data sources: CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015. 

    Study eligibility: Randomized controlled trials. Participants: Older adults aged >= 65 years who were admitted to hospital with a complex condition, divided into frail and moderately frail groups. 

    Intervention: CGA. 

    Control: Usual care. 

    Outcomes: Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality. 

    Study appraisal and synthesis: The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences. 

    Results: Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group. 

    Conclusion: There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited.

  • 62.
    Eldh, Ann Catrine
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Squires, J.A.
    Estabrooks, C.E.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Translating and testing the Alberta Context Tool for use among nurses in Swedish elder care2013Inngår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, artikkel-id 68Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. There is emerging evidence that context is important for successful transfer of research knowledge into health care practice. The Alberta Context Tool (ACT) is a Canadian developed research-based instrument that assesses 10 modifiable concepts of organizational context considered important for health care professionals’ use of evidence. Swedish and Canadian health care have similarities in terms of organisational and professional aspects, suggesting that the ACT could be used for measuring context in Sweden. This paper reports on the translation of the ACT to Swedish and a testing of preliminary aspects of its validity, acceptability and reliability in Swedish elder care.

    Methods. The ACT was translated into Swedish and back-translated into English before being pilot tested in ten elder care facilities for response processes validity, acceptability and reliability (Cronbach’s alpha). Subsequently, further modification was performed.

    Results. In the pilot test, the nurses found the questions easy to respond to (52%) and relevant (65%), yet the questions’ clarity were mainly considered ‘neither clear nor unclear’ (52%). Missing data varied between 0 (0%) and 19 (12%) per item, the most common being 1 missing case per item (15 items). Internal consistency (Cronbach’s Alpha > .70) was reached for 5 out of 8 contextual concepts. Translation and back translation identified 21 linguistic- and semantic related issues and 3 context related deviations, resolved by developers and translators.

    Conclusion. Modifying an instrument is a detailed process, requiring time and consideration of the linguistic and semantic aspects of the instrument, and understanding of the context where the instrument was developed and where it is to be applied. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation. This study suggests preliminary validity, reliability and acceptability evidence for the ACT when used with nurses in Swedish elder care.

  • 63. Farrohknia, Nasim
    et al.
    Castrén, Maaret
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Lind, Lars
    Oredsson, Sven
    Jonsson, Håkan
    Asplund, Kjell
    Göransson, Katarina
    Emergency department triage scales and their components: a systematic review of the scientific evidence2011Inngår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 19, nr 42Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed:

    1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED?

    2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)?

    3. How valid is each triage scale in predicting hospitalization and hospital mortality?

    A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted.

    We found ED triage scales to be supported, at best, by limited and often insufficient evidence.

    The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other scales. Two of the scales yielded limited scientific evidence, and one scale yielded insufficient evidence, on which to assess the risk of early death or hospitalization in patients assigned to the two lowest triage levels on a 5-level scale (validity).

  • 64.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Björvell, Catrin
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Comparison of the ability of VIPS and ICF to express nursing content in the health record2012Inngår i: 2012 11th International Congress on Nursing InformaticsJune 23 - June 27, Montreal, Canada: Proceedings, Montreal, Kanada, 2012, s. 529-Konferansepaper (Fagfellevurdert)
  • 65.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Björvell, Catrin
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Expressing nursing content: a comparison between VIPS and ICF2011Inngår i: 8th Biennial European Conference of the Association for European Nursing Diagnoses, Interventions and Outcomes., Funchal, Madeira, 2011Konferansepaper (Annet vitenskapelig)
  • 66.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Clinical decision making: predictors of patient participation in nursing care2008Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, nr 21, s. 2935-2944Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. To investigate predictors of patients' preferences for participation in clinical decision-making in inpatient nursing care. 

    Background. Patient participation in decision-making in nursing care is regarded as a prerequisite for good clinical practice regarding the person's autonomy and integrity. 

    Design. A cross-sectional survey of 428 persons, newly discharged from inpatient care. Methods. The survey was conducted using the Control Preference Scale. Multiple logistic regression analysis was used for testing the association of patient characteristics with preferences for participation. 

    Results. Patients, in general, preferred adopting a passive role. However, predictors for adopting an active participatory role were the patient's gender (odds ratio = 1.8), education (odds ratio = 2.2), living condition (odds ratio = 1.8) and occupational status (odds ratio = 2.0). A probability of 53% was estimated, which female senior citizens with at least a high school degree and who lived alone would prefer an active role in clinical decision-making. At the same time, a working cohabiting male with less than a high school degree had a probability of 8% for active participation in clinical decision-making in nursing care. 

    Conclusions. Patient preferences for participation differed considerably and are best elicited by assessment of the individual patient. Relevance to clinical practice. The nurses have a professional responsibility to act in such a way that patients can participate and make decisions according to their own values from an informed position. Access to knowledge of patients' basic assumptions and preferences for participation is of great value for nurses in the care process. There is a need for nurses to use structured methods and tools for eliciting individual patient preferences regarding participation in clinical decision-making.

  • 67.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Patient participation in clinical decision making in nursing: a comparative study of nurses and patients’ perceptions2006Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, nr 12, s. 1498-1508Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives. The aim of this study was to compare the degree of concordance between patients and Registered Nurses' perceptions of the patients' preferences for participation in clinical decision-making in nursing care. A further aim was to compare patients' experienced participation with their preferred participatory role. 

    Background. Patient participation in clinical decision-making is valuable and has an effect on quality of care. However, there is limited knowledge about patient preferences for participation and how nurses perceive their patients' preferences. 

    Methods. A comparative design was adopted with a convenient sample of 80 nurse-patient dyads. A modified version of the Control Preference Scale was used in conjunction with a questionnaire developed to elicit the experienced participation of the patient. 

    Results. A majority of the Registered Nurses perceived that their patients preferred a higher degree of participation in decision-making than did the patients. Differences in patient preferences were found in relation to age and social status but not to gender. Patients often experienced having a different role than what was initially preferred, e.g. a more passive role concerning needs related to communication, breathing and pain and a more active role related to activity and emotions/roles. 

    Conclusions. Registered Nurses are not always aware of their patients' perspective and tend to overestimate patients' willingness to assume an active role. Registered Nurses do not successfully involve patients in clinical decision-making in nursing care according to their own perceptions and not even to the patients' more moderate preferences of participation. 

    Relevance to clinical practice. A thorough assessment of the individual's preferences for participation in decision-making seems to be the most appropriate approach to ascertain patient's involvement to the preferred level of participation. The categorization of patients as preferring a passive role, collaborative role or active role is seen as valuable information for Registered Nurses to tailor nursing care.

  • 68.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Patients' and nurses' perceptions of nursing problems in an acute care setting2005Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 51, nr 2, s. 140-149Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. This paper reports a study to determine the degree of agreement or disagreement between nurses and patients in their perceptions of the presence, severity, and importance of nursing problems. 

    Background. Patient experiences, values and preferences are increasingly acknowledged as important factors underpinning healthcare decision-making. The ability to identify patient problems accurately is an important prerequisite for planning and implementing individualized high quality care. 

    Methods. A convenience sample of patients (n = 80) and Registered Nurses (n = 30) in an acute care setting responded to a 43-item questionnaire. 

    Findings. Nurses identified patients' problems with a sensitivity of 0.53 and a positive predictive value of 0.50. Patients identified several severe problems that were not identified by nurses, particularly problems with nutrition, sleep, pain, and emotions/spirituality. Nurses underestimated the severity in 47% of mutually-identified problems. An overall level of agreement of 44% was found on the importance of patient problems. Low levels of agreement on severity and importance were related more to individual differences than to systematic differences. 

    Conclusions. Nurses need to be more aware that patients and nurses often hold disparate views of the priorities in nursing care. To plan individualized nursing care effectively, nurses need to elicit and use individual patients' preferences more systematically in care planning.

  • 69.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Angsmo, Ewa
    Midböe, Lars
    Björvell, Catrin
    Nilsson, Gunilla
    Ehnfors, Margareta
    Fogelberg Dahm, Marie
    Wärn Hede, Gunnel
    Östlinder, Gerthrud
    IKT SOM STÖD FÖR GOD OMVÅRDNAD2007Inngår i: Skandinaviska Hälsoinformatik och termkonferensen, Kalmar, 2007Konferansepaper (Annet vitenskapelig)
  • 70.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehnfors, M.
    Partient participation in decision making in nursing.2006Inngår i: Studies in health technology and informatics, 2006, Vol. 122, s. 54-57Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Patient participation in decision making concerning nursing needs is an important aspect of high quality care, of interest for both planning and implementing care. However, patients' perspective on participation in clinical decision making has not been studied extensively and the literature is inconclusive of what roles patients prefer to adopt. The aim was to investigate associations between patient demographics and preferences for participation in clinical decision making and to compare patients and RNs perceptions of the patients' preferences for participation. A cross sectional study including 80 nurse-patient dyads was adopted. The Control Preference scale was used to collect data. The findings showed that younger and more educated patients preferred to be more active in some aspects of decision making than older and less educated patients did. Further, in comparison with RNs inference of patient preferences for participation, patients preferred to be more passive in decision making in relation to nursing needs in general, as well as for physical and psychosocial needs. Differences in perceptions between patients and RNs concerning patient participation could hamper high quality care and need to be addressed.

  • 71.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehnfors, M.
    Patient participation in decision-making in nursing2006Inngår i: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, nr 122, s. 54-57Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Patient participation in decision making concerning nursing needs is an important aspect of high quality care, of interest for both planning and implementing care. However, patients' perspective on participation in clinical decision making has not been studied extensively and the literature is inconclusive of what roles patients prefer to adopt. The aim was to investigate associations between patient demographics and preferences for participation in clinical decision making and to compare patients and RNs perceptions of the patients' preferences for participation. A cross sectional study including 80 nurse-patient dyads was adopted. The Control Preference scale was used to collect data. The findings showed that younger and more educated patients preferred to be more active in some aspects of decision making than older and less educated patients did. Further, in comparison with RNs inference of patient preferences for participation, patients preferred to be more passive in decision making in relation to nursing needs in general, as well as for physical and psychosocial needs. Differences in perceptions between patients and RNs concerning patient participation could hamper high quality care and need to be addressed.

  • 72.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehnfors, M
    Quality of nursing diagnoses: evaluation of an educational intervention2005Inngår i: International Journal of Nursing Terminology and Classification, ISSN  2047-3095, Vol. 16, nr 2, s. 33-43Artikkel i tidsskrift (Fagfellevurdert)
  • 73.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehnfors, M
    Wennemyr, T.A
    A computerized decision-support system for nursing care planning based on standardized terminology and scientific knowledge2003Inngår i: Proceedings 8th International Congress in Nursing Informatics 2003, 2003Konferansepaper (Fagfellevurdert)
  • 74.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehnfors, Margareta
    Univ Orebro, Sch Hlth & Med Sci, S-71082 Orebro, Sweden.
    Björvell, Catrin
    Karolinska Univ Hosp, S-17176 Stockholm, Sweden; Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A comparison between the VIPS model and the ICF for expressing nursing content in the health care record2013Inngår i: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 82, nr 2, s. 108-117Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Multi-professional standardized terminologies are needed that cover common as well as profession-specific care content in order to obtain a full coverage and description of the contributions from different health professionals' perspectives in health care. Implementation of terminologies in clinical practice that do not cover professionals' needs for communication might jeopardize the quality of care. PURPOSE: The aim of the study was to compare the structure and content of the Swedish VIPS model for nursing documentation and the international classification of function, disability and health (ICF). METHOD: Mapping was performed between key words and prototypical examples for patient status in the VIPS model and terms in the ICF and its framework of domains, chapters and specific terms. The study had two phases. In the first phase 13 key words for patient status in the VIPS model and the 289 terms (prototypical examples) describing related content were mapped to comparable terms in the ICF. In phase two, 1424 terms on levels 2-4 in the ICF were mapped to the key words for patient status in the VIPS model. RESULTS: Differences in classification structures and content were found, with a more elaborated level of detail displayed in the ICF than in the VIPS model. A majority of terms could be mapped, but several essential nursing care concepts and perspectives identified in the VIPS model were missing in the ICF. Two-thirds of the content in the ICF could be mapped to the VIPS' key words for patient status; however, the remaining terms in the ICF, describing body structure and environmental factors, are not part of the VIPS model. CONCLUSION: Despite that a majority of the nursing content in the VIPS model could be expressed by terms in the ICF, the ICF needs to be developed and expanded to be functional for nursing practice. The results have international relevance for global efforts to implement unifying multi-professional terminologies. In addition, our results underline the need for sufficient coverage and level of detail to support different professional perspectives in health care terminologies.

  • 75.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska Univ Hosp, Stockholm, Sweden; Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Gustavsson, Petter
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden.
    Educational support for research utilization and capability beliefs of evidence-based practice skills: a national survey of senior nursing students2012Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, nr 4, s. 888-897Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim of the study was to investigate Swedish university nursing students’ experience of educational support for research utilization and capability beliefs regarding evidence-based practice skills.

    Background. Nursing programmes are offered at 26 universities in Sweden and even though there are common regulations for nursing education at the national level, substantial variations are found in local curricula. Little is known about students’ capability beliefs regarding evidence-based practice skills, particularly in comparison across universities.

    Methods. A cross-sectional survey design using self-administered postal questionnaires was conducted in 2006. A total of 1440 students (from 26 different universities) participated, constituting 68% of the national population of nursing students in their 6th and final semester.

    Results. Campus education supported the students to a greater extent than clinical education in following the development of knowledge in an area of interest, using research findings, and acquiring knowledge on how to pursue changes in clinical practice. Perceived support during campus education varied between universities. Students reported high capability beliefs regarding evidence-based practice skills, but large differences were found between universities for: stating a searchable question, seeking out relevant knowledge and critically appraising and compiling best knowledge.

    Conclusion. The identified differences between universities concerning the students’ perceived support for research utilization and their capability beliefs regarding evidence-based practice skills have implications for curricula, pedagogical perspectives in nursing education and the potential to implement evidence-based practice in healthcare settings. Further studies are warranted to investigate students’ individual characteristics and organizational characteristics as determinants of research utilization support and capability beliefs regarding evidence-based practice skills.

  • 76.
    Florin, Jan
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Jansson, Inger
    Strandberg, Elisabeth
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Björvell, Catrin
    Cross-mapping diagnostic nursing concepts between the ICNP and the ICF for expressing nursing in the health care record2016Inngår i: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 225, s. 1016-1017Artikkel i tidsskrift (Fagfellevurdert)
  • 77. Forberg, Ulrika
    et al.
    Johansson, Eva
    Ygge, Britt-Marie
    Wallin, Lars
    Karolinska Institutet.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Accuracy in documentation of peripheral venous catheters in paediatric care: an intervention study in electronic patient records2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 9-10, s. 1339-1344Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims. The aim of this study is to compare the accuracy and completeness in the recording of peripheral venous catheters before and after implementing a template in the electronic patient record in paediatric care.

    Background. As a basis for quality improvement and research purposes and to ensure patient safety, accurate clinical data need to be easily accessible in patient records. Several studies have concluded that the relation between performed care and what is documented in patient records is poor.

    Design. Before and after study.

    Method. The study took place at a large paediatric university hospital in Sweden. Inclusion criteria were patients who were admitted to one of the included wards, had one or several peripheral venous catheters and were available at the ward at the time for data collection. Data were collected by observations and record audits before and then four and 10 months after the introduction of a template for recording peripheral venous catheters in a structured and standardised way.

    Results. A significant increase in peripheral venous catheters with complete recording was observed after as compared with before the intervention. The percentage of peripheral venous catheters with recording of any kind was relatively stable (85-93%). The overall recording of peripheral venous catheters insertion did not improve, but there was an increase in the recording of side and size after the intervention. One of the 22 complications observed before the intervention was documented and none of the complications (n = 17 and n = 9) after.

    Conclusion. The electronic patient record did not provide accurate data on peripheral venous catheters in paediatric care neither before nor after the intervention. Relevance to clinical practice. Further efforts to increase the documentation of catheter-related complications are needed. Integrated decision support systems in electronic patient records that remind nurses to inspect peripheral venous catheters regularly could be one solution.

  • 78.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Rudman, Ann
    Wallin, Lars
    Newly graduated nurses’ research use in clinical practice – a pattern-oriented approach2008Inngår i: Knowledge Translation 2008: Forum for the Future, Banff, Kanada, 2008Konferansepaper (Fagfellevurdert)
  • 79.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Rudman, Ann
    Gustavsson, Petter
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Low research use among newly graduated nurses: a threat to patient safety?2011Inngår i: Medicinska Riksstämman 2011, Stockholm, 2011Konferansepaper (Annet vitenskapelig)
    Abstract [sv]

    Background: The application of research-based knowledge in clinical practice has the potential to improve quality of care, effectiveness and safety. However, the gap between research and practice is well-known and has been addressed globally. Among the educational goals of nursing education are abilities of critical reflection and implementation of new knowledge into practice. Knowledge about the extent of newly graduated nurses’ research use (RU) in clinical practice and factors that can hinder or facilitate their RU is however scarce. Aim: The overall aim of the thesis presented here was to study nurses’ self-reported RU the first three years postgraduation, change in RU over time and associated factors. Further, the aim was to study nursing students’ RU intentions and whether intention and educational factors could predict RU behavior. Methods: Data derive from the LANE study, a national and longitudinal survey study comprising three cohorts of nursing students, subsequently nurses, graduating in 2002, 2004 and 2006. Outcome measures were instrumental, conceptual and persuasive RU (IRU, CRU and PRU) at one, two and three years postgraduation (Y1, Y2, Y3), as well as IRU intention in last term of undergraduate studies. Results: At all time points, IRU was reported as most prevalent, followed by CRU and finally PRU. About one third of the respondents reported IRU on half or more than half of the working shifts. Seven different RU profiles across the three kinds of RU were identifed. The two clusters representing overall low RU were predominating, representing about half or more of the samples. Low users tended to become even lower over time between Y1 and Y2. A number of individual, organizational and educational factors were found as significantly related to overall low RU at Y2. IRU intention in last term of undergraduate studies showed that 34% of the sample intended to use research to a larger extent and IRU intention predicted IRU behavior at Y1. In addition, intention acted as a mediating factor for the effects from a number of other educational factors on IRU behavior. Implications: The results constitute unique knowledge. Considering today’s demand for evidence-based nursing practice, the relatively low extent of RU is worrying and may impact patient safety. Multiple factors were associated with the extent of RU the first years postgraduation and results have implications both for undergraduate nursing education and the healthcare organization.

  • 80. Forsman, Henrietta
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Research use in nursing practice and its association to educational, individual and work contextual factors2007Inngår i: 7th Conference on Advances in health Care Science Research, Stockholm, 2007Konferansepaper (Fagfellevurdert)
  • 81. Forsman, Henrietta
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Research use in nursing practice in relation to educational, individual and work contextual factors.2007Inngår i: Knowledge Utilization Colloquium, Stockholm, 2007Konferansepaper (Fagfellevurdert)
  • 82.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Rudman, Ann
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Research use in clinical practice: extent and patterns among nurses one and three years postgraduation2009Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, nr 6, s. 1195-1206Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim.  This paper is a report of a study of nurses’ research use in clinical practice one and three years postgraduation in Sweden.

    Background.  Internationally, learning to critically appraise and use research is an educational objective within nursing training, with the aim of promoting research use in nursing practice. The extent to which these skills is acquired and used among relatively newly graduated nurses is largely unexplored, however.

    Method.  A descriptive study was conducted in 2006 using a national longitudinal survey of two nursing cohorts one (n = 1,365) and three (n = 933) years postgraduation. The self-reported extent of instrumental, conceptual and persuasive research use was measured. Data were analysed using both variable- and pattern-oriented approaches based on cluster analysis.

    Results.  Research use was reported to occur in about half or fewer of the working shifts. In both samples, seven clusters of nurses with different research use profiles were identified. Clusters representing overall low and very low users in all three types of research use were predominant both at one (45·6%) and three (51·6%) years postgraduation, whereas clusters of nurses reporting overall high research use were uncommon. The proportion of very low users was larger 3 years after graduation than 1 year after graduation.

    Conclusions.  The low extent of reported research use, raises the question of whether scientific perspectives included in nursing education are translated into clinical application. The pattern-oriented approach illustrates the complexity of research use and identification of typical research use profiles in specific contexts may have potential to guide interventions aimed at supporting evidence-based practice.

  • 83.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gustavsson, Petter
    Rudman, Ann
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    A longitudinal study of nurses' research use the first two years post-graduation.2009Inngår i: The 2009 Knowledge Utilization Colloqium, Wales, 2009Konferansepaper (Fagfellevurdert)
  • 84. Forsman, Henrietta
    et al.
    Gustavsson, Petter
    Rudman, Ann
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    The complexity of research use – extent and patterns among nurses one and three years post-graduation2008Inngår i: 9th European Doctoral Conference in Nursing Science, Maastricht, The Netherlands, 2008Konferansepaper (Fagfellevurdert)
  • 85.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Rudman, Ann
    Gustavsson, Petter
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Nurses' research utilization two years after graduation: a national survey ofassociated individual, organizational, and educational factors2012Inngår i: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 7, artikkel-id 46Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. Nurses' research utilization (RU) as part of evidence-based practice is strongly emphasized in today's nursing education and clinical practice. The primary aim of RU is to provide high-quality nursing care to patients. Data on newly graduated nurses' RU are scarce, but a predominance of low use has been reported in recent studies. Factors associated with nurses' RU have previously been identified among individual and organizational/contextual factors, but there is a lack of knowledge about how these factors, including educational ones, interact with each other and with RU, particularly in nurses during the first years after graduation. The purpose of this study was therefore to identify factors that predict the probability for low RU among registered nurses two years after graduation.

    Methods. Data were collected as part of the LANE study (Longitudinal Analysis of Nursing Education), a Swedish national survey of nursing students and registered nurses. Data on nurses' instrumental, conceptual, and persuasive RU were collected two years after graduation (2007, n = 845), together with data on work contextual factors. Data on individual and educational factors were collected in the first year (2002) and last term of education (2004). Guided by an analytic schedule, bivariate analyses, followed by logistic regression modeling, were applied.

    Results. Of the variables associated with RU in the bivariate analyses, six were found to be significantly related to low RU in the final logistic regression model: work in the psychiatric setting, role ambiguity, sufficient staffing, low work challenge, being male, and low student activity.

    Conclusions. A number of factors associated with nurses' low extent of RU two years postgraduation were found, most of them potentially modifiable. These findings illustrate the multitude of factors related to low RU extent and take their interrelationships into account. This knowledge might serve as useful input in planning future studies aiming to improve nurses', specifically newly graduated nurses', RU.

  • 86.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Rudman, Ann
    Gustavsson, Petter
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Nurses’ use of research findings in clinical practice - a prospective study of the first two years post-graduation2009Inngår i: Conference on Advances in Health Care Science Research, Stockholm, 2009Konferansepaper (Annet vitenskapelig)
  • 87.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Rudman, Ann
    Gustavsson, Petter
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Use of research by nurses during their first two years after graduating2010Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 66, nr 4, s. 878-890Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. This paper reports on a study of research use among nurses two years after graduation, as well as changes over time in research use in relation to changes in working conditions. 

    Background. The demand for evidence-based practice is widely expressed, and newly graduated nurses should possess the skills to provide high-quality care based on the best knowledge available. The way in which nurses use research during the first few years after graduating is, however, largely unknown. 

    Method. As part of a national longitudinal survey, nurses reported their extent of instrumental, conceptual and persuasive research use in 2006 (n = 1365) and 2007 (n = 1256). Data were analysed cross-sectionally and prospectively, using variable- and pattern-oriented methods. 

    Results. Instrumental research was reported most frequently, on about half of the working shifts. Seven profiles of research use were found, showing structural stability over time when compared with results from year 1. Most typically, nurses maintained the same profile over time; moreover, low users tended to become even lower users. Two years after graduation, 54 center dot 9% reported overall low use. Changes in working conditions did not explain the decrease in research use. 

    Conclusion. The results support previous claims of a gap between research and clinical practice. The predominance of overall low users is alarming and requires further research, including investigation of individual and organizational factors, to study their impact on nurses' research use.

  • 88. Fossum, M.
    et al.
    Terjesen, S.
    Ødegaard, M.
    Sneltvedt, U.
    Andreassen, L.
    Ehnfors, M.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Clinical decision support systems to prevent and treat pressure ulcers and under-nutrition in nursing homes2009Inngår i: Studies in Health Technology and Informatics, 2009, s. 877-878Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Clinical decision support systems (CDSSs) are believed to have the potential to improve care and change the behavior of health personnel. The project has focused on developing a CDSS to support prevention of pressure ulcer and undernutrition that is completely integrated in the electronic health record in nursing homes. Nursing staff have been involved in all phases in the development of the CDSS, which at present is ready to be implemented and systematically evaluated. © 2009 The authors and IOS Press. All rights reserved.

  • 89. Fossum, Mariann
    et al.
    Alexander, Greg
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Effects of a computerized decision support system on the prevalence of pressure ulcers and malnutrition in nursing homes2011Inngår i: 8th Biennial European Conference of the Association for European Nursing Diagnoses, Interventions and Outcomes., Funchal, Madeira, 2011Konferansepaper (Annet vitenskapelig)
  • 90. Fossum, Mariann
    et al.
    Alexander, Greg L
    Göransson, Katarina
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Registered nurses’ thinking strategies about malnutrition and pressure ulcer in nursing homes: a scenario-based think aloud study2011Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, nr 17-18, s. 2425-2435Artikkel i tidsskrift (Fagfellevurdert)
  • 91. Fossum, Mariann
    et al.
    Alexander, Gregory
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly2011Inngår i: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 80, nr 9, s. 607-617Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Computerized decision support systems (CDSSs) have been shown to help health care professionals to avoid errors and improve clinical practice and efficiency in health care. Little is known about its influence on nursing practice and outcomes for residents in nursing homes.

    Aim: The aim of this study was to evaluate the effects on the risk for and prevalence of pressure ulcers (PUs) and malnutrition of implementing a CDSS to improve prevention and care of PUs and also to improve nutrition in the elderly in nursing homes.

    Design setting and participants: The study used a quasi-experimental design with two intervention groups and one control group. A convenience sample of residents from 46 units in 15 nursing homes in rural areas in Norway was included. A total of 491 residents participated at baseline in 2007 and 480 residents at follow-up in 2009.

    Methods: The intervention included educational sessions in prevention of PUs and malnutrition for registered nurses (RNs) and nursing aides (NAs) in the two intervention groups. In addition, one intervention group (intervention group 1) had a CDSS integrated into the electronic healthcare record (EHR) based on two research-based risk assessment instruments: the Risk Assessment Pressure Scale (RAPS) for PU risk screening and the Mini Nutritional Assessment (MNA®) scale for screening nutritional status. In each participating nursing home trained RNs and NAs examined all residents who consented to participate on the RAPS and the MNA® scale. This examination included a skin assessment and details about PUs were collected.

    Results: The proportion of malnourished residents decreased significantly in intervention group 1 between the two data collection periods (2007 and 2009). No other significant effects of the CDSS on resident outcomes based on the RAPS and MNA® scores were found.

    Conclusion: CDSSs used by RNs and NAs in nursing homes are still largely unexplored. A CDSS can be incorporated into the EHR to increase the meaningful use of these computerized systems in nursing home care. The effects of CDSS on healthcare provider workflow, clinical decision making and communication about preventive measures in nursing home practice still need further exploration. Based on results from our study, recommendations would be to increase both sample size and the number of RNs and NAs who participate in CDSS education programs. Highlights In this study we evaluate the effects on the risk for and prevalence of pressure ulcers and malnutrition of implementing a computerized decision support system. The proportion of malnourished residents in the intervention group decreased significantly. There was no significant change in prevalence of pressure ulcers, Risk Assessment Pressure Scale score and prevalence of malnourished residents and the Mini Nutritional Assessment® score after implementing a computerized decision support system. How computerized decision support system can be used and incorporated in the workflow in clinical practice needs to be further explored.

  • 92. Fossum, Mariann
    et al.
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Computer- based Clinical Decision Support Systems in Nursing Homes2008Inngår i: 9th European Doctoral Conference in Nursing Science, Maastricht, The Netherlands, 2008Konferansepaper (Fagfellevurdert)
  • 93. Fossum, Mariann
    et al.
    Ehnfors, Margareta
    Fruhling, Ann
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    An evaluation of the usability of a computerized decision support system for nursing homes2011Inngår i: Applied Clinical Informatics, ISSN 1869-0327, Vol. 2, s. 420-436Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Computerized decision support systems (CDSSs) have the potential to significantly improve the quality of nursing care of older people by enhancing the decision making of nursing personnel. Despite this potential, health care organizations have been slow to incorporate CDSSs into nursing home practices. Objective: This study describes facilitators and barriers that impact the ability of nursing personnel to effectively use a clinical CDSS for planning and treating pressure ulcers (PUs) and malnutrition and for following the suggested risk assessment guidelines for the care of nursing home residents. Methods: We employed a qualitative descriptive design using varied methods, including structured group interviews, cognitive walkthrough observations and a graphical user interface (GUI) usability evaluation. Group interviews were conducted with 25 nursing personnel from four nursing homes in southern Norway. Five nursing personnel participated in cognitive walkthrough observations and the GUI usability evaluation. Text transcripts were analyzed using qualitative content analysis. Results: Group interview participants reported that ease of use, usefulness and a supportive work environment were key facilitators of CDSS use. The barriers identified were lack of training, resistance to using computers and limited integration of the CDSS with the facility's electronic health record (EHR) system. Key findings from the usability evaluation also identified the difficulty of using the CDSS within the EHR and the poorly designed GUI integration as barriers. Conclusion: Overall, we found disconnect between two types of nursing personnel. Those who were comfortable with computer technology reported positive feedback about the CDSS, while others expressed resistance to using the CDSS for various reasons. This study revealed that organizations must invest more resources in educating nursing personnel on the seriousness of PUs and poor nutrition in the elderly, providing specialized CDSS training and ensuring that nursing personnel have time in the workday to use the CDSS.

  • 94. Fossum, Mariann
    et al.
    Ehnfors, Margareta
    Fruhling, Ann
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Implementing research-based clinical guidelines integrated in a computerized decision support system in elderly care facilities2012Konferansepaper (Fagfellevurdert)
  • 95. Fossum, Mariann
    et al.
    Ehnfors, Margareta
    Fruhling, Ann
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    The experience of using a computerized decision support system2012Inngår i: 2012 11th International Congress on Nursing InformaticsJune 23 - June 27, 2012, Montreal, Canada: Proceedings, Montreal, Kanada, 2012Konferansepaper (Fagfellevurdert)
  • 96. Fossum, Mariann
    et al.
    Terjesen, Solveig
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehnfors, Margareta
    Söderhamn, Olle
    Evaluation of the Norwegian version of the Mini Nutritional assessment (MNA®) among older nursing home patients2009Inngår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, nr 2, s. 50-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The Mini Nutritional Assessment (MNA®) is a well-known clinical scale that is often used for nutritional screening of older people in different settings recommended by several international clinical and scientific organizations. Aims: The aims of this article were: 1) to translate the MNA® from English to Norwegian and 2) to test the Norwegian version of the instrument for reliability and validity in a small sample of older nursing home patients. Methods: The English version of the MNA® was translated according to recommended procedures. A convenience sample of 26 older nursing home patients was screened with the MNA® by 10 registered nurses. Reliability and validity of the instrument were assessed. Results: Support for reliability and validity was shown in the study group. Conclusion: Positive support for sufficient quality of the Norwegian version of the MNA® was shown, but further testing of the instrument is needed.

  • 97.
    Fossum, Marianne
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden b Center for Caring Research – Southern Norway ; Department of Health and Nursing Science, Faculty of Health and Sport .
    Ehnfors, Margareta
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Svensson, Elisabeth
    Swedish Business School, Örebro University, Örebro, Sweden.
    Hansen, Linda M.
    Center for Caring Research – Southern Norway, Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: An intervention study2013Inngår i: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 82, nr 10, s. 911-921Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. Nursing documentation is essential for facilitating the flow of information to guarantee continuity, quality and safety in care. High-quality nursing documentation is frequently lacking; the implementation of computerized decision support systems is expected to improve clinical practice and nursing documentation.

    Aim. The present study aimed at investigate the effects of a computerized decision support system and an educational program as intervention strategies for improved nursing documentation practice on pressure ulcers and malnutrition in nursing homes.

    Design, setting and participants. An intervention study with two intervention groups and one control group was used. Fifteen nursing homes in southern Norway were included. A convenience sample of electronic healthcare records from 46 units was included. Inclusion criteria were records with presence of pressure ulcers and/or malnutrition. The residents were assessed before and after an intervention of a computerized decision support system in the electronic healthcare records. Data were collected through a review of 150 records before (2007) and 141 records after the intervention (2009).

    Methods. The nurses in intervention group 1 were offered educational sessions and were trained to use the computerized decision support system, which they used for eight months in 2008 and 2009. The nurses in intervention group 2 were offered the same educational program but did not use the computerized decision support system. The nurses in the control group were not subject to any intervention. The resident records were examined for the completeness and comprehensiveness of the documentation of pressure ulcers and malnutrition with three data collection forms and the data were analyzed with non-parametric statistics.

    Results. The implementation of the computerized decision support system and the educational program resulted in a more complete and comprehensive documentation of pressure ulcer- and malnutrition-related nursing assessments and nursing interventions.

    Conclusion. This study provides evidence that the computerized decision support system and an educational program as implementation strategies had a positive influence on nursing documentation practice.

  • 98. Frivoll Johnsen, Kersti
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Fossum, Mariann
    Universitetet i Agder, Kristansand, Norge.
    Dokumentasjon av sykepleie i sykehjem: nn vurdering av innhold og kvalitet på sykepleiedokumentasjonen og vurdering av reliabiliteten til instrumentet N-Catch2014Inngår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 34, nr 2, s. 27-32Artikkel i tidsskrift (Fagfellevurdert)
  • 99.
    Förberg, Ulrika
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Johansson, Eva
    Ygge, Britt-Marie
    Wallin, Lars
    Karolinska Institutet.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Accuracy in documentation of pheripheral venous catheters in paediatric care: An intervention study in electronic patient records2011Konferansepaper (Annet vitenskapelig)
  • 100.
    Förberg, Ulrika
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Unbeck, Maria
    Karolinska institutet.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Johansson, Eva
    Petzold, Max
    Ygge, Britt-Marie
    Karolinska institutet.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Effects of computer reminders on complications of peripheral venous catheters and nurses' adherence to a guideline in paediatric care: a cluster randomised study2016Inngår i: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 11, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Reminder systems in electronic patient records (EPR) have proven to affect both health care professionals' behaviour and patient outcomes. The aim of this cluster randomised trial was to investigate the effects of implementing a clinical practice guideline (CPG) for peripheral venous catheters (PVCs) in paediatric care in the format of reminders integrated in the EPRs, on PVC-related complications, and on registered nurses' (RNs') self-reported adherence to the guideline. An additional aim was to study the relationship between contextual factors and the outcomes of the intervention.

    METHODS: The study involved 12 inpatient units at a paediatric university hospital. The reminders included choice of PVC, hygiene, maintenance, and daily inspection of PVC site. Primary outcome was documented signs and symptoms of PVC-related complications at removal, retrieved from the EPR. Secondary outcome was RNs' adherence to a PVC guideline, collected through a questionnaire that also included RNs' perceived work context, as measured by the Alberta Context Tool. Units were allocated into two strata, based on occurrence of PVCs. A blinded simple draw of lots from each stratum randomised six units to the control and intervention groups, respectively. Units were not blinded. The intervention group included 626 PVCs at baseline and 618 post-intervention and the control group 724 PVCs at baseline and 674 post-intervention. RNs included at baseline were 212 (65.4 %) and 208 (71.5 %) post-intervention.

    RESULTS: No significant effect was found for the computer reminders on PVC-related complications nor on RNs' adherence to the guideline recommendations. The complication rate at baseline and post-intervention was 40.6 % (95 % confidence interval (CI) 36.7-44.5) and 41.9 % (95 % CI 38.0-45.8), for the intervention group and 40.3 % (95 % CI 36.8-44.0) and 46.9 % (95 % CI 43.1-50.7) for the control. In general, RNs' self-rated work context varied from moderately low to moderately high, indicating that conditions for a successful implementation to occur were less optimal.

    CONCLUSIONS: The reminders might have benefitted from being accompanied by a tailored intervention that targeted specific barriers, such as the low frequency of recorded reasons for removal, the low adherence to daily inspection of PVC sites, and the lack of regular feedback to the RNs.

    TRIAL REGISTRATION: Current Controlled Trials ISRCTN44819426.

1234 51 - 100 of 180
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf