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Duhalde, H., Bjuresäter, K., Karlsson, I. & Bååth, C. (2023). Missed nursing care in emergency departments: A scoping review. International Emergency Nursing, 69, Article ID 101296.
Open this publication in new window or tab >>Missed nursing care in emergency departments: A scoping review
2023 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 69, article id 101296Article, review/survey (Refereed) Published
Abstract [en]

Background: Patient safety is a global health priority. Errors of omission, such as missed nursing care in hospitals, are frequent and may lead to adverse events. Emergency departments (ED) are especially vulnerable to patient safety errors, and the significance missed nursing care has in this context is not as well known as in other contexts. Aim: The aim of this scoping review was to summarize and disseminate research about missed nursing care in the context of EDs. Method: A scoping review following the framework suggested by Arksey and O’Malley was used to (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; (5) collate, summarize, and report the results; and (6) consultation. Results: In total, 20 themes were derived from the 55 included studies. Missed or delayed assessments or other fundamental care were examples of missed nursing care characteristics. EDs not staffed or dimensioned in relation to the patient load were identified as a cause of missed nursing care in most included studies. Clinical deteriorations and medication errors were described in the included studies in relation to patient safety and quality of care deficiencies. Registered nurses also expressed that missed nursing care was undignified and unsafe. Conclusion: The findings from this scoping review indicate that patients’ fundamental needs are not met in the ED, mainly because of the patient load and how the ED is designed. According to registered nurses, missed nursing care is perceived as undignified and unsafe.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
adult, consultation, deterioration, drug safety, emergency care, emergency ward, health care quality, human, medication error, nurse, nursing care, patient safety, registered nurse, review
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-96064 (URN)10.1016/j.ienj.2023.101296 (DOI)001032532300001 ()37352646 (PubMedID)2-s2.0-85162862487 (Scopus ID)
Available from: 2023-07-07 Created: 2023-07-07 Last updated: 2023-08-10Bibliographically approved
Lillsjö, E., Bjuresäter, K. & Josefsson, K. (2023). Registered nurses’ challenges and suggestions for improvement of their leadership close to older adults in municipal home healthcare. BMC Nursing, 22(1), Article ID 80.
Open this publication in new window or tab >>Registered nurses’ challenges and suggestions for improvement of their leadership close to older adults in municipal home healthcare
2023 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 22, no 1, article id 80Article in journal (Refereed) Published
Abstract [en]

Background: Worldwide people are living longer. The need for healthcare for older adults is increasing. The trend is towards advanced home healthcare, where registered nurses are key figures. This implies challenges for municipal home healthcare, as well as for registered nurses’ leadership. The aim is to explore registered nurses’ perceptions of challenges and suggestions for improvements in their leadership close to older adults in municipal home healthcare. Methods: The present study is part of a larger web-based questionnaire survey with a cross-sectional design. The design is inductive, analysing data using qualitative content analysis and descriptive statistics. A questionnaire with open-ended and closed-ended questions was used. A total of n = 70 registered nurses leading close to older adults participated in seven municipalities in two geographic areas in Sweden. Results: The results show registered nurses’ perceptions of challenges as leaders close to older adults in terms of 11 categories. The categories are motivating for care, adjusting and coordinating nursing care to the older adult, relating to next of kin, managing communication difficulties, relating to social situations in the home, managing demands, working alone, having lack of time, collaborating with physicians, and care staff having low competence. The registered nurses suggested improvements for their leadership close to older adults in terms of nine categories. The categories are adjusting the work to the older adult, clarifying registered nurses’ responsibility, balancing demands and resources, setting time aside, improving staffs’ competence, ensuring staff’s competence development, improving the work environment, and cooperation between professions in the municipality, as well as between healthcare organizations. Conclusion: The results show that registered nurses’ leadership in municipal home healthcare implies a wide range of challenges. There is a need for strategies to improve the organizational preconditions to reduce challenges in registered nurses’ leadership in order to promote positive patient outcomes for safe and quality care. 

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
aged, article, content analysis, cross-sectional study, female, health care organization, home care, human, human experiment, leadership, major clinical study, male, nursing care, occupation, outcome assessment, perception, physician, questionnaire, registered nurse, responsibility, staff, Sweden, work environment
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-94274 (URN)10.1186/s12912-023-01215-x (DOI)000953165500001 ()36959626 (PubMedID)2-s2.0-85150980425 (Scopus ID)
Note

Correction published 30 March 2023. https://doi.org/10.1186/s12912-023-01266-0

 

Available from: 2023-04-13 Created: 2023-04-13 Last updated: 2023-04-19Bibliographically approved
Unis, B., Bjuresäter, K. & Nilsson, J. (2023). The Interplay of Multiple Influences on the Development of Sexuality in Late-Adolescence: A Grounded Theory Study. American journal of sexuality education, 18(3), 459-483
Open this publication in new window or tab >>The Interplay of Multiple Influences on the Development of Sexuality in Late-Adolescence: A Grounded Theory Study
2023 (English)In: American journal of sexuality education, ISSN 1554-6128, Vol. 18, no 3, p. 459-483Article in journal (Refereed) Published
Abstract [en]

The aim of this grounded theory study was to explore late-adolescents' process of sexual development along with their information- and support-seeking behaviors in a Swedish context. Data were collected in semi-structured interviews with late-adolescents aged between 18 and 21 years in high schools in central Sweden. The results showed that late-adolescents' sexual development involved seeking for knowledge, discussing norms and attitudes, learning through interactions, and growing through practice and experience. Information- and support-seeking behaviors were observed throughout their developent. This study highlights that, in order to be able to provide adequate help and support, healthcare professionals need to have an awareness of the changing information and support needs of adolescents in our constantly changing and diverse society.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Adolescents, attitudes, grounded theory, knowledge, sexual and reproductive health and rights, sexual health promotion, sexuality, support
National Category
Other Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-91749 (URN)10.1080/15546128.2022.2111010 (DOI)000842279100001 ()2-s2.0-85136470706 (Scopus ID)
Funder
Karlstad UniversityRegion Värmland
Available from: 2022-09-02 Created: 2022-09-02 Last updated: 2023-08-17Bibliographically approved
Willman, A., Nilsson, J. & Bjuresäter, K. (2022). Professional development among newly graduated registered nurses working in acute care hospital settings: A qualitative explorative study. Journal of Nursing Management, 30(7), 3304-3312
Open this publication in new window or tab >>Professional development among newly graduated registered nurses working in acute care hospital settings: A qualitative explorative study
2022 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 30, no 7, p. 3304-3312Article in journal (Refereed) Published
Abstract [en]

Aim To explore newly graduated registered nurses' perceptions of their work situation and management of nursing care in complex patient situations after 18 months of work experience. Background Newly graduated registered nurses working in acute care hospital settings play a critical role in providing safe nursing care. Methods An explorative qualitative design, with four focus group interviews with 14 newly graduated registered nurses working in acute care hospital settings. Results One theme emerged: 'Clarity and security in one's own nursing role despite facing challenges that hinder professional development' and three categories: 'Independency due to one's own efforts and experience', 'Well-functioning teamwork' and 'Challenges in the work situation'. Conclusion After 18 months in the profession, the nurses were considered to be advanced beginners; at the same time, the most experienced nurses on their respective wards. They found it challenging and need to further develop competences concerning managing and organizing the nursing care of several complex patient situations or new patient groups, as well as supervising novice registered nurses and nursing students. Implication for Nursing Management Powerful and urgent action is needed to be taken by national healthcare policymakers as well a hospital and nurse managers to develop long-term strategies to improve working conditions for newly registered graduated nurses.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
acute care hospital, leading nursing care, newly graduated registered nurses, qualitative design
National Category
Work Sciences Pedagogical Work
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-91943 (URN)10.1111/jonm.13771 (DOI)000849504500001 ()35986496 (PubMedID)2-s2.0-85137324408 (Scopus ID)
Available from: 2022-09-19 Created: 2022-09-19 Last updated: 2023-02-02Bibliographically approved
Willman, A., Nilsson, J. & Bjuresäter, K. (2021). Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses. Journal of Clinical Nursing (1-2), 83-92
Open this publication in new window or tab >>Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses
2021 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, no 1-2, p. 83-92Article in journal (Other academic) Published
Abstract [en]

Aims and objectives: To explore newly graduated registered nurses' experiences and how they manage complex patient situations.Background: Newly graduated registered nurses' working in acute care hospital settings are challenged by managing complex patient situations in rapidly changing clinical contexts involving increased patient acuity, comorbidities and staffing shortages.Design: Qualitative study design.Methods: Data were collected using focus groups interviews of a total of 16 newly graduated registered nurses with clinical work experience of 6 months of direct patient care in an acute care hospital setting. Analyses were conducted using qualitative content analysis. COREQ reporting guidelines were used.Results: The analysis resulted in the overarching theme "Not being sufficiently prepared and supported to meet responsibilities and demands." The theme included three categories: "Responsibility is not in proportion to competence," "Lack of medical competence and experience complicates patient safety" and "Strives for control to manage and organise nursing care."Conclusion: The results show that newly graduated registered nurses' are not sufficiently supported for the level of responsibility and the demands placed on them when providing nursing in complex patient situations in acute care hospital settings. If they are given sole responsibility for multiple complex patient situations, patient safety may be compromised.Relevance to practice: Special attention need to be paid to NGRNs support to medical competence in the areas of assessing, planning, prioritizing, leading, and distributing nursing care in daily clinical settings for at least their first year of professional work.

Keywords
acute care; competencies; new graduate nurse; nursing care
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-79293 (URN)10.1111/jocn.15483 (DOI)000571131300001 ()2-s2.0-85091162648 (Scopus ID)
Available from: 2020-08-10 Created: 2020-08-10 Last updated: 2022-05-11Bibliographically approved
Unis, B., Nilsson, J. & Bjuresäter, K. (2021). Sexual Health Promotion among Swedish Adolescents: Professionals' Experiences. International Journal of Sexual Health, 33(3), 410-425
Open this publication in new window or tab >>Sexual Health Promotion among Swedish Adolescents: Professionals' Experiences
2021 (English)In: International Journal of Sexual Health, ISSN 1931-7611, E-ISSN 1931-762X, Vol. 33, no 3, p. 410-425Article in journal (Refereed) Published
Abstract [en]

In this grounded theory study the aim was to explore professionals' experiences of promotion of adolescents' sexual health, and views on inter-professional collaboration in relation to this subject. Data collection was by five focus group interviews and two pair interviews with professionals working with sexual health promotion in health care and schools. The results showed that professionals were reaching out to young people through competence and trusting relationships along with working on a broader front. In conclusion, professionals need to be knowledgeable about the world of young people, accessible and able to offer adequate support, and improve their inter-professional collaborations.

Place, publisher, year, edition, pages
Routledge, 2021
Keywords
Adolescent sexuality, inter-professional collaboration, sexual and reproductive health and rights, sexual health promotion, sexuality education
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-85574 (URN)10.1080/19317611.2021.1921893 (DOI)000674824200001 ()2-s2.0-85110859095 (Scopus ID)
Available from: 2021-08-05 Created: 2021-08-05 Last updated: 2022-05-16Bibliographically approved
Willman, A., Bjuresäter, K. & Nilsson, J. (2020). Newly graduated nurses' clinical competencies and need for further training in acute care hospitals. Journal of Clinical Nursing, 29(13-14), 2209-2220
Open this publication in new window or tab >>Newly graduated nurses' clinical competencies and need for further training in acute care hospitals
2020 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 13-14, p. 2209-2220Article in journal (Refereed) Published
Abstract [en]

AIM: To assess self-reported clinical competence and the need for further training among newly graduated registered nurses (NGRNs) working in Swedish acute care hospital settings.

BACKGROUND: NGRNs are expected to take full responsibility for patients' nursing care in an increasingly complex clinical context, and professional nurses' clinical competence is critical in providing high-quality and safe nursing care.

DESIGN: A cross-sectional design.

METHODS: Data were collected using the 50-item ProffNurse SAS II. A total of 85 NGRNs who had recently commenced working with direct patient care at three hospitals in central Sweden participated in the study. The response rate was 69%. The STROBE cross-sectional reporting guidelines were used.

RESULTS: The NGRNs assessed their clinical competence as being highest in areas relating to team collaboration and ethics and lowest in areas relating to professional development and direct clinical practice. The need for further training was greatest in areas such as direct clinical practice and patient safety and lowest in areas such as team collaborating and ethics.

CONCLUSION: The use of instruments to identify NGRNs' self-assessed clinical competence is of value when designing and evaluating introductory programmes for NGRNs taking on positions in acute care hospital settings. The availability of experienced nurses from whom NGRNs can gain clinical competence and learn from is of importance, both from the perspective of the NGRNs themselves and patient safety.

RELEVANCE TO CLINICAL PRACTICE: An understanding of NGRNs' clinical competence and their need for further training may assist in both planning and organising nursing programmes and in making clinical policy decisions when designing introduction programmes in acute care settings.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
acute care, competencies, graduate nurses
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-79302 (URN)10.1111/jocn.15207 (DOI)000515710400001 ()32043711 (PubMedID)
Available from: 2020-08-11 Created: 2020-08-11 Last updated: 2021-09-09Bibliographically approved
Willman, A., Bjuresäter, K. & Nilsson, J. (2020). Newly graduated registered nurses' self-assessed clinical competence and their need for further training. Nursing Open, 29(13-14), 2209-2220
Open this publication in new window or tab >>Newly graduated registered nurses' self-assessed clinical competence and their need for further training
2020 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 29, no 13-14, p. 2209-2220Article in journal (Refereed) Published
Abstract [en]

Aim To explore and describe changes in self-assessed clinical competence and the need for further training among newly graduated Registered Nurses during their first 15 months of professional work in acute care hospital settings. Design Quantitative longitudinal design. Methods The 50-item Professional Nurse Self-Assessment Scale of clinical core competencies II was used. A total of 45 newly graduated Registered Nurses answered the questionnaire at four different occasions. Data were collected after 2, 5, 9 and 15 months of working experience. Result The components "ethical decision-making," "cooperation and consultation" and "clinical leadership" were rated highest in clinical competence and lowest in need for further training. The components "professional development" and "critical thinking" were rated lowest in clinical competence and "direct clinical practice" rated highest in need for further training. The clinical competence increased significant between 9-15 months, with the exception of "critical thinking" and need for further training decreased significantly between 9-15 months, with the exception of "critical thinking."

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
acute care settings, clinical competence, competence development, complex patient situations, newly registered graduated nurses, nurse competence
National Category
Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-76945 (URN)10.1002/nop2.443 (DOI)000508511400001 ()2-s2.0-85086282489 (Scopus ID)
Available from: 2020-02-20 Created: 2020-02-20 Last updated: 2022-11-16Bibliographically approved
Bjuresäter, K., Olsson, C., Nilsson, J. & Larsson, M. (2019). Competence for a new role - Contact Nurses´self-reported competence related to education and clinical experience.. In: : . Paper presented at ICN Congress, 27 June to 1 July 2019 Singapore..
Open this publication in new window or tab >>Competence for a new role - Contact Nurses´self-reported competence related to education and clinical experience.
2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-87381 (URN)
Conference
ICN Congress, 27 June to 1 July 2019 Singapore.
Available from: 2021-11-24 Created: 2021-11-24 Last updated: 2021-11-24Bibliographically approved
Larsson, M., Nilsson, J., Bjuresäter, K. & Olsson, C. (2019). Contact Nurses´self-reported competence in managing cancer related symptoms and consequences: A cross sectional survey. In: : . Paper presented at ICN Congress, 27 June to 1 July 2019 Singapore..
Open this publication in new window or tab >>Contact Nurses´self-reported competence in managing cancer related symptoms and consequences: A cross sectional survey
2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-87380 (URN)
Conference
ICN Congress, 27 June to 1 July 2019 Singapore.
Available from: 2021-11-24 Created: 2021-11-24 Last updated: 2021-11-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4974-6845

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