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  • 1.
    Athlin, Asa Muntlin
    et al.
    Univ Uppsala Hosp, Dept Emergency Care & Internal Med, Entrance 40, S-75185 Uppsala, Sweden.;Uppsala Univ, Dept Med Sci, Uppsala, Sweden.;Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.;Univ Adelaide, Sch Nursing, Adelaide, SA, Australia..
    Engstrom, Maria
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.;Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden.;Lishui Univ, Sch Med & Hlth, Dept Nursing, Lishui, Peoples R China..
    Gunningberg, Lena
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.;Univ Uppsala Hosp, Qual Dept, Uppsala, Sweden..
    Baath, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, Karlstad, Sweden.;Cty Council Varmland, Karlstad, Sweden..
    Heel pressure ulcer, prevention and predictors during the care delivery chain - when and where to take action?: A descriptive and explorative study2016In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 24, 134Article in journal (Refereed)
    Abstract [en]

    Background: Hazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes. However, few studies have investigated optimal pressure ulcer prevention in the initial stage of the care process, e.g. in the ambulance care or at the emergency department. The aim of the study was to describe heel pressure ulcer prevalence and nursing actions in relation to pressure ulcer prevention during the care delivery chain, for older patients with neurological symptoms or reduced general condition. Another aim was to investigate early predictors for the development of heel pressure ulcer during the care delivery chain. Methods: Existing data collected from a multi-centre randomized controlled trial investigating the effect of using a heel prevention boot to reduce the incidence of heel pressure ulcer across the care delivery chain was used. Totally 183 patients participated. The settings for the study were five ambulance stations, two emergency departments and 16 wards at two hospitals in Sweden. Results: A total of 39 individual patients (21 %) developed heel pressure ulcer at different stages across the care delivery chain. Findings revealed that 47-64 % of the patients were assessed as being at risk for developing heel pressure ulcer. Preventive action was taken. However, all patients who developed pressure ulcer during the care delivery chain did not receive adequate pressure ulcer prevention actions during their hospital stay. Discussion and Conclusions: In the ambulance and at the emergency department, skin inspection seems to be appropriate for preventing pressure ulcer. However, carrying out risk assessment with a validated instrument is of significant importance at the ward level. This would also be an appropriate level of resource use. Context-specific actions for pressure ulcer prevention should be incorporated into the care of the patient from the very beginning of the care delivery chain.

  • 2.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Trycksår. en utmaning i vården?2010Conference paper (Refereed)
  • 3.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Vara steget före: Bedömning av patienters smärta, näringstillstånd och hudkostym2008Doctoral thesis, comprehensive summary (Other scientific)
    Abstract [en]

    The overall aim was to describe and compare registered nurses’ (RNs’) and enrolled nurses’ (ENs’) assessments of pain, nutrition and skin and their perceptions of using assessment tools. Further to describe RNs’ and ENs’ perceptions of how they assess patients’ pain, nutrition and skin. Methods: One hundred and seventy patient records were reviewed for patients with hip fracture. Interviews were conducted with RNs (n=9) and ENs (n=9). Results of the RNs’ (n=34) and ENs’ (n=43) assessments of patients with hip fracture were compared. Interrater reliability was examined between and among RNs (n=50) and ENs (n=61) using assessment tools for assessments (n=228) of patients with hip fracture and stroke. Results: Sixty percent of patient records on admission and 78% at discharge had documentation of the patient’s skin status. Pressure ulcers were documented in 15% and 20% of patient records respectively. Patients at risk for developing pressure ulcers according to the Modified Norton Scale (MNS) received a mean of 4.6 nursing interventions, while those not at risk received a mean of 3.8. There were no established boundaries between RNs’ and ENs’ assessment who performed it and in what way it was done. There were no differences between RNs’ and ENs’ as­sessments of risk for malnutrition and pressure ulcer regarding screening or total scores. However, there were differences regarding their assessments on the subscales and patients’ pain.  RNs’ and ENs’ perceptions of using assessment tools varied. Interrater reliability regarding MNS total score was very good among RNs, good among ENs and between RNs and ENs. For Short- Form Mini Nutritional Assessment screening score, interrater reliability was good between RNs and ENs and among RNs, while it was moderate among ENs. Interrater reliability between and among RNs and ENs varied for Pressure Ulcer Card. Conclusions: RNs do not always document assessment of patients’ skin and risk for pressure ulcer. Patients at risk for pressure ulcers receive more nursing interventions than patients not at risk. There are both similarities and differences between RNs and ENs regarding how they perform their assessments and what the results of their assessments are. Interrater reliability between and among RNs and ENs varies regarding the different assessment tools. An important part of the work in establishing patient safety and high quality of care is to be one step ahead and continuously assess the patients’ pain, nutrition and skin.

  • 4.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Engström, Maria
    Högskolan i Gävle.
    Gunningberg, Lena
    Uppsala universitet.
    Muntlin Athlin, Åsa
    Uppsala universitet.
    Prevention of heel pressure ulcers among older patients-from ambulance care to hospital discharge: A multi-centre randomized controlled trial2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 30, 170-175 p.Article in journal (Refereed)
    Abstract [en]

    Abstract

    The aim was to investigate the effect of an early intervention, a heel suspension device boot, on the incidence of heel pressure ulcers among older patients (aged 70+).

    BackgroundPressure ulcers are a global healthcare issue; furthermore, the heel is an exposed location. Research indicates that preventive nursing interventions starting during the ambulance care and used across the acute care delivery chain are seldom used.

    MethodsA multi-centre randomized control study design was used. Five ambulance stations, two emergency departments and 16 wards at two Swedish hospitals participated. Altogether, 183 patients were transferred by ambulance to the emergency department and were thereafter admitted to one of the participating wards.

    ResultsSignificantly fewer patients in the intervention group (n=15 of 103; 14.6%) than the control group (n=24 of 80; 30%) developed heel pressure ulcers during their hospital stay (p=0.017).

    ConclusionsPressure ulcer prevention should start early in the acute care delivery chain to increase patient safety.

  • 5.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Idvall, Ewa
    Hedman-Wiberg, Katarina
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Interrater reliability using Modified Norton Scale and Pressure Ulcer Card in clinical practice2010Conference paper (Refereed)
  • 6.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Johansson, Inger
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Nursing assessment documentation and care of hip fracture patients' skin2007In: Journal of Orthopaedic Nursing 2007, 11, 4-14Article in journal (Refereed)
  • 7.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Mari-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Idvall, Ewa
    Institutionen för medicin och hälsa, Linköpings universitet.
    Wiberg-Hedman, Katarina
    Landstinget i Värmland.
    Wilde Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Interrater reliability using Modified Norton Scale, Pressure Ulcer Card, Short Form- Mini Nutritional Assessment by registered and enrolled nurses in clinical practice2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 5, 618-626 p.Article in journal (Other academic)
    Abstract [en]

    Aim.  Examine the interrater reliability between and among registered and enrolled nurses using Modified Norton Scale, Pressure Ulcer Card and Short Form-Mini Nutritional Assessment.

    Background.  In Sweden, registered nurses and enrolled nurses usually co-operate in patient care. National guidelines emphasize that reliable and valid assessment tools should be used. Interrater reliability for regular use of assessment tools is seldom studied.

    Design cross-sectional.  Registered nurses and enrolled nurses made 228 assessments of patients’ skin, risk for pressure ulcer and malnutrition, in patients with hip fracture and patients who had suffered a stroke.

    Results.  The interrater reliability of the Modified Norton Score total score was very good among registered nurses, good among enrolled nurses and between both groups. There was good, moderate and fair agreement on the subscales. Interrater reliability of Short Form Mini-Nutritional Assesment screening score was very good between both groups, good among registered nurses and moderate among enrolled nurses. There was good and moderate agreement on the items. There was good, moderate and fair agreement between and among registered nurses and enrolled nurses when using the Pressure Ulcer Card.

    Conclusion.  The Modified Norton Scale and Short Form Mini-Nutritional Assessment were reasonably understandable and easy to utilize in clinical care. Therefore, it seems possible for nurses to accomplish assessment using these tools. The agreement level was low for most skin sites except sacrum when nurses assessed patients’ skin with the Pressure Ulcer Card.

    Relevance to clinical practice.  The utilize of reliable and valid assessment tools is important in clinical practice. The tools could be used as an aid to the clinical judgement and therefore identify patients at risk for pressure ulcers and malnutrition. Pressure ulcer grading is a difficult skill that requires training and time to develop.

  • 8.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, M-L.
    Wilde-Larsson, B.
    Nurses Perceptions in assessment of Pressure Ulcer2003In: European Pressure Ulcer Advisory Panel, Review 2003 (6),10Article in journal (Refereed)
  • 9.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University.
    Gunningberg, Lena
    Department of Public Health and Caring Sciences, Uppsala University.
    Hommel, Ami
    Lund University.
    Pressure reducing intervention among persons with pressure ulcers: results from the first three national pressure ulcer prevalence surveys in Sweden2014In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 20, no 1, 58-65 p.Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectivesThe overall aim of this study was to describe preventive interventions among persons with pressure ulcer (PU) in three nationwide PU prevalence surveys in Sweden.

    Methods

    A cross-sectional research design was used; more than 70 000 persons from different hospitals and nursing homes participated in the three prevalence surveys conducted in March 2011, October 2011 and March 2012.

    The methodology used was that recommended by the European Pressure Ulcers Advisory Panel.

    Results

    The overall prevalence of PU categories I–IV in hospitals was 16.6%, 14.4% and 16.1%, respectively. Corresponding figures for nursing homes were 14.5%, 14.2% and 11.8%, respectively. Heel protection/floating heels and sliding sheets were more frequently planned for persons with PU category I.

    Conclusions

    Despite the three prevalence studies that have showed high prevalence of PU the use of preventing interventions is still not on an acceptable level. Heel protection/floating heels and sliding sheets were more frequently planned for persons with PUs, and individual-planned repositioning also increased. However, when persons already have a PU they should all have pressure-reducing preventive interventions to prevent the development of more PUs. Preventing PUs presents a challenge even when facilities have prevention programmes. A PU prevention programme requires an enthusiastic leader who will maintain the team's focus and direction for all staff involved in patient care.

  • 10.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Larsson, Maria
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Akuten och omvärlden – ett förbättringsprojekt i samarbete mellan Landstinget i Värmland och Karlstads universitet2014In: Universitetens, Högskolornas och Svensk sjuksköterskeförenings årliga konferens, Verksamhetsförlagd utbildning: Lärande i en föränderlig värld, 2014Conference paper (Other academic)
  • 11.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Larsson, Maria
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Akuten och omvärlden- ett förbättringsprojekt i samarbete mellan Landstinget i Värmland och Karlstads universitet, Malmö 20142014In: Akuten och omvärlden- ett förbättringsprojekt i samarbete mellan Landstinget i Värmland och Karlstads universitet, 2014Conference paper (Other academic)
  • 12.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Mårtensson, Gunila
    University of Gävle.
    Mamhaidir, Anna-Greta
    University of Gävle.
    Florin, Jan
    Dalarna University.
    Munthlin Athlin, Åsa
    Gunningberg, Lena
    Uppsala.
    Pressure Ulcer prevention-is nursing knowledge appropiate or not? A descriptive multicentre study in Sweden2013Conference paper (Refereed)
  • 13.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Stensson, M
    Sund, A-K
    Preventative care: knowledge and attitudes among nurses for pressure ulcers prevention2015Conference paper (Refereed)
  • 14.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wentzel-Persenius, Mona
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Sjuksköterskors uppfattningar om bedömning av malnutrition och tryckrodnad/trycksår2005Conference paper (Other (popular science, discussion, etc.))
  • 15.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wentzel-Persenius, Mona
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Nurses' Perception of Prevalence and Assessment of Pressure Damage2005Conference paper (Refereed)
  • 16.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wentzel-Persenius, Mona
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Nurses' Perceptions of Assessment of Pressure Ulcer2003Conference paper (Refereed)
  • 17.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wentzel-Persenius, Mona
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Sjuksköterskors uppfattningar om bedömning av tryckrodnader/trycksår2005Conference paper (Refereed)
  • 18.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Idvall, Ewa
    Malmö högskola.
    Hall-Lord, Marie Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Assessment of patients´pain, nutrition and skin in clinical practice: Registered and Enrolled Nurses Perceptions2012In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 16, no 1, 3-12 p.Article in journal (Refereed)
  • 19.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Idvall, Ewa
    Institutionen för medicin och hälsa, Linköpings universitet.
    Hall-Lord, Marie Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Registered nurses and enrolled nurses assessment of postoperative pain and risk for malnutrition and pressure ulcers in patients with hip fracture2010In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 14, no 1, 30-39 p.Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe and compare registered (RNs’) and enrolled nurses’ (ENs’) assessments of postoperative pain, risk for malnutrition and pressure ulcers in patients with hip fracture. Furthermore, the aim was to describe and compare their perceptions of using assessment tools. Thirty-four (34) RNs and forty-three (43) ENs, working on orthopaedic wards in Sweden, took part in the study. The assessments were carried out on 82 patients with hip fracture. The assessment tools included the numerical rating scale (NRS), short-form nutritional assessment tool (MNA-SF), modified Norton scale (MNS) and pressure ulcer card. Many patients were assessed to be in postoperative pain and at possible risk for malnutrition. Around 50% were assessed as being at risk for pressure ulcer formation (PU). There is a difference between RNs and ENs assessments of patients’ postoperative pain, risk for malnutrition and PU. ENs assessed to a greater degree that patients were in intense pain currently. RNs assessed to a greater degree that patients had been in intense pain in the past 24 h. Single items on the tools showed differences. However, there was no statistically difference for MNA-SF screening score and MNS total score. ENs found it easier to assess postoperative pain with the NRS compared to RNs.

  • 20.
    Bååth, Carina
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Idvall, Ewa
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Registered nurses and enrolled nurses assessment of postoperative pain, risk for malnutrition and risk for pressure ulcers in patients with hip fracture2009Conference paper (Refereed)
  • 21.
    Florin, Jan
    et al.
    Department of Health and Social Sciences, Dalarna University, Falun, Sweden..
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Gunningberg, Lena
    Uppsala universitet.
    Mårtenson, Gunilla
    Högskolan i Gävle.
    Attitudes towards pressure ulcer prevention: a psychometric evaluation of the Swedish version of the APuP instrument2016In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 13, no 5, 655-662 p.Article in journal (Refereed)
    Abstract [en]

    The primary aim was to conduct a psychometric evaluation of the Attitude towards Pressure ulcer Prevention (APuP) instrument in a Swedish context. A further aim was to describe and compare attitudes towards pressure ulcer prevention between registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs). In total, 415 RNs, ANs and SNs responded to the questionnaire. In addition to descriptive and comparative statistics, confirmatory factor analyses were performed. Because of a lack of support for the instrument structure, further explorative and consecutive confirmatory tests were conducted. Overall, positive attitudes towards pressure ulcer prevention were identified for all three groups, but SNs reported lower attitude scores on three items and a higher score on one item compared to RNs and ANs. The findings indicated no support in this Swedish sample for the previously reported five-factor model of APuP. Further explorative and confirmative factor analyses indicated that a four-factor model was most interpretable: (i) Priority (five items), (ii) Competence (three items), (iii) Importance (three items) and (iv) Responsibility (two items). The five-factor solution could not be confirmed. Further research is recommended to develop a valid and reliable tool to assess nurses' attitudes towards pressure ulcer prevention working across different settings on an international level.

  • 22.
    Gesar, Berit
    et al.
    Lunds universitet.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Hedin, Hanne
    Falun Hospital.
    Hommel, Ami
    Malmö university.
    Hip fracture; an interruption that has consequences four months later: A qualitative study2017In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 26, 43-48 p., S1878-1241(16)30100-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Effects following a hip fracture often lead to functional disabilities and increased dependence on others. Although persons sustaining a hip fracture constitute a heterogeneous group in Swedish health care, they tend to be treated as a homogenous one.

    AIM: The aim of this study was to reveal how previously healthy people, aged 65 years and older, described how they had adapted to daily life four months after a hip fracture.

    METHOD: The follow-up interviews were performed by the first author four months after the hip fracture. Data were analysed using conventional inductive content analysis.

    FINDINGS: The results from the interviews highlight that sustaining a hip fracture - even four months later - was seen by the participants as an interruption leading to lasting consequences for everyday life. The recovery process during this period was complex and consisted of both physical and psychological strain. Some were resigned, some strived in order to regain independence and some handled the situation by means of self-confidence and self-efficacy.

    CONCLUSION: Previous healthy and independently-living participants described, in different ways that the hip fracture was an interruption that still affected everyday life. The absence of psychological support may be one of the reasons for dependency after four months.

  • 23.
    Gesar, Berit
    et al.
    Landstinget i Dalarna.
    Hommel, Ami
    Region Skåne.
    Hedin, Hanne
    Landstinget Dalarna.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Older patients' perception of their own capacity to regain pre-fracture function after hip fracture surgery: an explorative qualitative study2017In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 24, 50-58 p.Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore healthy older patients' perceptions of their own capacity to regain pre-fracture function in the acute phase following hip fracture surgery.

    BACKGROUND: The incidence of hip fractures is expected to increase. In Sweden, of the patients who sustain a hip fracture, 40 per cent are healthy and lived independently pre fracture. However, a hip fracture often results in declined functional outcomes for 40 per cent of these patients.

    DESIGN: The study had an explorative inductive qualitative design.

    METHODS: Semi-structured interviews (n = 30) were conducted two to five days after hip fracture surgery. Data were analysed using manifest inductive content analysis.

    RESULTS: As a description of patients' perception of their own capacity to regain pre-fracture function after a hip fracture, one main category emerged: To end up in a new situation with or without control. Patients expressed that they believed in recovery and thought nothing would be altered. However, since they had to adapt to the ward culture at the acute hospital, they became passive and became insecure about their future life situation.

    CONCLUSION: The attitudes of staff at the acute hospital can influence the outcome for hip fracture patients. Patients believe in recovery but do not receive psychological support to regain physical capacity.

  • 24.
    Grøndahl, Vigdis Abrahamsen
    et al.
    Östfold university Norway.
    Persenius, Mona
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Helgesen, Ann Karin
    Östfold university Norway.
    The use of life stories and its influence on persons with dementia, their relatives and staff: a systematic mixed studies review2017In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, 28Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dementia is an important predictor of nursing home admissions. Due to progressive dementia symptoms, over time it becomes difficult for persons with dementia to communicate their wishes and participate in decisions concerning their everyday lives. Their well-being, sense of dignity, integrity and personhood are at risk. The persons' life stories have been highlighted as particularly important in dementia care and are referred to as seeing the person beyond the dementia. The aim of this study was to explore and describe the use of life stories and its influence on persons with dementia living in nursing homes, their relatives and staff.

    METHODS: A systematic mixed studies review was conducted. The literature searches were performed in the following databases: CINAHL, PubMed and PsycINFO and the Cochrane library, as well as by hand searching references in the studies included. An updated search was performed eight months after the first search. Data was synthesised inspired by integrative analysis.

    RESULTS: Three studies using quantitative design and two studies (presented in three papers) using qualitative design representing research from 2006 to 2015 were included in the review. Life stories generally had a positive influence on the persons with dementia, their relatives, and staff. The use of life stories might contribute to 'Maintenance of the person with dementia as a whole person rather than a demented patient'. On the other hand, enabling persons with dementia to tell their own story could be a challenge. For the staff it could be challenging when sensitive information emerged uninvited. Involving relatives could also be difficult as to whose story were uncovered.

    CONCLUSIONS: The use of person's life story might be of significance, but there is not enough evidence to make any statement about its importance as the research is scarce. Studies, including randomised controlled trials, are needed to measure the impact of life story work on the physiological and psychological aspects of persons with dementia, and also how it influences their relatives and staff.

  • 25. Gunningberg, L
    et al.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hommel, Ami
    Idvall, Ewa
    Evidence based guidelines on pressure ulcer prevention and feed back of quality indicators - Patient safety on national level in Sweden2011Conference paper (Refereed)
  • 26.
    Gunningberg, Lena
    et al.
    Uppsala University.
    Hommel, Ami
    Lunds university.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Idvall, Ewa
    Malmö University.
    The first national pressure ulcer prevalence survey in county council and municipality settings in Sweden2013In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Journal of Evaluation In Clinical Practice, ISSN 1356-1294, Vol. 19, no 6, 862-867 p.Article in journal (Refereed)
    Abstract [en]

    Aim  To report data from the first national pressure ulcer prevalence survey in Sweden on prevalence, pressure ulcer categories, locations and preventive interventions for persons at risk for developing pressure ulcers. Methods  A cross-sectional research design was used in a total sample of 35 058 persons in hospitals and nursing homes. The methodology used was that recommended by the European Pressure Ulcer Advisory Panel. Results  The prevalence of pressure ulcers was 16.6% in hospitals and 14.5% in nursing homes. Many persons at risk for developing pressure ulcers did not receive a pressure-reducing mattress (23.3-27.9%) or planned repositioning in bed (50.2-57.5%). Conclusions  Despite great effort on the national level to encourage the prevention of pressure ulcers, the prevalence is high. Public reporting and benchmarking are now available, evidence-based guidelines have been disseminated and national goals have been set. Strategies for implementing practices outlined in the guidelines, meeting goals and changing attitudes must be further developed.

  • 27.
    Gunningberg, Lena
    et al.
    Uppsala University.
    Mårtensson, Gunnila
    University of Gävle.
    Mamhaidir, Anna-Greta
    University of Gävle.
    Florin, Jan
    Dalarna University.
    Munthlin Athlin, Åsa
    Uppsala University.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study2015In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 12, no 4, 462-468 p.Article in journal (Refereed)
  • 28.
    Hall-Lord, Marie-Louise
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Johansson, Inger
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Experiences of pain and distress in hip fracture patients2004In: Journal of Orthopaedic Nursing, 8: 221-230Article in journal (Refereed)
  • 29. Hansbo, Maria
    et al.
    Mattsson, Gunilla
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Knowledge among ICU nursesabout pressure ulcers prevention2014Conference paper (Refereed)
  • 30. Hommel, A
    et al.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Idvall, E
    Gunningberg, L
    The first national pressure ulcer prevalence study in Sweden2011Conference paper (Refereed)
  • 31.
    Hommel, Ami
    et al.
    Lunds universitet.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Country Council Varmland, Varmland, Sweden.
    A national quality registers as a tool to audit items of the fundamentals of care to older patients with hip fractures2016In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 11, no 2, 85-93 p.Article in journal (Refereed)
    Abstract [en]

    Background The Swedish healthcare system has a unique resource in the national quality registers. A national quality registry contains individualised data concerning patient problems, medical interventions and outcomes after treatment, within all healthcare settings. Many healthcare settings face challenges related to the way they deliver the fundamentals of care, therefore, it is important to audit the outcome. It is estimated that the number of people aged 80 years or older will have almost quadrupled between 2000 and 2050. Hip fracture has been recognised as the most serious consequence of osteoporosis because of the risk of its complications, which include pain, acute confusional state, pressure ulcers, infections, disability, diminished quality of life and mortality.

    The aim of this study was therefore to explore if and how a national quality register can be used as an audit tool for the fundamentals of care when it concerns older patients suffering from a hip fracture.

    Method

    For this study we retrospectively selected and audited variables retrieved from the national quality hip fracture register. The audit included 1083 patients 80 years and older, consecutively admitted to a university hospital in the south of Sweden, in 2011–2013.

    Results

    Nearly half of the patients were admitted from their own homes and were living alone. Almost half of the patients could walk outdoors before the fracture occurred. After 4 months, 28.5% of the patients walked outdoors. Additionally, after 4 months about 30% of the patients were still suffering from pain after hip fracture surgery and still using analgesics. There was a reduction in length of stay between 2011 and 2013. As a part of the national quality register the questions from EQ5D were used before surgery and after 4 months. Before discharge from hospital there were less registered complications in 2012 and 2013 compared with 2011.

    Conclusions

    The national hip fracture quality register allows healthcare staff to analyse nursing outcomes and to highlight some fundamental aspects of care.

    Implications for practiceGreater awareness, among hospital staff, of risk factors for complications in hip fracture patients may lead to improved patient care. Through registration in a quality register and working with the results we as Registered Nurses can ensure quality health care for older adults.

  • 32. Hommel, Ami
    et al.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Carolines berättelse2013In: Ortopedisk vård och rehabilitering / [ed] Hommel & Bååth, Lund: Studentlitteratur, 2013, 419-423 p.Chapter in book (Other academic)
  • 33. Hommel, Ami
    et al.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Kvalitetsregister inom ortopedin2013In: Ortopedisk vård och rehabilitering / [ed] Hommel & Bååth, Lund: Studentlitteratur, 2013, 411-419 p.Chapter in book (Other academic)
  • 34.
    Hommel, Ami
    et al.
    Lunds universitet.
    Bååth, CarinaKarlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Ortopedisk vård och rehabilitering2013Collection (editor) (Other academic)
    Abstract [sv]

    Rörelseorganens sjukdomar och skador spänner över ett brett fält och för att vården ska fungera behövs hela teamet runt patienten: läkare, sjuksköterska, undersköterska, sjukgymnast, arbetsterapeut och ortopedingenjör. Detta är den första boken som beskriver samtliga professioners perspektiv och kompetens i den ortopediska vården. Författarna representerar hela vårdteamet och i avslutningen speglas patientperspektivet i form av Carolines berättelse om att få en allvarlig sjukdom.

    Boken bygger på den senaste forskningen och det kvalitetsarbete som pågår. Relevanta nationella kvalitetsregister presenteras, men framför allt beskriver författarna hur dessa register kan och bör användas i det dagliga vårdarbetet, samt hur vårdens kvalitet kan mätas utifrån kvalitetsindikatorer.

    Bokens målgrupp är företrädelsevis sjuksköterske-, arbetsterapeut- och sjukgymnaststudenter på grundläggande nivå. Men alla yrkesverksamma som arbetar med patienter inom ortopedisk vård kan ha nytta av boken.

  • 35.
    Hommel, Ami
    et al.
    Lunds university.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Osteoporos2013In: Ortopedisk vård och rehabilitering / [ed] Hommel & Bååth, Lund: Studentlitteratur, 2013, 15-17 p.Chapter in book (Other academic)
  • 36. Hommel, Ami
    et al.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Working with Core Competencies in Orthopedic Nursing2015Conference paper (Refereed)
  • 37.
    Hommel, Ami
    et al.
    Skåne University Hospital.
    Gunningberg, Lena
    Uppsala university.
    Idvall, Ewa
    Malmö University.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Landstinget i Värmland.
    Successful factors to prevent pressure ulcers - an interview study.2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 1-2, 182-189 p.Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore successful factors to prevent pressure ulcers in hospital settings.

    BACKGROUND: Pressure ulcer prevalence has been recognised as a quality indicator for both patient safety and quality of care in hospital and community settings. Most pressure ulcer can be prevented if effective measures are implemented and evaluated. The Swedish Association of Local Authorities and Regions initiated nationwide pressure ulcer prevalence studies in 2011. In 2014, after four years of measurement, the prevalence was still unacceptably high on a national level. The mean prevalence of pressure ulcer in the spring of 2014 was 14% in hospital settings with a range from 2·7-36·4%.

    DESIGN: Qualitative semistructured interviews were conducted.

    METHODS: A qualitative content analysis, in addition to Promoting Action on Research Implementation in Health Services frameworks, was used in the analysis of the data text. Individual interviews and focus groups were used to create opportunities for both individual responses and group interactions. The study was conducted at six hospitals during the fall of 2014.

    RESULTS: Three main categories were identified as successful factors to prevent pressure ulcer in hospitals: creating a good organisation, maintaining persistent awareness and realising the benefits for patients.

    CONCLUSION: The goal for all healthcare personnel must be delivering high-quality, sustainable care to patients. Prevention of pressure ulcer is crucial in this work. It seems to be easier for small hospitals (with a low number of units/beds) to develop and sustain an effective organisation in prevention work.

    RELEVANCE TO CLINICAL PRACTICE: The nurse managers' attitude and engagement are crucial to enable the personnel to work actively with pressure ulcer prevention. Strategies are proposed to advance clinical leadership, knowledge, skills and abilities for the crucial implementation of pressure ulcer prevention.

  • 38.
    Johansson, Inger
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Acute confusion states, pain, health, functional status and quality of care among patients with hip fracture during hospital stay2013In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 17, no 3, 120-130 p.Article in journal (Refereed)
    Abstract [en]

    AimThe aim of the study was to investigate: acute confusional states, pain and pain relief, physical health, psychological well-being and functional status among patients with hip fracture during hospital stay. A further aim was to describe patient's perceptions of quality of care.

    MethodForty-nine patients with hip fracture ⩾70 years old were consecutively included in the study at two hospitals in Sweden. Data were collected by interview and observation using structured questionnaires at four occasions.

    ResultsThe incidence of acute confusion was 32% on admission and the day after surgery and 14% the day before discharge. Additional diagnosis and on-going medication were significantly more common among confused patients. Patients with confusion experienced more intense pain at rest on admission and the day before discharge than non-confused patients. On perceived reality in quality of care patients' reported most favourable scores with regard to respect and empathy from the nurses and less favourable scores with regard to the information of responsible persons and information after procedures. The overall subjective importance of quality of care was higher than on the perceived quality of care.

    ConclusionMore attention, systematic observations and preventive actions should be taken when there are signs of acute confusion, pain and pain relief among patients with hip fracture. Patients' ratings of the subjective nature of care were higher than the perceived reality of quality of care and needs to be given attention since subjective importance reflects how the patients want their care to be.

  • 39.
    Johansson, Inger
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Akut förvirringstillstånd, smärta och vårdkvalitet i samband med höftfraktur2004Conference paper (Refereed)
  • 40. Johansson, Iréne
    et al.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Acute confusional state and consequences in elderly patients with hip fracture2004Conference paper (Refereed)
  • 41. Madsen, Ulla
    et al.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Berthelsen, Connie
    Hommel, Ami
    Quality of life, functionalstatus and needs of care among patients after vascular lower limp amputation; astudy protocol2014Conference paper (Refereed)
  • 42.
    Madsen, Ulla Riis
    et al.
    Orthopedic Surgery , Slagelse & Holbæk Hospital, Denmark.
    Hommel, Ami
    Lund University.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Berthelsen, Connie Bøttcher
    Aarhus University, Denmark.
    Pendulating-A grounded theory explaining patients' behavior shortly after having a leg amputated due to vascular disease.2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, no 1, 32739Article in journal (Refereed)
    Abstract [en]

    Introduction Although the group of vascular leg amputated patients constitutes some of the most vulnerable and frail on the orthopedic wards, previous research of amputated patients has focused on patients attending gait training in rehabilitation facilities leaving the patient experience shortly after surgery unexplored. Understanding patients' behavior shortly after amputation could inform health professionals in regard to how these vulnerable patients' needs at hospital can be met as well as how to plan for care post-discharge. Aim To construct a grounded theory (GT) explaining patients' behavior shortly after having a leg amputated as a result of vascular disease. Method In line with constructivist GT methodology, data from ethnographic observations and interviews were simultaneously collected and analyzed using the constant comparative method covering the patients' experiences during the first 4 weeks post-surgery. Data collection was guided by theoretical sampling and comprised 11 patients. A GT was constructed. Results Patients went through a three-phased process as they realized they were experiencing a life-changing event. The first phase was "Losing control" and comprised the sub-categories "Being overwhelmed" and "Facing dependency." The second phase was "Digesting the shock" and comprised the sub-categories "Swallowing the life-changing decision," "Detecting the amputated body" and "Struggling dualism." The third phase was "Regaining control" and comprised the sub-categories "Managing consequences" and "Building-up hope and self-motivation." "Pendulating" was identified as the core category describing the general pattern of behavior and illustrated how patients were swinging both cognitively and emotionally throughout the process. Conclusion The theory of "Pendulating" offers a tool to understand the amputated patients' behavior and underlying concerns and to recognize where they are in the process. Concepts from the theory could be used by health professionals who support patients coping with the situation by offering terms to express and recognize patients' reactions.

  • 43. Muntlin Athlin, Åsa
    et al.
    Gunningberg, Lena
    Uppsala universitet.
    Engström, Maria
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Pressure ulcer prevention –Why don’t we start from the beginning?2014Conference paper (Refereed)
  • 44.
    Persenius, Mona
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Rystedt, Ingrid
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Quality of life and sense of coherence in young people and adults with uncomplicated epilepsy: a longitudinal study2015In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 47, 127-131 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of the study was, in a ten-year follow-up, to describe and explore potential changes in quality of life and sense of coherence in relation to gender differences among persons with epilepsy in the transition from adolescence to adulthood. MATERIALS AND METHODS: A longitudinal study of sense of coherence (SOC) and quality of life with repeated measurement design (1999, 2004, and 2009) was conducted in a population of persons (n=69) who were aged 13-22years in 1999 and 23-33years in 2009. The Quality-of-Life Index (QLI) and the Sense of Coherence (SOC) scale were used. RESULTS:There was a significant decrease (p≤0.001) in seizures compared with the 2004 results, mainly among the women (p=0.003). When comparing the total QLI scores, no significant differences were found between the three data collections and there were no differences in total scores between men and women. There was a decrease in the SOC total score over the 10-year period study. Total SOC was significantly higher among those being 30-33years old compared to those being 23-29years old (p=0.014) and among those having a driving license (p=0.029) compared to those not having a driving license.CONCLUSIONS:Both quality of life and sense of coherence are important for maintaining health and well-being. Promoting health and well-being requires effective high-quality multidisciplinary person-centered care.

  • 45.
    Wentzel Persenius, Mona
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Medicinskt ansvariga sjuksköterskor och avdelningschefers uppfattningar om bedömning av malnutrition2003Conference paper (Refereed)
  • 46.
    Wentzel Persenius, Mona
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Nurses' Perceptions in Assessment of Malnutrition2003Conference paper (Refereed)
  • 47.
    Wentzel Persenius, Mona
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Nurses' Perceptions of Assessment of Nutritional Status2004Conference paper (Refereed)
  • 48.
    Wentzel Persenius, Mona
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    RN's perceptions of nutritional assessment: -who is assessed and when?2005Conference paper (Refereed)
  • 49.
    Wentzel Persenius, Mona
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Sjuksköterskors uppfattningar om bedömning av nutritionstillstånd2005Conference paper (Refereed)
  • 50.
    Wentzel Persenius, Mona
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bååth, Carina
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Wilde Larsson, Bodil
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Assessment and documentation of patients' nutritional status: perceptions of registered nurses and their chief nurses2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 16, 2125-2136 p.Article in journal (Refereed)
    Abstract [en]

    To study, within municipal care and county council care, (1) chief nurses' and registered nurses' perceptions of patient nutritional status assessment and nutritional assessment/screening tools, (2) registered nurses' perceptions of documentation in relation to nutrition and advantages and disadvantages with a documentation model.

    BACKGROUND:

    Chief nurses and registered nurses have a responsibility to identify malnourished patients and those at risk of malnutrition.

    DESIGN AND METHODS:

    In this descriptive study, 15 chief nurses in municipal care and 27 chief nurses in county council care were interviewed by telephone via a semi-structured interview guide. One hundred and thirty-one registered nurses (response rate 72%) from 14 municipalities and 28 hospital wards responded to the questionnaire, all in one county.

    RESULTS:

    According to the majority of chief nurses and registered nurses, only certain patients were assessed, on admission and/or during the stay. Nutritional assessment/screening tools and nutritional guidelines were seldom used. Most of the registered nurses documented nausea/vomiting, ability to eat and drink, diarrhoea and difficulties in chewing and swallowing, while energy intake and body mass index were rarely documented. However, the majority documented their judgement about the patient's nutritional condition. The registered nurses perceived the VIPS model (Swedish nursing documentation model) as a guideline as well as a model obstructing the information exchange. Differences were found between nurses (chief nurses/registered nurses) in municipal care and county council care, but not between registered nurses and their chief nurses.

    CONCLUSIONS:

    All patients are not nutritionally assessed and important nutritional parameters are not documented. Nutritionally compromised patients may remain unidentified and not properly cared for.

    RELEVANCE TO CLINICAL PRACTICE:

    Assessment and documentation of the patients' nutritional status should be routinely performed in a more structured way in both municipal care and county council care. There is a need for increased nutritional nursing knowledge.

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