Peer learning supports bachelor nursing students’ professional development, yet its usefulness across clinical contexts and educational levels remains underexplored. This cross-sectional survey study used quantitative and qualitative data (n = 1264; 50.3% response rate) collected between May 2020 and June 2022 to examine bachelor nursing students’ perceptions of their learning environment and professional development, during different clinical placements and educational levels, when supervised within peer learning. Reporting followed STROBE and COREQ guidelines. Most students reported that peer learning significantly enhanced learning (67.7%), professional development (65.7%), autonomy (59.1%) and understanding of the nursing process (57.5%). Students favoured regular changes of peers. Peer learning environments were scored significantly higher than traditional one-to-one supervision. However, peer learning benefits appear to decline in later semesters and at certain clinical settings. Structured reflection based on the profession's role and function, as well as context-sensitive implementation, may enhance the relevance of peer learning for more advanced students.

En rapport där alumner med examen från 2020 – 2022 från samtliga utbildningsprogram vid Fakulteten för hälsa, natur- och teknikvetenskap erbjöds att svara på en enkät om sin utbildning och nuvarande sysselsättning. Resultatet kan bidra till att förbättra våra program för att erbjuda presumtiva studenter aktuella och attraktiva utbildningar.

IntroductionFirst-line managers in Swedish communities have responsibility for that care to older people is provided, staffing is sufficient and the budget is balanced in their unit. It is a struggle with limited resources due to a growing population in need of care. This can lead to missed nursing care. The aim was to describe first-line managers<acute accent> perceptions of missed nursing care in community health care for older people.MethodsA qualitative design with a phenomenographic approach, interviewing 24 first-line managers. Ethics approval for the study was received from the Research Ethics Committee at Karlstad University (Dnr HNT 2020/566).ResultsThe results are shown in six descriptive categories containing 15 perceptions. The descriptive categories are 'occurrence of missed nursing care', 'becoming aware of missed nursing care', 'reasons for missed nursing care', 'missed nursing care has consequences for the older persons', 'missed nursing care has consequences for the staff' and 'taking action to decrease missed nursing care'.ConclusionsIt is important for first-line managers to become aware of the existence and reasons for missed nursing, as it has consequences for older people and staff. Managers need to take missed nursing care seriously in order to work with improvements for maintaining good quality of care and patient safety.

AimThe aim of the study was to translate, adapt and validate the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care for use in the Swedish community health care context. DesignA cross-sectional study. Data were collected from October 2019 to January 2020, and the questionnaire was sent to Registered Nurses, Enrolled Nurses and assistant nurses. MethodsThe study was performed in four phases: (1) translation, (2) adaptation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care to the Swedish context, (3) content validity testing, and (4) evaluation of psychometric properties. The collected data resulted in 611 responses. Explorative factor analysis was performed to explore the interrelationship, and Cronbach's alpha was used to evaluate the internal consistency. ResultsExplorative factor analysis presented six factors/subscales: (1) fundamental care, (2) timely needed-based care, (3) dignity and support, (4) ensuring respectful treatment, (5) social activities, and (6) documentation, planning and reporting. The Cronbach's alpha for the components showed values between 0.7 and 0.9. ConclusionThe analyses indicate an instrument to be usable for Enrolled Nurses and nurse assistants in community health care. Additional tests, can contribute to refining the content of the items and further test reliability and validity of the instrument. No patient or public contributionAs this is a study of translation and validation of the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care.

Övergripande syfte – Att undersöka samt öka och fördjupa kunskapen om vård som inte blivit utförd, inom kommunal vård och omsorg för äldre, utifrån vårdpersonals och enhetschefers uppfattningar och erfarenheter.

Metod – Forskningsområdet vård som inte blivit utförd inom kommunal vård och omsorg för äldre kartlades med en scoping review, 16 artiklar inkluderades (I). Kvantitativ och kvalitativ metod användes för att samla in och analysera data (II-IV). Det genomfördes en tvärsnittsstudie med 624 sjuksköterskor, undersköterskor och vårdbiträden som besvarade ett frågeformulär med flervalsfrågor och en öppen fråga. Instrumentet Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH) samt studiespecifika frågor, för svensk kommunal kontext om vård som inte blivit utförd användes. Beskrivande och analytisk statistik användes samt kvalitativ innehållsanalys (II). En översättning, anpassning och validering av BERNCA-NH gjordes med explorativ faktoranalys (III). En intervjustudie genomfördes med 24 enhetschefer inom kommunal vård och omsorg för äldre, där deras uppfattningar av vård som inte blivit utförd efterfrågades. Analysen utfördes med fenomenografisk ansats (IV).

Resultat – Det förekommer att vård inte blivit utförd inom kommunal vård och omsorg för äldre, orsakat av tidsbrist eller på grund av organisatoriska förhållanden (I, II). Instrumentet BERNCA-NH/HC, SWE indikerade en god reliabilitet och validitet, men ytterligare tester behövs (III). Enhetschefer som är medvetna om förekomsten av att vård inte alltid blir utförd, försöker följa upp händelserna för att förebygga att det ska hända igen. Vård som inte blivit utförd kan innebära negativa konsekvenser för både vårdpersonal och de äldre (IV).

Konklusion – Det är av vikt att få kännedom om vård som inte blivit utförd samt att det går att mäta. Utifrån det kan orsaker diskuteras och förbättringsarbete ske. Vård som inte blivit utförd är relaterat till patientsäkerhet och behöver lyftas upp på agendan.

Overall purpose – To explore, increase and extend the knowledge of missed nursing care, within municipal health care for older people, based on the perceptions and experiences of care staff and first line managers. 

Method – The research area of missed nursing care in municipal health care for older people was mapped with a scoping review, 16 papers included (I). Quantitative and qualitative methods were used to collect and analyse data (II-IV). A cross-sectional study was conducted with 624 registered nurses, enrolled nurses and nurse assistants who answered a questionnaire with multiple-choice questions and an open question. The instrument Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH), for Swedish municipal context of health care was used. Descriptive and analytical statistics were used as well as qualitative content analysis (II). A translation, adaptation, and validation of BERNCA-NH was done with explorative factor analysis (III). An interview study was conducted with 24 first line managers within municipal health care for older people, about their perceptions of missed nursing care. The analysis had a phenomenographic approach (IV). 

Results – Missed nursing care exits within municipal health care for older people, caused by lack of time or due to organisational conditions (I, II). The BERNCA-NH/HC, SWE instrument indicated good reliability and validity, but further testing is needed (III). First line managers who are aware of that missed nursing care occur, try to follow up the situations to prevent it from happen again. Missed nursing care can have negative consequences for both care staff and older people (IV). 

Conclusion – It is important to be aware of missed nursing care and that it can be measured. Based on that, causes can be discussed and improvement work can take place. Missed nursing care is related to patient safety and needs to be put on the agenda. 

Antalet äldre ökar i Sverige, liksom i resten av världen. Det innebär att framför allt kommunal vård och omsorg står inför en utmaning för att kunna möta ett ökande vårdbehov. Det är dessutom känt att det finns vård som inte blivit utförd, fastän den borde ha utförts. Avhandlingens övergripande syfte var att undersöka samt öka och fördjupa kunskapen om vård som inte blivit utförd, inom kommunal vård och omsorg för äldre, utifrån vårdpersonals och enhetschefers uppfattningar och erfarenheter. Det undersöktes med en scoping review, en tvärsnittsstudie och en intervjustudie. Vårdpersonal besvarade ett frågeformulär med flervalsfrågor och en öppen fråga om vård som inte blivit utförd, samt enhetschefer intervjuades. Resultatet visade att det förekommer att vård inte blivit utförd, orsakat av tidsbrist eller på grund av organisatoriska förhållanden. Vård som inte blivit utförd kan innebära negativa konsekvenser för både vårdpersonal och den äldre. Genom att få kännedom om att vård inte blir utförd kan strategier utvecklas för att minimera risken för att det händer igen. Mindre förekomst av vård som inte blivit utförd kan ge en ökad patientsäkerhet som kommer vara arbetsgivare, vårdpersonal och de äldre till gagn.  

Aim: To examine the extent and nature of missed nursing care in elderly care in community healthcare contexts from the perspective of healthcare staff, and to identify instruments used to measure missed nursing care and the content of these instruments. Design: Scoping review. Methods: Searches were conducted in the CINAHL, PubMed, Scopus and Google Scholar databases in March 2020. The selection process followed the PRISMA flow diagram. Results: Sixteen research papers were found from nine countries. The instruments used in the studies were Basel Extent of Rationing of Nursing Care for nursing homes (BERNCA-NH), modified MISSCARE survey and study-specific instruments or items. The item content differed, as did the number of items, which was between one and 44. The studies reported values for missed nursing care, as well as described reasons for and/or the relation between missed nursing care and organization, working climate and patient outcomes.

Background With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses' perspective. Methods A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question. Results The care activity most often missed in home care was: 'set up or update care plans' (41.8%), and in nursing homes: 'scheduled group activity' (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual. Conclusion Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.

Background: Population ageing will lead to increased need for care, both as home care and in nursing homes. The time spent in hospital are shorten, so more and more advanced care takes place as community care. To meet this challenges, it will be important to ensure a sustainable health care workforce in which registered nurses (RNs) have a key role. Staffing in community care is related to patient safety and care quality.

Aim of the study: To describe registered nurse´s perceptions of staffing in community care.

Methods: A number of 56 RNs (age 26 to 65, median age 47) working in community care answered a questionnaire including questions about staffing. Data were collected in 2019/2020. Descriptive statistical- and qualitative content analyses were used. 

Results: The majority of the RNs (71%) perceived the planned staffing in community care as acceptable or good. Although, when looking back on the previous week, around half of the RNs (55%) perceived it to be lower that needed. The RNs holds perceptions of staffing in a continuum from positive to negative. The RNs perceptions of staffing are expressed in five sub-themes; “it´s working, it´s all fine,” “the willingness to do good”, “being in a vicious circle”, “having a feeling of resignation”, and “challenging for a vulnerable organization”.

Conclusions and implications: RNs perceptions on staffing in community care are important in contributing to a sustainable and resilient workforce, they are like the organisation´s band-aid. There is a need to optimise and increase nurse staffing in community care.

Introduction The prognosis of survival for a person suffering from cardiac arrest increases when a layperson performs cardiopulmonary resuscitation (CPR) on-site. In Sweden, providing CPR training to people working in public places is considered a social benefit. Objective The aim of this study was to investigate the effect of a 3-hour CPR intervention for electricians. Methods Data were collected through an intervention by means of simulation and consisted of a pre-and post-assessment of the participants’ CPR performance. Results The results show a statistically significant improvement in ventilation (41%) and quality of compression (36%). Conclusion With short rehearsal training, the layperson can significantly improve the quality of CPR given. In a situation of cardiac arrest, this can be crucial for the patient’s survival and continued quality of life.