Patienters upplevelser av sjuksköterskeledd telefonuppföljning vid cancer : En litteraturöversikt

Bakgrund: Antalet patienter som lever med att fått en cancerdiagnos ökar med modern diagnostik och behandling. Detta leder till ökad belastning på vården. Under senare år har viss uppföljning av patientgruppen kommit att skötas av sjuksköterskor via telefon. Syfte: Att belysa cancerpatienters upplevelser av sjuksköterskeledd telefonuppföljning. Metod: Litteraturöversikt baserad på elva artiklar med kvalitativ eller kvantitativ ansats.. Resultaten från artiklarna granskades, analyserades och sammanställdes. Använda databaser var CINAHL och PubMed. Resultat: Analysen resulterade i sex kategorier: Trygg relation till sjuksköterskan, Behov av information samt att detta behov tillgodoses, Bekvämt och tidsbesparande alternativ, Möjlighet till ett normalt liv, Ekonomiska vinster och Känna sig generellt nöjd med uppföljningen. Diskussion: Patientupplevelsen av sjuksköterskeledd telefonuppföljning var positiv. En god relation till sjuksköterskan har samband med känslan av trygghet. Slutsats: Patienterna var generellt nöjda med den sjuksköterskeledda telefonuppföljningen. Sjuksköterskeledd telefonuppföljning visade inte på några negativa upplevelser hos patientgruppen. Ingenting i litteraturöversiktens resultat tyder på att det skulle missgynna patienterna om mängden sjuksköterskeledda telefonuppföljningar skulle öka. Fler studier skulle behövas för att ytterligare belysa vad patienterna upplever för behov och för att sjuksköterskan i framtiden ska kunna forma uppföljningen på bästa sätt.Godkännande datum: 2017-03-21</p

Tracking pressure injuries as adverse events : National use of the Global Trigger Tool over a 4-year period.

AIM: To examine the frequency, preventability, and consequences of hospital acquired pressure injuries in acute care hospitals over a 4-year period. METHOD: A retrospective record review was performed using the Swedish version of the Global Trigger Tool (GTT). A total of 64 917 hospital admissions were reviewed. Data were collected between 2013 and 2016 from all 63 Swedish acute care hospitals. RESULTS: The prevalence of pressure injuries (category 2-4) was 1%. Older patients, "satellite patients", and patients with acute admissions had more pressure injuries. Most pressure injuries (91%) were determined to be preventable. The mean extended length of hospital stay was 15.8 days for patients who developed pressure injuries during hospitalization. CONCLUSION: The GTT provides a useful and complementary national perspective on hospital acquired pressure injuries across hospitals, informing health care providers on safety priorities to reduce patient harm. Clinical leaders can use information on the preventability and the consequences of pressure injuries, as well as evidence-based arguments for improving the health care organization

Incidence of adverse events in Sweden during 2013-2016: a cohort study describing the implementation of a national trigger tool

Objectives To describe the implementation of a trigger tool in Sweden and present the national incidence of adverse events (AEs) over a 4-year period during which an ongoing national patient safety initiative was terminated. Design Cohort study using retrospective record review based on a trigger tool methodology. Setting and participants Patients amp;gt;= 18 years admitted to all somatic acute care hospitals in Sweden from 2013 to 2016 were randomised into the study. Primary and secondary outcome measures Primary outcome rneasure was the incidence of AEs, and secondary measures were type of injury, severity of harm, preventability of AEs, estimated healthcare cost of AEs and incidence of AEs in patients cared for in another type of unit than the one specialised for their medical needs (off-site). Results In a review of 64 917 admissions, the average AE rates in 2014 (11.6%), 2015(10.9%) and 2016 (11.4%) were significantly lower than in 2013 (13.1 %). The decrease in the AE rates was seen in different age groups, in both genders and for preventable and non-preventable AEs. The decrease comprised only the least severe AEs. The types of AEs that decreased were hospital-acquired infections, urinary bladder distention and compromised vital signs. Patients cared for off-site had 84% more preventable AEs than patients cared for in the appropriate units. The cost of increased length of stay associated with preventable AEs corresponded to 13%-14% of the total cost of somatic hospital care in Sweden. Conclusions The rate of AEs in Swedish somatic hospitals has decreased from 2013 to 2016. Retrospective record review can be used to monitor patient safety over time, to assess the effects of national patient safety interventions and analyse challenges to patient safety such as the increasing care of patients off-site. It was found that the economic burden of preventable AEs is high.Funding Agencies|Swedish Association of Local Authorities and Regions</p

Adverse events in psychiatry : a national cohort study in Sweden with a unique psychiatric trigger tool

Background The vast majority of patient safety research has focused on somatic health care. Although specific adverse events (AEs) within psychiatric healthcare have been explored, the overall level and nature of AEs is sparsely investigated. Methods Cohort study using a retrospective record review based on a two-step trigger tool methodology in the charts of randomly selected patients 18 years or older admitted to the psychiatric acute care departments in all Swedish regions from January 1 to June 30, 2017. Hospital care together with corresponding outpatient care were reviewed as a continuum, over a maximum of 3 months. The AEs were categorised according to type, severity and preventability. Results In total, the medical records of 2552 patients were reviewed. Among the patients, 50.4% were women and 49.6% were men. The median (range) age was 44 (18–97) years for women and 44.5 (18–93) years for men. In 438 of the reviewed records, 720 AEs were identified, corresponding to the AEs identified in 17.2% [95% confidence interval, 15.7–18.6] of the records. The majority of AEs resulted in less or moderate harm, and 46.2% were considered preventable. Prolonged disease progression and deliberate self-harm were the most common types of AEs. AEs were significantly more common in women (21.5%) than in men (12.7%) but showed no difference between age groups. Severe or catastrophic harm was found in 2.3% of the records, and the majority affected were women (61%). Triggers pointing at deficient quality of care were found in 78% of the records, with the absence of a treatment plan being the most common. Conclusions AEs are common in psychiatric care. Aside from further patient safety work, systematic interventions are also warranted to improve the quality of psychiatric care.Funding Agencies|Swedish Association of Local Authorities and Regions; Linkoping University</p