Patient safety and job-related stress: A focus group study

Summary This study focused on work-related stress among nurses working with critically ill patients. The aim of the study was to examine the effects of workrelated stress with regard to patient safety. The study uses a qualitative design based on focus group interviews with nurses who work with acute, critically ill patients in hospitals. Two regional hospitals were chosen. Inclusion criteria for the focus group panels included the following: nurses with advanced training in anesthesiology, intensive care, or operating-room nursing. Twenty-three nurses were chosen and they were divided into four groups. This study shows that a demanding work environment together with minimal control and social support from colleagues results in increased stress that can often have an effect on patient safety. © 2007 Elsevier Ltd. All rights reserved

Patient safety and falls: a qualitative study of home care nurses in Norway

Artikkelen rapporterer fra en studie hvor hensikten var å utforske sykepleieres erfaringer med pasientsikkerhet knyttet til fall blant hjemmeboende eldre som er avhengig av hjemmesykepleie.This study explored patient safety and falls, based on the experiences of home care nurses. Four focus group interviews were conducted with 20 home care nurses. The data were analyzed by content analysis. This study identified the following four themes: (i) patient safety was not viewed as primary prevention; (ii) the lack of investigation into causes of falls; (iii) the frailty of older people who can no longer live at home independently and safely; and (iv) patient autonomy versus patient safety. In this study, we showed that home care nurses felt that healthcare personnel were more concerned with the treatment of falls, rather than fall prevention. In addition, home care nurses rarely focused on falls before they occurred. The patient’s autonomy was placed before patient safety. This study illustrates that home care nurses might be more aware of fall prevention in clinical practice. Additional research is recommended to shed more light on this topic

A Design-Based introduction to learning centres

In the last decades, outskirt areas in Denmark have suffered from depopulation and economic decline, a development that has led to a centralised education system where higher education institutions are vested in a central body in urban areas rather than in rural communities. University College Zealand has initiated a research project in collaboration with three municipalities in the region of Zealand and partners from the Nordic countries, which investigates the potential of municipal learning centres as a means to solve educational challenges in outskirt areas. A municipal learning centre is a physical location owned by a municipality, which offers (a)synchronous courses through digital couplings to higher education institutions. The paper presents research findings showing that the development of an ecosystem based on collaboration between municipalities, higher education institutions and private and public businesses is pivotal for achieving a sustainable model for online education in rural areas. Furthermore, the paper presents a series of thinking technologies in the form of models and categories, which can be used as tools for establishing learning centres and designing learning activities for learning centres. --- Kommuner placeret i yderområder i Danmark har i de seneste årtier oplevet affolkning og økonomisk nedgang, og denne udvikling har medvirket til et centraliseret uddannelsessystem, hvor videregående uddannelsesinstitutioner flyttes fra yderområder til større byer. University College Sjælland har igangsat et forskningsprojekt i samarbejde med tre kommuner i Region Sjælland og partnere fra de nordiske lande, som har til formål at undersøge hvorvidt uddannelseskonceptet kommunale læringscentre kan medvirke til at løse uddannelsesudfordringer i landets yderområder. Et kommunalt læringscenter er en fysisk lokation som ejes af en kommune, som gennem læringscenteret kan give borgere mulighed for at tage et kursus eller en uddannelse via synkrone og asynkrone koblinger til en uddannnelsesinstitution. Artiklen præsenterer forskningsresultater, som viser at udviklingen af et økosystem, som fordrer samarbejde mellem kommuner, videregående uddannelsesinstitutioner og private såvel som offentlige virksomheder, er en forudsætning for at opnå en bæredygtig model for online uddannelse i yderområder. Artiklen præsenterer desuden en række tænketeknologier i form af modeller og kategorier, som kan anvendes i arbejdet med at etablere læringscentre og udvikle læringsdesign til konceptet

Cerebrospinal fluid markers in Creutzfeldt-Jakob disease

<p>Abstract</p> <p>Background</p> <p>The objective was to assess the utility of total tau protein (tTau), the ratio of (tTau)/181 phosphorylated tau protein (P-Tau) and 14-3-3 protein, as diagnostic markers in cerebrospinal fluid (CSF) for Creutzfeldt-Jakob disease (CJD).</p> <p>Methods</p> <p>CSF samples received from Norwegian hospitals between August 2005 and August 2007 were retrospectively selected from consecutive patients with tTau values > 1200 ng/L (n = 38). The samples from patients clinically diagnosed with CJD (n = 12) were compared to those from patients with other degenerative neurological diseases: Alzheimer's/vascular dementia (AD/VaD, n = 21), other neurological diseases (OND, n = 5). Total Tau, P-Tau, and β-Amyloid (Aβ₄₂) were measured with commercial kits. Additionally, 14-3-3 protein was measured semi-quantitatively by immunoblot.</p> <p>Results</p> <p>The minimum cut-off limits for diagnosis of CJD were chosen from the test results. For tTau the lower limit was fixed at 3000 ng/L, for the tTau/P-Tau ratio it was 60, and for 14-3-3 protein it was 0.75 arbitrary units. For tTau and tTau/P-Tau ratio, all but three CJD patients had levels above the minimum, whereas almost all of the other patients were below. For the 14-3-3 protein, two CJD patients were below the minimum and five were above. Only one of the other patients was higher than the limit. The sensitivities, specificities and diagnostic efficiencies were: tTau 75%, 92%, and 87%; tTau/P-Tau 75%, 96%, and 89%; and 14-3-3 protein 80%, 96%, and 91%.</p> <p>Conclusion</p> <p>The results suggest that 14-3-3 protein may be the better marker for CJD, tTau/P-Tau ratio and tTau are also efficient markers, but showed slightly inferior diagnostic properties in this study, with tTau/P-Tau marginally better than tTau.</p

Diettbehandling av farmakoresistent epilepsi hos barn

Bakgrunn: Bacheloroppgaven har undersøkt om ketogendiett kan ha en positiv effekt hos barn med farmakoresistent epilepsi. Ketogen diett har blir brukt som behandling for pasienter med epilepsi tidlig på 1900-tallet og er et aktuelt tema innenfor ernæring. For å undersøke effekten av ketogen diett på pasienter med farmakoresistent epilepsi har oppgaven inkludert eksisterende forskningsartikler. Problemstilling: «Har ketogen diett hos barn med farmakoresistent epilepsi positiv effekt?» Metode: Designet som er benyttet for å besvare problemstillingen er litteraturstudie. Det ble innhentet vitenskapelige forskningsartiklerved søk i databasen MEDLINEog PubMed. Totalt resulterte litteratursøketini enkeltstudier, en metaanalyse og en systematisk oversiktsartikkel. Resultater: Oppgaven tar for seg elleve forskningsartikler. Alle studiene indikerer forbedret anfallskontroll på ≥50% reduksjon eller anfallsfrihet, og noen studier oppnår både ≥50% reduksjon og anfallsfrihet. Konklusjon:Studiene som er inkludert i oppgaven indikerer at ketogen diett kan være et behandlingsalternativ hos pasienter med farmakoresistent epilepsi. Anfallsfrekvensen har vist å minske etter å ha implementert ketogen diett. Mekanismen bak den anfallsreduserende effekten av ketogen diett er uklar og mer forskning er nødvendig

Good enough care? A study of the difficulties Norwegian child welfare workers experience in working with mothers who have intellectual disabilities

This article explores the experiences of child welfare workers in relation to families where mothers have intellectual disabilities. The study is based on data from focus group interviews with child welfare workers in municipal child welfare services. All of the child welfare workers say that mothers with intellectual disabilities have serious and widespread problems linked to parental functioning. The child welfare workers interviewed in this study conclude that these mothers often have inadequate or no education, poor economy, unstable employment, and unsatisfactory housing conditions. Although these problems are common among the parents child welfare comes into contact with in general, the mothers in question represent a special challenge because of their intellectual disabilities. The informants in this study say that they as child welfare workers need to question if ‘normal’ requirements from child welfare can be used with regard to mothers with intellectual disabilities in order to evaluate whether their children receive good enough care

Patient safety culture in home care: experiences of home-care nurses

Beskriver en kvalitativ studie hvor hensikten var å utforske hjemmesykepleiere sine erfaringer med pasientsikkerhet i utøvelsen av sykepleie til hjemmeboende eldre.AIM: to explore home-care nurses' experiences of patient safety in their delivery of home care to older clients. BACKGROUND: high-risk organisations, such as the airline industry and the petroleum industry, have long been preoccupied with safety. Only recently has this also become a central theme in health care. METHOD: four focus group interviews with 20 nurses who work in home care. A qualitative thematic analysis was performed. RESULTS: one main theme was identified: struggling with responsibility in different situations. It comprises five subthemes: poor work morale and work ethic; documentation; lack of functional leadership; competence; and lack of updated routines and guidelines. CONCLUSIONS: patient safety culture is compromised by a lack of leadership, lack of responsibility among leadership, lack of routines, failure to update procedures, and a lack of knowledge and education among health-care workers. IMPLICATIONS FOR NURSING MANAGEMENT: nurse managers need to be made more aware of the dilemmas faced by nurses, how they struggle with their responsibilities, how they experience powerlessness in certain situations, and the lack of support they receive in decision-making

Religion in Textbooks and among Young Buddhists, Hindus and Muslims: A Comparative Study

This article presents three studies of religious beliefs and practices among young Norwegian Muslims, Buddhists and Hindus related to the presentation of these religions in religious education textbooks. Drawing on analyses of textbook presentations and group interviews with young informants from the three religions, the studies show that there are similarities as well as divergences between the textbook presentations and the descriptions given by the informants. By showing how textbooks may emphasize aspects of religions that the informants find marginal or exotic, this article adds to the understanding of the complex challenges posed to religious education by an increasingly multicultural context