Handledarskap på grund och avancerad nivå

Högskoleförordningen (SFS 2006:173) föreskriver akademiska krav i kursplan och kursmål för både grund- och avancerad nivå i sjuksköterskeutbildningar. I svensk sjuksköterskeförening, på lärosäten och i klinisk verksamhet pågår diskussioner om hur dessa teoretiska krav ska förenas i klinisk praktik. Syftet var att belysa faktorer av betydelse för handledarskapet på grund och avancerad nivå och undersöka handledningsstrategier som kan förenar teori och verksamhetsförlagd utbildning för sjuksköterske- och specialistsjuksköterskestuderande. Metoden var en litteraturstudie som baserades på 11 vetenskapliga artiklar som kritiskt grans-kades och analyserades. Resultatet visar att det förutsätts ett väl fungerande samarbete mellan fakultet och klinisk verksamhet med tydligt formulerade kursplaner, mål och riktlinjer för handledning och stöd till handledare från fakultet och verksamhet. För framgångsrikt handledarskap framhålls betydelsen av handledares professionella hållning, kliniska kompetens och pedagogiska förmåga med stöd, konstruktiv feedback, främjande av reflektion, kritiskt och analytiskt tänkande och ett vetenskapligt förhållningssätt.The Swedish National Agency for Higher Education (SFS 2006:173) state academic demands in curriculum and education goals for graduate and advanced level at the nursing education. At the Swedish nursing association (SSF), the university and in the clinical field there are discussions about how to integrate these theory demands into clinical practice. The aim of this literature study was to illuminate factors of signification for the preceptorship on graduate and advanced level and describe supervision strategies that connect theory and clinical practice for nurse students and nurse specialist students. Eleven scientific articles were reviewed and analysed in this literature study. The result shows that it anticipates cooperation between the nursing faculty and the clinical field with a clear curricu-lum, goals and guidelines for supervision and support for the preceptor. For suc-cessful preceptorship it is important that the preceptor is professional, has clinical competence and pedagogical skills with support, constructive feedback, reflection, critical and analyse thinking and a scientific conduction

Airborne bacteria in hospital operating rooms during ongoing surgery

IntroductionPost-operative infections obtained from open-wound surgeries constitute an unnecessary load on both healthcare and affected patients. It is well established that increased air cleanliness reduces the number of post-operative infections. Therefore, the ventilation system is important in order to reduce the number of infectious particles in the air during surgery. Ventilation with high airflow, as in operating rooms, consumes a high amount of energy and it is thus desirable to find energy efficient solutions. ObjectivesThe purpose of this work was to evaluate air quality, energy efficiency and working environment comfort for three different ventilation techniques in operating rooms. MethodThe newly developed ventilation system temperature controlled airflow (TcAF) was compared with the conventionally used turbulent mixed airflow (TMA) and laminar airflow (LAF). In total, 750 air sample measurements were performed during 45 orthopaedic operations: 15 for each type of ventilation system [1]. The concentration of colony forming units (CFU)/m3 was measured at three locations in the rooms: close to the wound (<0.5 m), at the instrument table and peripherally in the room. The working environment comfort was evaluated in a questionnaire.ResultsOur study shows that both LAF and TcAF maintains CFU concentrations in the air during ongoing surgery significantly below 10 CFU/m3 at the wound and at the instrument table, and for TcAF also in the periphery of the room, see Figure 1. The median CFU concentration in TMA was at or above 10 CFU/m3 at all locations. TcAF used less than half the airflow to that of LAF, resulting in a 28% reduction in energy consumption. The working environment comfort was perceived less noisy and having less draft in the TcAF than the LAF ventilation.SummaryBoth the LAF and TcAF ventilation maintain high air cleanliness with low CFU concentrations throughout the operation. TMA is less efficient in removing bacteria from the air close to the patient