Ikääntyneiden turvallinen lääkehoito : mittarin kehittämisprosessi

Tutkimuksen tarkoituksena oli kehittää turvallisen lääkehoidon toteuttamista arvioiva mittari. Mittarin sisältö laadittiin turvallisen lääkehoidon toteuttamisen osa-alueiden mukaisesti kirjallisuuskatsauksen avulla. Osa-alueita ovat: oikea lääke, oikea tarve lääkkeelle, oikea annos, oikea potilas, oikea lääkkeen antotapa, oikea lääkkeen käyttökuntoon saattaminen, oikea lääkkeen antoaika, oikea potilaan ohjaus, oikea lääkehoidon seuranta ja vaikutusten arviointi, oikea lääkehoidon dokumentointi ja kirjaaminen, oikea aseptiikka. Osa-alueista laadittiin mittari, joka käsitti 123 kysymystä. Asiantuntijapaneeli (n=7) arvioi mittarin sisältöä ja väittämien rakenteita. Pilot-testauksen aineisto kerättiin webropol-kyselynä yhden kaupungin kunnallisissa ikääntyneiden pitkäaikaishoidon yksiköissä lääkehoitoon osallistuvalta hoitohenkilökunnalta (N = 294). Vastausprosentti oli 24 %. Pilot-testauksessa arvioitiin vastaamiseen kuluvaa aikaa ja sähköisen kyselyn toimivuutta. Mittarin sisäisen johdonmukaisuuden arvioinnissa käytettiin Tarkkonen Rho -kerrointa, joka osoitti mittarin sisäisen johdonmukaisuuden hyväksi. Asiantuntijapaneelin arvioinnissa ja pilot-testauksessa saatiin tärkeää tietoa kehitetyn mittarin sisällöstä, selkeydestä, vastaamiseen kuluvasta ajasta ja käytettävyydestä. Turvallinen lääkehoito -mittari todettiin muokkauksen jälkeen turvallisen lääkehoidon toteuttamisen periaatteet hyvin huomioivaksi, toimivaksi ja luotettavaksi.Development process of the Safe medication – scale for elderly care : The aim of this study was to develop a safe medication administration assessment scale. The content of the scale was built according to divisions of safe medication administration by using scoping review method. The divisions are: right drug, right action, right dose, right patient, right route, right form, right time, right counselling, right response, right documentation, right aseptic. The scale consisted of 123 items. A panel of experts (n=7) determined the content of the scale and the structures of the items. The material for the pilot study was collected from the staff (N=294) of the communal long term elderly care wards of one town by using webropol questionnaire. The response rate was 24 %. The time used for responding and the usability of the online survey were evaluated. Tarkkonen's rho was used for estimation of reliability and the internal consistency was noted to be good. The appraisal of the panel of experts and the pilot study produced essential information of the content and the clarity of the scale. After final editing the Safe Medication – scale was noted to be functional and reliable

Development and psychometric testing of the preceptors? orientation competence instrument (POCI)

Aim: To develop and psychometrically test a Preceptors' Orientation Competence Instrument measuring orien-tation competence of nurses working as new employee preceptors.Background: Competence of nurse preceptor is essential for a successful preceptorship and thus nursing staff acute accent s commitment to the organization.Design: Instrument development according to the COSMIN guidelines.Methods and participants: Four phases were implemented: 1) establishment of the theoretical framework, modi-fication of the validated Mentor Competence Instrument and generation of new items; 2) content validity testing; 3) structural validity testing; and 4) internal consistency testing. Content validity was evaluated by 14 experts using content validity index methods. Structural validity was evaluated using exploratory factor analysis with a convenience sample of 844 Finnish nurses. Internal consistency was evaluated by measuring Cronbach's alpha.Results: The content validity index of subdimensions of the instrument ranged from 0.80 to 0.94 for relevance and 0.80-0.94 for clarity. Exploratory factor analysis resulted in a seven-factor model with 53 items (61.62% of total variance): preceptor characteristics, goal-oriented orientation, guidance in reflective discussion, knowledge of work unit orientation practices, creation of a supportive learning atmosphere, preceptor motivation and giving of developmental feedback. Cronbach's alpha values varied from 0.79 to 0.93.Conclusion: Preceptors' Orientation Competence Instrument demonstrated adequate psychometric properties based on content and construct validity as well as internal consistency. Therefore, it is useful for self-evaluation of orientation competence of nurses working as new employee preceptors.Peer reviewe

Towards digital counselling in primary care management of symptomatic knee osteoarthritis: a qualitative descriptive study in Finnish primary care

Digital counselling may improve patients’ health outcomes, when eHealth solutions are accessible and tailored to the patients’ needs, which is especially important for people with chronic and long-term conditions such as knee osteoarthritis. This study aims to identify patients’ eHealth needs to improve the quality of digital counselling in a primary care management of symptomatic knee osteoarthritis. A qualitative study was used to collect patients’ eHealth needs through semi-structured interviews in a single outpatient clinic in Finland between August 2020 and November 2020. The data was analyzed using both deductive and inductive content analysis approaches. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative research checklist to improve the transparency of the study. Analysis of the data revealed five main categories to be considered when implementing digital counselling in patients with symptomatic knee osteoarthritis: background factors (functional impairments, health literacy, digital literacy, cost-related access barriers), resources (digital methods and materials), sufficiency (knee osteoarthritis-related knowledge and skills), implementation (simplicity, trust, patient-centeredness), and benefits (self-care capabilities, confidence). According to our findings, both health and digital literacy seems to be important contributors to the adoption of digital counselling in a primary care management of symptomatic knee osteoarthritis. New eHealth solutions should not replace the first visit in the outpatient clinic. Instead, the use of eHealth solutions should be based on the first visit, during which a trusting relationship between patients and healthcare providers is established. In future, the level of health and digital literacy in patients with symptomatic knee osteoarthritis should be taken account

Nurse preceptors' orientation competence and associated factors-A cross-sectional study

Aims To identify distinct orientation competence profiles amongst nurse preceptors and explain the associated factors. Design A cross-sectional study design. Methods The data were collected during the winter of 2020-2021 from registered nurses (N = 8279, n = 844) at one university hospital in Finland through an online questionnaire that included a self-administered electronic version of the Preceptors' Orientation Competence Instrument. K-means clustering was then used to identify nurse preceptor profiles. Chi-square, Fisher's exact test, Kruskal-Wallis and Mann-Whitney tests were used to analyse factors associated with competence profiles. The results were reported as frequencies, percentages, mean and standard deviation. Results A total of three distinct orientation competence profiles (A, B, C) were identified. Profile A nurses evaluated their orientation competence at the highest level, whereas profile C nurses evaluated their competence at the lowest level. Sufficient clinical and theoretical experience, a motivation to work, willingness to orient new employees and participation in orientation and/or mentoring education were found to be associated with competence profiles. Conclusion The findings expand the current knowledge base of nurse preceptors' orientation competence. Health care organizations should recognize different orientation competence profiles amongst the nursing staff since the selection of a preceptor should always be based on possessing the necessary orientation competence rather than availability. The results indicate that preceptors (who reported taking on various tasks and covering multiple roles) need support from co-workers to sufficiently concentrate on employee orientation tasks. The results also indicate that preceptors need further orientation education, which should-for example-outline the learning goals for new employees and how preceptors can assess employee performance. Impact What problem did the study address? Prior research has not applied a robust theoretical framework covering all aspects relevant to a preceptor's competence. What were the main findings? A nurse's clinical and theoretical experience, motivation to work, willingness to orient new employees, and prior participation in orientation and/or student mentoring education were found to influence their level of orientation competence. Where and on whom will the research have an impact? Healthcare organizations can use the results of this study to make the selection of preceptors competency-based rather than their availability. Nurse leaders can use the results of this study to pinpoint which areas of nurses' orientation competence and associated factors need to be improved. Increased orientation competence will enable clinical nurses to provide high-quality orientation to new employees, which is crucial to the retention of nursing staff and the quality of patient care.Peer reviewe

Scoping review of intergenerational learning methods for developing digital competence and their outcomes

Due to the rapid digitalization of healthcare, it is important to strengthen professionals’ digital competence, particularly to support older professionals to stay in work until retirement age. People of different ages have different digital competencies. Younger generations are ‘digital natives’ who have learned to use digital devices fluently from a young age, while older generations have had to learn to use them in adulthood. The increasing number of new technologies causes in some cases stress, especially for more older healthcare workers. Intergenerational learning methods for developing digital competence may offer a way to narrow digital competence gaps in healthcare. The aim of this scoping review was to identify current evidence regarding intergenerational learning methods for developing digital competence, and their outcomes. The results can be used to help develop methods for intergenerational digital competence development and improve healthcare professionals’ digital competence. A scoping review was conducted across four databases (Scopus, CINAHL, Web of Science, ProQuest) without time limits. The search produced 2905 references, of which 23 studies are included in the review. Thematic analysis was used to analyze these studies’ results. The results showed that a key method for intergenerational digital competence development is reverse mentoring, where a less experienced person serves as a mentor to a more experienced one. Intergenerational digital competence development methods can be done one-on-one or in groups, in classes or on digital platforms. The outcomes of these methods illustrated that they promote mutual learning, increase the digital competence of older adults and the work life skills of young mentors, and narrow the gap between generations. Using such methods, it is possible to make better use of each generation’s expertise. Intergenerational learning could suggest ways of narrowing the digital gap and enhancing intergenerational communication. Healthcare could benefit from implementing intergenerational learning methods for developing digital competence, increasing the digital competence of healthcare professionals, and narrowing the gap between generations

Risk Factors for Excessive Social Media Use Differ from Those of Gambling and Gaming in Finnish Youth

Purpose: Adolescents' excessive social media use has characteristics similar to other addictive behaviours. This study aims to explore whether the same risk factors are associated with excessive social media use as with excessive gaming and gambling among Finnish adolescents. Methods: Multinomial logistic regression analyses were carried out using the European School Survey Project on Alcohol and Other Drugs data, collected from Finnish adolescents aged 15-16 in 2019 (n = 4595). Results: Excessive use of social media was more common among girls (reported by 46% of respondents) than boys of the same age (28%), whereas boys reported both excessive gaming (23%) and gambling (6%) more often than girls (4% and 1%, respectively). All differences between genders were statistically significant (p < 0.0001). Daily smoking was associated with a high risk of excessive gambling (AOR = 3.23) and low risk of excessive gaming (AOR = 0.27) but had no significant effect on excessive social media use. Cannabis use in the past 12 months was positively associated only with excessive gambling (AOR = 2.39), while past 12 months alcohol consumption increased the risk for excessive social media use (AOR = 1.25). Conclusions: Adolescent girls are at greater risk of excessive social media use than boys, while boys are at greater risk of excessive gaming and gambling. The associations with known risk factors are somewhat different for excessive use of social media as compared to excessive gambling and gaming and should be acknowledged when developing preventive measures for adolescents.Peer reviewe

Adherence of Finnish people with glaucoma to treatment plans and connected factors

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Parent and carer experiences of health care professionals' communication about childhood obesity : a qualitative systematic review protocol

OBJECTIVE: The objective of the systematic review is to identify, critically appraise, and synthesize the best available qualitative evidence on parent and carer experiences of health care professionals' communication about childhood obesity. INTRODUCTION: Parents and carers play a key role in a child's environment and healthy development, which is why they can find it confronting to discuss their child's weight. This review will provide an insight into the experiences of parents and carers with health care professionals' communication about their child's overweight or obesity. INCLUSION CRITERIA: This qualitative review will consider participants who are parents and carers with a child with overweight or obesity (birth to 12 years). The phenomenon of interest are parents' and carers' lived experiences of childhood obesity communication from a health care professional, and the context is health care settings. Communication includes verbal or written communication about a child's obesity from health care professionals and received by a parent or a carer. METHODS: The proposed review will systematically search the following databases: MEDLINE (EBSCO), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, LILACS, and the Finnish health sciences database MEDIC. ProQuest Dissertations and Theses (ProQuest) will be searched for unpublished articles. A manual search will be used to supplement the database searches. The quality of included studies will be assessed independently by 2 reviewers, and the qualitative data will be extracted from papers by 2 independent reviewers using the standardized JBI data extraction tool. The recommended JBI approach to critical appraisal, study selection, data extraction, and data synthesis meta-aggregation will be used. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022297709.publishedVersionPeer reviewe

Educational interventions promoting evidence-based practice among emergency nurses : A systematic review

Introduction: Emergency nurses are expected to adopt evidence-based practice (EBP). The aim of this systematic review was to describe educational interventions promoting EBP and their outcomes among emergency nurses, compared with no education, to inform clinicians and researchers about effective educational interventions suitable for use in emergency departments (EDs). Methods: CINAHL, Cochrane, PubMed and Scopus were systematically searched to identify studies published between January 1, 2006 and October 20, 2016 describing educational interventions designed to promote EBP among emergency nurses. 711 studies were identified and screened; 10 were selected for inclusion and quality assessment. The studies were analyzed using deductive content analysis, and the review's results are presented in accordance with the PRISMA guidelines. Results: Ten relevant studies on nine different self-developed educational interventions were identified. Eight studies had highly significant or significant results. Interventions involving face-to-face contact led to significant or highly significant effects on patient benefits and emergency nurses' knowledge, skills, and behavior. Interventions using written self-directed learning material led to significant improvements in nurses' knowledge of EBP. All the descriptions of the interventions were incomplete, and the reported details varied considerably between the studies. Conclusions: There have been few studies on educational interventions to promote EBP among emergency nurses but the available results are promising.Peer reviewe