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Vitenskapelig publikasjon
(side 216-232)
av Ingeborg Flatgård & Geir Vegard Berg
SammendragEngelsk sammendrag

Simulatortrening som læringsmetode er et viktig bidrag til økt pasientsikkerhet. Lokal full-skala simulatortrening søker å gjenskape virkeligheten og under debrifingsfasen utveksler deltakere opplevelser, erfaringer og kompetanse fra treningen. Debrifing tillegges størst vekt, og beskrives som betydningsfull for læring. Hensikten med studien var å beskrive hvilke erfaringer sykepleiere hadde med debrifingsfasen i full-skala simulatortrening gjennomført ved egen arbeidsplass for å skaffe dybdekunnskap om hva som gir læring. Data ble innhentet gjennom individuelle intervjuer med ti sykepleiere. En halvstrukturert intervjuguide ble benyttet. Data ble analysert med en kvalitativ innholdsanalyse. Sykepleierne erfarte at debrifingen må gjenspeile simuleringen og holdes i en positiv og direkte tone. Fasilitators kompetanse hadde betydning. Forståelsen for egen og andres roller økte og ga større trygghet og bedret samarbeid. Debrifingen opplevdes som en arena hvor en kunne lære av hverandre, reflektere og diskutere behov for endringer. Ytterligere forskning på simulering og debrifing lokalt er nødvendig for å finne ut i hvilken grad metoden bidrar til bedret klinisk praksis og pasientsikkerhet.

Nøkkelord: Fasilitator,kompetanse,læring,pasientsikkerhet,refleksjon

Nurses’ experiences of the debriefing phase in full-scale simulation at their workplace

Simulator training as a teaching method is an important contribution to increased patient safety. Local full-scale simulator training seeks to recreate reality, and during the debriefing phase, the participants exchange experiences from the training. The debriefing phase is considered significant for learning. The purpose of this study was to describe the nurses’ experiences with the debriefing phase in full-scale simulator training conducted at their workplace in order to acquire in-depth knowledge about learning. Data were collected through individual interviews with ten nurses with the use of an interview guide. The analysis was carried out using a qualitative content analysis. The nurses found that debriefing must reflect the simulation and be positive and more direct. The facilitator skills were important. Increased understanding of one’s own and others’ roles could promote cooperation and safety. Debriefing was experienced as an arena where one could learn from each other, reflect and discuss the needs for changes. Additional research on simulation and debriefing held locally is necessary to determine the extent to which the method contributes to increased clinical patient safety.

Vitenskapelig publikasjon
(side 233-246)
av Helle Nordestgaard Matthiesen & Charlotte Delmar
SammendragEngelsk sammendrag

Studier om relationer til livstruede syge, har primært haft fokus på relationernes perspektiv. Men hvordan oplever livstruede syge forholdet til relationer? Her mangler empirisk viden om, hvordan relationers trøst kan styrke værdighed og identitet hos den livstruede syge. Hensigten med denne artikel er at få en differentieret forståelse af, hvordan og i hvilket omfang trøst understøtter livstruede syges bestræbelser på at magte livet med de forandringer, sygdommen medfører. Projektet har et kvalitativt design. Forskningsspørgsmålene belyses ved individuelle samtaler med seks livstruede syge. Samtalerne tager afsæt i livsfortællinger, hvor det kvalitative dybdeinterview anvendes for at få en mere detaljeret indsigt i og forståelse af, hvordan livstruede syge møder døden. Undersøgelsen viser, at livstruede syge oplever fire forskellige former for trøst: Den aktive trøst, trøst som ynk, fravær af trøst og trøst som handlekraft. Den aktive trøst understøtter identitet gennem sociale aktiviteter tæt på værdier og tidligere livsstil. Trøst som ynk er medynk præget af sentimentalitet og omklamring. Fravær af trøst skaber afmagt. Trøst som handlekraft transformerer problemer til universelle problemer og har en understøttende identitetsskabende effekt i lighed med aktiv trøst.

Nøkkelord: Betydningsfulde relationer,livstruede syge,trøst,uhelbredeligt syge

How do terminally ill patients facing death experience comfort? – a differentiated understanding of their network

Studies on relations to persons with a life-threatening disease primarily focus on the relational perspective. But how does the patient experience these relations? Empirical knowledge is lacking on how comfort from these relations can strengthen dignity and identity. The intention with this article is to obtain a differentiated understanding of how and to which extent comfort supports patients in their strive to cope with life and the changes caused by the disease. The project has a qualitative design; research questions are investigated through individual interviews with six persons with a life-threatening disease. The qualitative in-depth interview is used to obtain a more detailed insight into and understanding of how the person with a life-threatening disease faces death. The study revealed that persons with a life-threatening disease experience four different types of comfort: Active comfort, comfort as pity, absence of comfort and comfort as a drive to act. The active comfort supports the identity. Comfort as pity is characterized by sentimentality and clinging. Absence of comfort creates powerlessness. Comfort as a drive to act transforms problems into universal problems and creates identity similar to active comfort.

Vitenskapelig publikasjon
(side 247-260)
av Britt Borregaard, Birgitte Lerbæk, Søren Bak & Mette Spliid Ludvigsen
Engelsk sammendrag

Deep sternal wound infection is one of the most serious complications after cardiac surgery, and it is treated with negative pressure wound therapy, NPWT. In Denmark the incidence rate for postoperative infections are at 3.5%. The aim of the study is to explore how patients with deep sternal wound infection after cardiac surgery experience NPWT. The study had an explorative design, were in-depth semi-structured interviews were performed. Seven men were given the opportunity to narrate their experiences. The analysis was conducted within a phenomenological hermeneutic framework based on the French philosopher Paul Ricoeur’s text interpretation theory. Four themes were developed: «Being affected by having an infection of the heart», «Needing time on your own», «Feeling difficulties understanding the hospitalisation» and «Needing professionals to go through the hospitalisation with you». Conclusively, patients treated with NPWT after cardiac surgery experience being psychologically affected during the process. The participants describe both the infection and the following hospitalisation as reasons for changes in their psychological state. Furthermore the participants call for more contact given by only a few nurses to improve their hospitalisation.

Vitenskapelig publikasjon
(side 261-277)
av Lisbeth Uhrenfeldt, Marie-Louise Ulsøe, Preben Ulrich Pedersen & Jette Ammentorp
Engelsk sammendrag

This study aimed for competency development and capacity building based on a course with a total of 35 hours of lectures and a double coaching intervention that included one mutual coaching session on the last day of the course and one individual face to face coaching session with each of the leaders. The participants were clinical leaders (n=9) from different departments in a Danish public urban teaching hospital. The evaluations through double interviews revealed that clinical leaders’ experiences could be categorized in two main themes: 1) combining clinical leadership and research strategy, and 2) clinically relevant research. The evaluations through surveys indicated that after the coaching, the clinical leaders had a clearer picture of their core qualifications and what/how to prioritize. We found stimulating dialogues about clinical relevant research in continuous education and supported by coaching gave clinical leaders inspiration for their leadership practice in hospitals.

Vitenskapelig publikasjon
(side 278-294)
av Jónvør Christiansen & Lisbeth Fagerström
SammendragEngelsk sammendrag

Formålet med studiet var at beskrive sygeplejelederes opfattelse af behovet for avanceret klinisk sygepleje (AKS) til ældre i primær sektor i Norden samt indholdet og organisatoriske forudsætninger for nye AKS modeller i ældreomsorgen. Metode: Kvalitativt design og semistruktureret interview blev udført med fem ledere i fire nordiske lande. Resultaterne er analyseret ifølge Kvale og Brinkmanns indholdsanalyse. Resultaterne er præsenteret i fire hovedkategorier med tilhørende underkategorier. Sygeplejeledere vurderer, at ældreområdet har behov for øget faglig kompetence, omorganisering og nye sygeplejemodeller. Sygeplejeledere må gøre det nødvendige forarbejde til strategisk integrering af AKS i ældrepleje.

Nøkkelord: Avanceret sygepleje, kvalitativ indholdsanalyse, lede forandring, omorganisering, sygeplejeledelse, ældreomsorg

Need for advanced practice nursing of older persons in the Nordic region. Nursing leaders’ perspective

The purpose of the study was to describe nursing managers' perception of the need for advanced practice nursing (APN) to older persons in primary healthcare in the Nordic region and the content and organizational preconditions for new APN models for elderly care. Method: Qualitative design and semistructered interview was conducted with five managers in four Nordic countries. The results are analyzed according to Kvale and Brinkmann's content analysis. The results are presented in four main categories with 11 subcategories. Nursing leaders assess that there is a need for increased professional competence, reorganization and new nursing models. Nursing leaders must do the necessary groundwork for the strategic integration of APN in elderly care.

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