Den övergripande avsikten med denna uppsats är att försöka ge en nyanserad bild av organisationsreceptet Lean Production. Vidare försöker jag utröna vilka potentiella vinster och risker som kan tänkas uppträda i samband med implementeringen av Lean Healthcare på Universitetssjukhuset i Lund. Utgångspunkten för denna analys är Region Skånes verksamhetsmål gällande personal, patienter och ekonomi. Analysen visar att det inte är helt okontroversiellt eller oproblematiskt att anpassa och införa produktionssystemet. Allvarligast verkar konsekvenserna kunna bli för tillgodoseendet av personalmålen, medan det ser mindre problematiskt ut gällande de ekonomiska målen och patientmålen.

Background: Urinary tract infections caused by indwelling urinary catheters causes unneccesay suffering among those it affects. These infections are also financially straining on the health care services. It is therefore of importance to gain knowledge about which evidence based preventive interventions that have the possibility to reduce the risk for bacteriuria and urinary tract infections among patients with indwelling urinary catheters. Aim: This study aimed to compile available knowledge concerning i) if silver alloy catheters does reduce bacteriuria in this patient group, ii) if aseptic catheterization does reduce bacteriuria in this patientgroup, iii) which routines for changing the urinary drainage bag reduces the risk of bacteriuria, iv) which routine genital hygenic care reduces the risk of bacteriuria? Method: Litterature was searched for in the data bases Cinahl, Medline and The Cochrane Library using the data bases? thesaurius combined with OR/AND.

Cancer was the second most common cause of death in Sweden in 2011. As the number of beds in hospitals decreases, numerous severely ill patients receive care at home. This results in family members performing important parts of the caring process. The aim of this study was to describe the caregivers' support needs from healthcare professionals when caring for an adult relative with cancer. A literature review was performed, in which results from empirical studies were reviewed and summarized.

Background: Postoperative infections are a serious patient safety problem and affects about 3 % of all patients undergoing surgery. The consequences are prolonged hospital stays, high social costs, increased use of antibiotics and impaired quality of life for the patient. It has been shown that postoperative infections may be caused by contamination already in the operating room. Today we know that there is growth of microorganisms on the instrument table´s top, but there is a research gap about the instrument table's edges.Aim: To examine if the sterile drape on the instrument table´s edges are sterile after finished surgery.Method: Contact plates are printed on strategically selected areas on the sterile drapes top and edges. In the pilot study, a total of 51 cultures were taken at the end of three operations which lasted over three hours.Results: Growth on the top surface and the edges of the sterile drape were detected.

Enligt Socialstyrelsen (2011) avlider cirka 1 500 människor årligen i Sverige på grund av vårdrelaterade infektioner. Den viktigaste åtgärden för att förebygga vårdrelaterade infektioner är att arbeta utifrån basala hygienrutiner (Socialstyrelsen, 2006). Det är idag oklart hur följsamheten till basala hygienrutiner ser ut inom primärvården i Sverige och bland distriktssköterskor. Syftet med studien var att undersöka distriktssköterskors följsamhet till basala hygienrutiner inom primärvården. Studien var baserad på strukturerade observationer och en enkät.

Bakground: Puerperal fever caused by group A Streptococcus is in a global context seen as a common cause of death in childbirth.Aim: To examine the consequences of group A streptococcus infections in women postpartum and to see what a nurse can do to stop the infection with adequate nursing interventions.Method: This is a review built on 15 articles. These articles were read in full and audited with a suitable template.Result: Women postpartum has 20 times higher risk to get group A stretococcus infection as compared to non pregnant. The consequences of Group A Streptococcus infection can lead to high fever, abscesses around the uterus, sepsis, acute respiratory distress syndrome (ARDS), hysterectomy and death. Patients who share room with infected patients carries an increased risk to be infected. Curtains between patient beds can be colonized by Group A Streptococcus.

During 2001-2002 a prototype, IMIS (Integrated Mobile Information System) was developed at BTH (Blekinge University of Technology) to demonstrate how mobile IT-systems can be used in healthcare. The prototype was based on the activity theory of Engeström. An ongoing project started in spring 2003. The purpose of the project is further development of IMIS with special focus in the diabetes healthcare. Participants in the project are scientists and students at BTH, ALMI Företagspartner, Blekinge FoU-enhet, Barndiabetesförbundet Blekinge, Blekinge Diabetesförening, Vårdcentralen Ronneby and Vårdcentralen Sölvesborg.

The purpose of this thesis is to discuss how an instrument originally developed for measuring changes toward lean thinking inservice organizations in general should be adjusted in order to be of use in service organizations within the healthcare sector, andin hospital organizations in specific. The adjustments are suggested based on difficulties specifically arising when implementinglean within the healthcare sector.Thesis starting point is a pre-existing lean assessment instrument developed for service organizations in general. The thesis appliesa qualitative method and integrates literature from the health care sector and lean production movement with the expertise of tenacademics and practitioners in order to find difficulties associated with the implementation of lean within the healthcare sector.These difficulties then lie as the substratum for the adjustments suggested to be made on the instrument.The thesis finds that lean, as a philosophy, does not differ between service organizations in general and service organizationswithin healthcare settings. However, due to deficits in the general understanding of lean some adaptions on the instrument mustbe made. First, some words associated with production must be changed to words associated with healthcare.

The effectiveness of Phlebiopsis gigantea to prevent spore infections from Heterobasidionannosum and Heterobasidion parviporum on hybrid larch stumps were investigated in fivestands in southern Sweden. All sites are former forest land and the age of the trees wasbetween 9 and 13 years.The study was implemented in August 2010, a month where spore dispersal should be great.The five sites were located in previously un?thinned monocultures of hybrid larch. The sporeload in the air was studied with the help of spore traps from three different tree species;Norway spruce, Scots pine and hybrid larch. A total of 146 spore traps, evenly distributed inall five sites were analyzed.

Senior citizens require a healthy oral cavity and healthy teeth in order to eat, speak and preserve their well-being. With age we know that the incidence and prevalence of diseases and symptoms originating from the oral cavity are more common compared to younger age groups. Senior citizens are the fastest growing population on earth, thus the need of healthcare providers with knowledge and skills in oral healthcare are in great demand.  The purpose of this thesis is to identify oral healthcare interventions and educational interventions which have been shown to improve oral health of residents over 65 years of age.  A literature review was conducted in which 15 scientific articles were scrutinized. Databases used were PubMed, Cinahl and Scopus. The results imply that good oral healthcare not only improve the oral health of senior citizens, but also prevents the occurrence of other diseases such as pneumonia and  improve the overall quality of life.

The role of Art in Healthcare and its requirements through a study of Diagnostic Center (DC), a Hospital with Art and Architecture integrated.Issues: Who selected Art for DC and on what foundations? How are Art and Architecture integrated, and what is the established knowledge of Art in Healthcare?Studies of reference material, theses, research articles and interviews. Hermeneutic and discourse analyses were used.Theorists: Barthes, Bourdieu, Foucault, Arnheim, Sjögren, Rasmussen.Results: A regional group selected local Art, mainly nonfigurative, and integrated it early in the architectural process. A stimulating non-traditional hospital environment with a modern design and two artists created work specifically for the environment.Art affects our Health and Caring Sciences is a scientific field that is studying how art affects patients and staff. It is relatively new but it is growing into a vast field of research, learning more about Art's effect on Health..

Background: In Sweden the healthcare has moved from the homes to the hospitals, as the system has developed. Parents were not allowed to visit their children when they were hospitalised in the past. It was noticed in the beginning of the 20th century that it might be harmful for the children to be left without parents at the hospital. Today it is considered a fact that the parents should stay with their hospitalised children and the healthcare is based on a family-centered care. Aim: The aim of this literature study was to elucidate parents experience when having hospitalised children.

Background: Hand hygiene is the simplest and most fundamental means to prevent care related infections. It is of great importance that the guideline of hand hygiene is followed for the patient?s sake. Unfortunately, healthcare workers perform hand hygiene too seldom. If the patient comes down with a care related infection, the suffering will increase.

Today significant resources are provided to improve the digital work environment within the Swedish healthcare to create efficiency, good work environment and patient safety. Despite this, major flaws are shown by the lack of communication between the eHealthcare systems. This becomes a stress factor among healthcare professionals because of increased administration and decreased physical contact with patients. The purpose of this study is to create a understanding of the concept of interoperability at different levels in the eHealthcare systems. This has been conducted through a qualitative interview study at a healthcare center where the respondents have been describing their digital work environment and the way it works today.

IN THIS THESIS WE EXAMINE LEAN IN HEALTHCARE, IN PARTICULAR WE LOOK AT THE PERCEIVED CHANGES BY THE PEOPLE WORKING IN THE PROCESS AS WELL AS THE ONES WORKING WITH MORE ADMINISTRATIVE TASKS. WE ALSO ASK OURSELVES IF THESE CHANGES ARE SUSTAINABLE. OUR STUDY IS DONE ON THREE CLINICS (LOCATED IN SÖDERTÄLJE, LANDSKRONA AND MALMÖ). THE STUDY IS PERFORMED THROUGH DEEP-INTERVIEWS WITH A FEW KEY PEOPLE IN THE DIFFERENT CLINICS. FURTHER A SURVEY IS SUBMITTED TO EACH OF THE THREE CLINICS TO GET A BROADER INSIGHT OF THE PERSONNEL'S VIEW ON THE CHANGES.