Bakgrund: Fundamenten i vården grundar sig i ett värdefullt bemötande där patientens grundläggande behov tillgodoses. Ett fungerande team i vårdarbetet är en viktig del i att skapa en personcentrerad och patientsäker hälso- och sjukvård. Dessa faktorer är viktiga delar i ett gott omhändertagande av patienter på en akutmottagning.Syfte: Syftet med denna studie var att utforska vilka omvårdnadsbehov som blir tillgodosedda hos kritisk sjuka eller skadade patienter samt funktionen av teamsamverkan på akutmottagningen på Akademiska sjukhuset i Uppsala.Metodbeskrivning: En kvalitativ fältstudie inspirerad av principerna för praktisk etnografi. Med hjälp utav ett observationsprotokoll utfördes 50 observationer som sedan analyserades med deskriptiv statistik samt en innehållsanalys.Resultat: Resultaten från denna studie visar att personalen var skickliga på att kommunicera och skapa en relation med patienterna. Däremot var de inte lika bra på att göra patienterna delaktiga i vården.

Being a patient in intensive care can be experienced terrifying. Studies have demonstrated the link between unpleasant memories of hospitalization in the ICU and the development of posttraumatic stress disorder, depression, anxiety, and perception of quality of life in its aftermath. Placed on a ventilator, the patient is exposed to multiple invasive procedures. The aim was to describe critical care patients' experience of being intubated or tracheostomated. Method: Literature review using conventional content analysis.

Bakgrund: Munnen kan inte ses som separat från resten av kroppen eftersom munhälsan påverkar den generella hälsan. Syfte: Syftet var att belysa betydelsen av användandet av munbedömningsinstrument för vårdpersonalen. Metod: Allmän litteraturstudie. Resultat: Genom en innehållsanalys framkom de två subkategorierna; Ger möjlighet att upptäcka och Tydliggör fortsatt behov av munbedömning. Dessa ledde till kategorin; Munbedömningsinstrumentet ger struktur.

Bakgrund: Vårdmiljön har stor betydelse för hur patienter upplever sin hälsa och sitt välbefinnande. En del trivs med att vårdas i flerbäddsrum medan andra inte gör det. Som sjuksköterska bör denne vara lyhörd för den enskilde individens behov.Syfte: Syftet med litteraturöversikten var att belysa patientens upplevelser av att vårdas i ett flerbäddsrum på en vårdavdelning.Metod: En litteraturöversikt valdes och materialet analyserades med hjälp av en kvalitativ innehållsanalys.Resultat: Studiens resultat visade att patienterna upplevde såväl fördelar som nackdelar med att vårdas i flerbäddsrum. Fördelarna var att de upplevde stöd och sällskap samt att de kunde dela erfarenheter med andra patienter. Nackdelarna var upplevelser av störande ljud samt bristande sekretess och integritet.Konklusion: Att vårdas i ett flerbäddsrum påverkar patienten både positivt och negativt och detta beror på att upplevelser är subjektiva och är individberoende.

The discussion of the swedish treatment of offenders often revolves round the two contradictions punishment and care. Modern prison is described to be based on values such as humanity, care and respect, although the main task is to protect the society from criminals by keeping them locked up. This study focused on the role of the prison officer with the purpose of understanding how he sees his profesional role in an organisation influenced by punishment and care.Central questions are: How does the prison officer handle his role as caretaker in an organisation where he not only has the right to, but also is obliged to, controle and power his clients? How does the prison officer define his working role and does he find any dificulties in combining these?The research was realized during the months of April and May 2005 through qualitative interviews and conversations with prison officers working in a swedish prison. It also contained a minor fieldstudy in that same prison.The results showed that the principle conflict between punishment and care have an insignificant influence on the daily work of the prison officer.

The number of elderly in Sweden is increasing due to improved living conditions and better medical care. It is important that society adapts to the increase and begins to work preventively to reduce the costs of the increase. An important aspect is the elderly accommodation, the cost of health care in specific accommodation is almost twice as high as those for ordinary housing. Therefore, it is important that we availability adapt dwelling to allow older people to live in ordinary housing for as long as they wish, instead of moving to assisted living before they need it. If we can fulfil the elder?s needs with home care instead, society can save a lot of money.In this report, three different forms of housing has undergone accessibility increases and been inventoried and analysed.

The care for the elderly in the municipalities has recently seen the need for a formalized system for quality assurance. Under increasing demands for monetary efficiency while bound by law to retain acceptable standards in health care, there is need for efficient and at the same time quality-assured management. The municipalities often solve this puzzle by introducing systems and standards influenced by theory-clusters such as NPM (New Public Management), TQM (Total Quality Management) or other quality management theories.This essay focuses on how the public administration in the municipalities defines quality and designs and implements system for formalized quality assurance. Our basic view of organizations is institutionalist and our theoretical framework includes theories about quality, NPM and TQM..

Purpose: The purpose of this interview study was to describe the nurses? view of their experiences of interaction with other professionals to improve the elderly patient's nutritional status in municipal elderly care.Method: The study is based on qualitative interviews with nine nurses and was analyzed according to a qualitative content analysis method.Results: The main themes that emerged: Communication among the involved, To feel secure in their role, Lack of structure. The nurses worked closely with nursing staff and cooperated more with doctors about nutrition than with the physiotherapist and occupational therapist. The nurses felt they had the main responsibility for maintaining a good nutritional status of the elderly patient and described themselves as primarily responsible for nutrition while they lacked nutritional competence equal to the responsibilities they had during the whole nutrition process. The nurses had no community dietitian?s skills and felt that the dietitian had a great responsibility and the most updated knowledge in diet and nutrition.

Introduction: Domestic violence is a big public health problem and the hiddennumbers over victims are big. There is a lack of scientific research in the Nordiccountries when it comes to how the health- and medical care identify and care for thevictims of domestic violence. Aim: This literature review has two aims: To investigatewhat kind of methods maternal health services, child health services and gynecologyclinics in the Nordic countries use to discover women and children exposed to domesticviolence and to investigate if there are any guidelines to go by when a victim ofdomestic violence is identified. Method: A literature review. 12 articles were found inPubMed, Scopus and Cinahl and three more were included after a manual search.

Utgångspunkten för denna litteraturstudie är att ventilatorassocierad pneumoni (VAP) går att förebygga. Syftet med detta arbete var att kartlägga olika evidensbaserade munvårdsmetoder som används av intensivvårdssjuksköterskor för att förebygga VAP hos ventilatorbehandlade patienter. Syftet var också att belysa vilka faktorer som påverkar intensivvårdssjuksköterskans utförande av evidensbaserad munvård till ventilatorbehandlade patienter. Studien utfördes som en systematisk litteraturstudie. Till resultatet användes 16 vetenskapliga artiklar.

Stroke is one of the most common diseases in Sweden and the third most common cause of death (National guidelines concerning stroke, 2000). Dysphagia is a common problem for stroke patients with almost 50 percent of patients suffering from severe swallowing dysfunction (Axelsson, Asplund, Norberg & Eriksson, 1989). The purpose of this study was to investigate how stroke patients with dysphagia experience their swallowing disorders. The method used was a qualitative literature study. An analysis of content was carried out using ideas and inspiration from Graneheim and Lundman (2003).

Background: Anxiety with children before surgery is well known. From the 1950s there are various assessment instruments. Despite that most day surgery units offer preparation for children and parents, there are many children who exhibit a strong anxiety the day of surgery, which can lead to postoperative behavioral changes. Today the nurse estimates the anxiety of a child on personal experience and knowledge, forming the basis for estimation whether the child is in need of sedation or not. The purpose: of this study was to evaluate instruments that the nurse can use in measuring the degree of anxiety of children before fast clinical settings, such as day surgery.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

The emergency medical care in Sweden has been under persistent debate, due to factors such as long waiting hours, inefficient patient flow, and understaffed departments. In an effort to meet the critique and with a willingness to improve the problems, an increasing amount of emergency clinics are adopting theories and models within Lean. Positive outcomes are evident, there has been some criticism directed towards Lean. Among these is the argument that in order for Lean to be successful it needs to be used within standardized and foreseeable processes, and that it therefore only is applicable to those kind of processes found within industrial production. This prompted the question of whether Lean was a suitable strategy within emergency medical care, considering the large variation of patients and non-foreseeable processes that in fact share little resemblance to that of industrial production.

Inom palliativ vård är existentiella frågeställningar och andlighet viktiga delar för att uppnå en holistisk vård. Det har dock visat sig att sjuksköterskor har bristandekunskap om och svårigheter att bemöta patienters andliga behov. Eriksson och Watsonär två omvårdnadsteoretiker som belyser den andliga dimensionen av omvårdnaden.Eriksson har en mer kristen syn på andlighet medan Watsons perspektiv ärexistentialistiskt med inflytande av österländskt filosofi. Båda uttrycker dock attetablering av tro och hopp är centrala kännetecken för andlig omvårdnad. Syftet meduppsatsen var att klargöra vilka andliga behov palliativa patienter kan ha och hur dekan komma till uttryck samt hur andliga behov kan uppfyllas.