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Pålsson, Y., Engström, M., Leo Svenne, C. & Mårtensson, G. (2018). A peer learning intervention targeting newly graduated nurses: a feasibility study with a descriptive design based on Medical Research Council framework. Journal of Advanced Nursing, 74(5), 1127-1138
Open this publication in new window or tab >>A peer learning intervention targeting newly graduated nurses: a feasibility study with a descriptive design based on Medical Research Council framework
2018 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 5, p. 1127-1138Article in journal (Refereed) Published
Abstract [en]

AIMS:

To describe the feasibility of a peer learning intervention targeting newly graduated nurses. Feasibility was tested concerning consistency of the theoretical description of peer learning with empirical findings in a new context, compliance and acceptability, as well as usability of a questionnaire measuring the intended future outcome variables.

BACKGROUND:

Newly graduated nurses who meet, socialize and share experiences have described supporting each other's ability to cope with stress. Peer learning involves individuals in a similar situation learning from and with each other through interaction. When implementing new interventions, feasibility studies are used to minimize problems in future evaluation studies.

DESIGN:

Quasi-experimental design with an intervention group, followed over time using descriptive methods. The study was based on the Medical Research Council framework.

METHODS:

Repeated semi-structured interviews, a checklist for fidelity and a questionnaire were conducted with 10 newly graduated nurses from January - March 2015. The intervention's main component included pairs of newly graduated nurses working the same shift and having joint responsibility for a group of patients for a period of three weeks. The intervention also included three months of regular reflection by the pair.

FINDINGS:

Using deductive analysis, the peer learning intervention was found to be consistent with the theoretical description. Due to the compliance and acceptability, there were lessons learned. The tested questionnaire was found to be useful.

CONCLUSIONS: This peer learning intervention seems to be feasible in this context. The present study will serve as the basis for a future full-scale evaluation study.

Keywords
acceptability, compliance; feasibility; intervention; newly graduated nurses; peer learning; process evaluation
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-25509 (URN)10.1111/jan.13513 (DOI)000430121900015 ()29193242 (PubMedID)2-s2.0-85045520168 (Scopus ID)
Projects
Lärandets drivkraft
Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-10-15Bibliographically approved
Eriksson, E. & Engström, M. (2018). Internationally educated nurses’ descriptions of their access to structural empowerment while working in another country’s health care context. Journal of Nursing Management, 26(7), 866-873
Open this publication in new window or tab >>Internationally educated nurses’ descriptions of their access to structural empowerment while working in another country’s health care context
2018 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 26, no 7, p. 866-873Article in journal (Refereed) Published
Abstract [en]

AIM:

To examine internationally educated nurses' experiences of empowerment structures using Kanter's theory of structural empowerment.

BACKGROUND:

There has been an increase in the number of nurses working in other countries worldwide and concerns have been raised regarding their working conditions.

METHOD:

Semi-structured interviews were conducted with a purposive sample of 11 internationally educated nurses. Directed content analysis was used to analyse the data and Kanter's theory of empowerment was used as a framework.

RESULTS:

Access to information was generally good. Access to support for their relationship with their managers varied. Regarding access to resources, nurses unfamiliar with clinical leadership found team leadership challenging. Access to in-house learning opportunities were reported as good. Access to informal power was more common than access to formal power.

CONCLUSIONS:

The findings support Kanter's theory and demonstrate that internationally experienced nurses encountered varying degrees of access to empowering structures. Access to information and formal power was more general and related to the unit. Access to resources, support, opportunities and informal power were related to both the unit and the informants' specific situation as IENs.

IMPLICATIONS FOR NURSING MANAGEMENT:

Managers need to support IENs when having a team leadership role, facilitate encounters between IENs and ordinary staff, and establishing mentorship for IENs.

Keywords
Internationally educated nurses, structural empowerment, support, teamwork, management
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-25517 (URN)10.1111/jonm.12617 (DOI)000446450700012 ()29528163 (PubMedID)2-s2.0-85043479195 (Scopus ID)
Projects
Eerik
Available from: 2017-11-11 Created: 2017-11-11 Last updated: 2018-11-26Bibliographically approved
Forsberg, M., Björn, C., Engström, M. & Nilsson, A. (2018). Nurse anesthetists' reflections on caring for patients with previous substance dependence: Balancing between professionalism and preconceptions. Journal of Perianesthesia Nursing, 33(1), 69-77
Open this publication in new window or tab >>Nurse anesthetists' reflections on caring for patients with previous substance dependence: Balancing between professionalism and preconceptions
2018 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 69-77Article in journal (Refereed) Published
Abstract [en]

Purpose

The study aim was to describe nurse anaesthetists’ reflections on provision of perioperative care to patients with previous substance dependence.

Design

A qualitative approach with a descriptive design.

Methods

Semi-structured interviews based on clinical vignettes were conducted with ten nurse anaesthetists.

Findings

The perioperative care provided to patients with previous substance dependence was perceived as balancing between professionalism and preconceptions for this specific patient group. The nurse anaesthetists felt that anesthetizing this group of patients constituted an anaesthesiological challenge with regard to knowledge, experience and time. However, the nurses also had feelings of distrust and uncertainty due to lack of knowledge.

Conclusion

The nurse anaesthetists strove to uphold the principle that patients who are/have been substance dependent have the same right to adequate treatment and care as all patients. If guidelines were developed for this patient group, care could be made safer and nurses’ sense of uncertainty minimized.

 

Keywords
nurse anaesthetist, relapse, substance abuse, perioperative care
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-21014 (URN)10.1016/j.jopan.2016.01.004 (DOI)000425223700010 ()2-s2.0-85015446147 (Scopus ID)
Available from: 2016-01-14 Created: 2016-01-14 Last updated: 2018-03-15Bibliographically approved
Vae, K. J., Engström, M., Mårtensson, G. & Löfmark, A. (2018). Nursing students' and preceptors’ experience of assessment during clinical practice: a multilevel repeated-interview study of student–preceptor dyads. Nurse Education in Practice, 30, 13-19
Open this publication in new window or tab >>Nursing students' and preceptors’ experience of assessment during clinical practice: a multilevel repeated-interview study of student–preceptor dyads
2018 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 30, p. 13-19Article in journal (Refereed) Published
Abstract [en]

Nursing students' learning process during clinical practice is dependent on the quality of their assessment, and the feedback that is given, however an issue that is very little examined. The aim of this study was to investigate student-preceptor dyads and their experiences of mid-course discussions and final assessment. Data were collected through repeated semi-structured individual interviews with 13 dyads close in time to the assessment discussions, and were analyzed by searching for similarities and differences in their experiences. Both students and preceptors shared the view that the preparations before the discussions caused uncertainty, but they described different reasons. Both students and preceptors meant that the assessment tool was used in a structured way. The feedback mediated to students emphasized what was important to concentrate on in the next part or next period, but less about the individual students' progress. The student-preceptor dyads did not share the view of what content had been in focus in the discussions and there were variations in the details. Conclusions can be drawn that one of the crucial elements of an assessment discussion, to give students constructive feedback in relation to learning outcomes, was not fulfilled.

Keywords
Student nurse, Preceptor, Assessment, Clinical practice
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-25612 (URN)10.1016/j.nepr.2017.11.014 (DOI)000435060300003 ()29475154 (PubMedID)2-s2.0-85042313882 (Scopus ID)
Projects
Lärandets drivkraft
Available from: 2017-11-27 Created: 2017-11-27 Last updated: 2018-07-05Bibliographically approved
Kaltenbrunner, M., Bengtsson, L., Mathiassen, S. E. & Engström, M. (2017). A questionnaire measuring staff perceptions of Lean adoption in healthcare: development and psychometric testing. BMC Health Services Research, 17(1), Article ID 235.
Open this publication in new window or tab >>A questionnaire measuring staff perceptions of Lean adoption in healthcare: development and psychometric testing
2017 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 235Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

During the past decade, the concept of Lean has spread rapidly within the healthcare sector, but there is a lack of instruments that can measure staff's perceptions of Lean adoption. Thus, the aim of the present study was to develop a questionnaire measuring Lean in healthcare, based on Liker's description of Lean, by adapting an existing instrument developed for the service sector.

METHODS:

A mixed-method design was used. Initially, items from the service sector instrument were categorized according to Liker's 14 principles describing Lean within four domains: philosophy, processes, people and partners and problem-solving. Items were lacking for three of Liker's principles and were therefore developed de novo. Think-aloud interviews were conducted with 12 healthcare staff from different professions to contextualize and examine the face validity of the questionnaire prototype. Thereafter, the adjusted questionnaire's psychometric properties were assessed on the basis of a cross-sectional survey among 386 staff working in primary care.

RESULTS:

The think-aloud interviews led to adjustments in the questionnaire to better suit a healthcare context, and the number of items was reduced. Confirmatory factor analysis of the adjusted questionnaire showed a generally acceptable correspondence with Liker's description of Lean. Internal consistency, measured using Cronbach's alpha, for the factors in Liker's description of Lean was 0.60 for the factor people and partners, and over 0.70 for the three other factors. Test-retest reliability measured by the intra-class correlation coefficient ranged from 0.77 to 0.88 for the four factors.

CONCLUSIONS:

We designed a questionnaire capturing staff's perceptions of Lean adoption in healthcare on the basis of Liker's description. This Lean in Healthcare Questionnaire (LiHcQ) showed generally acceptable psychometric properties, which supports its usability for measuring Lean adoption in healthcare. We suggest that further research focus on verifying the usability of LiHcQ in other healthcare settings, and on adjusting the instrument if needed.

Keywords
service sector, health care sector, Lean maturity, instrument development, survey
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hig:diva-22027 (URN)10.1186/s12913-017-2163-x (DOI)000397166800002 ()28340573 (PubMedID)2-s2.0-85016132981 (Scopus ID)
Projects
Lean
Available from: 2016-06-30 Created: 2016-06-30 Last updated: 2018-12-03Bibliographically approved
Hagerman, H., Högberg, H., Skytt, B., Wadensten, B. & Engström, M. (2017). Empowerment and performance of managers and subordinates in elderly care: a longitudinal and multilevel study. Journal of Nursing Management, 25(8), 647-656
Open this publication in new window or tab >>Empowerment and performance of managers and subordinates in elderly care: a longitudinal and multilevel study
Show others...
2017 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, no 8, p. 647-656Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate relationships between first-line managers' ratings of structural and psychological empowerment, and the subordinates' ratings of structural empowerment, as well as their ratings of the managers' leadership-management performance.

BACKGROUND: Work situations in elderly care are complex. To date, few studies have used a longitudinal, correlational and multilevel design to study the working life of subordinates and managers.

METHOD: In five Swedish municipalities, questionnaires were answered twice during 2010-12 by 56 first-line managers and 769 subordinates working in nursing homes or home-help services.

RESULTS: First-line managers' empowerment at Time 1 partially predicted subordinate's structural empowerment and ratings of their managers' leadership-management performance at Time 2. Changes over time partially revealed that the more access managers had to structural empowerment, i.e. increase over time, the higher the ratings were for structural empowerment and managerial leadership-management performance among subordinates.

CONCLUSIONS: Findings strengthen research and theoretical suggestions linking first-line managers' structural empowerment to their subordinates' structural empowerment and ratings of their manager's leadership-management performance.

IMPLICATIONS FOR NURSING MANAGEMENT: Managers with high access to structural empowerment are more likely to provide subordinates access to structural empowerment.

Keywords
first-line manager, leadership-management performance, linear mixed model, structural and psychological empowerment, subordinate
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hig:diva-24874 (URN)10.1111/jonm.12504 (DOI)000414511300009 ()28714218 (PubMedID)2-s2.0-85024843093 (Scopus ID)
Projects
B-LONG
Funder
AFA Insurance
Available from: 2017-08-17 Created: 2017-08-17 Last updated: 2018-03-13Bibliographically approved
Strömberg, A., Engström, M., Hagerman, H. & Skytt, B. (2017). How first-line managers in elderly care deal with what they perceive as different management approaches.
Open this publication in new window or tab >>How first-line managers in elderly care deal with what they perceive as different management approaches
2017 (English)In: Article in journal (Other academic) Submitted
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-25926 (URN)
Projects
B-LONG
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-03-13Bibliographically approved
Björkman, A., Engström, M., Olsson, A. & Wahlberg, A. C. (2017). Identified obstacles and prerequisites in telenurses’ work environment: a modified Delphi study. BMC Health Services Research, 17(1), Article ID 357.
Open this publication in new window or tab >>Identified obstacles and prerequisites in telenurses’ work environment: a modified Delphi study
2017 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 357Article in journal (Refereed) Published
Abstract [en]

Background: Telenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses’ work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses’ work environment.

Methods: A modified Delphi design, using qualitative as well as quantitative data sequentially through three phases, was taken. Data were initially collected via semi-structured interviews (Phase I) and later using a web survey (Phase II-III) between March 2015 and March 2016.

Results: The findings present a consensus view of telenurses’ experiences of important obstacles and prerequisites in their work environment. Central to the findings are the aspects of telenurses having a demanding work, cognitive fatigue and having no opportunity for recovery during the work shift was ranked as important obstacles. Highly ranked prerequisites for managing were being able to focus on one caller at a time, working in a calm and pleasant environment and having technical support 24/7.

Conclusions: Managers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work. 

Keywords
Delphi-study, Nursing, Telenursing, Work environment
National Category
Nursing Work Sciences
Identifiers
urn:nbn:se:hig:diva-24096 (URN)10.1186/s12913-017-2296-y (DOI)000403100900002 ()28521743 (PubMedID)2-s2.0-85019540444 (Scopus ID)
Projects
1177
Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2018-03-13Bibliographically approved
Engström, M., Löfmark, A., Ugland Vae, K. J. & Mårtensson, G. (2017). Nursing students' perceptions of using the Clinical Education Assessment tool AssCE and their overall perceptions of the clinical learning environment: a cross-sectional correlational study. Nurse Education Today, 51, 63-67
Open this publication in new window or tab >>Nursing students' perceptions of using the Clinical Education Assessment tool AssCE and their overall perceptions of the clinical learning environment: a cross-sectional correlational study
2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 51, p. 63-67Article in journal (Refereed) Published
Abstract [en]

Background

Clinical education is a vital part of nursing students' learning; the importance of assessment tools and feedback in stimulating student learning has been stressed, but this needs to be studied in more detail.

Objectives

To examine relationships between nursing students' perceptions of using an Assessment tool in Clinical Education (AssCE) during their mid-course discussion and final assessment, the content discussed during these meetings between the student, preceptor and nurse teacher and the students' overall perception of the clinical learning environment.

Design

A cross-sectional, correlational design was used.

Setting and Participants

A convenience sample of 110 nursing students from one Norwegian university college with two campuses.

Methods

Data were collected with self-developed questionnaires and analysed using logistic regression with SPSS and the PROCESS macro for mediation analysis.

Results

There was a positive relationship between nursing students' perceptions of using the assessment tool AssCE and their overall perception of the clinical learning environment. This relationship was, in turn, mediated by the content discussed during the formative mid-course discussion and summative final assessment.

Conclusions

Our conclusion is that the assessment tool AssCE supported students' clinical learning and that this relationship, in turn, was mediated by the degree to which the conversation during the assessment meeting focused on the student's knowledge, skills and professional judgement.

Keywords
Clinical education assessment tool, Clinical learning environment, Feedback, Nursing students
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-23346 (URN)10.1016/j.nedt.2017.01.009 (DOI)000396957900009 ()28130975 (PubMedID)2-s2.0-85010375382 (Scopus ID)
Projects
AssCE
Available from: 2017-01-20 Created: 2017-01-20 Last updated: 2018-03-13Bibliographically approved
Sjölund, B.-M., Mamhidir, A.-G. & Engström, M. (2017). Pain prevalence among residents living in nursing homes and factors associated with quality of life and well-being.
Open this publication in new window or tab >>Pain prevalence among residents living in nursing homes and factors associated with quality of life and well-being
2017 (English)In: Article in journal (Other academic) Submitted
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-25928 (URN)
Projects
Smärta hos äldre med eller utan kognitiv nedsättning - en interventionsstudie där äldres och vårdares perspektiv efterfrågas
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-03-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9912-5350

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