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National telephone advice nursing in Sweden: patient safety and communication
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.ORCID-id: 0000-0001-9513-3102
2012 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Ort, förlag, år, upplaga, sidor
Uppsala: Uppsala universitet, 2012.
Serie
Acta Universitatis Upsaliensis, ISSN 1651-6206
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:hig:diva-13108ISBN: 978-91-554-8404-0 (tryckt)OAI: oai:DiVA.org:hig-13108DiVA, id: diva2:557037
Disputation
Universitetshuset, Biskopsgatan 3, Uppsala (Svenska)
Opponent
Handledare
Projekt
Nationellt samordnad telefonrådgivning utifrån ett patientsäkerhetsperspektivTillgänglig från: 2012-10-01 Skapad: 2012-09-26 Senast uppdaterad: 2018-03-13Bibliografiskt granskad
Delarbeten
1. Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why?
Öppna denna publikation i ny flik eller fönster >>Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why?
2012 (Engelska)Ingår i: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 18, nr 7, s. 379-383Artikel i tidskrift (Refereegranskat) Published
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:hig:diva-12917 (URN)10.1258/jtt.2012.120416 (DOI)000311522300003 ()2-s2.0-84868326380 (Scopus ID)
Projekt
National telephone advice nursing in Sweden
Tillgänglig från: 2012-09-17 Skapad: 2012-09-17 Senast uppdaterad: 2018-03-13Bibliografiskt granskad
2. Incident reporting in nurse-led national telephone triage in Sweden: The reported errors reveal a pattern that needs to be broken
Öppna denna publikation i ny flik eller fönster >>Incident reporting in nurse-led national telephone triage in Sweden: The reported errors reveal a pattern that needs to be broken
2010 (Engelska)Ingår i: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 16, nr 5, s. 243-247Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

We conducted a retrospective study of incident reports concerning the national, nurse-led telephone triage system in Sweden. The Swedish Health Care Direct organization (SHD) is staffed by registered nurses who act as telenurses and triage the callers' need for care, using a computerized decision support system. Data were collected during 2007 from all county councils that participated in the SHD and were analysed using content analysis. Incident reports were then compared concerning differences in reported categories and who reported the errors. The 426 incident reports included 452 errors. Of the analysed incident reports, 41% concerned accessibility problems, 25% incorrect assessment, 15% routines/guidelines, 13% technical problems and 6% information and communication. The most frequent outgoing incident reports (i.e. sent from SHD to other health-care providers) concerned accessibility problems and the most frequently incoming reports (i.e. sent to SHD from other health-care providers) concerned incorrect assessment. There was a significant difference (P < 0.001) between outgoing and incoming reports regarding the main category. Telenurses have limited possibilities for referring the caller to their primary health-care provider or specialist, which may cause them to over-triage or under-triage the callers' need for care. This over-triage or under-triage may in turn cause other health-care providers to report incorrect assessment to SHD. The implications for practice are that poor accessibility is a matter that should be addressed and that the reasons for incorrect assessment should be explored.

Nyckelord
Swedish Health Care Direct organization (SHD), registered nurses, national telephone triage, telenurses
Nationell ämneskategori
Omvårdnad
Identifikatorer
urn:nbn:se:hig:diva-7557 (URN)10.1258/jtt.2009.090813 (DOI)000280360000004 ()20457800 (PubMedID)2-s2.0-77954882765 (Scopus ID)
Projekt
Nationellt samordnad telefonrådgivning utifrån ett patientsäkerhetsperspektiv
Tillgänglig från: 2010-09-11 Skapad: 2010-09-11 Senast uppdaterad: 2018-03-13Bibliografiskt granskad
3. Communication challenges in Swedish telephone advice nursing: analysis of actual calls
Öppna denna publikation i ny flik eller fönster >>Communication challenges in Swedish telephone advice nursing: analysis of actual calls
Visa övriga...
2011 (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:hig:diva-13125 (URN)
Projekt
National telephone advice nursing in Sweden
Tillgänglig från: 2011-09-26 Skapad: 2012-10-01 Senast uppdaterad: 2018-03-13Bibliografiskt granskad
4. Telenurses' experiences of working with computerized decision support: Supporting, inhibiting and quality improving
Öppna denna publikation i ny flik eller fönster >>Telenurses' experiences of working with computerized decision support: Supporting, inhibiting and quality improving
2009 (Engelska)Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, nr 5, s. 1074-1083Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim. This paper is a report of a study conducted to describe telenurses' experiences of working with computerized decision support systems and how such systems could influence their work. Background. Telenursing is an expanding service in many Western countries, and in recent years centralization of telenursing services has occurred in Sweden. In connection with this, the use of computerized decision support has increased. Method. Eight Registered Nurses from three telephone advice call centres in Sweden who were using computerized decision support took part in semi-structured interviews in 2006. The data were analysed using qualitative content analysis. Findings. The findings are presented as one theme and three categories. Telenurses experienced their work with a decision support system as supporting, inhibiting and quality improving. Based on two of the categories -'supporting' and 'inhibiting'- a theme was revealed: being strengthened, but simultaneously controlled and inhibited. This theme represents the individual level. The telenurses found that the decision support system simplified their work, complemented their knowledge, gave them security and enhanced their credibility. They also described experiencing the system as incomplete, sometimes in conflict with their own opinions and controlling. The third category referred to the organizational level: the decision support system ensured the quality of telenursing. Conclusions. Although the telenurses experienced computerized decision support as both supporting and inhibiting, they preferred working with it. They also described how a computerized decision support system cannot replace telenurses'knowledge and competence, and that it should be considered as complementary.

Nyckelord
Communications skills; Competence; Computerized decision support; Experiences; Knowledge; Qualitative research; Telenurses
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:hig:diva-5083 (URN)10.1111/j.1365-2648.2009.04966.x (DOI)000264821000017 ()19399984 (PubMedID)2-s2.0-63849324097 (Scopus ID)
Projekt
Nationellt samordnad telefonrådgivning utifrån ett patientsäkerhetsperspektiv
Tillgänglig från: 2009-10-13 Skapad: 2009-08-24 Senast uppdaterad: 2018-03-13Bibliografiskt granskad

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