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  • 1.
    Erlingmark, Julia
    et al.
    University Hospital, Uppsala, Sweden.
    Hedström, Mariann
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Nurse staffing and renal anaemia outcomes in haemodialysis care2016In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 42, no 3, p. 185-189Article in journal (Refereed)
    Abstract [en]

    Background

    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes.

    Objectives

    To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management.

    Design

    Cross-sectional audit. Participants Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. Measurements The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management.

    Results

    The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres.

    Conclusions

    These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation.

  • 2.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Evidence-based Renal Care: Does it Matter2018In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 44, no 2, p. 63-64Article in journal (Other academic)
  • 3.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Fluid removal in haemodialysis - is yours too fast?2017In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 43, no 2, p. 71-72Article in journal (Other academic)
  • 4.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Single-case experimental designs: a clinical research opportunity in renal care2019In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 45, no 2, p. 72-73Article in journal (Other academic)
  • 5.
    Lindberg, Magnus
    et al.
    Uppsala universitet.
    Fernandes, Manuel Agostinho Matos
    University of Evora.
    Self-efficacy in relation to limited fluid intake amongst Portuguese haemodialysis patients2010In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 36, no 3, p. 133-138Article in journal (Refereed)
    Abstract [en]

    Self-efficacy is a temporary and influenceable characteristic, related to situations and tasks, mediating health-promoting behaviours. This study aimed to evaluate psychometric properties of a Portuguese version of the Fluid Intake Appraisal Inventory, and to describe self-efficacy in relation to limited fluid intake amongst Portuguese haemodialysis patients. Respondents were recruited from three dialysis units, and 113 of 155 eligible patients gave their informed consent. The translated scale was distributed and collected by the head nurses. Interdialytic weight gain was calculated as percentage of dry weight. Satisfactory psychometric properties were estimated in the Portuguese context. The participants' self-efficacy in relation to low fluid intake was asymmetrically distributed; the majority had moderately to high self-efficacy while some patients had very low self-efficacy to limited fluid intake. There was a significant difference in self-efficacy to fluid restrictions; patients with a weight gain of 3.5% or less presented higher self-efficacy scores than did patients exceeding the cutoff point.

  • 6.
    Stenberg, Jenny
    et al.
    Uppsala universitet.
    Keane, David
    Department of Renal Medicine, Leeds Teaching Hospitals Trust Leeds, United Kingdom.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Furuland, Hans
    Uppsala universitet.
    Systematic fluid assessment in haemodialysis: Development and validation of a decision aid2020In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 46, no 1, p. 52-61Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: About a third of patients undergoing haemodialysis have poorly controlled fluid status, which may affect survival. Clinical assessment is subjective and imprecise, which has led to the increasing use of devices based on bioimpedance spectroscopy (BIS). However, BIS cannot provide a simple target applicable to all patients. Our aim was to develop and validate a decision aid combining clinical assessment of fluid status with information from BIS in target weight determination.

    METHODS: The decision aid was based on empirical experience and a literature review identifying physiological parameters already used in the clinical assessment of fluid status. Content validity was established by patient representatives, interdisciplinary stakeholders and external experts, who assessed item relevance and comprehensiveness. Reliability was assessed by inter-rater agreement analysis between nurses assessing typical patient cases.

    RESULTS: The decision aid for Recognition and Correction of Volume Alterations (RECOVA) consists of three parts (1) a scoring system; (2) thresholds and triggers; (3) a decision aid algorithm. Agreement between raters in the assessment of symptoms was almost perfect, with Intraclass Correlation Coefficient > 0.90. Agreement in clinical response was only fair, but increased to moderate, with training and self-reported confidence.

    CONCLUSION: RECOVA may enable systematic clinical assessment of fluid status, facilitating early recognition of fluid alterations, and incorporation of bioimpedance into target weight management. However, implementation into clinical practice will require training of staff. Clinical intervention studies are required to evaluate if RECOVA facilitates response to and correction of recognised fluid alterations.

  • 7.
    Westergren, Eva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Ludvigsen, Mette S
    Randers Regional Hospital, Department of Clinical Medicine, Aarhus University, Denmark AND Nord University, Faculty of Nursing and Health Sciences, Norway .
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Associations between materials used and work-related musculoskeletal hand complaints among haemodialysis nurses2020In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686Article in journal (Refereed)
    Abstract [en]

    Background

    One in every two haemodialysis nurses has reported musculoskeletal complaints concerning their hands, which is twice that reported for hospital nurses in general. It is possible that there is an association between the materials used by haemodialysis nurses and the occurrence of hand complaints.

    Objectives

    To examine the association between the type of dialysis machine and disposables used with the occurrence of hand complaints among haemodialysis nurses. To compare occupational risks of developing work‐related musculoskeletal disorders based on the materials used for haemodialysis.

    Design

    Cross‐sectional.

    Participants

    Two hundred and eighty‐two nurses working in 27 haemodialysis centres in Sweden participated in a survey, and 19 nurses at five centres were observed during priming procedures.

    Measurements

    Nurses supplied demographic data and answered the Nordic Musculoskeletal Questionnaire. Centre level data regarding machines and disposables used for haemodialysis during the past year were also collected.

    Results

    There were no differences in the prevalence of hand complaints based on the type of haemodialysis machines, dialysers or tubing used. There were no differences found in physical exposure to the hands during priming, based on machine type used.

    Conclusion

    The results of this study could not reveal any association between disposable materials used and the occurrence of hand complaints among haemodialysis nurses. Additionally, there were no occupational risks detected based on the types of machines used. Hence, the results of the present study strongly indicate that a deeper ergonomic analysis of the work environment is needed to understand the prevalence of hand complaints among nurses working in haemodialysis settings.

1 - 7 of 7
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