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  • 1.
    Arvidsson, Lisa
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Healthcare personnel's working conditions in relation to risk behaviours for organism transmission: A mixed-methods study2022Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 31, nr 7-8, s. 878-894Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To investigate healthcare personnel's working conditions in relation to risk behaviours for organism transmission.

    BACKGROUND: Healthcare personnel's behaviour is often influenced by working conditions that in turn can impact the development of healthcare-associated infections. Observational studies are scarce, and further understanding of working conditions in relation to behaviour is essential for the benefit of the healthcare personnel and the safety of the patients.

    DESIGN: A mixed-methods convergent design.

    METHODS: Data were collected during 104 h of observation at eight hospital units. All 79 observed healthcare personnel were interviewed. Structured interviews covering aspects of working conditions were performed with the respective first-line manager. The qualitative and quantitative data were collected concurrently and given equal priority. Data were analysed separately and then merged. The study follows the GRAMMS guidelines for reporting mixed-methods research.

    RESULTS: Regardless of measurable and perceived working conditions, risk behaviours frequently occurred especially missed hand disinfection. Healthcare personnel described staffing levels, patient-level workload, physical factors and interruptions as important conditions that influence infection prevention behaviours. The statistical analyses confirmed that interruptions increase the frequency of risk behaviours. Significantly higher frequencies of risk behaviours also occurred in activities where healthcare personnel worked together, which in the interviews was described as a consequence of caring for high-need patients.

    CONCLUSIONS: These mixed-methods findings illustrate that healthcare personnel's perceptions do not always correspond to the observed results since risk behaviours frequently occurred regardless of the observed and perceived working conditions. Facilitating the possibility for healthcare personnel to work undisturbed when needed is essential for their benefit and for patient safety.

    RELEVANCE FOR CLINICAL PRACTICE: The results can be used to enlighten healthcare personnel and managers and when designing future infection prevention work.

    Fulltekst (pdf)
    fulltext
  • 2.
    Arvidsson, Lisa
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Nurses’ assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress2023Inngår i: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 74, nr 2, s. 501-513Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Nurses’ working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees’ behaviour at work. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions.

    OBJECTIVE: To investigate the relationship between nurses assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress.

    METHODS: A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions of Work Effectiveness Questionnaire-II, Utrecht Work Engagement Scale-9 and the Health & Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed.

    RESULTS: The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis were 0.254–0.268. Significant differences in self-efficacy were found in the grouped working conditions.

    CONCLUSIONS: This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.

    Fulltekst (pdf)
    fulltext
  • 3.
    Lindberg, Magnus
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Bäckström-Andersson, Helena
    Gävle Hospital, Gävle, Sweden.
    Lindström, Rosmarie
    Gävle Hospital, Gävle, Sweden.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Dry weight from the haemodialysis patient perspective2013Inngår i: Renal Society of Australasia Journal, ISSN 1832-3804, Vol. 9, nr 2, s. 68-73Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background:The concept of dry weight is central to fluid control in patients on haemodialysis (HD). Few studies have explored the concept from the patient perspective. Thus, the aim of the present study was to explore how patients on HD perceive the concept of dry weight and how they act in relation to it.

    Methods:A purposive sample of 10 HD patients was interviewed once during a dialysis session in May–June 2009. The narratives were analysed using manifest qualitative content analysis.

    Findings: The findings indicated that the concept was regarded as either an aid to securing treatment-related health, as indicating the fluid surplus volume or as a reminder of the daily fluid allotment. Some informants, however, did not report any specific perception. Plans for dealing with the perceptions were expressed in terms of using self-care strategies to control fluid balance, transferring responsibility to the HD team, and managing the physical consequences or social and psychological concerns.

    Conclusion: Four ways in which HD patients perceived the dry weight concept were demonstrated. It is important that HD patients understand the significance of dry weight, both for their own wellbeing and for treatment adequacy. Prevalent misunderstandings about the dry weight concept have to be addressed by the dialysis team in order to prevent further suffering. By acknowledging the patient’s perspective of the dry weight concept, the dialysis team could help the patient to successfully develop self-care strategies for dealing with the consequences of chronic renal failure.

  • 4.
    Lindberg, Magnus
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Wågström, Britt-Mari
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Arvidsson, Lisa
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research and Development, Uppsala University / County Council of Gävleborg, Gävle, Sweden.
    Risk behaviours for organism transmission in daily care activities: a longitudinal observational case study2018Inngår i: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 100, nr 3, s. e146-e150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: To understand healthcare personnel's infection prevention behaviour has long been viewed as a key factor in preventing healthcare-associated infections. Suboptimal hand hygiene compliance and handling of materials, equipment and surfaces present the main risks for potential organism transmission. Further exploration is needed regarding the role of context-specific conditions and the infection prevention behaviours of healthcare personnel. Such knowledge could enable the development of new intervention strategies for modifying behaviour.

    AIM: To describe risk behaviours for organism transmission in daily care activities over time.

    METHODS: Unstructured observations of healthcare personnel carrying out patient related activities were performed on 12 occasions over a period of 18 months.

    FINDINGS: Risk behaviours for organism transmission occur frequently in daily care activities and the results shows that the occurrence is somewhat stable over time. Interruptions in care activities contribute to an increased risk for organism transmission that could lead to subsequent healthcare-associated infection.

    CONCLUSION: Interventions aimed at reducing the risks of healthcare-associated infections need to focus on strategies that address: hand hygiene compliance; the handling of materials, equipment, work clothes and surfaces; as well as the effects of interruptions in care activities if they are to alter healthcare personnel's infection prevention behaviour sufficiently.

  • 5.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Methicillin-resistant Staphylococcus aureus (MRSA) an Unclear and Untoward Issue: Patient-Professional Interactions, Experiences, Attitudes and Responsibility2012Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of the present thesis was to investigate experiences of living with multidrug-resistant bacteria (MDRB), using methicillin-resistant Staphylococcus aureus (MRSA) colonization as an illustration, and to develop and validate a tool to describe healthcare personnel’s attitudes towards patients with MDRB. A further objective was to study MRSA-colonized persons’ and healthcare personnel’s experiences of patient-professional interactions and responsibilities for infection prevention.

    Four empirical studies were conducted. A total of 18 MRSA-colonized persons and 20 healthcare personnel were interviewed regarding their experiences, and a total of 726 RNs responded the MDRB Attitude Questionnaire.

    The findings revealed the difficulties associated with living with MRSA colonization, which was described as something uncertain, and as an indefinable threat that has to be managed in both everyday life and in contacts with healthcare. Interactions with healthcare personnel were described as unprofessional owing to personnel’s inappropriate behaviour and insufficient information provision. According to the personnel, achieving adequate patient-professional interactions required having knowledge and experiences of MRSA. They also experienced difficulties in providing tailored information to patients. The MRSA-colonized persons described their unwanted responsibility to inform healthcare personnel about the colonization, but also felt responsible for limiting the spread of infection to others. Furthermore, responsibility for infection control was regarded as shared between healthcare personnel and patients. The personnel described such responsibility as a natural part of their daily work, although it was not always easy to adhere to hygiene precautions. The MRSA-colonized persons felt that healthcare personnel have insufficient knowledge of the bacteria and of hygiene precautions. The MDRB Attitude Questionnaire showed that registered nurses do have knowledge deficiencies. The MDRB Attitude Questionnaire has adequate psychometric properties.

    In conclusion, MRSA colonization constitutes a psychological strain for carriers, and interactions with healthcare personnel resulted in feelings of stigmatization. The present thesis indicates that there is a need to improve healthcare personnel’s knowledge, behaviour and emotional response in relation to patients with MDRB, in order to ensure patient safety and address patients’ needs. The heads of department is responsible for such improvements, and the MDRB Attitude Questionnaire is useful in identifying areas in need for improvement.

  • 6.
    Lindberg, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Centre for research and Development, Uppsala University, Gävle. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala; Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Nursing student's expectations for their future profession and motivating factors - a longitudinal descriptive study from Sweden2020Inngår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 84, artikkel-id 104218Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    The shortage of registered nurses is a global concern. Motives to become registered nurses can be to help others, altruism, personal development and career security. Motives in combination with student expectations regarding the role are not explored.

    Objective

    To describe students' motives to become registered nurses and their expectations regarding their future profession.

    Design

    A longitudinal descriptive design with a qualitative approach was used to follow nursing students in the beginning, during and at the end of their education.

    Participants and setting

    A purposive sampling of a group with initially 75 students starting a three-year nursing program at a university in Sweden.

    Methods

    A study specific questionnaire with open-ended questions was used in the beginning, during and the end of the students' education. At data collection two and three, a copy of the earlier answers was attached. Data were analysed using manifest and latent content analysis.

    Results

    An important profession with career opportunities, interesting duties and team work were described. Students expected diversified duties, possibilities for development and work satisfaction. Increased concerns regarding their upcoming work life was described at the end of the education.

    Conclusion

    The students had a positive understanding of the profession and perceived their forthcoming role as interesting. The leading role of coordinating patient care was more comprehensive than expected. Supportive conditions and well planned transition periods could strengthen newly graduated nurses in their professional role and could be an important aspect in the future retention of RNs.

  • 7.
    Lindberg, Maria
    et al.
    Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden; Section for Caring Sciences, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    Section for Caring Sciences, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Högman, Marieann
    Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Skytt, Bernice
    Högskolan i Gävle, Institutionen för vårdvetenskap och sociologi, Ämnesavdelningen för vårdvetenskap. Section for Caring Sciences, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Suffering from meticillin-resistant Staphylococcus aureus: experience and understanding of colonisation2009Inngår i: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 73, nr 3, s. 271-277Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective was to explore individuals' experiences and understandings of meticillin-resistant Staphylococcus aureus (MRSA) colonisation. Thirteen interviews were performed and processed using content analysis, resulting in the theme ‘Invaded, insecure and alone’. The participants experienced fears and limitations in everyday life and expressed a need to protect others from contagion. Moreover, they experienced encounters with, and information from, healthcare workers differently: some were content, whereas others were discontent. The described fears, limitations and inadequate professional–patient relationship generated unacceptable distress for MRSA-colonised persons. Thus, the healthcare sector should assume responsibility for managing MRSA, and healthcare workers must improve their professionalism and information skills, so as to better meet MRSA-colonised persons' needs

  • 8.
    Lindberg, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University; Centre for Research and Development, Uppsala University/County Council of Gävleborg.
    Carlsson, Marianne
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University.
    MRSA-colonized persons’ and healthcare personnel's experiences of patient-professional interactions in and responsibilities for infection prevention in Sweden2014Inngår i: Journal of Infection and Public Health, ISSN 1876-0341, Vol. 7, nr 5, s. 427-435Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patient-professional interactions and adherence to infection control measures are central to the quality of care and patient safety in healthcare. Persons colonized with methicillin-resistant Staphylococcus aureus (MRSA) describe insufficient support and unprofessional behavior among healthcare personnel. Methods: A descriptive qualitative study was conducted to investigate managers', physicians', registered nurses' and MRSA-colonized persons' experiences of patient-professional interactions in relation to and responsibilities for infection prevention in the care of colonized patients. Five persons with MRSA colonization and 20 healthcare personnel employed within infection, hematology, nephrology or primary healthcare settings participated. The data were collected using open-ended semi-structured individual interviews with the MRSA-colonized persons and semi-structured focus group interviews with the healthcare personnel. Results: The participants perceived MRSA as an indefinable threat and described that the responsibility for infection prevention is important, but such adherence was a neglected and negotiable issue. The described actions that were acknowledged as unprofessional and inappropriate adherence to infection prevention resulted in stigmatized patients. Conclusion: Colonized persons' and healthcare personnel's understanding of MRSA determines whether the personnel's behavior is perceived as proper or improper. Individual responsibility for patient-professional interactions in relation to MRSA colonization and adherence to infection control measures should be more stringent.

  • 9.
    Lindberg, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Centre for Research and Development, Region Gävleborg/Uppsala University; Uppsala University.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Development and Validation of the Infection Prevention Appraisal Scale2023Inngår i: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 13, nr 1, s. 157-165Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    It has been emphasized that future studies aimed at improving adherence to infection prevention guidelines should focus on beliefs in, e.g., self-efficacy. Reliable situation specific measures are needed to measure the phenomenon of self-efficacy, but there seems to be few valid scales available that are suitable for measuring one’s belief in self-efficacy regarding infection prevention measures. The purpose of the study was to develop a unidimensional appraisal scale to capture nurses’ beliefs in their abilities to practice medical asepsis in care situations. When creating the items, evidence-based guidelines for preventing healthcare-associated infections were used together with Bandura’s guide for constructing self-efficacy scales. Face validity, content validity, and concurrent validity were tested in various samples of the target population. Furthermore, dimensionality was evaluated on data collected from 525 registered nurses and licensed practical nurses recruited from the medical, surgical, and orthopaedic wards of 22 Swedish hospitals. The Infection Prevention Appraisal Scale (IPAS) consists of 14 items. Face and content validity were endorsed by target population representatives. The exploratory factor analysis suggested unidimensionality, and the internal consistency was good (Cronbach’s alpha 0.83). The total scale score correlated with the General Self-Efficacy Scale, as expected, and supported concurrent validity. The Infection Prevention Appraisal Scale demonstrates sound psychometric properties supporting a unidimensional measure of self-efficacy to medical asepsis in care situations.

    Fulltekst (pdf)
    fulltext
  • 10.
    Lindberg, Maria
    et al.
    Uppsala universitet.
    Lindberg, Magnus
    Uppsala universitet.
    Haemodialysis nurses knowledge about methicillin-resistant Staphylococcus aureus2012Inngår i: Journal of renal care, ISSN 1755-6686, Vol. 38, nr 2, s. 82-85Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Healthcare workers may lack knowledge about antibiotic-resistant bacteria and thereby increase the spread of such organisms. The aim of the present study was to describe the relationship between self-rated knowledge and actual knowledge about methicillin-resistant Staphylococcus aureus (MRSA) among 326 Swedish haemodialysis nurses. Data were collected through a postal questionnaire. The findings suggest that ongoing education about MRSA should be provided to haemodialysis nurses, but also that standardised evaluation of adequate knowledge, skills and competencies' regarding safe practices is warranted. Future research should focus on effective mechanisms to ensure that haemodialysis nurses provide safe MRSA care.

  • 11.
    Lindberg, Maria
    et al.
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Lindberg, Magnus
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Högman, Marieann
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Carlsson, Marianne
    Department of Public Health and Caring Sciencies, Uppsla University.
    Attitudes toward patients with multidrug-resistant bacteria: scale development and psychometric evaluation2011Inngår i: Journal of Infection Prevention, ISSN 1757-1782, Vol. 12, nr 5, s. 196-203Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There is a need for validated assessment tools for measuring attitudes towards patients with multidrug- resistant bacteria. Such an assessment tool was developed and psychometrically evaluated in the present study. A literature review and discussions with experts and key informants were used to develop the questionnaire. To ensure item adequacy and interpretability, face validity and pre-tests were performed. Item validity, content validity and internal consistency reliability were evaluated in a non-random sample of 329 hemodialysis nurses. The psychometric properties were satisfactory, indicating good item validity. The content validity revealed three appropriate factors with good internal consistency reliability. The haemodialysis nurses’ knowledge about multidrug-resistant bacteria was not suf. cient, and their intentional behaviour was unsatisfactory with respect to infection control precautions. The multidrug-resistant bacteria Attitude Questionnaire would be a valuable tool, in nursing practice and nursing education, in promoting quality improvements in patient safety with regard to healthcare associated infections.

  • 12.
    Lindberg, Maria
    et al.
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Högman, Marieann
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Carlsson, Marianne
    Department of Public Health and Caring Sciencies, Uppsla University.
    The Multidrug-Resistant Bacteria Attitude Questionnaire: validity and understanding of responsibility for infection control in Swedish registered district, haematology and infection nurses2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 3-4, s. 424-436Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. To assess the discriminative and construct validity of the Multidrug-Resistant Bacteria Attitude Questionnaire and to study registered nurses knowledge of, behaviour toward and emotional responses to patients with multidrug-resistant bacteria in relation to how they understand their own, managers and politicians responsibility for adherence to preventive measures for infection control. Background. Multidrug-resistant organisms are a global problem and an essential topic in healthcare regarding patient safety improvement. Design. Descriptive and correlational cross-sectional survey. Method. Data were collected in a non-random sample consisting of 397 registered nurses; district, haematology or infection registered nurses. One-way analysis of variance and independent t-tests were used for comparisons and a principal component analysis was performed. Results. Discriminative and construct validity were supported, as the infection registered nurses generally had higher scores on knowledge, behaviour and emotional response, compared with district registered nurses and haematology registered nurses and the three-factor solution was confirmed. Registered nurses with higher scores on knowledge and emotional response attributed greater responsibility to themselves and to politicians. The Multidrug-Resistant Bacteria Attitude Questionnaire was translated using a forward-back translation process. Conclusion. The questionnaire has adequate psychometric properties. Insufficient knowledge of, behaviour toward and emotional response to patients with multidrug-resistant bacteria were described, but the registered nurses did estimate their own responsibility for adherence to preventive measures for infection control as being great or very great. Relevance to clinical practice. There is a considerable need to improve knowledge, behaviour and emotional response regarding infection prevention measures among healthcare workers. The hospital management are responsible for such improvements and the Multidrug-Resistant Bacteria Attitude Questionnaire is useful in identifying such needs, as it has adequate psychometric properties and is able to discriminate between groups. Evaluation among healthcare workers may indicate where to situate additional training, as this is of clinical significance for safe care.

  • 13.
    Lindberg, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Continued wearing of gloves: a risk behaviour in patient care2020Inngår i: Infection Prevention in Practice, E-ISSN 2590-0889, Vol. 2, nr 4, artikkel-id 100091Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    The wearing of gloves is included in the standard principles for preventing healthcare associated infections. A continued wearing of gloves may, however, result in the transmission of organisms instead of preventing infections. Few studies have explored how common it is for surfaces to be touched by potentially contaminated gloves.

    Methods

    Secondary analysis of field notes from 48 hours of unstructured observations of healthcare personnel's actions during patient care. The new focus was on to what extent healthcare personnel wore gloves that should have been removed or changed, what surfaces were touched by contaminated gloves and what patient-related activities were involved.

    Results

    A continued wearing of gloves occurred in about half of the observed episodes of patient care. On average, 3.3 surfaces were touched by contaminated gloves. The surfaces most frequently touched were ‘unused single-use items’, ‘equipment controls/switches/regulators/flush buttons’ and ‘bed linen’. This occurred mostly while helping patients with ‘personal hygiene’, when performing ‘test taking’ or during procedures involving the operation of medical or other ‘equipment’.

    Conclusion

    The continued wearing of gloves during patient-related activities carries the risk of organism transmission, as the gloves touch many surfaces. The most critical moments seem to be when the use of gloves is considered essential. A better understanding of the motivators of improper glove-use behaviour is needed to develop interventions that rectify the improper use of gloves.

  • 14.
    Lindberg, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Centre for Research and Development, Uppsala University, Gävle.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Perceptions of infection control practices and the use of vignettes to alter infection control behavior: A feasibility study: Infection control practices2019Inngår i: Florence Nightingale Journal of Nursing, ISSN 2147-4923, Vol. 27, nr 3, s. 231-240Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To explore the perceptions of infection control practices among healthcare personnel and evaluate the use of authentic vignettes as a means to alter infection control behavior.

    Method: Four authentic vignettes were used as a part of reflective dialogues with healthcare personnel. An evaluation of the dialogues was performed with six healthcare personnel using the focus group technique. Qualitative content analysis was used to analyze the data.

    Results: The mind-set to help one another and do one’s best in every situation was described as a core aspect in preventing the transmission of microorganisms. Having support, taking personal responsibility, being knowledgeable about infection control practices, and having a reasonable workload were seen to play decisive roles in controlling the spread of infection. Discussing authentic comprehensible vignettes with colleagues during the allotted time was considered a valuable method for improving infection control practices.

    Conclusion: Meaningful insights on how best to use vignettes as a means to improve infection control practice were gained. These findings should be considered when designing theory-driven interventions in different contexts, which are aimed at improving infection control practices in health care.

  • 15.
    Lindberg, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Wijk, Katarina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Uppsala universitet.
    Strömberg, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    A complex challenge with unclear improvement: the need for involvement, contextualization and facilitation when managers implement a leadership model2023Inngår i: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 36, nr 2, s. 236-246Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose

    Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager’s job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers’ perceptions of, prerequisites for and experiences from the implementation of changes in their manager’s work conditions.

    Design/methodology/approach

    A grounded theory–based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis.

    Findings

    Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers’ descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process.

    Originality/value

    This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.

    Fulltekst (pdf)
    fulltext
  • 16.
    Lindberg, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Centre for Research and Development, Region Gavleborg/Uppsala University; .
    Sving, Eva
    Centre for Research and Development, Region Gavleborg/Uppsala University.
    Wijk, Katarina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Centre for Research and Development, Region Gavleborg/Uppsala University.
    Kartläggning av patientsäkerhets engagemang, baslinjemätning som grund för planering av intervention på arbetsplats med syfte att ge hälso- och sjukvårdsanställda förutsättningar försäkrare vård2019Konferansepaper (Annet vitenskapelig)
  • 17.
    Mamhidir, Anna-Greta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Lindberg, Maria
    Uppsala universitet.
    Larsson, Rigmor
    Landstinget Gävleborg.
    Fläckman, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap.
    Deficient knowledge of multidrug-resistant bacteria and preventive hygiene measures among primary healthcare personnel2011Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, nr 4, s. 756-762Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM:

    This paper is a report of a study conducted to describe primary healthcare personnel's knowledge of multidrug-resistant and preventive hygiene measures.

    BACKGROUND:

    The group of patients at risk for multi-drug resistant bacteria is largely cared for in primary care. Knowledge of multidrug-resistant and hygiene preventive measures among primary healthcare personnel is therefore essential.

    METHOD:

    A descriptive and comparative questionnaire survey among primary healthcare personnel was performed in 2008. In total, five urban and rural primary healthcare centres situated in one county in central Sweden were included. Convenient sampling was used and 10 physicians, 38 district nurses and 10 nursing assistants participated. Knowledge/medical facts concerning multidrug-resistant and hygiene preventive measures were investigated and data were analysed using a quantitative approach.

    RESULTS:

    Knowledge/medical facts concerning several aspects of multidrug-resistant bacteria, particularly Extended-Spectrum-Beta-Lactamase producing bacteria, were deficient as was knowledge of different aspects of hygiene preventive measures. Physicians showed significantly better results than district nurses and nursing assistants did. Awareness of proper hand-washing as an effective preventive method and use of aprons in nursing care was high among all participants. Staff who knew they had cared for these patients had significantly better results than the others did.

    CONCLUSION:

    Our findings suggest that evidence-based education of multidrug-resistant and hygiene preventive measures, in primary health with subsequent follow-ups should become a prioritized clinician and management concern. Research is needed that focus implementation of evidence-based educations, staff attitudes and responsibilities related to the work with patients at risk of multidrug-resistant bacteria.

  • 18.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Centre for Research and Development, Region Gavleborg/Uppsala University.
    Åberg Jönsson, Fredrik
    Centre for Research and Development, Region Gavleborg/Uppsala University.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Centre for Research and Development, Region Gavleborg/Uppsala University.
    Enabled and perceived factors for implementing improvements in health care in order to achieve patient centered care, a case report from Sweden: Möjliggörande och upplevda faktorer för implementering av förbättringsarbete i hälso- och sjukvården för att uppnå patient-centrerad vård, en fallstudie2019Konferansepaper (Annet vitenskapelig)
  • 19.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Åberg Jönsson, Fredrik
    Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient-centred care: A case report from Sweden2020Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 26, nr 3, s. 791-800Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract Rationale, aim, and objectives More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient-centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them. Methods Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first-line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed. Results A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow-up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge-related preconditions had greatest impact on implementation. Conclusions The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence-based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

  • 20.
    Ädel, Eva
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Löfmark, Anna
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Pålsson, Ylva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet; Lishui University, China.
    Lindberg, Maria
    Centre for Research and Development, Uppsala University/Region Gävleborg.
    Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study2021Inngår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 55, artikkel-id 103169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    The aim of the present study was to elucidate health-promoting and -impeding aspects of peer-learning by examining nursing students' descriptions of learning together as peers, and how this might interact with their health.

    Background

    Peer-learning is a useful strategy for teaching and learning in nursing students' clinical practice education. In the research, benefits such as improved cooperation and increased self-confidence have been described and labelled as health-promoting.

    Design

    A qualitative descriptive approach Method Thirteen first-year nursing students aged 22-45 years, who had completed their first clinical practice education on a medical or surgical hospital ward, participated in one-on-one semi-structured interviews. The interviews were analyzed using qualitative content analysis.

    Result

    Working as a pair was primarily described as positive, as the peers felt basic support from each other, even though they described negative experiences that limited their own development and challenged their patience.

    Conclusion

    Peer-learning as a model for supervision in clinical practice incorporates valuable health-promoting aspects, as the students felt safe, supported, increased self-confidence, and participation. The interaction between peers helped them grow as human beings, and the mutual support the peers felt was a vital health-promoting aspect that limited the impact of the described health-impeding aspects, which included sometimes finding peer-learning trying, stressful and irritating.

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