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  • 1.
    Arvidsson, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Healthcare personnel assessed self-efficacy levels to medical asepsis and their relationship to structural empowerment, work engagement and work-related stressManuscript (preprint) (Other academic)
    Abstract [en]

    BACKGROUND: Healthcare personnel’s 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 healthcare personnel 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 nursing assistants at surgical and orthopaedic units responded to a questionnaire containing: Infection Prevention Appraisal Scale, Conditions of Work Effectiveness Questionnaire-II, Utrecht Work Engagement Scale and HSE Management Standards Indicator Tool. Correlational analysis and group comparisons were performed. 

    RESULTS: Healthcare personnel rated high levels of self-efficacy to medical asepsis in care situations. Low correlations with a definite, but small relationship were found between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis. The comparative analysis revealed significant differences between some of the groups within the questionnaires. There were also differences between assessments of risk for organism transmission at work and self-efficacy. 

    CONCLUSIONS: This study revealed that HCP rated high levels of self-efficacy to medical asepsis, and to some extent, it seems to have a relationship to structural empowerment, work engagement and work-related stress. It is valuable knowledge that it would be possible to make improvements at the managerial and organisational level that benefit both HCP and patients in the long run. 

  • 2.
    Arvidsson, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Healthcare personnel's working conditions relationship to risk behaviours for organism transmission2021Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Healthcare personnel (HCP) often experience undesirable working conditions. Risk behaviours for organism transmission can lead to healthcare associated infections and risk behaviours has been described to be influenced by working conditions. Research is lacking regarding HCPs working conditions and its relation to risk behaviours for organism transmission which this thesis aims to investigate. 

    Methods: Study I had a mixed-methods convergent design. Observations and interviews were performed with 79 HCP, i.e., registered nurses (RNs) and assistant nurses (ANs). First-line managers were interviewed about the unit´s overall working conditions. The qualitative and quantitative data were analysed separately and then merged. Study II was a cross-sectional study with 417 RNs and ANs. The questionnaire included: self-efficacy to aseptic care, structural empowerment (SE), work engagement (WE) and work-related stress (WRS). Correlational analysis and group comparisons were performed. 

    Results: In Study I risk behaviours frequently occurred regardless of measurable and perceived working conditions. The HCP described e.g. staffing levels and interruptions to influence risk behaviours. In the statistical analyses, risk behaviours were more frequent in interrupted activities and when the HCP worked together. In Study II the HCP rated high levels of self-efficacy to aseptic care. Differences were found between self-efficacy and some of the grouped working condition variables and definite but small relationships were found between self-efficacy to aseptic care and SE/WE/WRS. 

    Conclusion: The HCP rated high levels of self-efficacy to aseptic care, but on the other hand, risk behaviours frequently occurred irrespective of working conditions. Healthcare managers are responsible for HCPs work environment and should continuously work to promote sufficient working conditions and to increase HCPs understanding of risk behaviours, which consequently also promote patient safety.

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  • 3.
    Arvidsson, Lisa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Lindberg, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Healthcare personnel's working conditions in relation to risk behaviours for organism transmission: A mixed-methods study2022In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 31, no 7-8, p. 878-894Article in journal (Refereed)
    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.

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  • 4.
    Arvidsson, Lisa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Lindberg, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nurses’ assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress2023In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 74, no 2, p. 501-513Article in journal (Refereed)
    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.

    Download full text (pdf)
    fulltext
  • 5.
    Lindberg, Magnus
    et al.
    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.
    Skytt, Bernice
    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.
    Wågström, Britt-Mari
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Arvidsson, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindberg, Maria
    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; 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 study2018In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 100, no 3, p. e146-e150Article in journal (Refereed)
    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.

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