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  • 1.
    Aaby Orellana, Tanja
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Kirkegaard, Betina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sjuksköterskors upplevelser av att implementera personcentrerad omvårdnad i slutenvården: -         En Empirisk Studie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Person-centred care (PCC) is when the person seeking care get’s involved in their care and are seen as more then their illness or ailment. PCC as a concept began in dementia care, but is now the approach that most healthcare institutions strive after. To achieve the improved care that PCC can bring, there is need for a well- planned and clear implementation plan from the management.

    Aim: To describe the nursing staffs experience of implementing person-centred care as a work procedure in inpatient care.

    Method: An inductive qualitative study where eleven interviews was completed. Eight interviews were strategically chosen and a content analysis was carried out.

    Result: There is hope among the participants that implementation will bring a better and safer care, but also concerns about fear of change among the healthcare staff and increased workloads. Participants experience that PCC will place higher demans on the healthcare staff, especially nurses, regarding time, knowledge and communication skills.

    Conclusion: To provide the best care, there has to be dedicated and competent staff who also have the support and understanding from the management. Despite the obstacles that seem to exist, there is a positive spirit among the nurses in relation to the implementation of person-centred care.  There is hope that person-centred care, among other things, will increase participation that could lead to shorter hospital stays and risk of needing to seek care again short after being discharged from the hospital. Ultimately it provides a better care in the whole for the individual person seeking care.

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    Sjuksköterskors upplevelser av att implementera personcentrerad omvårdnad i slutenvården
  • 2.
    Abdirahman, Seynab
    et al.
    Jönköping University, School of Health and Welfare.
    Ahmed Mohamed, Fatma
    Jönköping University, School of Health and Welfare.
    Sjuksköterskors upplevelser av att vårda patienter med olika kulturella bakgrunder: En litteraturöversikt av kvalitativa artiklar2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In connection with increased globalization, multicultural societieslead to more transcultural care encounters. The multicultural world makes itnecessary for nurses to plan a care based on transcultural nursing. Previous researchshows that nurses lack cultural competence. By acquiring cultural competence,nurses can provide better care for the care recipient that has a different culturalbackground.Aim: To describe nurses' experiences of caring for patients with different culturalbackgrounds.Method: Qualitative method with inductive approach. Article searches wereconducted in CINAHL, MEDLINE and PsycInfo. After quality review, 13 articlesremained which were compiled in a matrix. The articles were analyzed using Friberg'sanalysis model.Results: Three main categories emerged in the results. The first main category ischallenges in communication with subcategories language barriers and nursesexperiences of interpreters use. The second main category is challenges in nursingwork with subcategories cultural differences, prejudices and uncertainty and lowerquality nursing. Third main category is organizational aspects with subcategoriesneed for knowledge and resources and the importance of routines. The results shownurses' challenges in transcultural care meetings. Nurses express a need to getresources such as an interpreter and knowledge in transcultural nursing.Conclusions: Transcultural care encounters are characterized by difficulties due tolanguage barriers and cultural differences. The lack of cultural competency affects the quality of care when meeting patients with different cultural backgrounds.

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  • 3.
    Abelsson, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Anxiety caused by simulated prehospital emergency care2019In: Clinical Simulation in Nursing, ISSN 1876-1399, E-ISSN 1876-1402, Vol. 29, p. 24-28Article in journal (Refereed)
    Abstract [en]

    During the simulation, participants experience different degrees of stress and anxiety. It could be described as “Anxiety is like perpetually hearing the enemy music but never seeing the threat”. This study aimed to describe the Emergency Medical Services personnel's feelings of anxiety during simulation. The study had a qualitative design with interviews of 28 participants. The data were analyzed using content analysis. The result shows how the simulation could be perceived as a stage performance in the form of a theatre. The perceived acting was unpleasant and embarrassing due to unfamiliarity to perform. To be scrutinized meant having spectators reviewing ones' performance. It was considered more natural to care for actors than manikins. The interaction and connection with a human, even unconscious, were more natural. To care for a human did not require the imagination to empathize in the simulation.

  • 4.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Att ansvara för en annan människas liv2013Conference paper (Other (popular science, discussion, etc.))
  • 5.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Att bedöma patienter utsatta för trauma2013Conference paper (Other academic)
  • 6.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Att träna på en patient som går att starta om2015Conference paper (Other academic)
  • 7.
    Abelsson, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Being responsible for the life of another human being2017In: Disaster and Emergency Medicine Journal, ISSN 2451–4691, Vol. 2, no 4, p. 164-166Article in journal (Refereed)
    Abstract [en]

    A common feature of prehospital emergency care are short and fragmentary patient encounters with in­creased demands for efficient and rapid treatment. Crucial decisions are often made, based on the premise of the ambulance staff`s ability to capture the situation instantaneously. The assessment is, therefore, a pre-requisite for decisions about appropriate actions. However, a low exposure to severe trauma cases leads to vulnerability for the ambulance staff, which makes the assessment more difficult. Assessment of severe trauma patients at the scene of accident is difficult and complicated. No trauma scenarios are alike and practical skills, training, and feedback are therefore necessary.

  • 8.
    Abelsson, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Bringing your simulation into an attractive scientific program - Without the need for research data2017Conference paper (Refereed)
  • 9.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Den specialistutbildade ambulanssjuksköterskans uppfattning av att bedöma patienter utsatta för svårt trauma2013Conference paper (Other academic)
  • 10.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Developing ethical competence among students in nurse specialist programs2014Conference paper (Other academic)
  • 11.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Dom ser döda ut allihop: Att våga fatta svåra beslut2015In: Samverkan 112, ISSN 1650-7487, Vol. AprilArticle in journal (Other academic)
  • 12.
    Abelsson, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    First response emergency care - experiences described by firefighters2019In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 8, p. 247-258Article in journal (Refereed)
    Abstract [en]

    Purpose – The purpose of this paper was to describe firefighters’ experiences of First Response Emergency Care.

    Design/methodology/approach – An explorative descriptive design with a qualitative approach. Data was collected through group interviews of 35 firefighters and subjected to qualitative content analysis.

    Findings – The results showed that the firefighters’ professional role and their uniform serve as protection against mentally strenuous situations. It is important to protect the dignity of the injured or dead, as well as to protect and safeguard colleagues from the experience of the tragedy of an accident. Having a solid and sterling medical education gives a sense of security when providing emergency care, as well as when caring for the relatives. Debriefing brings thoughts and feelings to the surface for processing and closure. The sense of sadness lingers for those they were unable to save, or the ones that had been dead on arrival or were forgotten.

    Originality/value – A firefighter’s work situation is exposed and stressful. The firefighter’s uniform as a mental barrier, colleagues, time to mentally prepare and being allowed to show feelings are factors all needed to cope. It is therefore important to encourage, promote and strengthen the protective role of camaraderie for the firefighter, which can likely be emphasized for other uniform-wearing professions such as police, military and ambulance personell. Being acknowledged for their contribution to other peoples’ lives and wellbeing can confirm the firefighters’ importance.

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  • 13.
    Abelsson, Anna
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013).
    Full scale pre-hospital care scenario: Prehsopital workshop2015Conference paper (Refereed)
  • 14.
    Abelsson, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Kan man se blod i mörkret?2017Conference paper (Other (popular science, discussion, etc.))
  • 15.
    Abelsson, Anna
    Department of Health Sciences, Karlstad University, Sweden.
    Learning through simulation2017In: Disaster and Emergency Medicine Journal, ISSN 2451–4691, Vol. 2, no 3, p. 125-128Article in journal (Refereed)
    Abstract [en]

    With simulation, caregivers are given the opportunity to improve their knowledge and skills. With simulation, both theoretical and practical knowledge is taught. With the experiences that simulation creates, critical thinking and better care are developed. Learning through simulation complements the learning that takes place in everyday work and can have a positive effect of the advances of the care profession. The purpose of simulation may vary and different learning theories are used, both based on learning objectives and the purpose of the simulation. The experience gained from simulation prepares caregivers on how similar complex situations can be handled in the future.

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  • 16.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Mapping the use of simulation in prehospital care2013Conference paper (Refereed)
  • 17.
    Abelsson, Anna
    Department of Health Sciences, Karlstad University, Sweden.
    Medical tattoos impact on CPR decisions2017In: Disaster and Emergency Medicine Journal, ISSN 2451-4691, Vol. 2, no 3, p. 140-141Article in journal (Other academic)
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  • 18.
    Abelsson, Anna
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013).
    Nästa gång du hör sirener vill jag att du skall tänka på mig2014In: Vård i fokus, ISSN 0781-495X, Vol. 1Article in journal (Other academic)
  • 19.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Prehospital simulation differs from others: Prehospital workshop2015Conference paper (Refereed)
  • 20.
    Abelsson, Anna
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013).
    Prehospital simulering2014Conference paper (Other academic)
  • 21.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Simulering i ambulanssjukvården2013Conference paper (Other academic)
  • 22.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Simulering som lärande inom prehospital akutsjukvård2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the research was to deepen the understanding of learning through simulation in prehospital emergency care.

    Method: In this research, qualitative and quantitative methods are used as well as integrative literature studies (I, II). Qualitative data from the interview studies (III, V) were analyzed by phenomenographic methodology. Quantitative data from the intervention study (IV) were analyzed using descriptive and analytical statistics.

    Results: Research on simulation and learning within the prehospital trauma care context is relatively rare (I). Simulation of realistic scenarios where the caregivers are exposed to stress contributes to strengthen caregiver knowledge, skills and experience (II). Caregivers request simulation opportunities regarding critical and emergency situations (III). They describe that learning through regular simulation provides in-depth knowledge and skills in the care of a patient exposed to high-energy trauma (V). Interventions with repeated simulation opportunities related to the care of the patient exposed to high-energy trauma give some improvement in care provided at the site of the accident (IV).

    Conclusion: Through simulation, the caregivers develop knowledge and skills and receive enhanced confidence in the care of an injured and sick patient. The research suggests several areas with potential for improvement with regard to the care of patients exposed to high-energy trauma. A model has been developed for systematic trauma simulation.

     

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  • 23.
    Abelsson, Anna
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013).
    Simulering som pedagogisk metod: ett sätt att träna olika patientsituationer2015Conference paper (Refereed)
  • 24.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Så räddar du liv2014Conference paper (Other (popular science, discussion, etc.))
  • 25.
    Abelsson, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    The case of the women with the broken heart2018In: Disaster and Emergency Medicine Journal, ISSN 2451-4691, Vol. 3, no 2, p. 67-68Article in journal (Refereed)
    Abstract [en]

    Takotsubo can be detected as a kindred disease, predominantly affecting post-menopausal women. By correctly identifying these patients as having an acute heart failure syndrome, the outcome can be favorable.

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  • 26.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    The simulation used in prehospital care2013Conference paper (Refereed)
  • 27.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    To optimize prehospital CPR- performed by fire fighters2015Conference paper (Refereed)
  • 28.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    What do we need to train the ambulance staff in and how can we train them?2014In: Workshop vid Society in Europe for Simulation Applied to Medicine, Pre-Hospital Special Interest Group Pre-Conference Course., 2014Conference paper (Refereed)
  • 29.
    Abelsson, Anna
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Öppet samtal mellan Sveriges prehospitala doktorander och representanter för nationell prehospital forskning2013Conference paper (Other (popular science, discussion, etc.))
  • 30.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Appelgren, Jari
    Karlstad University.
    Axelsson, Christer
    University of Borås.
    Enhanced self-assessment of CPR by low-dose, high-frequency training2021In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 10, no 1, p. 93-100Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose was to investigate what effect an intervention of low-dose, highfrequencycardiopulmonary resuscitation (CPR) training with feedback for one month wouldhave on professionals’ subjective self-assessment skill of CPR.

    Design/methodology/approach - This study had a quantitative approach. In total, 38firefighters performed CPR for two minutes on a Resusci Anne QCPR. They then self-assessedtheir CPR through four multiple-choice questions regarding compression rate, depth, recoil, andventilation volume. After one month of low-dose, high-frequency training with visual feedback,the firefighters once more performed CPR and self-assessed their CPR.

    Findings - With one month of low-dose, high-frequency training with visual feedback, the levelof self-assessment was; 87% (n=33) correct self-assessment of compression rate, 95% (n=36)correct self-assessment of compression depth, 68% (n=26) correct self-assessment of recoil and87% (n=33) correct self-assessment of ventilations volume. The result shows a reduced numberof firefighters who overestimate their ability to perform CPR.

    Originality/value - With low-dose, high-frequency CPR training with visual feedback for amonth, the firefighters develop a good ability to self-assess their CPR to be performed withinthe guidelines. By improving their ability to self-assess their CPR quality, firefighters can selfregulatetheir compression and ventilation quality.

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  • 31.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Appelgren, Jari
    Faculty of Arts and Social Sciences, Karlstad University, Karlstad, Sweden.
    Axelsson, Christer
    Prehospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Low-dose, high-frequency CPR training with feedback for firefighters2019In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 8, no 1, p. 64-72Article in journal (Refereed)
    Abstract [en]

    Purpose

    The purpose of this paper is to investigate the effects of the intervention of low-dose, high-frequency cardiopulmonary resuscitation (CPR) training with feedback for firefighters for one month.

    Design/methodology/approach

    The study had a quantitative approach. Data were collected through an intervention by means of simulation. The data collection consisted of a pre- and post-assessment of 38 firefighter’s CPR performance.

    Findings

    There was a statistically significant improvement from pre- to post-assessment regarding participants’ compression rates. Compression depth increased statistically significantly to average 2 mm too deep in the group. Recoil decreased in the group with an average of 1 mm for the better. There was a statistically significant improvement in participants’ ventilation volume from pre- to post-assessment.

    Originality/value

    Prehospital staff such as firefighters, police, and ambulance perform CPR under less than optimal circumstances. It is therefore of the utmost importance that these professionals are trained in the best possible way. The result of this study shows that low-dose, high-frequency CPR training with an average of six training sessions per month improves ventilation volume, compression depth, rate, and recoil. This study concludes that objective feedback during training enhances the firefighters’ CPR skills which in turn also could be applied to police and ambulance CPR training.

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  • 32.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Bisholt, Birgitta
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Nurse students learning acute care by simulation: Focus on observation and debriefing2017In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 24, p. 6-13Article in journal (Refereed)
    Abstract [en]

    Introduction:

    Simulation creates the possibility to experience acute situations during nursing education which cannot easily be achieved in clinical settings.

    Aim:

    To describe how nursing students learn acute care of patients through simulation exercises, based on observation and debriefing.

    Design:

    The study was designed as an observational study inspired by an ethnographic approach.

    Method:

    Data was collected through observations and interviews. Data was analyzed using an interpretive qualitative content analysis.

    Results:

    Nursing students created space for reflection when needed. There was a positive learning situation when suitable patient scenarios were presented. Observations and discussions with peers gave the students opportunities to identify their own need for knowledge, while also identifying existing knowledge. Reflections could confirm or reject their preparedness for clinical practice. The importance of working in a structured manner in acute care situations became apparent. However, negative feedback to peers was avoided, which led to a loss of learning opportunity.

    Conclusion:

    High fidelity simulation training as a method plays an important part in the nursing students' learning. The teacher also plays a key role by asking difficult questions and guiding students towards accurate knowledge. This makes it possible for the students to close knowledge gaps, leading to improved patient safety.

  • 33.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Falk, P.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Surgical and Intensive care Clinics, Värnamo County Hospital, Region Jönköping county, Sweden.
    Sundberg, B.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Surgical and Intensive care Clinics, Ryhov County Hospital, Region Jönköping county, Sweden.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Empowerment in the perioperative dialog2021In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 1, p. 96-103Article in journal (Refereed)
    Abstract [en]

    Aim: To describe how the nurse anaesthetist empowers the patient in the perioperative dialogue. Design: A qualitative descriptive design with interviews with 12 nurse anaesthetist (NA). Method: A hermeneutic text interpretation with a foundation in Gibson's empowerment model. Result: The results highlight Gibson's nursing domain: Helper, Supporter, Counsellor, Educator, Resource Consultant, Resource Mobilizer, Facilitator, Enabler and Advocate. The overall understanding is revealed as a relationship can be built through closeness between the patient and the NA. The NA helps the patient master the situation by talking to and touching the patient. The patient is helped to find their own strengths and to cope with their fears. The patients decide over their own bodies. When the patients do not want to or cope with protecting themselves, the NA protects and represents the patient.

  • 34.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Gustafsson, Marcus
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Petersèn, Christina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Knutsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
    Physical stress triggers in simulated emergency care situations2021In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 1, p. 156-162Article in journal (Refereed)
    Abstract [en]

    Aim

    To practise emergency care situations during the education can be stressful. The aim of this study is to identify factors that cause stress in simulated emergency care.

    Design

    A descriptive observational study.

    Methods

    Video recordings (N = 26) subjected to observation with written field notes in turn subjected to interpretive qualitative content analysis.

    Results

    To assess the patient's condition and decide what measures to take trigger stress reactions. If the students failed to connect the correct and relevant information in the conversation with the physician, the students showed signs of stress. Also, to calculate medication dosages stress the students.

  • 35.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science.
    Gwinnutt, Carl
    Resuscitation Council (UK), London, UK.
    Greig, Paul
    Department of Anaesthetics, Guy’s and St Thomas’s NHS Foundation Trust, London, UK.
    Smart, Jonathan
    Innosonian Europe, Farnborough, Hampshire, UK.
    Mackie, Kevin
    Resuscitation Council (UK), London, UK.
    Validating peer-led assessments of CPR performance2020In: Resuscitation Plus, E-ISSN 2666-5204, Vol. 3, article id 100022Article in journal (Refereed)
    Abstract [en]

    Background

    A patient’s survival from cardiac arrest is improved if they receive good quality chest compressions as soon as possible. During cardiopulmonary resuscitation (CPR) training subjective assessments of chest compression quality is still common. Recently manikins allowing objective assessment have demonstrated a degree of variance with Instructor assessment. The aim of this study was to compare peer-led subjective assessment of chest compressions in three groups of participants with objective data from a manikin.

    Method

    This was a quantitative multi-center study using data from simulated CPR scenarios. Seventy-eight Instructors were recruited, from different backgrounds; lay persons, hospital staff and emergency services personnel. Each group consisted of 13 pairs and all performed 2 ​min of chest compressions contemporaneously by peers and manikin (Brayden PRO®). The primary hypothesis was subjective and objective assessment methods would produce different test outcomes.

    Results

    13,227 chest compressions were assessed. The overall median score given by the manikin was 88.5% (interquartile range 71.75–95), versus 92% (interquartile range 86.75–98) by observers. There was poor correlation in scores between assessment methods (Kappa −0.051 – +0.07). Individual assessment of components within the manikin scores demonstrated good internal consistency (alpha ​= ​0.789) compared to observer scores (alpha ​= ​0.011).

    Conclusion

    Observers from all backgrounds were consistently more generous in their assessment when compared to the manikin. Chest compressions quality influences outcome following cardiac arrest, the findings of this study support increased use of objective assessment at the earliest opportunity, irrespective of background.

  • 36.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lindwall, Lillemor
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Ethical dilemmas in prehospital emergency care – from the perspective of specialist ambulance nurse students2018In: International Journal of Ethics Education, ISSN 2363-9997, Vol. 3, no 2, p. 181-192Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe specialist ambulance nurse students’ experiences of ethical conflicts and dilemmas in prehospital emergency care. In the autumn of 2015, after participating in a mandatory lecture on ethics, 24 specialist ambulance nurse (SAN) students reported experiences and interpretations concerning conflicts and ethical dilemmas from prehospital emergency care. The text consisted of 24 written critical incidents which were interpreted using hermeneutic text interpretation. The text revealed three themes: Not safeguarding a patient’s body and identity; Not agreeing on the care actions; and Not treating the patient with dignity. The SANs experiences ethical dilemmas and conflict of values when they witness how others violate a patient’s dignity. Discussion and reflection is based on ethical conflicts and dilemmas experienced when students see how caregivers do not safeguard the patient’s body or identity. When caregivers have a conflicting will, it results in patients not being treated in an ethical manner. Also, seeing how caregivers put themselves in a power position over patients is described as an ethical dilemma that students experience when they choose not to intervene.

  • 37.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Lindwall, Lillemor
    Karlstads universitet, Institutionen för hälsovetenskaper.
    What is dignity in prehospital emergency care?2017In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 24, no 3, p. 268-278Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ethics and dignity in prehospital emergency care are important due to vulnerability and suffering. Patients can lose control of their body and encounter unfamiliar faces in an emergency situation.

    OBJECTIVE: To describe what specialist ambulance nurse students experienced as preserved and humiliated dignity in prehospital emergency care.

    RESEARCH DESIGN: The study had a qualitative approach.

    METHOD: Data were collected by Flanagan's critical incident technique. The participants were 26 specialist ambulance nurse students who described two critical incidents of preserved and humiliated dignity, from prehospital emergency care. Data consist of 52 critical incidents and were analyzed with interpretive content analysis.

    ETHICAL CONSIDERATIONS: The study followed the ethical principles in accordance with the Declaration of Helsinki.

    FINDINGS: The result showed how human dignity in prehospital emergency care can be preserved by the ambulance nurse being there for the patient. The ambulance nurses meet the patient in the patient's world and make professional decisions. The ambulance nurse respects the patient's will and protects the patient's body from the gaze of others. Humiliated dignity was described through the ambulance nurse abandoning the patient and by healthcare professionals failing, disrespecting, and ignoring the patient.

    DISCUSSION: It is a unique situation when a nurse meets a patient face to face in a critical life or death moment. The discussion describes courage and the ethical vision to see another human.

    CONCLUSION: Dignity was preserved when the ambulance nurse showed respect and protected the patient in prehospital emergency care. The ambulance nurse students' ethical obligation results in the courage to see when a patient's dignity is in jeopardy of being humiliated. Humiliated dignity occurs when patients are ignored and left unprotected. This ethical dilemma affects the ambulance nurse students badly due to the fact that the morals and attitudes of ambulance nurses are reflected in their actions toward the patient.

  • 38.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lindwall, Lillemor
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Suserud, Björn-Ove
    Faculty of Caring Science, Work Life and Social Welfare, PreHospen-Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Rystedt, Ingrid
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Ambulance nurses’ competence and perception of competence in prehospital trauma care2018In: Emergency Medicine International, ISSN 2090-2840, E-ISSN 2090-2859, Vol. 2018, article id 5910342Article in journal (Refereed)
    Abstract [en]

    Introduction. We focus on trauma care conducted in the context of a simulated traumatic event. This is in this study defined as a four-meter fall onto a hard surface, resulting in severe injuries to extremities in the form of bilateral open femur fractures, an open tibia fracture, and a closed pelvic fracture, all fractures bleeding extensively. 

    Methods. The simulated trauma care competence of 63 ambulance nurses in prehospital emergency care was quantitatively evaluated along with their perception of their sufficiency. Data was collected by means of simulated trauma care and a questionnaire. 

    Results. Life-saving interventions were not consistently performed. Time to perform interventions could be considered long due to the life-threatening situation. In comparison, the ambulance nurses’ perception of the sufficiency of their theoretical and practical knowledge and skills for trauma care scored high. In contrast, the perception of having sufficient ethical training for trauma care scored low. 

    Discussion. This study suggests there is no guarantee that the ambulance nurses’ perception of theoretical and practical knowledge and skill level corresponds with their performed knowledge and skill. The ambulance nurses rated themselves having sufficient theoretical and practical knowledge and skills while the score of trauma care can be considered quite low.

  • 39.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Lindwall, Lillemor
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Suserud, Björn-Ove
    Högskolan i Borås.
    Rystedt, Ingrid
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Effect of repeated simulation on the quality of trauma care2017In: Clinical Simulation in Nursing, ISSN 1876-1399, E-ISSN 1876-1402, Vol. 13, no 12, p. 601-608Article in journal (Refereed)
    Abstract [en]

    Background

    Simulation participants are not dependent on learning during an actual clinical situation. This allows for a learning environment that can be constructed to meet the knowledge and experience needs of the participant. Simulations in a prehospital emergency are an ideal way to address these needs without risking patient safety.

    Method

    Nurses in prehospital emergency care (n = 63) participated in simulation interventions. During the simulation, the performed trauma care was assessed in two groups of participants with different frequency of simulation.

    Results

    Several statistically significant differences and clinical improvements were found within and between the groups. Differences were noted in specific assessments, examinations, care actions, and time from assessment to action.

    Conclusion

    The result suggested that repeated simulation may contribute to a clinical improvement in trauma care, and more frequent simulation may led to even greater improvements.

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  • 40.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lundberg, Lars
    Centre for Defence Medicine, Swedish Armed Forces, Sweden.
    Cardiopulmonary resuscitation quality during CPR practice versus during a simulated life-saving event2018In: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 24, no 4, p. 652-655Article in journal (Refereed)
    Abstract [en]

    Introduction. As a part of the emergency medical services, the Swedish fire brigade can increase the survival rate in out-of-hospital cardiac arrests.

    Aim. To compare the quality of cardiopulmonary resuscitation (CPR) performed by firefighters at a routine CPR practice versus when involved in a simulated life-saving event.

    Methods. In this study, 80 firefighters divided into two groups performed CPR according to guidelines: one group indoors during a routine training session; the other group outdoors during a smoke diving exercise wearing personal protective clothing and self-contained breathing apparatus. Descriptive and inferential statistics were used to analyze the data.

    Results. The results showed a tendency for the outdoor group to perform CPR with better ventilation and compression quality, as compared to the indoor group. The ventilation of the manikin was not hampered by the firefighters wearing personal protective clothes and self-contained breathing apparatus, as the Swedish firefighters remove their facial mask and ventilate the patient with their mouth using a pocket mask.

    Conclusions. Overall, the results in both groups showed a high quality of CPR which can be related to the fire brigade training and education traditions. CPR training is regularly performed, which in turn helps to maintain CPR skills.

  • 41.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lundberg, Lars
    Swedish Armed Forces Centre for Defence Medicine, Sweden.
    CPR performed in battlefield emergency care2019In: Australasian Journal of Paramedicine, ISSN 2202-7270, Vol. 16, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Introduction

    During military missions medical care is provided to military personnel as well as civilians. Although cardiopulmonary resuscitation (CPR) may not be a common task in a military field hospital, all personnel need to be trained to deal with cardiac arrest.

    Methods

    This study was a comparative simulation study. Participants (n=36) from the Swedish armed forces performed CPR for 2 minutes at one of three different locations: at ground level, a military bed, or a transportable military stretcher. Compression depth and rate after 2 minutes of CPR and at the time of the participants’ own request to be relieved were measured. Descriptive and inferential analysis was conducted.

    Results

    There is a direct correlation between compression depth and working level, concluding that the higher working level, the lower the compression depth. There is in total an overall low percentage of participants within limits for correctly conducted CPR regarding both compression depth and rate. Time to fatigue is related to working level, where increased level results in early fatigue.

    Conclusion

    The quality of CPR is affected by the level at which it is performed. The quality of CPR was satisfactory when working at ground level, but suboptimal when working at hospital bed level or military stretcher level. When working at raised levels, participants appeared to misjudge their own compression depth and rate. This may indicate that changes are needed when CPR is practised in the military hospital setting. Future studies regarding the use footstools are required due to the height of military beds and transportable stretchers.

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  • 42.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Lundberg, Lars
    CPR performed in the military environment2016In: Society in Europe for Simulation Applied to Medicine Lisbon 16/6 2016., Lisabon, 2016Conference paper (Refereed)
  • 43.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lundberg, Lars
    Swedish Armed Forces, Centre for Defense Medicine, Stockholm, Sweden.
    Military medical personnel's perceptions of treating battle injuries2019In: Journal of military and veterans health, ISSN 1835-1271, E-ISSN 1839-2733, Vol. 27, no 2, p. 10-17Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate military personnel’s self-rated perceptions of their knowledge, experience and training after high-fidelity battle injury simulation.

    Design: 26 military medical personnel participated in this quantitative study. Data was collected using a questionnaire after a six-day exercise where participants self-rated 10 statements regarding having sufficient medical, practical and ethical knowledge, experience and training. Descriptive and inferential analyses were conducted to obtain the results.

    Results: Nurses rated themselves statistically significantly higher than medics in having sufficient medical knowledge and experience, practical knowledge, experience and training, as well as ethical knowledge and experience. The nurses also rated themselves statistically significantly higher than physicians in having practical knowledge, experience and training. Physicians’ self-rated perception was low regarding sufficient knowledge, experience and training in practical skills. Physicians, nurses and medics all reported low ratings for sufficient training in ethical issues.

    Discussion: Military medical personnel are required to have the knowledge and skills to work autonomously in challenging and threatening environments. For personnel that seldom see battlefield-like injuries, a clinical placement in a country with a high frequency of battlefield-like injuries would be advisable. A comparison between subjective and objective assessments may identify deficiencies in competence, which can negatively impact quality of care.

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  • 44.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lundberg, Lars
    University of Borås, Prehospen-Centre for Prehospital Research, Borås, Sweden.
    Prehospital CPR training performed with visual feedback2018In: Disaster and Emergency Medicine Journal, ISSN 2451-4691, Vol. 3, no 2, p. 41-45Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Swedish firefighters are a part of the emergency medical services. Therefore, they perform prehospital cardiopulmonary resuscitation (CPR) on a regular basis. Training becomes crucial for maintaining the CPR skills and increasing the patients’ chances of survival. Training with visual feedback is for Swedish firefighters a new way of training CPR. The aim of this study was to evaluate firefighters’ perception of a CPR manikin with visual feedback.

    METHOD: This study had a qualitative approach. Data were collected by interviews with 16 firefighters after performing CPR on a manikin with visual feedback. The data were analyzed with a manifest content analysis.

    RESULTS: Visual feedback makes it easy to identify and maintain correct compression rate. There is a need for identifying too deep compressions. Uncertainty regarding the closeness to the stomach arises when using the whole hand during compressions instead of just the wrist. To accomplish an open airway requires a bit of adjustment of the manikins’ head.

    DISCUSSION: To train and learn CPR is feasible with visual feedback. The firefighters can maintaing a correct compression rate and correct compression depth during the sessions. Ventilating a patient with bag-valvemask or pocket mask may require training with visual feedback to guarantee the firefighters being able to secure an open airway of the patient. All these skills are essential and improve the chance of survival for the patients.

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  • 45.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lundberg, Lars
    Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden.
    Simulation as a means to develop firefighters as emergency care professionals2019In: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 25, no 4, p. 650-657Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to evaluate the simulated emergency care performed by firefighters and their perception of simulation as an educational method.

    METHODS: This study had a mixed method with both a quantitative and a qualitative approach. Data were collected by simulation assessment, a questionnaire, and written comments. Descriptive analysis was conducted on the quantitative data whereas a qualitative content analysis was conducted on the qualitative data. Finally, a contingent analysis was used where a synthesis configured both the quantitative and the qualitative results into a narrative result.

    RESULTS: The cognitive workload that firefighters face during simulated emergency care is crucial for learning. In this study, the severity and complexity of the scenarios provided were higher than expected by the firefighters. Clearly stated conditions for the simulation and constructive feedback were considered positive for learning. Patient actors induced realism in the scenario, increasing the experience of stress, in comparison to a manikin.

    CONCLUSION: To simulate in a realistic on-scene environment increases firefighters' cognitive ability to critically analyze problems and manage emergency care. Simulation of emergency care developed the firefighters as professionals.

  • 46.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    The nurse anesthetist perioperative dialog2020In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 19, no 1, article id 37Article in journal (Refereed)
    Abstract [en]

    Background In the perioperative dialogue, pre-, intra- and postoperatively, the patient shares their history. In the dialogue, the nurse anesthetist (NA) gets to witness the patient's experiences and can alleviate the patients' suffering while waiting for, or undergoing surgery. The aim of this study was to describe the nurse anesthetist's experiences of the perioperative dialogue. Methods The study had a qualitative design. Interviews were conducted with 12 NA and analyzed with interpretive content analysis. The methods were conducted in accordance with the COREQ guidelines. Results In the result, three categories emerge: A mutual meeting (the preoperative dialogue) where the patient and the NA through contact create a relationship. The NA is present and listens to the patient, to give the patient confidence in the NA. In the category, On the basis of the patient's needs and wishes (the intraoperative dialogue), the body language of the NA, as well as the ability to read the body language of the patient, is described as important. In the category, To create a safe situation (the postoperative dialogue) the NA ensures that the patient has knowledge of what has happened and of future care in order to restore the control to the patient. Conclusion The patient is met as a person with their own needs and wishes. It includes both a physical and a mental meeting. In a genuine relationship, the NA can confirm and unreservedly talk with the patient. When the patients leave their body and life in the hands of the NA, they can help the patients to find their inherent powers, which allows for participation in their care. Understanding the patient is possible when entering in a genuine relationship with the patient and confirm the patient. The perioperative dialogue forms a safety for the patients in the operating environment.

  • 47.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    To enhance the quality of CPR performed by youth layman2019In: International Journal of Emergency Medicine, ISSN 1865-1372, E-ISSN 1865-1380, Vol. 12, no 1, article id 30Article in journal (Refereed)
    Abstract [en]

    By educating laymen, survival after cardiac arrest can increase in society. It is difficult to reach the entire population with cardiopulmonary resuscitation (CPR) training. However, if 15% of the population knows how to perform CPR, an increase in short- and long-term survival in patients suffering a cardiac arrest could be seen. To educate youth is a way to reach parts of the population. This study aimed to investigate the effect of a 2-h CPR intervention for youth.

  • 48.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Rystedt, Ingrid
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Suserud, Björn-Ove
    Högskolan i Borås.
    Lindwall, Lillemor
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Experiences of simulation in prehospital emergency care settings, the paramedic and ambulance nurses` point of view2014Conference paper (Refereed)
  • 49.
    Abelsson, Anna
    et al.
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Rystedt, Ingrid
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Suserud, Björn-Ove
    Högskolan i Borås.
    Lindwall, Lillemor
    Karlstads universitet, Institutionen för hälsovetenskaper.
    Learning by simulation in prehospital emergency care: an integrative literature review2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 2, p. 234-240Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Acquiring knowledge and experience on high-energy trauma is often difficult due to infrequent exposure. This creates a need for training which is specifically tailored for complex prehospital conditions. Simulation provides an opportunity for ambulance nurses to focus on the actual problems in clinical practice and to develop knowledge regarding trauma care. The aim of this study was to describe what ambulance nurses and paramedics in prehospital emergency care perceive as important for learning when participating in simulation exercises.

    METHODS: An integrative literature review was carried out. Criteria for inclusion were primary qualitative and quantitative studies, where research participants were ambulance nurses or paramedics, working within prehospital care settings, and where the research interventions involved simulation.

    RESULTS: It was perceived important for the ambulance nurses' learning that scenarios were advanced and possible to simulate repeatedly. The repetitions contributed to increase the level of experience, which in turn improved the patients care. Moreover, realism in the simulation and being able to interact and communicate with the patient were perceived as important aspects, as was debriefing, which enabled the enhancement of knowledge and skills. The result is presented in the following categories: To gain experience, To gain practice and To be strengthened by others.

    CONCLUSION: Learning through simulation does not require years of exposure to accident scenes. The simulated learning is enhanced by realistic, stressful scenarios where ambulance nurses interact with the patients. In this study, being able to communicate with the patient was highlighted as a positive contribution to learning. However, this has seldom been mentioned in a previous research on simulation. Debriefing is important for learning as it enables scrutiny of one's actions and thereby the possibility to improve and adjust one's caring. The effect of simulation exercises is important on patient outcome.

  • 50.
    Abelsson, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Rystedt, Ingrid
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Suserud, Björn-Ove
    Faculty of Caring Science, Work Life and Social Welfare, PreHospen - Centre for prehospital Research, University of Borås, Borås, Sweden.
    Lindwall, Lillemor
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Learning high-energy trauma care through simulation2018In: Clinical Simulation in Nursing, ISSN 1876-1399, E-ISSN 1876-1402, Vol. 17, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Simulation provides the opportunity to learn how to care for patients in complex situations, such as when patients are exposed to high-energy trauma such as motor vehicle accidents. The aim of the study was to describe nurses' perceptions of high-energy trauma care through simulation in prehospital emergency care. The study had a qualitative design. Interviews were conducted with 20 nurses after performing a simulated training series. Data were analyzed using a phenomenographic method. The result indicates that simulation establishes, corrects, and confirms knowledge and skills related to trauma care in prehosp ital emergency settings. Trauma knowledge is readily available in memory and can be quickly retrieved in a future trauma situation. 

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