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  • 1.
    Johansson, Lotta
    et al.
    Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Lindahl, Berit
    Faculty of Caring Science, Work Life and Social Welfare, Borås University College, Sweden.
    Knutsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Ögren, Mikael
    Department of Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Persson Waye, Kerstin
    Department of Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Ringdal, Mona
    Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Evaluation of a sound environment intervention in an ICU: A feasibility study2018In: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 31, no 2, p. 59-70Article in journal (Refereed)
    Abstract [en]

    Background: Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes.

    Objectives: (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms.

    Methods: A quasi-randomized clinical trial design was chosen. The intervention consisted of a refurbished two-bed ICU patient room (experimental) with a new suspended wall-to-wall ceiling and a low frequency absorber. An identical two-bed room (control) remained unchanged.

    Inclusion criteria: Patients >18 years old with ICU lengths of stay (LoS) >48. h. The final study group consisted of 31 patients: six from the rebuilt experimental room and 25 from the control room. Methodological problems and possible solutions were continuously identified and documented.

    Results: Undertaking a full-scale intervention study with continuous measurements of acoustic data in an ICU is possible. However, this feasibility study demonstrated some aspects to consider before start. The randomization process and the sound measurement procedure must be developed. Furthermore, proper education and training are needed for determining ICU delirium.

    Conclusion: This study raises a number of points that may be helpful for future complex interventions in an ICU. For a full-scale study to be completed a continuously updated cost calculation is necessary. Furthermore, representatives from the clinic need to be involved in all stages during the project. 

  • 2.
    Tingsvik, Catarina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Bexell, Eva
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Andersson, Ann-Christine
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Henricson, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Meeting the challenge: ICU-nurses' experiences of lightly sedated patients2013In: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 26, no 3, p. 124-129Article in journal (Refereed)
    Abstract [en]

    Background

    Sedation of intensive care patients is necessary for comfort and to implement appropriate treatment. The trend of sedation has gone from deep to light sedation. The topic is of interest to intensive care nursing because patients are generally more awake, which requires a different clinical approach than caring for deeply sedated patients.

    Purpose

    The aim of this study was to describe intensive care unit (ICU) nurses experiences of caring for patients who are lightly sedated during mechanical ventilation.

    Methods

    A qualitative approach was used. Semi-structured interviews with nine intensive care nurses were conducted. The interview texts were subjected to qualitative content analysis, resulting in the formulation of one main category and six sub-categories.

    Findings

    The nurses’ experience of lightly sedated patients was described as a challenge requiring knowledge and experience. The ability to communicate with the lightly sedated patient is perceived as important for ICU nurses. Individualised nursing care respecting the patients’ integrity, involvement and participation are goals in intensive care, but might be easier to achieve when the patients are lightly sedated.

    Conclusion

    The results reinforce the importance of communication in nursing care. It is difficult however to create an inter-personal relationship, encourage patient involvement, and maintain communication with deeply sedated patients. When patients are lightly sedated, the nurses are able to communicate, establish a relationship and provide individualised care. This is a challenge requiring expertise and patience from the nurses. Accomplishing this increases the nurses satisfaction with their care. The positive outcome for the patients is that their experience of their stay in the ICU might become less traumatic.

  • 3.
    Åkerman, Eva
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ersson, Anders
    Skåne University Hospital, Department of Intensive Care Medicine in Malmö, Sweden.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Samuelson, Karin
    Division of Nursing, Department of Health Sciences, Lund University, Lund, Sweden.
    Preferred content and usefulness of a photodiary as described by ICU-patients-A mixed method analysis2013In: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 26, no 1, p. 29-35Article in journal (Refereed)
    Abstract [en]

    Many ICU-patients have memory-gaps which may affect their recovery. A tool in the recovery can be an ICU-diary to explain and clarify thoughts and events from the ICU-period. There are different standards for the content in the ICU-diary. The aim of this study was to identify the preferred content and usefulness of an ICU-diary as described by ICU-patients.

    Method: a descriptive, exploratory cohort design with a mixed method approach. The patients answered a questionnaire (n=115) and participated in an interview (n=15) six months after the ICU-stay. Data analysis was carried out in three stages; the questionnaire was analysed by descriptive statistics and categorized by content (four open-ended questions) and the interviews were analysed by manifest content analysis.

    Results: The patients explained that detailed information about daily activities and medical facts had to be included to understand and give a sense of coherence of what had happened. The content in the ICU-diary had to be chronological in order to follow the process in which photos were an important part. The patients re-read the ICU-diary during the recovery which helped them to fill in the memory gaps and used it as a tool for communication.

    Conclusion; To construct a coherent story, it was essential that the ICU-diary was complete and were amplified by photos, all appearing in a chronological order. The results of this study could form a basis for further developments of standards and guidelines for ICU-diaries

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