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  • 1.
    Johansson, Yvonne A
    et al.
    Skaraborgs Sjukhus.
    Borg, Claes-Göran
    Skaraborgs Sjukhus.
    Lundmark, Rose-Marie
    Skaraborgs Sjukhus.
    Nils-Olof, Olsson
    Skaraborgs Sjukhus.
    Kenne Sarenmalm, Elisabeth
    Skaraborgs Sjukhus, Centrum för Forskning och Utveckling.
    När inträffar undvikbara och icke undvikbara skador?: Journalgranskning med Markörbaserad Journalgranskning2016Conference paper (Other academic)
  • 2.
    Johansson, Yvonne A
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Skaraborgs Sjukhus.
    Ericsson, Iréne
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Bergh, Ingrid
    University of Skövde. Institutionen för hälsa och lärande.
    Kenne Sarenmalm, Elisabeth
    Skaraborgs Sjukhus. Centrum för Forskning och Utveckling.
    Delirium in older hospitalized patients—signs and actions: a retrospective patient record review2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, p. 1-11, article id 43Article in journal (Refereed)
    Abstract [en]

    Background: Delirium is common in older hospitalized patients, and is associated with negative consequences for the patients, next of kin, healthcare professionals and healthcare costs. It is important to understand its clinical features, as almost 40% of all cases in hospitals may be preventable. Yet, delirium in hospitalized patients is often unrecognized and untreated. Few studies describe thoroughly how delirium manifests itself in older hospitalized patients and what actions healthcare professionals take in relation to these signs. Therefore, the aim of this study was to describe signs of delirium in older hospitalized patients and action taken by healthcare professionals, as reported in patient records.

    Methods: Patient records from patients aged ≥65 (n = 286) were retrospectively reviewed for signs of delirium, which was found in 78 patient records (27%). Additionally, these records were reviewed for action taken by healthcare professionals in relation to the patients' signs of delirium. The identified text was analyzed with qualitative content analysis in two steps.

    Results: Healthcare professionals responded only in part to older hospitalized patients’ needs of care in relation to their signs of delirium. The patients displayed various signs of delirium that led to a reduced ability to participate in their own care and to keep themselves free from harm. Healthcare professionals met these signs with a variation of actions and the care was adapted, deficient and beyond the usual care. A systematic and holistic perspective in the care of older hospitalized patients with signs of delirium was missing.

    Conclusion: Improved knowledge about delirium in hospitals is needed in order to reduce human suffering, healthcare utilization and costs. It is important to enable older hospitalized patients with signs of delirium to participate in their own care and to protect them from harm. Delirium has to be seen as a preventable adverse event in all hospitals units. To improve the prevention and management of older hospitalized patients with signs of delirium, person-centered care and patient safety may be important issues.

    Keywords: Signs of delirium, Neurocognitive disorders, Older hospitalized patients, Person-centered care, Patient safety, Patient participation, Action by healthcare professionals, Qualitative content analysis.

  • 3.
    Johansson, Yvonne A
    et al.
    Skaraborgs Sjukhus.
    Kenne Sarenmalm, Elisabeth
    Skaraborgs Sjukhus. Centrum för Forskning och Utveckling.
    Böl, Inger
    Skaraborgs Sjukhus. Utvecklingsenheten.
    Hospital transition to person-centered care - a culture journey in practice2017In: 30th World Congress on Advanced Nursing Practice September 04-06, 2017 | Edinburgh, Scotland: Exploring Latest Innovations and Advances in Nursing Practice, 2017, Vol. 2, p. 1-Conference paper (Refereed)
    Abstract [en]

    This action research project started in 2015 with the aim to achieve an overall sustainable hospital transition to person-centered care. In the first wave of change towards an overall hospital transition to person-centered care, hospital managers were invited to work-shops and discussions. Eight hospital units were nominated as pilot units. Specific acilitators/change leaders were educated in the philosophy of person-centered care. A learning network was created including the project managers, project unit managers and facilitators/change leaders. Based on the theory of person-centered care, and the importance of focusing soft skills and learning skills and not just technical skills, as well as experiences and reflections during this action research project, a general model for transition to person-centered care was developed. Steps included in the model: 1) Introduction; 2) V alues linked to person-centered care; 3) Multidisciplinary teams including/involving patients and/or next of kin; 4) Communication skills, and in-depth knowledge about person-centered care, 5) Practical application of the person-centered approach into clinical practice.

  • 4.
    Johansson, Yvonne A.
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Skaraborgs Sjukhus.
    Tsevis, Theofanis
    Tema åldrande, Karolinska universitetssjukhuset, Karolinska Institutet Stockholm.
    Bogdanovic, Nenad
    Tema åldrande, Karolinska universitetssjukhuset Karolinska Institutet Stockholm.
    Kenne Sarenmalm, Elisabeth
    Sahlgrenska akademin Göteborgs Universitet. Skaraborgs Sjukhus, Centrum för Forskning och Utveckling.
    Assessment of cognitive function and delirium - Lack of clinical routines2018Conference paper (Refereed)
    Abstract [en]

    Introduction: Cognitive impairment and delirium are often unidentified in hospitalized patients. Despite the fact that 40 % of all cases of delirium might be prevented, national guidelines are missing in Sweden. Study aim was to examine the routines about assessing cognitive function and delirium in a university hospital and a county hospital in Sweden.

    Methods: A web based questionnaire was developed and distributed to 58 managers. The questionnaire addressed routines for identifying cognitive impairment and delirium in clinical practice, for instance which assessment tools, and which terms were used.

    Results: The response rate was 43 % (25/58) equally distributed for nurses and physicians managers (43 and 44 %). Study findings showed that structured assessment of cognitive function and delirium were missing. Twelve managers (48 %) had established routines for assessment of cognitive function and seven (28 %) for assessment of delirium. It was unclear how the assessments were performed. Most common was free descriptions based on varying questions. Assessment tools and the term delirium were rarely used.  

    Conclusion: Established routines of assessing cognitive function and delirium are missing. Validated rapid clinical assessment tools for cognitive function and delirium are needed as well as consensus to use the term “delirium”.

  • 5.
    Johansson, Yvonne A
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Tsevis, Theofanis
    Tema åldrande, Karolinska universitetssjukhuset.
    Bogdanovic, Nenad
    Tema åldrande, Karolinska universitetssjukhuset. Karolinska Institutet.
    Kenne Sarenmalm, Elisabeth
    Sahlgrenska akademin; FoU, Skaraborgs sjukhus.
    Delirium bör bedömas enhetligt och strukturerat i vården2018In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, article id 2018;115:E4IIArticle in journal (Other (popular science, discussion, etc.))
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