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Sundblad, H. & Hommel, A. (2023). Certified Registered Nurse Anesthetists' Experience of Relocation to COVID-19 Intensive Care-A Qualitative Interview Study.. AANA journal, 91(4), 273-278
Open this publication in new window or tab >>Certified Registered Nurse Anesthetists' Experience of Relocation to COVID-19 Intensive Care-A Qualitative Interview Study.
2023 (English)In: AANA journal, ISSN 2162-5239, Vol. 91, no 4, p. 273-278Article in journal (Refereed) Published
Abstract [en]

In spring 2020, a global SARS-Cov-2 pandemic was declared. The number of patients in need of intensive care exceeded the number of available care places at intensive care units (ICUs) and certified registered nurse anesthetists (CRNAs) were relocated to ICUs to support the care during the pandemic. The aim of this study was to illuminate the experiences of the CRNAs regarding relocation to COVID-19 intensive care. An interview study based on qualitative content analysis was conducted. The participants were CRNAs who usually work in the operating unit, however, were relocated to work in the COVID-19 ICU at a university hospital in southern Sweden during the pandemic. Four themes emerge in the results: sense of pride, competence, work environment, and nursing. The results illuminate the CRNAs' experience of relocating from their usual working environment to caring for critically ill patients in a COVID-19 ICU. The CRNAs managed the relocation well, although sometimes it was difficult. The CRNAs showed great loyalty, dedication, competence, and flexibility in their professional capacity. The time they worked in COVID-19 intensive care was a challenging period, but it gave them a well-deserved sense of pride and competence.

Place, publisher, year, edition, pages
AANA Publishing, 2023
Keywords
COVID-19, certified registered nurse anesthetist, intensive care, resilience, working environment
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-62052 (URN)37527166 (PubMedID)2-s2.0-85166037161 (Scopus ID)
Available from: 2023-08-22 Created: 2023-08-22 Last updated: 2023-10-20Bibliographically approved
Deprez, J., Kottner, J., Eilegård Wallin, A., Ohde, N., Bååth, C., Hommel, A., . . . Beeckman, D. (2023). What are the prognostic factors for the development of incontinence-associated dermatitis (IAD): a protocol for a systematic review and meta-analysis. BMJ Open, 13(7), Article ID e073115.
Open this publication in new window or tab >>What are the prognostic factors for the development of incontinence-associated dermatitis (IAD): a protocol for a systematic review and meta-analysis
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 7, article id e073115Article in journal (Refereed) Published
Abstract [en]

Introduction: Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research.

Methods and analysis: This protocol follows the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Prospective and retrospective observational studies or clinical trials in which prognostic factors associated with the development of IAD are described are eligible. There are no restrictions on study setting, time, language, participant characteristics or geographical regions. Reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports are excluded. MEDLINE, CINAHL, EMBASE and The Cochrane Library will be searched from inception until May 2023. Two independent reviewers will independently evaluate studies. The Quality in Prognostic Studies tool will be used to assess the risk of bias, and the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies-Prognostic Factors checklist will be used for data extraction of the included studies. Separate analyses will be conducted for each identified prognostic factor, with adjusted and unadjusted estimated measures analysed separately. Evidence will be summarised with a meta-analysis when possible, and narratively otherwise. The Q and I2 statistics will be calculated in order to quantify heterogeneity. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guidance.

Ethics and dissemination: No ethical approval is needed since all data is already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023
Keywords
Prognosis, Risk Factors, Systematic Review, WOUND MANAGEMENT
National Category
Dermatology and Venereal Diseases
Identifiers
urn:nbn:se:mau:diva-62010 (URN)10.1136/bmjopen-2023-073115 (DOI)001034612700056 ()37429690 (PubMedID)2-s2.0-85164280207 (Scopus ID)
Available from: 2023-08-21 Created: 2023-08-21 Last updated: 2023-09-13Bibliographically approved
Sandberg, M., Ivarsson, B., Johansson, A. & Hommel, A. (2022). Experiences of patients with hip fractures after discharge from hospital. International Journal of Orthopaedic and Trauma Nursing, 46, Article ID 100941.
Open this publication in new window or tab >>Experiences of patients with hip fractures after discharge from hospital
2022 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 46, article id 100941Article in journal (Refereed) Published
Abstract [en]

Background:  To achieve successful rehabilitation after hip fracture and meet patient needs it is important to listen to how individual patients perceive their situation.

Purpose:  The aim of this study was to explore how patients with hip fractures experience the time after hospitalization.

Methods:  A qualitative study was performed, data were analyzed using content analysis and included a total of 14 patients who had undergone surgery for a hip fracture.

Results:  The result comprised two main themes, In the hands of others, and A new unfamiliar life. These included in total nine categories.

Conclusions:  Not all patients received adequate pain management or were treated in a professional way by the health system. Interventions targeting an improved care trajectory which include all care providers, the person with the hip fracture and their significant others are needed. Further research is needed to reveal the reasons for uneven/differing care.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Hip fractures, Continuity of patient care, Health services, Recovery
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-56017 (URN)10.1016/j.ijotn.2022.100941 (DOI)000913682200001 ()35843064 (PubMedID)2-s2.0-85134630742 (Scopus ID)
Available from: 2022-11-14 Created: 2022-11-14 Last updated: 2024-02-05Bibliographically approved
Hommel, A. & Andersson, Å. (2022). God och nära vård (1ed.). In: Leksell Janeth & Lepp Margret (Ed.), Implementering av sjuksköterskans kärnkompetenser: (pp. 78-101). Stockholm: Liber
Open this publication in new window or tab >>God och nära vård
2022 (Swedish)In: Implementering av sjuksköterskans kärnkompetenser / [ed] Leksell Janeth & Lepp Margret, Stockholm: Liber, 2022, 1, p. 78-101Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2022 Edition: 1
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-56065 (URN)978-91-47-12837-2 (ISBN)
Available from: 2022-11-16 Created: 2022-11-16 Last updated: 2022-11-23Bibliographically approved
Hommel, A. (2022). Magnetsjukhus och transformerande ledarskap (1ed.). In: Ziegert, Kristina (Ed.), Våga leda omvårdnad: (pp. 191-206). Stockholm: Liber
Open this publication in new window or tab >>Magnetsjukhus och transformerande ledarskap
2022 (Swedish)In: Våga leda omvårdnad / [ed] Ziegert, Kristina, Stockholm: Liber , 2022, 1, p. 191-206Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2022 Edition: 1
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-56066 (URN)978-91-47-12839-6 (ISBN)
Available from: 2022-11-16 Created: 2022-11-16 Last updated: 2022-11-23Bibliographically approved
Ulrika, K., Hommel, A., Madeleine, B. R., Lena, G., Eva, S. & Carina, B. (2022). Pressure ulcer prevalence and prevention interventions: A ten-year nationwide survey in Sweden. International Wound Journal, 19(7), 1736-1747
Open this publication in new window or tab >>Pressure ulcer prevalence and prevention interventions: A ten-year nationwide survey in Sweden
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2022 (English)In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 19, no 7, p. 1736-1747Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe pressure ulcer prevalence and prevention interventions in hospital care in Sweden based on nationwide surveys conducted over a 10-year period. All Swedish hospitals were invited to participate in annual pressure ulcer prevalence surveys during the period 2011-2020. The data collection protocols included gender, age, skin assessment, risk assessment, and preventive interventions. In total, more than 130,000 patients were included in the ten prevalence surveys. The prevalence of pressure ulcers in Swedish hospital patients decreased significantly from 17.0 %to 11.4% between 2011 and 2020 and hospital-acquired pressure ulcers decreased from 8.1% to 6.4% between 2018 and 2020. There was no significant decline in medicaldevice-related pressure ulcers during the same period. The proportion of patients who were risk and skin assessed increased, as did the use of pressure-reducing mattresses, sliding sheets, heel protection, and nrepositioning plans. This study shows that the implementation of a national patient safety program has had an impact on the nationwide prevalence of pressure ulcers in hospital care and the occurrence of prevention strategies. However, one in ten patients in Swedish hospitals still suffers from pressure ulcers. Further improvements can be made.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
Sweden, hospital, point prevalence, pressure ulcer, prevention
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-50543 (URN)10.1111/iwj.13779 (DOI)000761598500001 ()35224868 (PubMedID)2-s2.0-85140933562 (Scopus ID)
Available from: 2022-03-10 Created: 2022-03-10 Last updated: 2024-02-05Bibliographically approved
Jonsson, M. H., Åkesson, A., Hommel, A., Grubb, A. & Bentzer, P. (2021). Markers of renal function at admission and mortality in hip fracture patients-a single center prospective observational study. Scandinavian Journal of Clinical and Laboratory Investigation, 81(3), 201-207
Open this publication in new window or tab >>Markers of renal function at admission and mortality in hip fracture patients-a single center prospective observational study
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2021 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 81, no 3, p. 201-207Article in journal (Refereed) Published
Abstract [en]

Plasma cystatin C and shrunken pore syndrome (SPS) are associated with increased mortality in older adults. The objective was to assess the association between these markers of kidney function at admission and mortality in hip fracture patients. Hip fracture patients presenting at Lund University Hospital were eligible for inclusion. Cox regression was used to assess association between plasma cystatin C, creatinine, cystatin C- or creatinine-based estimations of glomerular filtration rate (eGFR(CYS) and eGFR(CREA)), or SPS (defined as eGFR(CYS)/eGFR(CREA) < 0.7) and mortality during one year follow up. Improvement in discrimination relative to the Nottingham Hip fracture score was assessed by Receiver Operational Characteristics (ROC) analysis and calculation of Net Reclassification Index (NRI). 996 patients were included in the study. Cystatin C, creatinine, eGFR(CYS) and eGFR(CREA) were associated with one-year mortality in both unadjusted and adjusted analyses. The association with mortality was stronger for cystatin C and for eGFR(CYS) than for creatinine and eGFR(CREA). Patients with SPS had doubled mortality compared with patients without SPS (43.7 and 20.2%, respectively, p < .001). Hazard ratio for SPS in the adjusted analysis was 1.66 (95%CI; 1.16-2.39, p = .006). None of the markers improved discrimination compared to the Nottingham Hip Fracture Score using ROC analysis whereas eGFR(CYS) and eGFR(CREA) improved NRI. Our conclusion is that plasma concentrations of creatinine or cystatin C, eGFR(CYS) or eGFR(CREA) or SPS at admission in hip fracture patients are associated with mortality when known risk factors are accounted for. Identification of high risk patients may be improved by eGFR(CYS) or eGFR(CREA).

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Creatinine, cystatin C, hip fractures, mortality, shrunken pore syndrome
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:mau:diva-41039 (URN)10.1080/00365513.2021.1884892 (DOI)000619712100001 ()33606570 (PubMedID)2-s2.0-85101072272 (Scopus ID)
Available from: 2021-03-08 Created: 2021-03-08 Last updated: 2024-02-05Bibliographically approved
Kjällquist-Petrisi, A. & Hommel, A. (2021). Preceptors’ experiences of peer learning in an intensive care unit. Nurse Education in Practice, 54, Article ID 103086.
Open this publication in new window or tab >>Preceptors’ experiences of peer learning in an intensive care unit
2021 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 54, article id 103086Article in journal (Refereed) Published
Abstract [en]

In Sweden, there is a lack of nurses with competence in intensive and critical care as well as experienced critical care nurses with a formal education in preceptorship. Using the peer learning model could be one way to assure the quality of critical care practice placements for post-graduate nursing students as this model requires only one preceptor for every two students. This study's aim was to examine the experience of preceptors regarding peer learning at a university hospital intensive care unit. The study followed a qualitative descriptive design. The participants were nine preceptors with experience working as critical care nurses ranging from 3 to 24 years. Each preceptor was interviewed individually using a semi-structured interview guide. The data were subjected to conventional inductive content analysis. The analysis reveals three categories: collaboration and communication; responsibility; and psychosocial environment. Some preceptors felt responsible for the delivery of adequate clinical practice despite students having difficulties in communicating and collaborating with each other or being at different experience levels. While preceptors and students need more preparation and knowledge about peer learning it can, nevertheless, contribute to the development of collaboration and communication skills within the intensive care setting.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Intensive care, Peer learning, Post-graduate nursing students, Preceptors’ experiences
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-44114 (URN)10.1016/j.nepr.2021.103086 (DOI)000679951100035 ()34091102 (PubMedID)2-s2.0-85107647574 (Scopus ID)
Available from: 2021-06-24 Created: 2021-06-24 Last updated: 2022-11-23Bibliographically approved
Kulbay, A., Vest, D., Thorngren, K.-G., Hommel, A. & Hedström, M. (2021). Sekundärprevention – fortfarande en utmaning efter fragilitetsfraktur: Få läkemedelsbehandlingar efter höftfrakturer – trots frakturkedjor. Läkartidningen, 118, Article ID 21033.
Open this publication in new window or tab >>Sekundärprevention – fortfarande en utmaning efter fragilitetsfraktur: Få läkemedelsbehandlingar efter höftfrakturer – trots frakturkedjor
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2021 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 118, article id 21033Article in journal (Refereed) Published
Abstract [en]

Yearly 16 000 osteoporosis related hip fractures occur in Sweden. They cause suffering for patients and high costs for society. Subsequent fractures can be reduced with osteoporosis diagnostics and treatment. 4 322 patients from two hospitals using Fracture Liaisson Services in Sweden were included to identify the rate of osteoporosis diagnostics and treatment during the first year after a hip fracture. Data between 2010-01-01 and 2018-12-31 were included from the Swedish National Hip Fracture Registry (Rikshöft). 99.2 % of all patients underwent FRAX risk assessment and DEXA was conducted on 17.3 % of patients. Women were more frequently examined with DEXA than men (21% vs 10.2 %). 6% received medical osteoporosis treatment after the fracture, women were treated more often than men (7% vs 4%). Conclusions: less than 10% received drug therapy after the first year after the hip fracture. Men underwent diagnostics and received treatment at a lower rate than women.

Place, publisher, year, edition, pages
Sveriges läkarförbund, 2021
National Category
Orthopaedics
Identifiers
urn:nbn:se:mau:diva-46848 (URN)34633058 (PubMedID)
Available from: 2021-11-15 Created: 2021-11-15 Last updated: 2022-11-23Bibliographically approved
Loodin, Å. & Hommel, A. (2021). The effects of preoperative oral carbohydrate drinks on energy intake and postoperative complications after hip fracture surgery: A pilot study. International Journal of Orthopaedic and Trauma Nursing, 41, Article ID 100834.
Open this publication in new window or tab >>The effects of preoperative oral carbohydrate drinks on energy intake and postoperative complications after hip fracture surgery: A pilot study
2021 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 41, article id 100834Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hip fractures represent a major clinical burden for patients. Studies on the effect of preoperative carbohydrate loading before different surgical interventions have shown promising results but have not been tested in patients with hip fracture.

AIM: This study aimed to investigate the effects of preoperative oral carbohydrate drinks on the postoperative energy intake and incidence of complications after hip fracture surgery.

METHOD: This was a pilot study using a quasi-experimental design with a control group and an intervention group.

RESULT: The number of patients affected by more than one complication was higher in the control group than in the intervention group. According to the logistic regression analysis, the risk of any postoperative complication was reduced by approximately 50% OR (95% CI) 0.508 (0.23-1.10) in patients in the IG compared to those in the CG (p = 0.085).

CONCLUSION: The result of this pilot study indicated that using preoperative carbohydrate drinks can decrease the number of postoperative complications in patients with a hip fracture. Furthermore, the number of patients who meet their energy needs during the first three days postoperatively might increase. More research is needed to confirm the effect of preoperative carbohydrate drinks.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Complications, Hip fracture, Nutrition, Pilot study, Preoperative oral carbohydrate nutrition
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-39741 (URN)10.1016/j.ijotn.2020.100834 (DOI)000653013600001 ()33353850 (PubMedID)2-s2.0-85098197793 (Scopus ID)
Available from: 2021-01-25 Created: 2021-01-25 Last updated: 2024-02-05Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6114-6535

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