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  • 1.
    Ahlqvist, Margary
    et al.
    Division of Medicine and Surgery, Karolinska University Hospital, Stockholm, Sweden..
    Bogren, Agneta
    Hagman, Sari
    Nazar, Isabel
    Nilsson, Katarina
    Nordin, Karin
    Valfridsson, Berit Sunde
    Söderlund, Mona
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nordström, Gun
    Handling of peripheral intravenous cannulae: effects of evidence-based clinical guidelines.2006In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 11, p. 1354-61Article in journal (Refereed)
    Abstract [en]

    AIM: This study aimed at evaluating the outcome of implemented evidence-based clinical guidelines by means of surveying the frequency of thrombophlebitis, nurses' care, handling and documentation of peripheral intravenous cannulae. BACKGROUND: Peripheral intravenous cannulae are frequently used for vascular access and, thereby, the patients will be exposed to local and systemic infectious complications. Evidence-based knowledge of how to prevent these complications and how to care for patients with peripheral intravenous cannula is therefore of great importance. Deficient care, handling and documentation of peripheral intravenous cannulae have previously been reported. DESIGN: A cross-sectional survey was conducted by a group of nurses at three wards at a university hospital before and after the implementation of the evidence-based guidelines. METHOD: A structured observation protocol was used to review the frequency of thrombophlebitis, the nurses' care, handling and the documentation of peripheral intravenous cannulae in the patient's record. RESULTS: A total of 107 and 99 cannulae respectively were observed before and after the implementation of the guidelines. The frequency of peripheral intravenous cannulae without signs of thrombophlebitis increased by 21% (P < 0.01) and the use of cannula size 0.8 mm increased by 22% (P < 0.001). Nurses' documentation of peripheral intravenous cannula improved significantly (P < 0.001). CONCLUSION: We conclude that implementation of the guidelines resulted in significant improvements by means of decreased frequency of signs of thrombophlebitis, increased application of smaller cannula size (0.8 mm), as well as of the nurses' documentation in the patient's record. RELEVANCE TO CLINICAL PRACTICE: Further efforts to ameliorate care and handling of peripheral intravenous cannulae are needed. This can be done by means of increasing nurses' knowledge and recurrent quality reviews. Well-informed patients can also be more involved in the care than is common today.

  • 2.
    Bullington, Jennifer
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Söderlund, Mona
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Bos Sparén, Elisabeth
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Kneck, Åsa
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Omérov, Pernilla
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Communication skills in nursing: A phenomenologically-based communication training approach2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 9, p. 136-141Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to present a communication skills training curriculum for nursing students, based upon phenomenology. Research shows that nurses have difficulty prioritizing dialogue with patients, due to lack of time, organizational and cultural factors. Like other health care professionals, nurses may also have difficulties communicating with patients due to personal fears and shortcomings. The communication training curriculum based upon phenomenology aims at systematically training students to stay focused upon patients' and relatives' narratives, allowing them to reflect upon and better understand their current situation. This approach to communication is applicable in any clinical situation where it important to provide space for the patients' experiences. The philosophical principles guiding the training are presented here as well as the practical steps in the program. Finally, the approach is compared to other common communication methods used in nursing (motivational interviewing, caring conversations, empathy training). The authors hope that the article will highlight the nurses’ role as dialogue partner as well as emphasize the importance of communication skills training in nursing education. This approach can be refined, tested and modified in future research and may serve as an inspirational model for creating a generic communicative competence for nurses.

  • 3.
    Söderlund, Mona
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle, Sektionen för omvårdnad (Karolinska institutet, Department of Neurobiology, Care Science and Society, Department of Nursing).
    Förhållningssätt och kommunikation i mötet med personer med demenssjukdom: utvärdering av ett träningsprogram med validationsmetoden2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Communication difficulties among residents with dementia disease living in nursing homes may complicate care situations. These residents can have difficulties describing how they experience their everyday lives, which can lead to withdrawal, social isolation, or feelings of homelessness. Research indicates that nurses involved in dementia care experience communication as difficult and challenging. The validation method developed by Feil is held to facilitate communication through emphatic and confirmatory approaches. Scientific reviews show insufficient evidence for recommending the use of the method, in spite of this the method is used in dementia care. Evaluations of the validation method have primarily focused on the residents’ perspective, and reports on nurses’ experiences of the validation method are sparse. The overall aim for this thesis was to evaluate Feils’ validation method by describing nurses’ experiences and skills in communication observed during implementation of a training programme. Twelve nurses participated in the validation method training programme that included 10 days of theoretical training with supervision about once a month, and practical training integrated in everyday work. During practical training nurses had conversation with 3 residents each 2-3 times a week, and videotaped one conversation per month. Methods: The design is based on naturalistic scientific approach. Data were collected with interviews (I, II) and a questionnaire (II) before and after the programme, and videotaped conversations during the programme (III, IV). An interview was conducted as a comparison with nurses from another nursing home, who had long experiences of using the validation method (I). The result showed that nurses improved their communication and had closer relationships with residents with dementia disease after validation method training, in accordance with nurses with long experiences (I). The training strengthened the nurses, but also posed an extra strain on them. Even though the nurses described an extra strain on the entire nursing staff, this was not reflected in the results from the questionnaire about the work climate (II). Videotaped one-to-one conversations between nurses and residents showed that the nurses developed their approaches and communication skills, although to different degrees. An overall pattern revealed nurses’ movements within and between various paths when improving their communication skills (III). The findings were in congruence with the nurses described experiences (I). In videotaped conversations from the end of the programme, the residents had the possibilities to use their remaining communication abilities and to communicate what was currently on their mind (IV). This may be related to the development of the nurses’ communication skills during the programme. Conclusions of this thesis were that the nurses developed their skills in caring approach and communication when communicating with residents with dementia disease, which gave these residents possibilities to communicate according to their abilities. In order to integrate new knowledge about communication the results showed that it was necessary to combine theoretical and practical training with supervision and reflection. To provide nursing staff with this type of training could be seen as an investment for nursing homes, an opportunity to increase job satisfaction for nurses and to increase social community for residents.

  • 4.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC.
    Conversations between residents with dementia disease and nurses: evaluation of an intervention with the Validation methodManuscript (preprint) (Other academic)
  • 5.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC. Ersta Sköndal University College, Department of Health Care Sciences. Umeå universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska Institutet, Stockholm Sjukhem.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska Institutet.
    Conversations between persons with dementia disease living in nursing homes and nurses: qualitative evaluation of an intervention with the validation method2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, p. 37-47Article in journal (Refereed)
    Abstract [en]

    Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons’ communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one-to-one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one’s mind and speaking more freely about what is on one’s mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses’ communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.

  • 6.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Department of palliative care research.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of palliative care research.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nurses’ movements within and between various paths when improving their communication skills – an evaluation of validation method training2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, p. 265-273Article in journal (Refereed)
  • 7.
    Söderlund, Mona
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Fagerberg, Ingegerd
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    A safe haven for everyone: Working with shared values in a nursing home for people with dementia2019In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 39, no 3, p. 168-174Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe from a staff perspective what promotes a positive atmosphere in a nursing home for people with dementia. A nursing home renowned for its positive atmosphere and quality of care was chosen for our research. The study has a qualitative descriptive design using a modified grounded theory. Eight members of staff were interviewed. The analysis consisted of open, axial and selective coding and constant comparison between each narrative. The core category was ‘A safe haven for everyone’, with three categories; ‘Relating to people with dementia’, ‘Relating to work’ and ‘Relating to each other’. A shared set of values embraced by all staff was the foundation in the nursing home and supported the atmosphere and quality of care. The positive atmosphere had been founded on mutual trust between manager and staff, lending staff the freedom to be creative in their work, and ensuring that the residents with dementia were cared for in the best possible way.

  • 8.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Bemötande och förhållningssätt vid demenshandikapp.: Utvärderingsrapport från interventionsstudier2006Report (Other academic)
  • 9.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Department of palliative care research.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Implementation of the validation method: Nurses’ descriptions of caring relationships with residents with dementia diseaseValidation method implementation:  2012In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 11, no 5, p. 567-585Article in journal (Refereed)
  • 10.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Norberg, Astrid
    Ersta Sköndal University College, Department of Health Care Sciences. Department of Nursing, Umeå University, Umeå, Sweden.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Validation method training: nurses' experiences and ratings of work climate2014In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 1, p. 79-89Article in journal (Refereed)
    Abstract [en]

    Background: Training nursing staff in communication skills can impact on the quality of care for residents with dementia and contributes to nurses' job satisfaction. Changing attitudes and practices takes time and energy and can affect the entire nursing staff, not just the nurses directly involved in a training programme. Therefore, it seems important to study nurses' experiences of a training programme and any influence of the programme on work climate among the entire nursing staff.

    Aims and objectives: To explore nurses' experiences of a 1-year validation method training programme conducted in a nursing home for residents with dementia and to describe ratings of work climate before and after the programme.

    Design: A mixed-methods approach.

    Methods: Twelve nurses participated in the training and were interviewed afterwards. These individual interviews were tape-recorded and transcribed, then analysed using qualitative content analysis. The Creative Climate Questionnaire was administered before (n = 53) and after (n = 56) the programme to the entire nursing staff in the participating nursing home wards and analysed with descriptive statistics.

    Results: Analysis of the interviews resulted in four categories: being under extra strain, sharing experiences, improving confidence in care situations and feeling uncertain about continuing the validation method. The results of the questionnaire on work climate showed higher mean values in the assessment after the programme had ended.

    Conclusion: The training strengthened the participating nurses in caring for residents with dementia, but posed an extra strain on them. These nurses also described an extra strain on the entire nursing staff that was not reflected in the results from the questionnaire. The work climate at the nursing home wards might have made it easier to conduct this extensive training programme.

    Implications for practice: Training in the validation method could develop nurses' communication skills and improve their handling of complex care situations.

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