The effect of a short educational intervention on the use of urinary catheters: a prospective cohort study.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesTo assess the effectiveness of implementation of evidence-based recommendations to reduce catheter-associated urinary tract infections (CAUTIs).Prospective cohort study, conducted in 2010-12, with a before and after design.A major referral university hospital.Data were collected before (n = 244) and 1 year after (n = 255) the intervention for patients who received urinary catheters.The intervention comprised two elements: (i) aligning doctors' and nurses' knowledge of indications for the use of catheters and (ii) an educational effort consisting of three 30- to 45-minute sessions on evidence-based practice regarding catheter usage for nursing personnel on 17 medical and surgical wards.The main outcome measures were the proportion of (i) admitted patients receiving urinary catheters during hospitalization, (ii) catheters inserted without indication, (iii) inpatient days with catheter and (iv) the incidence of CAUTIs per 1000 catheter days. Secondary outcome measures were the proportion of (i) catheter days without appropriate indication and (ii) patients discharged with a catheter.There was a reduction in the proportion of inpatient days with a catheter, from 44% to 41% (P = 0.006). There was also a reduction in the proportion of catheter days without appropriate indication (P < 0.001) and patients discharged with a catheter (P = 0.029). The majority of catheters were inserted outside the study wards.A short educational intervention was feasible and resulted in significant practice improvements in catheter usage but no reduction of CAUTIs. Other measures than CAUTI may be more sensitive to detecting important practice changes.Icelandic Nurses' Association Research Fund Landspitali University Hospital Research Fund Ministry of Welfare in Icelan

The complexity of shaping self-management in daily practice

_Background and context:_ Many countries are giving patients a more active role in health care, on both the individual and collective level. This paper focuses on one aspect of the participation agenda on the individual level: self-management. The paper explores self-management in practice, including the implications of the difficulties encountered. _Objective:_ to gain insight into the complexity of self-management practice. This is crucial for developing both self-management interventions and the participation policy agenda. _Methods:_ qualitative semi-structured interviews with experts (n=6) and patients with a chronic condition (n=20). _Results:_ in terms of level of involvement and type of activity, shaping self-management in practice depends on personal and social dynamics, patients’ ideas of the good life, and their interactions with care professionals. Clashes can arise when patients and professionals hold differing ideas, based on different values, about the level and type of patient involvement. _Discussion:_ The discussion on self-management should account for the fact that how we define self-management is very much a normative issue

Encumbered by vulnerability and temporality - the meanings of trigger situations when learning to live with diabetes

AIMS AND OBJECTIVES: The aim of the study was to illuminate the meanings of trigger situations experienced in everyday life when learning to live with diabetes. BACKGROUND: Adults become active learners when faced with situations they do not know how to manage, triggering a need to understand something in a different way than before. Knowing more about experiential learning for persons living with diabetes is important for understanding how learning can be supported by health care. DESIGN: A life-world approach with a phenomenological hermeneutical method, inspired by the philosophy of Paul Ricoeur. METHODS: This method was used for interpreting transcriptions of interviews and consists of three stages: naïve understanding, structural analysis and a comprehensive understanding. Participants (n = 13), with either type I or type II diabetes, were interviewed on three different occasions over a three-year period after being diagnosed with diabetes. RESULTS: When learning to live with diabetes, the meanings of trigger situations were described as 'the unpredictable body heightens insecurity with awareness of one's own dependability', 'losing control in unsustainable situations' and 'encumbered by vulnerability and temporality in earlier familiar situations'. CONCLUSION: The meanings of trigger situations were to lose the smooth, unreflected way of managing an everyday life situation, interlaced with feelings of lost control of how to live with new insights of being vulnerable. Trigger situations meant an opportunity for learning, as well as being demanding, unplanned and with limited freedom of choice. Trigger situations presented life and body as unpredictable. RELEVANCE TO CLINICAL PRACTICE: If healthcare professionals can identify the worries and questions raised in trigger situations, knowledge gaps can be identified and reflected on to stimulate learning

Patients' expectations and experiences of provided surgery-related patient education : A descriptive longitudinal study

Funding Information: The authors thank Guðný Bergóra Tryggvadóttir, specialist at the Social Science Research Institute at the University of Iceland for providing statistical support, nurses at the Landspítali University Hospital and at Akureyri Hospital who participated in data collection and the participants who provided valuable information about themselves. Funding Information: The study was funded by the University of Iceland Science Fund, the Landspitali University Hospital Science Fund and the Icelandic Nurses' Association Science Fund Publisher Copyright: © 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.Aims: The aim of this study was to explore the educational expectations and experiences of surgical patients. Design: Prospective, longitudinal, descriptive and two-centre study. Data were collected with questionnaires at the hospital and 6 weeks and 6 months postsurgery. Methods: Patients undergoing elective surgery and hospitalized overnight from January to July 2016 answered questions about the content of received pre-operative and pre-discharge education, topics they wanted more information on, sources of information, satisfaction with and usefulness of the information and if their recovery was as expected. Results: Patients (N = 697, 49% male, mean age 64.1 [SD 12.6] years) perceived the provided education as useful and satisfactory but less so after discharge. Most common topics which they expected more education about were postoperative complications, pain management, fatigue, lack of stamina and expected recovery time. Most patients received information through face-to-face teaching (79.7%) and in writing (78.4%). Expectations on recovery were related to patients' satisfaction with the education and how useful they evaluated it.Peer reviewe

Characterization of Antioxidant Potential of Seaweed Extracts for Enrichment of Convenience Food

In recent years, there has been a growing interest in natural antioxidants as replacements of synthetic compounds because of increased safety concerns and worldwide trend toward the usage of natural additives in foods. One of the richest sources of natural antioxidants, nowadays largely studied for their potential to decrease the risk of diseases and to improve oxidative stability of food products, are edible brown seaweeds. Nevertheless, their antioxidant mechanisms are slightly evaluated and discussed. The aims of this study were to suggest possible mechanism(s) of Fucus vesiculosus antioxidant action and to assess its bioactivity during the production of enriched rye snacks. Chemical and cell-based assays indicate that the efficient preventive antioxidant action of Fucus vesiculosus extracts is likely due to not only the high polyphenol content, but also their good Fe2+-chelating ability. Moreover, the data collected during the production of Fucus vesiculosus-enriched rye snacks show that this seaweed can increase, in appreciable measure, the antioxidant potential of enriched convenience cereals. This information can be used to design functional foods enriched in natural antioxidant ingredients in order to improve the health of targeted consumers

Leverandørinvolvering og samarbeid på Statfjord-feltet - For sikre og bærekraftige leveranser til det største oljefunnet i Nordsjøen

Equinor ASA er den fremste offshoreoperatøren på norsk kontinentalsokkel, med formålet “omdanne naturressurser til energi for mennesker og framgang for samfunnet”. Equinor har ukentlige forsyninger ut til samtlige av sine installasjoner offshore, hvor 80% av varestrømmene er innen boring og brønn. Rapportens hensikt er å utarbeide en liste med konkrete tiltak på områder som bør forbedres innen samarbeid og leverandørinvolvering. Problemstillingen er definert deretter: På hvilke områder vil endring i leverandørinvolvering og samarbeid gi en bærekraftig og sikker forsyningsprosess for boreoperasjoner på Statfjord? Rapporten tar for seg leverandørinvolvering og samarbeid på ulike installasjoner, men konklusjonen avgrenses til leverandørinvolveringen på Statfjord. Resultatet er basert på erfaringer og observasjoner fra informantene, som er analysert og diskutert opp mot teori. Rapporten er basert på samtaler med informanter, vitenskapelige artikler og faglitteratur. Informasjonen er innhentet gjennom samtaler med boreforsyningsansvarlig hos Equinor i tillegg til logistikkoordinator og Service Pusher hos leverandør. Samtalene baseres på spørsmål fra studentenes spørsmålsliste, anbefalt fra boken Case Study Research. Gjennom analyse og diskusjon er det utarbeidet en konklusjon som peker på de viktigste områdene for endring innen leverandørinvolvering. Områdene er: 1) relasjonsbasert samarbeid, 2) bruk av digitale verktøy, 3) grad av involvering, 4) leverandørforhold og 5) måling av leveringsservice. For å oppnå endring på de respektive områdene er det utarbeidet en rekke tiltak. På det første området, relasjonsbasert samarbeid, er tiltaket relasjonsbygging gjennom sosiale interaksjoner med leverandør. Under området bruk av digitale verktøy er det anbefalt opplæringskurs i WELS. Ved endring innen grad av involvering er det kommet frem til to tiltak; benytte høy leverandørinvolvering med krav om logistikkoordinator og organisering av morgenmøtene slik at logistikkoordinator kan delta på samtlige. Under leverandørforhold er det anbefalt å fokusere på strategiske mål, for å underbygge Equinor sitt formål. Tiltaket KPI er anbefalt på området måling av leveringsservice. Endring på de respektive områdene er ressurskrevende ved oppstart, men vil basert på Statfjords levetid være lønnsomme over tid, og gi en bærekraft og sikker forsyningsprosess.Equinor ASA is the leading offshore operator on the Norwegian continental shelf, with the purpose of “turn natural resources into energy for people and progress for society”. Equinor has weekly supplies out to all their offshore installations, where drilling and well accounts for 80% of these supplies. The purpose for this report is to produce a list of specific measures that should be enhanced within the areas of cooperation and supplier involvement. The objective for this report is defined as follows: In which areas will change in supplier involvement and cooperation provide a sustainable and secure supply process for drilling operations at Statfjord? This report addresses key issues on supplier involvement and collaboration on various installations, but the information is limited to supplier involvement at Statfjord. The results are based on experiences and observations from the informants which have been analyzed and discussed based on relevant theory. The methods used in this report are conversations with informants, scientific articles and books. The information was obtained through conversations with the drilling supply manager at Equinor, the logistics coordinator, and the Service Pusher at the supplier. The conversations are based on questions from the students’ questionnaire, recommended in the book Case Study Research. A conclusion has been produced through analysis and discussion which points to the most critical areas for change within supplier involvement. The following areas are: 1) relationship-based collaboration, 2) use of digital tools, 3) degree of involvement, 4) supplier relationships and 5) measurement of delivery service. Several measures have been taken to achieve change in the respective areas. Training courses in WELS are recommended in the second area. In the event of a change in the third area, two measures were identified: increased supplier involvement with requirements for the logistics coordinator and improvement in organizing morning meetings. Under supplier conditions, it is recommended to focus on strategic goals to substantiate Equinor’s purpose. The KPI measure is recommended in the area of measurement of delivery service. Changes in the respective areas are resource demanding at first, but based on Statfjord’s lifetime the mentioned change will be profitable, and provide a sustainable and secure supply process

Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)

IntroductionLow fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality. Methods Subjects were COPD patients (n=121) admitted to Landspitali University Hospital from March 2015-March 2016. Patients were screened for nutritional risk using Icelandic screening tool (ISS) and NRS-2002. Body composition was measured by bioelectrical impedance analysis (BIA). Lung function was measured by spirometry. ResultsThe prevalence of malnutrition according to the ESPEN criteria was 21%. The association between nutritional assessment, applying different components of the ESPEN criteria, and COPD severity was highly significant, with the highest risk being associated with low FFMI OR (95% CI) 4.77 (2.03, 11.20; p&lt;0.001). There was a trend towards higher risk of hospitalization for &gt;7 days in subjects with low FFMI (OR 2.46 95% CI 0.92, 6.59; p=0.074) and increased risk of 6 and 9 months’ mortality (OR 2.72 95% CI 0.88, 8.39, P=0.082 and OR 2.72 95% CI 0.94, 7.87, P=0.065, respectively) in subjects diagnosed as malnourished by the ESPEN criteria. ConclusionThis study describes the prevalence of malnutrition in hospitalized COPD patients using the ESPEN criteria from 2015. Our findings suggest that FFMI could be used independently of weight loss for the diagnosis of malnutrition in COPD patients, although there remain some problems associated with its measurement in the clinical setting

How do people with intellectual disabilities and diabetes experience and perceive their illness?

Introduction Diabetes is a significant health problem amongst people with intellectual disabilities, yet there is a lack of qualitative literature looking specifically at their experiences and perceptions of living with this chronic illness. Method Using Interpretative Phenomenological Analysis, this study explored the experiences and perceptions of four people with intellectual disabilities and diabetes. Results Results showed that participants demonstrated some knowledge of the language surrounding diabetes, but considerable confusion and uncertainty about their illness. The impact of diabetes was described in terms of physical, emotional and social consequences, and participants spoke of diabetes in the context of co-existing health problems. Conclusions People with intellectual disabilities and diabetes face many challenges when perceiving and coping with their illness. Gaining insight into these challenges could help health professionals work together more effectively and provide appropriate support to people with intellectual disabilities and diabetes. © 2011 Blackwell Publishing Ltd

Аутстаффинг, прекаризация и лизинг персонала как инструменты повышения эффективности его использования на предприятии (на примере КУП «Петриковский райжилкомхоз»)

To access publisher's full text version of this article click on the hyperlink at the bottom of the pagePatient education in connection with hip replacement is intended to prepare patients for surgery, discharge and postoperative recovery. Patients experience symptoms and emotions due to disease or upcoming surgery which can affect how their knowledge expectations are fulfilled.To describe the differences between received and expected knowledge in patients undergoing elective hip replacement in three Nordic countries, and to analyse how these differences are related to patients' characteristics, preoperative symptoms and emotions.A descriptive, prospective survey with two data collection points; before admission and at hospital discharge after surgery.Two Finnish, three Icelandic and two Swedish hospitals.The population consisted of patients on a waiting list for hip replacement. Of the consecutively included patients, 320 answered questionnaires both before admission and at discharge and were included in the study. The mean age of the patients was 64 years, and 55% were women.Structured questionnaires were used; the knowledge expectations of hospital patients scale and self-reported scales for symptoms and emotions before admission and received knowledge of hospital patients scale at discharge. Fulfilment of knowledge expectation was assessed by calculating the difference between received and expected knowledge with a paired sample t-test. A multiple stepwise regression model was used to explain the variance of fulfilled knowledge expectations.Patients expected more knowledge than they received (p<0.001) and 77% of them had unfulfilled knowledge expectations. Patients with a higher level of education were more likely to have unfulfilled knowledge expectations. A higher level of education was also related to a greater difference between received and expected knowledge. The difference was more correlated with patients' emotions than their symptoms. A depressive state was the major predictor of the variance in the difference between received and expected knowledge.In order to better support patients by education it is necessary to assess their emotional state, educational level and knowledge expectations before surgery