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6. Long-term effects of restriction of intravenous fluid in adult ICU patients with septic shock

Author

Kjær, Maj-Brit Nørregaard, Meyhoff, Tine Sylvest, Sivapalan, Praleene, Granholm, Anders, Hjortrup, Peter Buhl, Madsen, Martin Bruun, Møller, Morten Hylander, Egerod, Ingrid, Wetterslev, Jørn, Lange, Theis, Cronhjort, Maria, Laake, Jon Henrik, Jakob, Stephan M., Nalos, Marek, Ostermann, Marlies, Gould, Doug, Cecconi, Maurizio, Malbrain, Manu L. N. G., Ahlstedt, Christian, Kiel, Louise Bendix, Bestle, Morten H., Nebrich, Lars, Hildebrandt, Thomas, Russell, Lene, Vang, Marianne, Rasmussen, Michael Lindhart, Sølling, Christoffer, Brøchner, Anne Craveiro, Krag, Mette, Pfortmueller, Carmen, Kriz, Miroslav, Siegemund, Martin, Albano, Giovanni, Aagaard, Søren Rosborg, Bundgaard, Helle, Crone, Vera, Wichmann, Sine, Johnstad, Bror, Martin, Yvonne Karin, Seidel, Philipp, Mårtensson, Johan, Hollenberg, Jacob, Wistrand, Mats, Donati, Abele, Barbara, Enrico, Karvunidis, Thomas, Hollinger, Alexa, Carsetti, Andrea, Lumlertgul, Nuttha, Joelsson-Alm, Eva, Lambiris, Nikolas, Aslam, Tayyba Naz, Friberg, Fredrik Femtehjell, Vesterlund, Gitte Kingo, Mortensen, Camilla Bekker, Vestergaard, Stine Rom, Caspersen, Sidsel Fjordbak, Jensen, Diana Bertelsen, Borup, Morten, Rasmussen, Bodil Steen, and Perner, Anders

Published
2023
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7. A retrospective multicenter cohort study of the association between anti-Factor Xa values and death, thromboembolism, and bleeding in patients with critical COVID-19

Author

Jonmarker, Sandra, Litorell, Jacob, Alarcon, Felix, Al-Abani, Kais, Björkman, Sofia, Farm, Maria, Grip, Jonathan, Söderberg, Mårten, Hollenberg, Jacob, Wahlin, Rebecka Rubenson, Kander, Thomas, Rimling, Liivi, Mårtensson, Johan, Joelsson-Alm, Eva, Dahlberg, Martin, and Cronhjort, Maria

Published
2023
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14. Piloting and watch over in the end‐of‐life care of intensive care unit patients with COVID‐19—A qualitative study.

Author

Pettersson, Charlotte, Forsén, Johanna, Joelsson‐Alm, Eva, Fridh, Isabell, Björling, Gunilla, and Mattsson, Janet

Subjects
DEHUMANIZATION, CRITICALLY ill, PATIENTS, QUALITATIVE research, MEDICAL quality control, INTERPROFESSIONAL relations, INTENSIVE care nursing, INTERVIEWING, PRIVACY, PATIENT-family relations, DECISION making, FAMILY relations, VISITING the sick, FAMILY roles, SOUND recordings, INTENSIVE care units, RESEARCH methodology, TERMINAL care, COVID-19, COVID-19 pandemic, EMPLOYEES' workload, MEDICAL ethics, CRITICAL care nurses
Abstract

Background: During the COVID‐19 pandemic, intensive care units (ICUs) were under heavy pressure, with a significantly increased number of severely ill patients. Hospitals introduced restrictions, and families could not visit their ill and dying family members. Patients were cared for without privacy, and several died in shared patient rooms, leaving the intensive care nurse to protect the patient's need for loving care in a vulnerable situation at the end of life. Aim: This study aimed to investigate how piloting and watch over were revealed in end‐of‐life care for patients with COVID‐19 in intensive care COVID‐19. Study Design: A qualitative study was conducted with an abductive approach was conducted. Data were collected via semi‐structured interviews to cover the research area while allowing the informant to talk freely about the topic; 11 informants were interviewed. Results: The findings are presented based on four categories: The road to the decision, End‐of‐life care, Farewell of close family members and Closure. Each category and subcategory reveal how piloting and watch over were addressed in the end‐of‐life care of patients with COVID‐19 in the ICU during the pandemic. Overall findings indicated that workload and organization of care directly affect the quality of care given, the acceptance of privacy and the possibility of dignified end‐of‐life care. Conclusions: Workload directly affects the quality of care, risking dehumanization of the patient. Visiting restrictions hindered supporting family members through the various piloting phases. Visiting restrictions also forced the ICU nurses to take on the role of the relative in watching over the patient. Relevance to Clinical Practice: Collaboration with family members is essential for the intensive care nurse to be able to provide a person‐centred and dignified end‐of‐life care. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Adherence to evidence-based guidelines for prevention of urinary retention in hip surgery patients : a multicentre observational study

Author

Winberg, Madeleine, Hälleberg Nyman, Maria, Fjordkvist, Erika, Eldh, Ann Catrine, Joelsson-Alm, Eva, Winberg, Madeleine, Hälleberg Nyman, Maria, Fjordkvist, Erika, Eldh, Ann Catrine, and Joelsson-Alm, Eva

Abstract

Urinary retention is a healthcare complication putting patients at risk of unnecessary suffering and harm. Orthopaedic patients are known to face an increased such risk, calling for evidence-based preoperative assessment and corresponding measures to prevent bladder problems. The aim of this study was to evaluate healthcare professionals' adherence to risk assessment guidelines for urinary retention in hip surgery patients. This was an observational study from January 2021 to April 2021 with a descriptive and comparative design, triangulating three data sources: (I) Medical records for 1382 hip surgery patients across 17 hospitals in Sweden were reviewed for preoperative risk assessments for urinary retention and voiding-related variables at discharge; (II) The patients completed a survey regarding postoperative lower urinary tract symptoms, and; (III) data were extracted from a national quality registry regarding type of surgery, preoperative physical status, and perioperative urinary complications. Group differences were analysed with Chi-square/Fisher's exact test, t-test, Wilcoxon rank-sum test, or Mann-Whitney U-test. Logistic regression was used to analyse variables associated with completed risk assessments for urinary retention. Of all study participants, 23.4% (n = 323) had a preoperative documented risk assessment of urinary retention. Whether a risk assessment was performed was significantly associated with acute surgery [odds ratio (OR) 3.56, 95% confidence interval (CI) 2.48-5.12] and undergoing surgery at an academic hospital (OR 4.59, 95% CI 2.68-7.85). Acute patients were more often affected by urinary retention and had bladder issues and/or an indwelling catheter at discharge. More than every tenth patient (11. 9%, n = 53) completing the survey experienced intensified bladder problems after their hip surgery. The study shows a lack of adherence to risk assessment for urinary retention according to evidence-based guidelines, which negatively affects

Published
2024
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20. Mobilisation of post-ICU patients - a crucial teamwork between physiotherapists and nurses at surgical wards : A qualitative study

Author

Siesage, Katinka, Schandl, Anna, Johansson, Matheo, Nygren-Bonnier, Malin, Karlsson, Emelie, Joelsson-Alm, Eva, Siesage, Katinka, Schandl, Anna, Johansson, Matheo, Nygren-Bonnier, Malin, Karlsson, Emelie, and Joelsson-Alm, Eva

Abstract

PURPOSE: To describe experiences of the ward nurse in relation to extended physiotherapy and mobilising of post-ICU patients. METHODS: Individual semi-structured interviews were conducted with 17 registered nurses working on surgical wards in a Swedish regional hospital. Qualitative content analysis was used to analyse the data. The study was reported according to the consolidated criteria for reporting qualitative research (COREQ). RESULTS: The study findings are presented in three categories: challenges to mobilising post-ICU patients, shared responsibility facilitates mobilisation, and extended physiotherapy is beneficial for patients' wellbeing. Nurses stated that they lacked knowledge and skills to perform the safe mobilisation of post-ICU patients due to their complex medical history and needs. Collaboration with physiotherapists was perceived to facilitate mobilisation and to be beneficial for patients' wellbeing outcome. CONCLUSIONS: The study indicates that post-ICU patients are at risk of remaining immobilised because ward nurses find mobilisation too complex to conduct without support from physiotherapists. Shared responsibility through multi-professional teamwork regarding patient rehabilitation is perceived as contributing the knowledge required to achieve safe mobilisation that enhances autonomy and physical ability in post-ICU patients.

Published
2024
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21. Piloting and watch over in the end-of-life care of intensive care unit patients with COVID-19—A qualitative study

Author

Pettersson, Charlotta, Forsén, Johanna, Joelsson-Alm, Eva, Fridh, Isabell, Björling, Gunilla, Mattsson, Janet, Pettersson, Charlotta, Forsén, Johanna, Joelsson-Alm, Eva, Fridh, Isabell, Björling, Gunilla, and Mattsson, Janet

Abstract

Background: During the COVID-19 pandemic, intensive care units (ICUs) were under heavy pressure, with a significantly increased number of severely ill patients. Hospitals introduced restrictions, and families could not visit their ill and dying family members. Patients were cared for without privacy, and several died in shared patient rooms, leaving the intensive care nurse to protect the patient's need for loving care in a vulnerable situation at the end of life. Aims: This study aimed to investigate how piloting and watch over were revealed in end-of-life care for patients with COVID-19 in intensive care COVID-19. Study Design: A qualitative study was conducted with an abductive approach was conducted. Data were collected via semi-structured interviews to cover the research area while allowing the informant to talk freely about the topic; 11 informants were interviewed. Results: The findings are presented based on four categories: The road to the decision, End-of-life care, Farewell of close family members and Closure. Each category and subcategory reveal how piloting and watch over were addressed in the end-of-life care of patients with COVID-19 in the ICU during the pandemic. Overall findings indicated that workload and organization of care directly affect the quality of care given, the acceptance of privacy and the possibility of dignified end-of-life care. Conclusions: Workload directly affects the quality of care, risking dehumanization of the patient. Visiting restrictions hindered supporting family members through the various piloting phases. Visiting restrictions also forced the ICU nurses to take on the role of the relative in watching over the patient. Relevance to Clinical Practice: Collaboration with family members is essential for the intensive care nurse to be able to provide a person-centred and dignified end-of-life care.

Published
2024
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22. First-line managers' experience of guideline implementation during the COVID-19 pandemic

Author

Fjordkvist, Erika, Eldh, Ann Catrine, Winberg, Madeleine, Joelsson-Alm, Eva, Halleberg Nyman, Maria, Fjordkvist, Erika, Eldh, Ann Catrine, Winberg, Madeleine, Joelsson-Alm, Eva, and Halleberg Nyman, Maria

Abstract

Aim(s)To explore first-line managers' experience of guideline implementation in orthopaedic care during the COVID-19 pandemic.DesignA descriptive, qualitative study.MethodsSemi-structured interviews with 30 first-line nursing and rehabilitation managers in orthopaedic healthcare at university, regional and local hospitals. The interviews were analysed by thematic analysis.ResultsFirst-line managers described the implementation of guidelines related to the pandemic as different from everyday knowledge translation, with a swifter uptake and time freed from routine meetings in order to support staff in adoption and adherence. The urgent need to address the crisis facilitated guideline implementation, even though there were specific pandemic-related barriers such as staffing and communication issues. An overarching theme, Hanging on to guidelines for dear life, is substantiated by three themes: Adapting to facilitate change, Anchoring safety through guidelines and Embracing COVID guidelines.ConclusionA health crisis such as the COVID-19 pandemic can generate enabling elements for guideline implementation in healthcare, despite prevailing or new hindering components. The experience of guideline implementation during the COVID-19 pandemic can improve understanding of context aspects that can benefit organizations in everyday translation of evidence into practice.Implications for the Profession and/or Patient CareRecognizing what enabled guideline implementation in a health crisis can help first-line managers to identify local enabling context elements and processes. This can facilitate future guideline implementation.ImpactDuring the COVID-19 pandemic, the healthcare context and staff's motivation for guideline recognition and adoption changed. Resources and ways to bridge barriers in guideline implementation emerged, although specific challenges arose. Nursing managers can draw on experiences from the COVID-19 pandemic to support implementation of new evidence-based prac, Funding Agencies|Forskningsradet om Haelsa, Arbetsliv och Valfard; Nyckelfonden; [STYA- 2020/0002]

Published
2024
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25. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Author

Abad Gurumeta, Alfredo, Abernethy, Caroline, Abigail, Patrick, Achaibar, Kira, Adam, Emily, Afshari, Arash, Agudelo Montoya, M. Elizabeth, Akgün, Fatma Nur, Aletti, Gabriele, Alkış, Neslihan, Allan, Katie, Allan, Ashley, Allaouchiche, Bernard, Allcock, Clare, Almasy, Emoke, Amey, Isobel, Amigoni, Maria, Andersen, Elin, Andersson, Peder, Anipchenko, Natalya, Antunes, Pedro, Armstrong, Earlene, Aslam, Tayyba Naz, Aslin, Bjorn, Assunção, José Pedro, Ausserer, Julia, Avvai, Mary, Awad, Nahla, Ayas Montero, Begoña, Ayuso, Mercedes, Azevedo, Patricia, Badarau, Victoria, Badescu, Roxana, Baiardo Redaelli, Martina, Baird, Colin, Baird, Yolanda, Baker, Tim, Balaji, Packianathaswamy, Bălan, Cristina, Balandin, Alina, Balescu-Arion, Carmen, Baliuliene, Vilda, Baltasar Isabel, Jorge, Baluch, Saif Nasr, Bandrabur, Daniela, Bankewitz, Carla, Barber, Katrina, Barbera, Francesco, Barcraft-Barnes, Helena, Barletti, Valentina, Barnett, Gill, Baron, Kirsty, Barros, Ana, Barsan, Victoria, Bartlett, Pauline, Batistaki, Chrysanthi, Baumgarten, Georg, Baytas, Volkan, Beauchamp, Nigel, Becerra Cayetano, Isabel A., Bell, Stephanie, Bellandi, Mattia, Belletti, Alessandro, Belmonte Cuenca, Julio, Benitez-Cano, Adela, Beretta, Luigi, Berger, Marc, Bergmann, Nicole, Bergmark, Kristina, Bermudez Lopez, Maria, Bernotaite, Monika, Beurskens, Charlotte, Bidd, Heena, Bifulco, Francesca, Bignami, Elena, Bilic, Aleksandar, Bilskiene, Diana, Bischoff, Petra, Bishop, Luke, Bjonness, Therese, Blaylock, Hether, Blethyn, Kate, Blincoe, Thomas, Blokhin, Ivan, Blunt, Nadia, Boer, Christa, Bois, Grégory, Bonicolini, Eleonora, Booth, Joanna, Borecka-Kedzierska, Miroslawa, Borstnar, Katarina, Borys, Michał, Boselli, Emmanuel, Bouvet, Lionel, Bouwman, Arthur, Bowen, Leonora, Bowrey, Sarah, Boxall, Leigh, Božić, Teodora, Bradley, Tom, Branco, Teresa, Brazzi, Luca, Brazzoni, Marcella, Brear, Tracy, Brogly, Nicolas, Brohi, Farooq, Broms, Jacob, Bubliauskas, Andrius, Bucolo, Gea Erika, Buerkle, Hartmut, Buggy, Donal, Buhre, Wolfgang, Bukauskas, Tomas, Butturini, Francesco, Byttner, Anders, Cabrera Díaz, Itahísa, Calderon, Adriana, Calhau, Ricardo, Callejo, Angel, Cammu, Guy, Campesato, Manuela, Can, Özlem S, Candeias, Margarida, Cantor, Andreea, Carise, Elsa, Carmona, Cristina, Carreteiro, Joana, Carrieri, Cosima, Carter, Anna, Casal, Manuela, Casanova, Irene, Cascella, Marco, Casero, Luis M., Casiraghi, Guiseppina Maria, Castelo-Branco, Laila, Castro Arranz, Carlos, Cernea, Daniela Denisa, Cervantes, Jesoporiol, Chandler, Ben, Charnock, Robert, Chatzimicali, Aikaterini, Chinery, Elane, Chishti, Ahmed, Chondhury, Priyakam, Christie, Emily, Christodoudiles, George, Ciardo, Stefano, Cimpeanu, Luminata, Cindea, Iulia, Cinnella, Gilda, Clark, Sebastian, Clayton, Matthew, Cocu, Simona, Collyer, Thomas, Colvin, Carie, Cope, Sean, Copeta, Filomena, Copotoiu, Sanda-Maria, Correia de Barros, Filinto, Corso, Ruggero Massimo, Cortegiani, Andrea, Costa, Gabriela, Cowton, Amanda, Cox, Nicolas, Craig, James, Cricca, Valentina, Cronin, John, Cunha, Mariana, Cuomo, Arturo, Curley, Katherine, Czuczwar, Mirosław, Dabrowska, Domenika, Damster, Sabrine, Danguy des Déserts, Marc, Daniliuc, Aura, Danninger, Thomas, Darwish, Imad, Dascalu, Corina, Davies, Kirsty, Davies, Simon, De Boer, Hans, De Flaviis, Adelisa, De Selincourt, Gabrielle, Deana, Cristian, Debaene, Bertrand, Debreceni, Gabor, Dedhia, Jatin, Delgado Garcia, Isabel, Della Rocca, Giorgio, Delroy-Buelles, Llana, Desai, Tejal, Dhillon, Parveen, Di Giacinto, Ida, Di Mauro, Piero, Diaz Gomez, Tamara V., Dimitrovski, Aleksandar, Dinic, Vesna, Dîrzu, Dan-Sebastian, Divander, Mona Britt, Dolinar, Janez, Domingues, Susana, Doolan, James, Downes, Charlotte, Dragoescu, Nicoleta Alice, Droc, Gabriela, Dum, Elisabeth, Dumitrescu, Alexandra, Duncan, Louise, Dzurňáková, Paul, Eberl, Susanne, Edwards, Jayne, Edwards, Mark, Ekelund, Kim, Ekengren, Patrik, Elghouty, Eyad, Ellerkmann, Richard, Ellis, Helen, Elme, Andreas, Ernst, Thomas, Errando, Carlos Luis, Estenes, Simao, Ewaldsson, Callis, Farid, Nahla, Featherstone, James, Febres, Daniela, Fedorov, Sergey, Feggeler, Johanna, Feijten, Prisca, Fellmann, Tobias, Fernandez Candil, Juan, Fernandez Castineira, Ana, Fernández Castineira, Juan, Fernando, Aruna, Ferrando, Carlos, Ferreira, Leonia, Ferreira, Patrick, Feyling, Anders, Filipescu, Daniela, Fleischer, Andreas, Floris, Leda, Foerster, Urs, Fox, Benjamin, Franke, Uwe, Frasca, Denis, Frey, Christian, Frost, Victoria, Fullin, Giorgio, Fumagalli, Jacopo, Furneval, Julie, Fusari, Maurizio, Gallacher, Stuart, Galushka, Svetlana, Gambale, Giorgio, Gambino, Irene, Garcia-Perez, Maria Luisa, Garg, Sanjeev, Garlak, Justyna, Gavranovic, Zeljka, Gavrilov, Roman, Gaynor, Lames, Gecaj Gashi, Agreta, Georghiou, Maria, Gerjevic, Bozena, Gferer, Gudrun, Giarratano, Antonino, Gibson, Andy, Gievski, Vanja, Giles, Julian, Gillberg, Lars, Gilowska, Katarzyna, Gilsanz Rodriguez, Fernando, Gioia, Antonio, Giovannoni, Cecilia, Girotra, Vandana, Gkinas, Dimitrios, Gkiokas, George, Godoroja, Daniela, Goebel, Ulrich, Goel, Vandana, Gonzalez, Matilde, Goranovic, Tatjana, Gornik-Wlaszczuk, Ewa, Gosavi, Smita, Gottfridsson, peter, Gottschalk, André, Granell, Manuel, Granstrom, Anna, Grassetto, Alberto, Greenwood, Anna, Grigoras, Ioana, Grintescu, Ioana, Gritsan, Alexey, Gritsan, Galina, Grynyuk, Andriy, Guadagnin, Giovanni Maria, Guarnieri, Marcello, Güçlü, Çiğdem, Guerrero Diez, Maria, Gunenc, Ferim, Günther, Ulf, Gupta, Pawan, Guttenthaler, Vera, Hack, Yvonne, Hafisayena, Ade, Hagau, Natalia, Haldar, Jagannath, Hales, Dawn, Hancı, Volkan, Hanna-Jumma, Sameer, Harazim, Hana, Harlet, Pierre, Harper, Daniel, Harris, Benjamin, Harvey, Orla, Hashimi, Medita, Hawkins, Lesley, Hayes, Conrad, Heaton, James, Heier, Tom, Helliwell, Laurence, Hemmes, Sabrine, Henderson, Kate, Hermanides, Jeroen, Hermanns, Henning, Herrera Hueso, Berta, Hestenes, Siv, Hettiarachchi, Roshane, Highgate, Judith, Hodgson, Keith, Hoelbling, Daniel, Holland, Jonathan, Horhota, Lucian, Hormis, Anil, Hribar, Renata, Hua, Alina, Humphreys, Sally, Humphries, Ryan, Humpliková, Simona, Hunt, Janez, Husnain, Ali, Hussein, Ahmed, Hyams, Benjamin, Iannuccelli, Fabrizio, Ilette, Katie, Ilyas, Carl, Inan, Turgay, India, Immaculada, Ionițăv, Victor, Irwin, Foo, Jain, Vipul, Janez, Benedikt, Jankovic, Radmilo, Jenkins, Sarah, Jenko, Matej, Jimenez, Raquel, Jiménez Gomez, Bárbara, Joachim, Sugganthi, Joelsson-Alm, Eva, John, John, Jonikaite, Lina, Jovic, Miomir, Jungwirth, Bettina, Junke, Etienne, Kabakov, Borys, Kadaoui, Salah-Din, Kanski, Andrzej, Karadag, Süheyla, Karbonskiene, Aurika, Karjagin, Juri, Kasnik, Darja, Katanolli, Fatos, Katsika, Eleni, Kaufmann, Kai, Keane, Helen, Kelly, Martin, Kent, Melanie, Keraitiene, Grazina, Khudhur, Ahmed, Khuenl-Brady, Karin, Kidd, Laurie, King, Siobhan, Kirchgäßner, Katharina, Klancir, Tino, Klucniks, Andris, Knotzer, Johann, Knowlden, Peter, Koers, Lena, Kompan, Janez, Koneti, Kiran K, Kooij, Fabian, Koolen, Eric, Koopman - van Gemert, Anna Wilhelmina Margaretha Maria, Kopp, Kristen, Korfiotis, Dimitrios, Korolkov, Oleg, Kosinová, Martina, Köstenberger, Markus, Kotzinger, Oskar, Kovačević, Marko, Kranke, Peter, Kranke, Eva, Kraus, Christiane, Kraus, Stephanie, Kubitzek, Christiane, Kucharski, Rafal, Kucukguclu, Semih, Kudrashou, Allaksandr, Kumar, Vinayak, Kummen, Live, Kunit, Cornelia, Kushakovsky, Vlad, Kuvaki, Bahar, Kuzmanovska, Biljana, Kyttari, Aikaterina, Landoni, Giovanni, Lau, Gary, Lazarev, Konstantin, Legett, Samantha, Legrottaglie, Anna Maria, Leonardi, Silvia, Leong, Maria, Lercher, Helene, Leuvrey, Matthieu, Leva, Brigitte, Levstek, Meta, Limb, James, Lindholm, Espen, Linton, Fiona, Liperi, Corradero, Lipski, Fabian, Lirk, Philipp, Lisi, Alberto, Lišková, Katarina, Lluch Oltra, Aitana, Loganathan, Vinothan, Lombardi, Stefania, Lopez, Eloisa, Lopez Rodríguez, Maria, Lorenzini, Laura, Lowicka, Malgorzata, Lugovoy, Alexander, Luippold, Madeleine, Lumb, Andrew, Macas, Andrius, Macgregor, Mark, Machado, Humberto, Maciariello, Maria, Madeira, Isabel, Maitan, Stefan, Majewski, Jacek, Maldini, Branka, Malewski, Georgia, Manfredini, Livia, Männer, Olja, Marchand, Bahareh, Marcu, Alexandra, Margalef, Jordi, Margarson, Michael, Marinheiro, Lucia, Markic, Ana, Markovic Bozic, Jasmina, Marrazzo, Francesco, Martin, Jane, Martin Ayuso, Maria, Martinez, Esteher, Martino, Enrico Antonio, Martinson, Victoria, Marusic-Gaser, Katarina, Mascarenhas, Catia, Mathis, Cindy, Matsota, Paraskevi, Mavrommati, Eleni, Mazul Sunko, Branka, McCourt, Killian, McGill, Neil, McKee, Raymond, Meço, Başak Ceyda, Meier, Sonja, Melbourne, Susan, Melbybråthen, Grethe, Meli, Andrea, Melia, Aiden, Melotti, Rita Maria, Menga, Maria Rosaria, Mercer, Pauline, Merotra, Susan, Mescolini, Silvia, Metterlein, Thomas, Michalov, Martin, Michlig, Sam, Midgley, Susan, Milić, Morena, Milojevic, Milan, Miñana, Amanda, Minto, Gary, Mirabella, Lucia, Mirea, Liliana, Mittelstädt, Ludger, Moeglen, Aude, Moise, Alida, Mokini, Zhirajr, Molin, Anna, Moltó, Luis, Monea, Maria Concetta, Montalto, Francesca, Montgomery, Jane, Montgomery, Claire, Montillo, Gerardo, Moore, Sally, Moore, Faye, Moreira, Zelia, Moreno, Tania, Moreno, Ricardo, Moret, Enrique, Moreton, Sarah, Morgan, Marianne, Moro Velasco, Concepción, Morri, Davide, Moull, Alice, Moura, Fernando, Mráz, Peter, Mrozek, Katarzyna, Mukhtar, Karim, Muniyappa, Sudeshkumar, Murray, Heather, Murthy, Burra VS, Mushambi, Mary, Nadolski, Maria, Nardelli, Pasquale, Nardin, Giordano, Navarro Pérez, Rosalía, Naveiro, Andrea, Negri, Manuela, Nesek Adam, Visnja, Neskovic, Vojislava, Neuwersch, Stefan, Neves, Miriam, Nguyen, Bavinh, Ní Eochagáin, Aisling, Nicholas, Caroline, Nightingale, Jeremy, Norrie, Kylie, Novak-Jankovic, Vesna, Novakova, Andrea, Novillo, Marta, Numan, Sandra, Oduro-Dominah, Louise, Oldner, Anders, Oliveira, Isabel, Ologoiu, Daniela, Oloktsidou, Irini, O'Reilly, Rosalind, Orlando, Alessandro, Ovezov, Alexey, Ozbilgin, Sule, Paal, Peter, Padin Barreiro, Lidia, Palugniok, Ryszard, Papaioannou, Alexandra, Papapostolou, Konstantinos, Paranthaman, Prabhakar, Pardey Bracho, Gilda, Parente, Suzana, Parfeni, Alexandru, Pasin, Laura, Passey, Samuel, Pastor, Ernesto, Patch, Sarah, Patil, Andan, Paunescu, Marilena-Alina, Pehboeck, Daniel, Pereira, Manuela, Pereira, Carla, Perez Caballero, Paula, Pérez García, Aníbal, Pérez Soto, Antonia, Perez Tejero, Gisela, Perez-Cerda, Francisco, Pesenti, Antonio, Petta, Rocco, Philippe, Simon, Pickering, David, Pico Veloso, Jandro, Pina, Pedro, Pinho-Oliveira, Vítor, Pinol, Santiago, Pinto, Rita, Pistidda, Laura, Pitterle, Manuela, Piwowarczyk, Paweł, Plotnikova, Olga, Pohl, Holger, Poldermann, Jorinde, Polkovicová, Lucia, Pompei, Livia, Popescu, Mihai, Popović, Radmila, Pota, Vincenzo, Potocnik, Miriam, Potręć, Beata, Potter, Alison, Pramod, Nalwaya, Prchalova, Martina, Preckel, Benedikt, Pugh, Richard, Pulletz, Mark, Radoeshki, Aleksandar, Rafi, Amir, Ragazzi, Riccardo, Raineri Santi, Maurizio, Rajamanickam, Tamiselvan, Rajput, Zahra, Ramachandran, Rajeskar, Ramasamy, Radhika, Ramessur, Suneil, Rao, Roshan, Rasmussen, Anders, Rato, André, Razaque, Usman, Real Navacerrada, M. Isabel, Reavley, Caroline, Reid, James, Reschreiter, Henrik, Rial, Erick, Ribas Carrasco, Patricia, Ribeiro, Sandy, Rich, Nathalie, Richardson, Lydia, Rimaitis, Kestutis, Rimaitis, Marius, Ringvold, Else-Marie, Ripke, Fabian, Ristescu, Irina, Ritchie, Keith, Ródenas, Frederic, Rodrigues, Patrícia, Rogers, Emma, Rogerson, David, Romagnoli, Stefano, Romero, Esther, Rondovic, Goran, Rose, Bernd Oliver, Roth, Winfried, Rotter, Marie-Therese, Rousseau, Guy, Rudjord, Anders, Rueffert, Henrik, Rundgren, Malin, Rupprecht, Korbinian, Rushton, Andrew, Russotto, Vincenzo, Rypulak, Elżbieta, Ryszka, Maciej, Sà, Jacinta, Sà Couto, Paula, Saby, Sandrine, Sagic, Jelena, Saleh, Omar, Sales, Gabriele, Sánchez Sánchez, Yván, Sanghera, Sumayer, Şanli Karip, Ceren, Santiveri Papiol, Francisco Javier, Santos, Sofia, Sarno, Stephen, Saul, Daniel, Saunders, David, Savic, Nenad, Scalco, Loïc, Scanlon, Deborah, Schaller, Stefan, Schax, Christoph, Scheffer, Gert Jan, Schening, Anna, Schiavone, Vincenzo, Schmidt-Ehrenberg, Florian, Schmidt-Mutter, Catherine, Schönberg, Christina, Schopflin, Christian, Schreiber, Jan-Uwe, Schultz, Marcus, Schurig, Marlen, Scott, Carmen, Sebestian, Siby, Sehgal, Selena, Sem, Victoria, Semenas, Egidijus, Serafini, Elena, Serchan, Pashalitsa, Shields, Martin, Shobha, Ramakrishnan, Shosholcheva, Mirjana, Siamansour, Tanja, Siddaiah, Narendra, Siddiqi, Khalid, Sinclair, Rhona, Singh, Permendra, Singh, Rajendra, Sinha, Aneeta, Sinha, Ashok, Skinner, Amanda, Smee, Elizabeth, Smekalova, Olga, Smith, Neil, Smith, Thomas, Smitz, Carine, Smole, Daniel, Sojčić, Nataša, Soler Pedrola, Maria, Somanath, Sameer, Sonksen, Julian, Sorella, Maria Christina, Sörmus, Alar, Soro, Marina, Soto, Carmen, Spada, Anna, Spadaro, Savino, Spaeth, Johannes, Sparr, Harald, Spielmann, Annika, Spindler-Vesel, Alenka, Stamelos, Matthaios, Stancombe L, Liucia, Stanculescu, Andreea, Standl, Thomas, Standley, Tom, Stanek, Ondrej, Stanisavljević, Snežana, Starczewska, Malgorzata, Stäuble, Christiane, Steen, Julie, Stefan, Oana Maria, Stell, Elizabeth, Stera, Caterina, Stevens, Markus, Stoerckel, Marlène, Stošić, Biljana, Stourac, Petr, Stroumpoulis, Konstantinos, Struck, Rafael, Suarez de la Rica, Alejandro, Sultanpori, Altaf, Sundara Rajan, Rajinikanth, Suying, Ong, Svensen, Christer, Swan, Louise, Syrogianni, Paulina, Sysiak, Justyna, Szederjesi, Janos, Taddei, Stefania, Tan Hao, Ern, Tanou, Virginia, Tarabová, Katarina, Tardaguila Sancho, Paula, Tarroso, Maria, Tartaglione, Marco, Taylor, Emma, Tbaily, Lee, Telford, Richard, Terenzoni, Massimo, Theodoraki, Kassiani, Thornley, Helen, Tiganiuc, Liviu, Toim, Hardo, Tomescu, Dana, Tommasino, Concezione, Toni, Jessica, Toninelli, Arturo, Toretti, Ilaria, Townley, Stephen, Trepenaitis, Darius, Trethowan, Brian, Tsaousi, Georgia, Tsiftsi, Aikaterini, Tudor, Adrada, Turan, Güldem, Turhan, Sanem Çakar, Unic-Stojanovic, Dragana, Unterbuchner, Christoph, Unzueta, Carmen, Uranjek, Jasna, Ursic, Tomaz, Vaida, Simona, Valldeperas Ferrer, Silvia, Valldeperas Hernandez, Maria Inmaculada, Valsamidis, Dimitri, Van Beek, Rienk, Van dasselaer, Nick, Van Der Beek, Tim, Van Duivenvoorde, Yoni, van Klei, Wilton A., Van Poorter, Frans, Van Zaane, Bas, Van Zundert, Tom, Van Zyl, Rebekka, Vargas Munoz, Ana Milena, Varsani, Nimu, Vasconcelos, Pedro, Vassilakis, Georgios, Vecchiatini, Tommaso, Vecera, Lubomir, Vercauteren, Marcel, Verdouw, Bas, Verheyen, Veerle, Verri, Marco, Vicari Sottosanti, Luigi Giancarlo, Vico, Manuel, Vidal Mitjans, Patricia, Vilardi, Anna, Vissicchio, Daniela, Vitale, Giovanni, Vitković, Bibiana, Vizcaychipi, Marcela Paola, Voicu, Alexandra, Voje, Minca, Volfová, Ivana, Volta, Carlo Alberto, Von Lutterotti, Theresa, von Tiesenhausen, Anna, Vrecic-Slabe, Simona, Vukcevic, Dejan, Vukovic, Rade, Vullo, P. Agostina, Wade, Andrew, Wallberg, Hanna, Wallden, Jakob, Wallner, Johann, Walther Sturesson, Louise, Watson, Davina, Weber, Stefan, Wegiel Leskiewiq, Anna, Weller, Debbie, Wensing, Carine, Werkmann, Markus, Westberg, Henrik, Wikström, Erik, Williams, Benedict, Wilson, Robin, Wirth, Steffen, Wittmann, Maria, Wood, Laura, Wright, Stella, Zachoval, Christian, Zambon, Massimo, Zampieri, Silvia, Zampone, Salvatore, Zangrillo, Alberto, Zani, Gianluca, Zavackiene, Asta, Zieglerder, Raphael, Zonneveldt, Harry, Zsisku, Lajos, Zucker, Tom-Philipp, Żukowski, Maciej, Zuleika, Mehrun, Zupanĕiĕ, Darja, Kirmeier, Eva, Eriksson, Lars I, Lewald, Heidrun, Jonsson Fagerlund, Malin, Hoeft, Andreas, Hollmann, Markus, Meistelman, Claude, Hunter, Jennifer M, Ulm, Kurt, and Blobner, Manfred

Published
2019
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27. Adverse Events of Peripherally Administered Norepinephrine During Surgery: A Prospective Multicenter Study

Author

Christensen, Jens, primary, Andersson, Elisabeth, additional, Sjöberg, Fredric, additional, Hellgren, Elisabeth, additional, Harbut, Piotr, additional, Harbut, Joanna, additional, Sjövall, Fredrik, additional, von Bruhn Gufler, Christian, additional, Mårtensson, Johan, additional, Rubenson Wahlin, Rebecka, additional, Joelsson-Alm, Eva, additional, and Cronhjort, Maria, additional

Published
2024
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28. Extended physiotherapy after Intensive Care Unit (ICU) stay: A prospective pilot study with a before and after design.

Author

Siesage, Katinka, Joelsson-Alm, Eva, Schandl, Anna, and Karlsson, Emelie

Subjects
*PHYSICAL therapy, *RESEARCH funding, *HOSPITAL care, *PILOT projects, *CLINICAL trials, *FISHER exact test, *DISCHARGE planning, *MANN Whitney U Test, *CHI-squared test, *DESCRIPTIVE statistics, *LONGITUDINAL method, *PRE-tests & post-tests, *EXPERIMENTAL design, *INTENSIVE care units, *VOCATIONAL rehabilitation, *URBAN hospitals, *COMPARATIVE studies, *LENGTH of stay in hospitals, *DATA analysis software, *CRITICAL care medicine
Abstract

To examine whether extended compared to standard level of physiotherapy is feasible and has beneficial effects on physical function in ICU survivors. This prospective pilot study with a before and after design included patients discharged from ICU to a surgical ward. The comparison group were recruited between January and April 2019 and received standard level of physiotherapy. The intervention group were recruited between May and December 2019 and received extended physiotherapy, corresponding to 50% additional physiotherapist, working 4 hours per weekday. The intervention participants received an individual rehabilitation plan developed in collaboration with a ward-based physiotherapist, and an extended number of sessions provided by the extra resource included practicing individualized exercises, for example walking and stair climbing. Physical function was measured with the Chelsea Critical Care Physical Assessment tool (CPAx) at ICU discharge, during hospital stay and discharge. Group differences were analyzed using the Mann–Whitney U-test and Chi2 test. Out of 46 eligible patients, 39 (85%) fulfilled the study (comparison n = 12, intervention n = 27) and were included in the final analyses. No adverse events occurred, and the attendance rate was high (98.5%). There were no statistically significant differences between the groups regarding physical function, hospital stay, and readmissions, but there were tendencies to better outcomes in all these parameters in favor of the intervention group. Additionally, patients in the intervention group had statistically significantly higher scores in the CPAx items "transferring from bed to chair" (median 5 vs 4, p =.039) and "stepping" (median 5 vs 4, p =.005) at hospital discharge. This pilot study indicates that extended physiotherapy after ICU discharge is feasible and does not entail patient safety risks. However, determining the potential beneficial effects for the patients remains to be evaluated in a larger trial. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Facilitating facilitators to facilitate : Some general comments on a strategy for knowledge implementation in health services

Author

Eldh, Ann Catrine, Halleberg-Nyman, Maria, Joelsson-Alm, Eva, Wallin, Lars, Eldh, Ann Catrine, Halleberg-Nyman, Maria, Joelsson-Alm, Eva, and Wallin, Lars

Abstract

Numerous endeavours to ensure that day-to-day healthcare is both evidence-based and person-centred have generated extensive, although partial, comprehension of what guarantees quality improvement. To address quality issues, researchers and clinicians have developed several strategies as well as implementation theories, models, and frameworks. However, more progress is needed regarding how to facilitate guideline and policy implementation that guarantees effective changes take place in a timely and safe manner. This paper considers experiences of engaging and supporting local facilitators in knowledge implementation. Drawing on several interventions, considering both training and support, this general commentary discusses whom to engage and the length, content, quantity, and type of support along with expected outcomes of facilitators' activities. In addition, this paper suggests that patient facilitators could help produce evidence-based and person-centred care. We conclude that research about the roles and functions of facilitators needs to include more structured follow-ups and also improvement projects. This can increase the speed of learning with respect to what works, for whom, in what context, why (or why not), and with what outcomes when it comes to facilitator support and tasks.

Published
2023
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35. Patient related outcomes after receiving a person centred nurse led follow up programme among patients undergoing revascularisation for intermittent claudication : A secondary analysis of a randomised clinical trial

Author

Haile, Sara T, Johansson, Unn-Britt, Lööf, Helena, Linné, Anneli, Joelsson-Alm, Eva, Haile, Sara T, Johansson, Unn-Britt, Lööf, Helena, Linné, Anneli, and Joelsson-Alm, Eva

Abstract

OBJECTIVE: The aim was to evaluate the effect of a person centred nurse led follow up programme on health related quality of life (HRQoL), health literacy, and general self efficacy compared with standard care for patients undergoing revascularisation for intermittent claudication (IC), and to describe factors associated with HRQoL one year after revascularisation. METHODS: This was a secondary analysis of a randomised controlled trial. Patients with IC scheduled for revascularisation at two vascular surgery centres in Sweden between 2016 and 2018 were randomised to intervention or control. During the first year after surgery, the intervention group received a person centred follow up programme with three visits and two telephone calls with a vascular nurse, while the control group received standard follow up with two visits to a vascular surgeon or vascular nurse. Outcomes were HRQoL measured by VascuQol-6, health literacy, and general self efficacy measured by validated questionnaires. RESULTS: Overall, 214 patients were included in the trial; this secondary analysis comprised 183 patients who completed the questionnaires. One year after revascularisation, HRQoL had improved with a mean increase in VascuQol-6 of 7.0 scale steps (95% CI 5.9 - 8.0) for the intervention and 6.0 scale steps (95% CI 4.9 - 7.0) for the control group; the difference between the groups was not significant (p = .18). In an adjusted regression analysis, the intervention was associated with higher VascuQoL-6 (2.0 scale steps, 95% CI 0.08 - 3.93). There was no significant difference between the groups regarding health literacy or general self efficacy. The prevalence of insufficient health literacy among all participants was 38.7% (46/119) at baseline and 43.2% (51/118) at one year. CONCLUSION: In this study, a person centred, nurse led follow up programme had no significant impact on HRQoL, health literacy, or general self efficacy among patients undergoing revascularisation for IC. The prev

Published
2023
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36. Experiences of patient violence in Swedish intensive care units

Author

Sjöberg, Fredric, Salzmann-Erikson, Martin, Joelsson-Alm, Eva, Schandl, Anna, Sjöberg, Fredric, Salzmann-Erikson, Martin, Joelsson-Alm, Eva, and Schandl, Anna

Abstract

Introduction: In the intensive care unit (ICU), every second patient develops acute brain dysfunction and delirium, because of severe illness and/or medical treatment (1). ICU patients may have delusions and even believe that the healthcare personnel try to infict harm upon them (2). This belief in combination with psychomotor agitation may lead to violent incidents in intense resistance (3). Except for debilitating consequences for patients, violent incidents are major problems in healthcare causing physical and psychological harm to healthcare workers (4–6). However, systematic approaches to describe healthcare workers’ experiences and management of aggressive ICU patients are needed. Objectives: To explore ICU healthcare workers’ experiences and perceptions of violent behaviors in patients with acute brain dysfunction. Methods: A qualitative descriptive design including focus group interviews with 36 ICU healthcare workers (physicians, nurses, nurse assistants and physiotherapists) in 4 Swedish ICUs who had experience of managing aggressive patients with acute brain dysfunction. A six-step refective thematic analysis was used to analyse data. Results: Nurses and assistant nurses were perceived to be at a nincreased risk of being exposed to violence, while physicians were mostly exposed to verbal assaults and threats from relatives. Delusions were perceived to be associated with a higher risk of violence in bedside work. The healthcare workers stated that incidents were under-reported, where only serious threats or physical assaults were reported. Most violent situations were experienced as unavoidable due to the patients’ illness. Conclusions: This study contributes an understanding of workplace violence in the ICU and may serve as a basis for development of violence prevention strategies useful in care and treatment of delirious patients.

Published
2023

37. Long-term effects of restriction of intravenous fluid in adult ICU patients with septic shock

Author

Kjær, Maj Brit Nørregaard, Meyhoff, Tine Sylvest, Sivapalan, Praleene, Granholm, Anders, Hjortrup, Peter Buhl, Madsen, Martin Bruun, Møller, Morten Hylander, Egerod, Ingrid, Wetterslev, Jørn, Lange, Theis, Cronhjort, Maria, Laake, Jon Henrik, Jakob, Stephan M., Nalos, Marek, Ostermann, Marlies, Gould, Doug, Cecconi, Maurizio, Malbrain, Manu L.N.G., Ahlstedt, Christian, Kiel, Louise Bendix, Bestle, Morten H., Nebrich, Lars, Hildebrandt, Thomas, Russell, Lene, Vang, Marianne, Rasmussen, Michael Lindhart, Sølling, Christoffer, Brøchner, Anne Craveiro, Krag, Mette, Pfortmueller, Carmen, Kriz, Miroslav, Siegemund, Martin, Albano, Giovanni, Aagaard, Søren Rosborg, Bundgaard, Helle, Crone, Vera, Wichmann, Sine, Johnstad, Bror, Martin, Yvonne Karin, Seidel, Philipp, Mårtensson, Johan, Hollenberg, Jacob, Wistrand, Mats, Donati, Abele, Barbara, Enrico, Karvunidis, Thomas, Hollinger, Alexa, Carsetti, Andrea, Lumlertgul, Nuttha, Joelsson-Alm, Eva, Lambiris, Nikolas, Aslam, Tayyba Naz, Friberg, Fredrik Femtehjell, Vesterlund, Gitte Kingo, Mortensen, Camilla Bekker, Vestergaard, Stine Rom, Caspersen, Sidsel Fjordbak, Jensen, Diana Bertelsen, Borup, Morten, Rasmussen, Bodil Steen, Perner, Anders, Kjær, Maj Brit Nørregaard, Meyhoff, Tine Sylvest, Sivapalan, Praleene, Granholm, Anders, Hjortrup, Peter Buhl, Madsen, Martin Bruun, Møller, Morten Hylander, Egerod, Ingrid, Wetterslev, Jørn, Lange, Theis, Cronhjort, Maria, Laake, Jon Henrik, Jakob, Stephan M., Nalos, Marek, Ostermann, Marlies, Gould, Doug, Cecconi, Maurizio, Malbrain, Manu L.N.G., Ahlstedt, Christian, Kiel, Louise Bendix, Bestle, Morten H., Nebrich, Lars, Hildebrandt, Thomas, Russell, Lene, Vang, Marianne, Rasmussen, Michael Lindhart, Sølling, Christoffer, Brøchner, Anne Craveiro, Krag, Mette, Pfortmueller, Carmen, Kriz, Miroslav, Siegemund, Martin, Albano, Giovanni, Aagaard, Søren Rosborg, Bundgaard, Helle, Crone, Vera, Wichmann, Sine, Johnstad, Bror, Martin, Yvonne Karin, Seidel, Philipp, Mårtensson, Johan, Hollenberg, Jacob, Wistrand, Mats, Donati, Abele, Barbara, Enrico, Karvunidis, Thomas, Hollinger, Alexa, Carsetti, Andrea, Lumlertgul, Nuttha, Joelsson-Alm, Eva, Lambiris, Nikolas, Aslam, Tayyba Naz, Friberg, Fredrik Femtehjell, Vesterlund, Gitte Kingo, Mortensen, Camilla Bekker, Vestergaard, Stine Rom, Caspersen, Sidsel Fjordbak, Jensen, Diana Bertelsen, Borup, Morten, Rasmussen, Bodil Steen, and Perner, Anders

Abstract

Purpose: To assess long-term outcomes of restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock included in the European Conservative versus Liberal Approach to Fluid Therapy in Septic Shock in Intensive Care (CLASSIC) trial. Methods: We conducted the pre-planned analyses of mortality, health-related quality of life (HRQoL) using EuroQol (EQ)-5D-5L index values and EQ visual analogue scale (VAS), and cognitive function using Mini Montreal Cognitive Assessment (Mini MoCA) test at 1 year. Deceased patients were assigned numerical zero for HRQoL as a state equal to death and zero for cognitive function outcomes as worst possible score, and we used multiple imputation for missing data on HRQoL and cognitive function. Results: Among 1554 randomized patients, we obtained 1-year data on mortality in 97.9% of patients, HRQoL in 91.3%, and cognitive function in 86.3%. One-year mortality was 385/746 (51.3%) in the restrictive-fluid group versus 383/767 (49.9%) in the standard-fluid group, absolute risk difference 1.5%-points [99% confidence interval (CI) − 4.8 to 7.8]. Mean differences were 0.00 (99% CI − 0.06 to 0.05) for EQ-5D-5L index values, − 0.65 for EQ VAS (− 5.40 to 4.08), and − 0.14 for Mini MoCA (− 1.59 to 1.14) for the restrictive-fluid group versus the standard-fluid group. The results for survivors only were similar in both groups. Conclusions: Among adult ICU patients with septic shock, restrictive versus standard IV fluid therapy resulted in similar survival, HRQoL, and cognitive function at 1 year, but clinically important differences could not be ruled out.

Published
2023

38. Healthcare workers' experiences of patient safety in the intensive care unit during the COVID-19 pandemic : A multicentre qualitative study

Author

Berggren, Karin, Ekstedt, Mirjam, Joelsson-Alm, Eva, Swedberg, Lena, Sackey, Peter, Schandl, Anna, Berggren, Karin, Ekstedt, Mirjam, Joelsson-Alm, Eva, Swedberg, Lena, Sackey, Peter, and Schandl, Anna

Abstract

AimTo describe healthcare workers' experiences of preconditions and patient safety risks in intensive care units during the COVID-19 pandemic. BackgroundHealthcare workers' ability to adapt to changing conditions is crucial to promote patient safety. During the COVID-19 pandemic, healthcare workers' capacity to maintain safe care was challenged and a more in-depth understanding on frontline experiences of patient safety is needed. DesignA qualitative descriptive design. MethodsIndividual interviews were conducted with 29 healthcare workers (nurses, physicians, nurse assistants and physiotherapists) from three Swedish hospitals directly involved in intensive care of COVID-19 patients. Data were analysed with inductive content analysis. Reporting followed the COREQ checklist. ResultsThree categories were identified. Hazardous changes in working conditions describes patient safety challenges associated with the extreme workload with high stress level. Imperative adaptations induced by changed preconditions for patient safety which include descriptions of safety risks following adaptations related to temporary intensive care facilities, handling shortage of medical equipment and deviations from routines. Safety risks triggered by reorganisation of care describe how the diluted skill-mix and team disruptions exposed patients to safety risks, and that safety performance mostly relied on individual healthcare worker's responsibility. ConclusionsThe study suggests that healthcare workers experienced an increase in patient safety risks during the COVID-19 pandemic mainly because the extremely high workload, imperative adaptations, and reorganisation of care regarding skill-mix and teamwork. Patient safety performance relied on the individuals' adaptability and responsibility rather than on system-based safety. Relevance to Clinical PracticeThis study provides insights on how healthcare workers' experiences can be used as a source of information for recognition of patient saf

Published
2023
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42. Patients' experiences of preparing for transfer from the intensive care unit to a hospital ward: A multicentre qualitative study.

Author

Gullberg, Agneta, Joelsson‐Alm, Eva, and Schandl, Anna

Subjects
*INTENSIVE care units, *RESEARCH, *PATIENT participation, *TRANSITIONAL care, *CONVALESCENCE, *PATIENT-centered care, *INTERVIEWING, *PATIENTS' attitudes, *QUALITATIVE research, *HOSPITAL care, *HOSPITAL wards, *HEALTH, *INFORMATION resources, *CONTENT analysis, *PSYCHOLOGICAL distress, *HEALTH promotion
Abstract

Background: The transfer from an intensive care unit (ICU) to a regular ward often causes confusion and stress for patients and family members. However, little is known about the patients' perspective on preparing for the transfer. Aim: The purpose of the study was to describe patients' experiences of preparing for transfer from an ICU to a ward. Study Design: Individual interviews with 14 former ICU patients from three urban hospitals in Stockholm, Sweden were conducted 3 months after hospital discharge. Qualitative content analysis was used to interpret the interview transcripts. Reporting followed the consolidated criteria for reporting qualitative research checklist. Results: The results showed that the three categories, the discharge decision, patient involvement, and practical preparations were central to the patients' experiences of preparing for the transition from the intensive care unit to the ward. The discharge decision was associated with a sense of relief, but also worry about what would happen on the ward. The patients felt that they were not involved in the decision about the discharge or the planning of their health care. To handle the situation, patients needed information about planned care and treatment. However, the information was often sparse, delivered from a clinician's perspective, and therefore not much help in preparing for transfer. Conclusions: ICU patients experienced that they were neither involved in the process of forthcoming care nor adequately prepared for the transfer to the ward. Relevant and comprehensible information and sufficient time to prepare were needed to reduce stress and promote efficient recovery. Relevance to Clinical Practice: The study suggests that current transfer strategies are not optimal, and a more person‐centred discharge procedure would be beneficial to support patients and family members in the transition from the ICU to the ward. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Long-term effects of restriction of intravenous fluid in adult ICU patients with septic shock

Author

Kjær, Maj-Brit Nørregaard, primary, Meyhoff, Tine Sylvest, additional, Sivapalan, Praleene, additional, Granholm, Anders, additional, Hjortrup, Peter Buhl, additional, Madsen, Martin Bruun, additional, Møller, Morten Hylander, additional, Egerod, Ingrid, additional, Wetterslev, Jørn, additional, Lange, Theis, additional, Cronhjort, Maria, additional, Laake, Jon Henrik, additional, Jakob, Stephan M., additional, Nalos, Marek, additional, Ostermann, Marlies, additional, Gould, Doug, additional, Cecconi, Maurizio, additional, Malbrain, Manu L. N. G., additional, Ahlstedt, Christian, additional, Kiel, Louise Bendix, additional, Bestle, Morten H, additional, Nebrich, Lars, additional, Hildebrandt, Thomas, additional, Russell, Lene, additional, Vang, Marianne, additional, Lindhart, Michael, additional, Søllling, Christoffer, additional, Brøchner, Anne Craveiro, additional, Krag, Mette, additional, Pfortmueller, Carmen, additional, Kriz, Miroslav, additional, Siegemund, Martin, additional, Albano, Giovanni, additional, Aagaard, Søren Rosborg, additional, Bundgaard, Helle, additional, Crone, Vera, additional, Wichmann, Sine, additional, Johnstad, Bror, additional, Martin, Yvonne Karin, additional, Seidel, Philipp, additional, Mårtensson, Johan, additional, Hollenberg, Jacob, additional, Witstrand, Mats, additional, Donati, Abele, additional, Barbara, Enrico, additional, Karvunidis, Thomas, additional, Hollinger, Alexa, additional, Carsetti, Andrea, additional, Lumlertgul, Nuttha, additional, Joelsson-Alm, Eva, additional, Lambiris, Nikolas, additional, Aslam, Tayyba Naz, additional, Friberg, Fredrik Femtehjell, additional, Vesterlund, Gitte Kingo, additional, Mortensen, Camilla Bekker, additional, Vestergaard, Stine Rom, additional, Caspersen, Sidsel Fjordbak, additional, Jensen, Diana Bertelsen, additional, Brorup, Morten, additional, Rasmussen, Bodil Steen, additional, and Perner, Anders, additional

Published
2023
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47. Restriction of Intravenous Fluid in ICU Patients with Septic Shock

Author

Meyhoff, Tine S., Hjortrup, Peter B., Wetterslev, Jørn, Sivapalan, Praleene, Laake, Jon H., Cronhjort, Maria, Jakob, Stephan M., Cecconi, Maurizio, Nalos, Marek, Ostermann, Marlies, Malbrain, Manu, Pettilä, Ville, Møller, Morten H., Kjær, Maj-Brit N., Lange, Theis, Overgaard-Steensen, Christian, Brand, Björn A., Winther-Olesen, Marie, White, Jonathan O., Quist, Lars, Westergaard, Bo, Jonsson, Andreas B., Hjortsø, Carl J.S., Meier, Nick, Jensen, Thomas S., Engstrøm, Janus, Nebrich, Lars, Andersen-Ranberg, Nina C., Jensen, Jacob V., Joseph, Neeliya A., Poulsen, Lone M., Herløv, Louise S., Sølling, Christoffer G., Pedersen, Susan K., Knudsen, Kurt K., Straarup, Therese S., Vang, Marianne L., Bundgaard, Helle, Rasmussen, B. S., Aagaard, S. R., Hildebrandt, Thomas, Russell, Lene, Bestle, Morten H., Schønemann-Lund, Martin, Brøchner, Anne C., Elvander, Claes F., Hoffmann, Søren K.L., Rasmussen, Michael L., Martin, Yvonne K., Friberg, Fredrik F., Seter, Herman, Aslam, Tayyba N., Ådnøy, Sigrid, Seidel, Philipp, Strand, Kristian, Johnstad, Bror, Joelsson-Alm, Eva, Christensen, Jens, Ahlstedt, Christian, Pfortmueller, Carmen A., Siegemund, Martin, Greco, Massimiliano, Raděj, Jaroslav, Kříž, Miroslav, Gould, Doug W., Rowan, Kathy M., Mouncey, Paul R., Perner, Anders, Siegumfeldt, Rine Moulvad, and Vestergaard, Stine Rom

Subjects
PROTOCOL, Adult, SEPSIS, RESUSCITATION, MORTALITY, Critical Care/methods, ADULTS, General Medicine, Intensive Care Units, TRIALS, MANAGEMENT, Humans, Administration, Intravenous, 610 Medicine & health, Shock, Septic/mortality, Fluid Therapy/adverse effects
Abstract

BACKGROUND: Intravenous fluids are recommended for the treatment of patients who are in septic shock, but higher fluid volumes have been associated with harm in patients who are in the intensive care unit (ICU).METHODS: In this international, randomized trial, we assigned patients with septic shock in the ICU who had received at least 1 liter of intravenous fluid to receive restricted intravenous fluid or standard intravenous fluid therapy; patients were included if the onset of shock had been within 12 hours before screening. The primary outcome was death from any cause within 90 days after randomization.RESULTS: We enrolled 1554 patients; 770 were assigned to the restrictive-fluid group and 784 to the standard-fluid group. Primary outcome data were available for 1545 patients (99.4%). In the ICU, the restrictive-fluid group received a median of 1798 ml of intravenous fluid (interquartile range, 500 to 4366); the standard-fluid group received a median of 3811 ml (interquartile range, 1861 to 6762). At 90 days, death had occurred in 323 of 764 patients (42.3%) in the restrictive-fluid group, as compared with 329 of 781 patients (42.1%) in the standard-fluid group (adjusted absolute difference, 0.1 percentage points; 95% confidence interval [CI], -4.7 to 4.9; P = 0.96). In the ICU, serious adverse events occurred at least once in 221 of 751 patients (29.4%) in the restrictive-fluid group and in 238 of 772 patients (30.8%) in the standard-fluid group (adjusted absolute difference, -1.7 percentage points; 99% CI, -7.7 to 4.3). At 90 days after randomization, the numbers of days alive without life support and days alive and out of the hospital were similar in the two groups.CONCLUSIONS: Among adult patients with septic shock in the ICU, intravenous fluid restriction did not result in fewer deaths at 90 days than standard intravenous fluid therapy. (Funded by the Novo Nordisk Foundation and others; CLASSIC ClinicalTrials.gov number, NCT03668236.).

Published
2022
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49. Restriction of Intravenous Fluid in ICU Patients with Septic Shock

Author

Meyhoff, Tine S., primary, Hjortrup, Peter B., additional, Wetterslev, Jørn, additional, Sivapalan, Praleene, additional, Laake, Jon H., additional, Cronhjort, Maria, additional, Jakob, Stephan M., additional, Cecconi, Maurizio, additional, Nalos, Marek, additional, Ostermann, Marlies, additional, Malbrain, Manu, additional, Pettilä, Ville, additional, Møller, Morten H., additional, Kjær, Maj-Brit N., additional, Lange, Theis, additional, Overgaard-Steensen, Christian, additional, Brand, Björn A., additional, Winther-Olesen, Marie, additional, White, Jonathan O., additional, Quist, Lars, additional, Westergaard, Bo, additional, Jonsson, Andreas B., additional, Hjortsø, Carl J.S., additional, Meier, Nick, additional, Jensen, Thomas S., additional, Engstrøm, Janus, additional, Nebrich, Lars, additional, Andersen-Ranberg, Nina C., additional, Jensen, Jacob V., additional, Joseph, Neeliya A., additional, Poulsen, Lone M., additional, Herløv, Louise S., additional, Sølling, Christoffer G., additional, Pedersen, Susan K., additional, Knudsen, Kurt K., additional, Straarup, Therese S., additional, Vang, Marianne L., additional, Bundgaard, Helle, additional, Rasmussen, Bodil S., additional, Aagaard, Søren R., additional, Hildebrandt, Thomas, additional, Russell, Lene, additional, Bestle, Morten H., additional, Schønemann-Lund, Martin, additional, Brøchner, Anne C., additional, Elvander, Claes F., additional, Hoffmann, Søren K.L., additional, Rasmussen, Michael L., additional, Martin, Yvonne K., additional, Friberg, Fredrik F., additional, Seter, Herman, additional, Aslam, Tayyba N., additional, Ådnøy, Sigrid, additional, Seidel, Philipp, additional, Strand, Kristian, additional, Johnstad, Bror, additional, Joelsson-Alm, Eva, additional, Christensen, Jens, additional, Ahlstedt, Christian, additional, Pfortmueller, Carmen A., additional, Siegemund, Martin, additional, Greco, Massimiliano, additional, Raděj, Jaroslav, additional, Kříž, Miroslav, additional, Gould, Doug W., additional, Rowan, Kathy M., additional, Mouncey, Paul R., additional, and Perner, Anders, additional

Published
2022
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50. Effects of a person-centred, nurse-led follow-up programme on adherence to prescribed medication among patients surgically treated for intermittent claudication : Randomized clinical trial

Author

Haile, Sara T, Joelsson-Alm, Eva, Johansson, Unn-Britt, Lööf, Helena, Palmer-Kazen, Ulrika, Gillgren, Peter, Linné, Anneli, Haile, Sara T, Joelsson-Alm, Eva, Johansson, Unn-Britt, Lööf, Helena, Palmer-Kazen, Ulrika, Gillgren, Peter, and Linné, Anneli

Abstract

BACKGROUND: Management of intermittent claudication should include secondary prevention to reduce the risk of cardiocerebrovascular disease. Patient adherence to secondary prevention is a challenge. The aim of this study was to investigate whether a person-centred, nurse-led follow-up programme could improve adherence to medication compared with standard care. METHODS: A non-blinded RCT was conducted at two vascular surgery centres in Sweden. Patients with intermittent claudication and scheduled for revascularization were randomized to the intervention or control (standard care) follow-up programme. The primary outcome, adherence to prescribed secondary preventive medication, was based on registry data on dispensed medication and self-reported intake of medication. Secondary outcomes were risk factors for cardiocerebrovascular disease according to the Framingham risk score. RESULTS: Some 214 patients were randomized and analysed on an intention-to-treat basis. The mean proportion of days covered (PDC) at 1 year for lipid-modifying agents was 79 per cent in the intervention and 82 per cent in the control group, whereas it was 92 versus 91 per cent for antiplatelet and/or anticoagulant agents. The groups did not differ in mean PDC (lipid-modifying P = 0.464; antiplatelets and/or anticoagulants P = 0.700) or in change in adherence over time. Self-reported adherence to prescribed medication was higher than registry-based adherence regardless of allocation or medication group (minimum P < 0.001, maximum P = 0.034). There was no difference in median Framingham risk score at 1 year between the groups. CONCLUSION: Compared with the standard follow-up programme, a person-centred, nurse-led follow-up programme did not improve adherence to secondary preventive medication. Adherence was overestimated when self-reported compared with registry-reported.

Published
2022
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