Students' learning as the focus for shared involvement between universities and clinical practice: a didactic model for postgraduate degree projects.

In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master's level, there is no tradition of including a postgraduate degree project. The aim was to develop a didactic model for specialist nursing students' postgraduate degree projects within the second cycle of higher education (master's level) and with a specific focus on nurturing shared involvement between universities and healthcare settings. This study embodies a participatory action research and theory-generating design founded on empirically practical try-outs. The 3-year project included five Swedish universities and related healthcare settings. A series of activities was performed and a number of data sources secured. Constant comparative analysis was applied. A didactic model is proposed for postgraduate degree projects in specialist nursing education aimed at nurturing shared involvement between universities and healthcare settings. The focus of the model is student learning in order to prepare the students for participation as specialist nurses in clinical knowledge development. The model is developed for the specialist nursing education, but it is general and could be applicable to various education programmes.

Threats and violence in the Swedish pre-hospital emergency care.

Although acts of threats and violence are problems that have received increased attention in recent years within Swedish pre-hospital care, only a handful of scientific studies have been carried out in this field. Threats and violence have a negative influence on the well-being of ambulance personnel. The aim in this study was both to investigate the incidents of threats and violence within the Swedish ambulance service and to describe these situations. Data was collected with questionnaires answered by 134 registered nurses and paramedics from 11 ambulance stations located in four counties. The respondents' experiences of pre-hospital care varied from 3 months to 41 years (mean=12 years, median=8 years). The results showed that 66% of the ambulance personnel experienced threats and/or violence during their work while 26% experienced threats and 16% faced physical violence during the last year. The most common kind of threat was threats of physical violence with 27% of the respondents experiencing threats involving weapons. Commonly occurring physical violence was in the form of pushes, punches, kicks and bites. In most cases, the perpetrator was the patient himself often under the influence of alcohol or drugs. The most serious situations occurred when the reason for raising the ambulance alarm was intoxication or a decreased level of consciousness.

The relationship between working conditions and sick leave in Swedish dental hygienists.

UNLABELLED: The purpose of this study was to examine the relationship between working conditions and sick leave in Swedish dental hygienists. Seventy-one percent of 577 randomly selected dental hygienists responded to a questionnaire. From those who responded (n=411) a homogenous group of 252 was selected. They were assigned to four groups that exhibited either musculoskeletal disorders (MSD), low well-being (LWB), both low well-being and musculoskeletal disorders (BLM), or relative health (main group or M group). These groups were further divided according to number of sick days taken per year. Non-parametric statistics and logistic regressions were used for analyses. Those with MSD worked more clinical hours and treated more patients per day than the other groups. While the M group had fewer sick days, better work climates and decreased demands on work efficiency, increased sick leave within this group was related to greater staff numbers and less commitment to improving work processes. In the M group, role ambiguity and LWB were associated with absence of 1-3 days, compared with those who took no sick leave. Respondents in the LWB group, who perceived role ambiguity, were absent more than 7 days/year, compared with those who perceived role clarity. Management issues were the distinguishing factor for those who had severe health problems. IN CONCLUSION: role ambiguity is the predominant psychosocial factor associated with sick leave. Psychosocial management factors rather than physical work factors seem important for work and sick leave rates among dental hygienists.

The staff's satisfaction with the hospital bed.

AIM: To determine how nurses experience the functions of hospital beds and the bedside equipment when performing specified common nursing tasks. BACKGROUND: The hospital bed is an important working tool for the nursing staff but few studies have focused on hospital beds at acute wards. METHOD: Data was collected with questionnaires answered by 74 registered and enrolled nurses from three Departments. FINDINGS: The bed was frequently used when performing nursing tasks with patients in bed, but the manoeuvring features were difficult to adjust, resulting in unsatisfactory working postures. Transporting the patient in bed and cleaning of the bed were the most troublesome tasks. The bed clothes were often experienced as unsatisfactory for their patients. CONCLUSIONS: The beds have serious deficiencies. It is imperative to improve them, as a good physical milieu positively influences the working conditions of the staff.

How beds are used at a University Hospital--a study of bed and bedside activities.

Hospital beds have to fulfil many demands, and the features of the bed will consequently affect the comfort of both patients and staff at the ward. In the present study the use of hospital beds at Sahlgrenska University Hospital in Göteborg was investigated. The study was performed in two somatic wards; one general surgery ward and one internal medicine. The exact time of the observations as well as the categories of usage and activities performed on and at the bedside by the caring staff and the patients were registered. The study shows that there is a substantial difference between the two wards. In the surgery ward, the beds to a great extent play an active part in medical therapy and treatment, whereas beds in the medicine ward are used for vegetative recovery such as sleep, rest and alimentation. The personnel spent only a few hours with the patients, while they were in their beds, most of the caring occurring away from the bed. The results of the present study concerning how beds are utilized in modern hospital care should be considered when purchasing and designing hospital beds.

Beds used at a university hospital--a study of functions, problems and requirements.

The comfort and functional features of hospital beds are of fundamental importance to both the patients and staff on the ward. This study investigates the types and functions of the beds used at a large university hospital in Sweden, how the head nurses experienced and valued the hospital beds in their wards, and whether the nurses were familiar with standards, regulations and purchasing routines. An inventory of all the beds for adult patients was carried out in all 55 somatic wards. Interviews were conducted with 49 head nurses, and, for comparison purposes, with one purchaser as well as one expert nurse at the Gothenburg Medical Service Administration. The inventory reveals that the different wards have very similar kinds of beds regardless of specialty or caring needs. The head nurses stated that the beds were seldom ideal and that they themselves have little influence when new purchases are made. It is concluded that the head nurses have a considerable knowledge of the functions of hospital beds, which ought to be put forward in stronger terms and which should also be taken into account when new beds are purchased and designed.