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Nilsson, Gunilla
Publications (10 of 39) Show all publications
Stevenson-Ågren, J., Israelsson, J., Nilsson, G., Petersson, G. & Bath, P. A. (2018). Vital sign documentation in electronic records: the development of workarounds. Health Informatics Journal, 24(2), 206-215
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2018 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, no 2, p. 206-215Article in journal (Refereed) Published
Abstract [en]

Workarounds are commonplace in health care settings. An increase in the use of electronic health records (EHR) has led to an escalation of workarounds as health care professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in EHR has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined work flow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of hand-written notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and to ensure patients safety.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
electronic health records, healthcare professionals, patient safety, vital signs, workarounds
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Information Systems
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-55697 (URN)10.1177/1460458216663024 (DOI)000432068300008 ()27542887 (PubMedID)
Available from: 2016-08-22 Created: 2016-08-22 Last updated: 2018-07-11Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Nilsson, G., Petersson, G. & Bath, P. (2016). Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest. Health Informatics Journal, 22(1), 21-33
Open this publication in new window or tab >>Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest
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2016 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 22, no 1, p. 21-33Article in journal (Refereed) Published
Abstract [en]

Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPACTM Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. 

Place, publisher, year, edition, pages
Sage Publications, 2016
Keywords
vital signs, electronic health records, documentation
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-46355 (URN)10.1177/1460458214530136 (DOI)000368726900002 ()24782478 (PubMedID)2-s2.0-84955322777 (Scopus ID)
Available from: 2015-09-16 Created: 2015-09-16 Last updated: 2018-05-18Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Nilsson, G., Petersson, G. & Bath, P. (2015). Documentation of vital signs in electronic records: the development of workarounds. In: P. Bath, H. Spring, &, B Sen, B (Ed.), Health informatics for enhancing health and well-being: Proceedings of the seventeenth International Symposium for Health Information Management Research, York, UK 24-26 June 2015. Paper presented at ISHIMR 2015: 17th International Symposium for Health Information Management Research, York, UK, June 25-26, 2015.
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2015 (English)In: Health informatics for enhancing health and well-being: Proceedings of the seventeenth International Symposium for Health Information Management Research, York, UK 24-26 June 2015 / [ed] P. Bath, H. Spring, &, B Sen, B, 2015Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Workarounds are commonplace in health care settings. An increase in the use of electronic health records (EHR) has led to an escalation of workarounds as health care professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in EHR has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined work flow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of hand-written notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and to ensure patients safety.

Keywords
Electronic records, Vital signs, Workarounds, Patient safety
National Category
Other Medical Sciences not elsewhere specified
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-71128 (URN)
Conference
ISHIMR 2015: 17th International Symposium for Health Information Management Research, York, UK, June 25-26, 2015
Available from: 2018-02-28 Created: 2018-02-28 Last updated: 2018-05-18Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Nilsson, G., Petersson, G. & Bath, P. (2014). Dokumentation av vitalparametrar i datorjournaler: En risk för patientsäkerheten?. In: VITALIS - Nordens ledande eHälsomöte: Vetenskapliga papers presenterade vid Vitalis konferens, Svenska Mässan, Göteborg, 8-10 april 2014. Paper presented at VITALIS - Nordens ledande eHälsomöte. Göteborg: Göteborgs universitet
Open this publication in new window or tab >>Dokumentation av vitalparametrar i datorjournaler: En risk för patientsäkerheten?
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2014 (English)In: VITALIS - Nordens ledande eHälsomöte: Vetenskapliga papers presenterade vid Vitalis konferens, Svenska Mässan, Göteborg, 8-10 april 2014, Göteborg: Göteborgs universitet, 2014Conference paper, Poster (with or without abstract) (Other academic)
Abstract [sv]

Tidig upptäckt och snabb hantering av riskpatienter har betraktats som det ’första steget i kedjan till överlevnad’ i hjärtlungräddning (HLR)[1]. Patienter uppvisar ofta tecken på försämring av kliniskt tillstånd under perioden före oväntad hjärtstopp [2]. För att förbättra identifieringen av försämring i kliniskt tillstånd hos patienter har många varianter på system för snabb respons införts med fokus på mätning, rapportering och hantering av patienter med avvikande vitalparametrar [3]. Datorjournaler journaler används allt mer inom vården för i stort sett all dokumentation. Däremot är kunskapen begränsad kring betydelsen av dokumentationen i datorjournalen för att upptäcka försämring av patienternas kliniska tillstånd. Syftet med denna studie var att undersöka dokumentationen av vitala parametrar i datorjournalen för sjukhusvårdade patienter, som efter inläggning drabbats av oväntat hjärtstopp.

Place, publisher, year, edition, pages
Göteborg: Göteborgs universitet, 2014
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-46648 (URN)
Conference
VITALIS - Nordens ledande eHälsomöte
Available from: 2015-10-06 Created: 2015-10-06 Last updated: 2018-05-18Bibliographically approved
Semark, B., Petersson, G., Engström, S., Arvidsson, E. & Nilsson, G. (2014). Participation in decision making when starting long-term medication: patients´ experiences. European Journal for Person Centered Healthcare, 2(3), 282-289
Open this publication in new window or tab >>Participation in decision making when starting long-term medication: patients´ experiences
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2014 (English)In: European Journal for Person Centered Healthcare, ISSN 2052-5648, E-ISSN 2052-5656, Vol. 2, no 3, p. 282-289Article in journal (Refereed) Published
Abstract [en]

Rationale, aim and objective

To achieve the beneficial effect of drug treatment and reduce unnecessary health care costs, patients must be involved in shared decision making. The aim of this study was to describe patient experiences of participation in decision making when starting long-term medication.

Method

Nine patients at two health care centers were semi-structured interviewed about their experiences, beliefs and feelings about their participation in the decision to start long-term medication. Data was analyzed by a qualitative content method.

Results

Respondents stated that participating in decision making in drug treatment requires knowledge of the relevant area and requiring trusting the physician. The respondent’s responsibility and motivation facilitate adherence to drug treatment. 

Conclusion

Patients sought participation in the decision making of long-term medication and wished for adequate time needed for this dialogue. If they lacked sufficient knowledge, they wanted relevant and useful information from the physician. To experience trust in the physician through a good encounter increases the possibility for participation and enhancement of medication adherence. In order to participate in decision making, the patient needs the physician’s encouragement.

 

Keywords
patient, participastion, decision-making, drug treatment, adherence
National Category
Social and Clinical Pharmacy
Research subject
Chemistry, Biochemistry
Identifiers
urn:nbn:se:lnu:diva-30337 (URN)
Available from: 2013-11-11 Created: 2013-11-11 Last updated: 2018-01-11Bibliographically approved
Johansson, P., Petersson, G., Saveman, B.-I. & Nilsson, G. (2014). Using advanced mobile devices in nursing practice - the views of nurses and nursing students. Health Informatics Journal, 20(3), 220-231
Open this publication in new window or tab >>Using advanced mobile devices in nursing practice - the views of nurses and nursing students
2014 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 20, no 3, p. 220-231Article in journal (Refereed) Published
Abstract [en]

Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses’ and nursing students’ views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.

Place, publisher, year, edition, pages
Sage Publications, 2014
Keywords
Mobile health, Clinical decision-making, Evidence-based practice, Assistive technologies, Ehealth
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science; Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-25466 (URN)10.1177/1460458213491512 (DOI)000341757800007 ()2-s2.0-84907319203 (Scopus ID)
Available from: 2013-04-27 Created: 2013-04-27 Last updated: 2018-05-17Bibliographically approved
Stevenson-Ågren, J., Petersson, G., Nilsson, G. & Bath, P. (2013). Documentation of vital signs in electronic health records: issues for patient safety. In: Syed Sibte Raza Abidi, Peter A. Bath (Ed.), Proceedings of the sixteenth International Symposium for Health Information management Research, ISHIMR 2013: Exploiting Health Informatics for Connected, Collaborative and Customized Patient Care. Paper presented at ISHIMR 2013: Proceedings of the sixteenth International Symposium for Health Information management Research (pp. 153-154). Halifax: Dalhousie University & University of Sheffield
Open this publication in new window or tab >>Documentation of vital signs in electronic health records: issues for patient safety
2013 (English)In: Proceedings of the sixteenth International Symposium for Health Information management Research, ISHIMR 2013: Exploiting Health Informatics for Connected, Collaborative and Customized Patient Care / [ed] Syed Sibte Raza Abidi, Peter A. Bath, Halifax: Dalhousie University & University of Sheffield , 2013, p. 153-154Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Inadequate design and poor user-interface are given as reasons for unsuccessful implementation of electronic health records (EHR) [1,2]. However, rather than designing more suitable technology, the trend has been to 'muddle through' [2] and to urge health care workers to adapt to poorly designed systems [3]. This may work to some degree but little is known about the impact this could have on patient safety. The design of vital sign charts has an impact on the ability of clinicians to detect deterioration in patients' clinical status [4-6]. Changes in a patient's vital signs may indicate a lifethreatening event [7,8] so charts should be user-friendly to support clinicians in decision-making [9,10]. The aim of this study was to examine the documentation of physiological vital signs in an EHR. In this paper, we present the results regarding accessing information on a patient's physiological vital signs.

Place, publisher, year, edition, pages
Halifax: Dalhousie University & University of Sheffield, 2013
Keywords
Electronic health record, patient safety, vital signs
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-46647 (URN)
Conference
ISHIMR 2013: Proceedings of the sixteenth International Symposium for Health Information management Research
Available from: 2015-10-06 Created: 2015-10-06 Last updated: 2018-08-17Bibliographically approved
Johansson, P., Petersson, G. & Nilsson, G. (2013). Nursing students' experience of using a personal digital assistant (PDA) in clinical practice: an intervention study. Nurse Education Today, 33(10), 1246-1251
Open this publication in new window or tab >>Nursing students' experience of using a personal digital assistant (PDA) in clinical practice: an intervention study
2013 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 33, no 10, p. 1246-1251Article in journal (Refereed) Published
Abstract [en]

Background

A personal digital assistant (PDA) is a multifunctional information and communication tool allowing nursing students to keep up to date with expanding health related knowledge.

Objectives

This study was aimed at exploring nursing students' experience of using a PDA in clinical practice.

Method

In this intervention study, nursing students (n=67) used PDAs during a period of 15weeks, replied to questionnaires, and participated in focus group interviews.

Results

The PDA was found to support nursing students in clinical practice and to have the potential to be a useful tool with benefits for both the patients and for the students. The PDA was regarded as useful, and was presumed to imply increased confidence and time savings, and contribute to improved patient safety and quality of care.

Conclusions

With available mobile technology, nursing students would be able to access necessary information, independent of time and place. Therefore, it is important that stakeholders and educators facilitate the use of PDAs to support nursing students during their clinical practice, in order to prepare them for their future work, and to continuously improve the safety and quality of healthcare.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
computers handheld, intervention study, nursing informatics, nursing practice, nursing students
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-28874 (URN)10.1016/j.nedt.2012.08.019 (DOI)000326410800028 ()2-s2.0-84884140638 (Scopus ID)
Projects
Nurse Companion
Available from: 2013-09-15 Created: 2013-09-15 Last updated: 2018-05-17Bibliographically approved
Schildmeijer, K., Nilsson, L., Perk, J., Årestedt, K. & Nilsson, G. (2013). Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews. BMJ Open, 3, e003131
Open this publication in new window or tab >>Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews
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2013 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, p. e003131-Article in journal (Refereed) Published
Abstract [en]

Objectives The aim was to describe the strengths and weaknesses, from team member perspectives, of working with the Global Trigger Tool (GTT) method of retrospective record review to identify adverse events causing patient harm.

Design A qualitative, descriptive approach with focus group interviews using content analysis.

Setting 5 Swedish hospitals in 2011.

Participants 5 GTT teams, with 5 physicians and 11 registered nurses.

Intervention 5 focus group interviews were carried out with the five teams. Interviews were taped and transcribed verbatim.

Results 8 categories emerged relating to the strengths and weaknesses of the GTT method. The categories found were: Usefulness of the GTT, Application of the GTT, Triggers, Preventability of harm, Team composition, Team tasks, Team members’ knowledge development and Documentation. Gradually, changes in the methodology were made by the teams, for example, the teams reported how the registered nurses divided up the charts into two sets, each being read respectively. The teams described the method as important and well functioning. Not only the most important, but also the most difficult, was the task of bringing the results back to the clinic. The teams found it easier to discuss findings at their own clinics.

Conclusions The GTT method functions well for identifying adverse events and is strengthened by its adaptability to different specialties. However, small, gradual methodological changes together with continuingly developed expertise and adaption to looking at harm from a patient's perspective may contribute to large differences in assessment over time.

National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-30422 (URN)10.1136/bmjopen-2013-003131 (DOI)000330541900016 ()2-s2.0-84885339860 (Scopus ID)
Available from: 2013-11-14 Created: 2013-11-14 Last updated: 2017-12-06Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Nilsson, G., Petersson, G. & Bath, P. A. (2013). Variable documentation of vital signs in an electronic health record in patients at risk of in-hospital cardiac arrest could pose a threat to patient safety. European Journal of Cardiovascular Nursing, 12, S55-S56
Open this publication in new window or tab >>Variable documentation of vital signs in an electronic health record in patients at risk of in-hospital cardiac arrest could pose a threat to patient safety
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2013 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, p. S55-S56Article in journal, Meeting abstract (Other academic) Published
National Category
Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-32104 (URN)000328735000106 ()
Available from: 2014-02-05 Created: 2014-02-05 Last updated: 2018-05-18Bibliographically approved
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