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  • 1.
    Olsen, Rose Mari
    et al.
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos, Norway.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Skotnes, Liv Heidi
    Department of Medicine, Division of Geriatrics, Nord-Trøndelag Health Trust, Namsos, Norway.
    Enmarker, Ingela
    Centre for Care Research Mid-Norway, Steinkjer, Norway.
    Content of nursing discharge notes: Associations with patient and transfer characteristics2012In: Open Journal of Nursing, ISSN 2162-5336, Vol. 2, no 3, p. 277-287Article in journal (Refereed)
    Abstract [en]

    Background: In situations of care transfer of older people from hospital to home care at discharge, exchanging relevant and necessary information about the patient’s health status and individual needs are of importance to ensure continuity and appropriate nursing follow-up care. Objective: The objectives of the study were to: 1) examine the content of nurses’ discharge notes of older patients’ discharged from hospital to home care, and 2) investigate the association between the content of discharge notes and characteristics of patient and transfer. Methods: The nursing discharge notes of 70 older patients admitted to a geriatric unit and a general medicine ward at a local hospital in central Norway were analysed. The discharge notes were structured in accordance with the Well-being, Integrity, Prevention, and Safety (VIPS) model. Mean, standard deviations, and independent sample t-tests were performed to show and examine differences in use of VIPS keywords in relation to patient and transfer characteristics. To examine if use of VIPS keywords could be predicted by patient and transfer characteristics, linear multiple regression analyses were used. Results: Significant differences for mean scores on used VIPS keywords in the discharge note were found for gender, age, and medical department facility. While gender and medical department facility were significant predictors of mental related keywords in the discharge note, medical department facility was a significant predictor of physical related keywords. Conclusions: The result of this study indicate that documentation of patient status in the nursing discharge note of older patients transferred from hospital to home care is incomplete and are influenced by patient and transfer characteristics. In order to ensure continuity and appropriate nursing follow-up care, we emphasize the need for a more comprehensive approach to older patients, and that this must be reflected in the nursing discharge note.

  • 2.
    Olsen, Rose Mari
    et al.
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos, Norway.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Skotnes, Liv Heidi
    Department of Medicine, Division of Geriatrics, Nord-Trøndelag HealthTrust, Namsos, Norway.
    Enmarker, I
    Faculty of Health and Science, Nord-Trøndelag University College, Norway.
    Breakdown in informational continuity of care during hospitalization of older home-living patients - a case study2014In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 14, no Apr-Jun, p. Art. no. e012-Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:The successful transfer of an older patient between health care organizations requires open communication between them that details relevant and necessary information about the patient's health status and individual needs. The objective of this study was to identify and describe the process and content of the patient information exchange between nurses in home care and hospital during hospitalization of older home-living patients.

    METHODS:A multiple case study design was used. Using observations, qualitative interviews and document reviews, the total patient information exchange during each patient's episode of hospitalization (n = 9), from day of admission to return home, was captured.

    RESULTS:Information exchange mainly occurred at discharge, including a discharge note sent from hospital to home care, and telephone reports from hospital nurse to home care nurse, and meetings between hospital nurse and patient coordinator from the municipal purchaser unit. No information was provided from the home care nurses to the hospital nurses at admission. Incompleteness in the content of both written and verbal information was found. Information regarding physical care was more frequently reported than other caring dimensions. Descriptions of the patients' subjective experiences were almost absent and occurred only in the verbal communication.

    CONCLUSIONS:The gap in the information flow, as well as incompleteness in the content of written and verbal information exchanged, constitutes a challenge to the continuity of care for hospitalized home-living patients. In order to ensure appropriate nursing follow-up care, we emphasize the need for nurses to improve the information flow, as well as to use a more comprehensive approach to older patients, and that this must be reflected in the verbal and written information exchange.

  • 3. Omli, R.
    et al.
    Skotnes, Liv H.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Mykletun, A.
    Bakke, A.M.
    Kurhy, E.
    Residual urine as a risk factor for lower urinary tract infections: A 1-year follow-up study in nursing homes2008In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 56, no 5, p. 871-874Article in journal (Refereed)
  • 4. Omli, R.
    et al.
    Skotnes, Liv H.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Romild, U.
    Bakke, A.M.
    Mykletun, A.
    Kuhry, E.
    Pad per day usage, urinary incontinence and urinary tract infections in nursing home residents2010In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 39, no 5, p. 549-554Article in journal (Refereed)
  • 5.
    Skotnes, Liv H.
    et al.
    Nord-Trondelag University College, Namsos, Norway.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Kuhry, E.
    St Olavs Hospital Trondheim, Norway.
    Perceptions and barriers that influence the ability to provide appropiate incontinence care in nursing home residents: Statements from nursing staff2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 6, p. 437-444Article in journal (Refereed)
    Abstract [en]

    among nursing home residents. Urinary incontinence in older people has a multifactorial etiology and is therefore more difficult to assess and treat than uri- nary incontinence in younger people. Previous re- search has shown that incontinence care in nursing home residents often is inadequate and little systema- tized. The aim of this study was to identify percep- tions and barriers that influence the ability of the nursing staff to provide appropriate incontinence care. This was a qualitative study using focus-group meth- odology. Data were collected from three focus-group interviews with 15 members of the nursing staff from six different units in a nursing home. The focus-group interviews were recorded on tape, transcribed verba- tim and analyzed according to qualitative content analysis. Three topics and eight categories were iden- tified. The first topic, Perceptions and barriers associ- ated with residents, consisted of one category: "phy- sical and cognitive problems". The second topic, Per- ceptions and barriers associated with nursing staff, consisted of three categories: "lack of knowledge", "attitudes and beliefs" and "lack of accessibility". The third topic, Perceptions and barriers associated with organizational culture, consisted of four cate- gories: "rigid routines", "lack of resource", "lack of documentation" and "lack of leadership". The find- ings from this study show that there are many barri- ers that might influence the possibilities of nursing staff to provide appropriate incontinence care to re- sidents in nursing homes. However, it can neverthe- less seem like opinions and the attitude of nursing staff, together with a lack of knowledge about UI, are the most important barriers to provide appropriate incontinence care.

  • 6.
    Skotnes, Liv H.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Omli, R.
    Romild, Ulla
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kuhry, E.
    Urinary incontinence in Norwegian nursing home residents2012In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 2, no 2, p. 116-122Article in journal (Refereed)
    Abstract [en]

    Urinary incontinence is a multi-factorial condition that has a high impact on older persons living in nursing homes. While urinary incontinence is common, only a small percentage of nursing home residents have an official diagnosis. Factors influencing urinary incontinence in this population are poorly understood. The aim of this study was to evaluate the prevalence of urinary incontinence in Norwegian nursing home residents and to study the factors associated with urinary incontinence in this population. Residents from six different nursing homes were included in this study. Data on sex, age, medication, comorbid illnesses, urinary incontinence and the use of absorbent pads was collected. Barthel`s Index of Activities of Daily Living (ADL) was used to estimate residents’ functional levels. Post-voiding residual urine was measured by means of a portable ultrasound. A questionnaire was completed by the nursing staff for each of the residents. In total, 173 residents participated in the study. One hundred and twenty-two residents (69%) were incontinent for urine and 144 used absorbent pads (83%). Fourteen percent of residents used absorbent pads ‘just to make sure’. They did not have a history of urinary incontinence. Low ADL score, dementia and urinary tract infection were significantly associated with incontinence for urine. The prevalence of urinary incontinence in Norwegian nursing homes is high. Absorbent products are frequently used without a history of urinary incontinence. Physical impairment, dementia and urinary tract infections are significantly associated with urinary incontinence.

  • 7.
    Skotnes, Liv Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Forstyrrelser i de nedre urinveier hos gamle på sykehejm: urininkontinens, residualurin, urinveisinfeksjon, samt inkontinenspleie2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to get an overview over different dysfunction in the lower urinary tract in the elderly. Also, we wanted to describe the perceptions and barriers that influence the nursing staff`’s ability to provide appropriate incontinence care in nursing home residents. The thesis includes one quantitative study (paper I, II, III), and one qualitative study (paper IV). Paper I was a cross-sectional study. Paper II and III were a prospective surveillance with a follow-up period of 1 year. 183 residents from six Norwegian nursing homes participated. In paper I, the prevalence of urinary incontinence in Norwegian nursing home residents was evaluated. The factors possibly associated with urinary incontinence were also studied. In paper II, we investigated whether residual urine was a risk factor for developing urinary tract infections in the elderly in nursing homes. In paper III, the objective was to determine whether pads per day usage is a reliable measure of urinary incontinence in nursing home residents. Furthermore, we wanted to study the association between urinary tract infections, pads per day usage and fluid intake. In the qualitative study, the aim was to identify perceptions and barriers that influence the ability of nursing staff to provide appropriate incontinence care. Five charge nurses, five registered nurses and five certified nursing assistants participated in the focus group interviews.The analysis in paper I, showed that 122 (69 %) of the resident were incontinent for urine and 144 used absorbent pads (83 %). 14 % of residents used absorbent pads ‘just to make sure’. They did not have a history of urinary incontinence. Low ADL score, dementia and urinary tract infection were significantly associated with incontinence for urine (P = <0.01). In paper II, 93 of the residents (65.3 %) had postvoid residual urine (PVR) < 100 mL and 52 residents (34.7 %) had a PVR 100 mL. During the follow-up period, 51 residents (34.0 %) had one or more urinary tract infections (UTI). The prevalence of UTI among females was higher than among men (40.4 % versus. 19.6 %; P = 0.015). There was no significant difference in mean PVR among residents that did or did not develop UTI (79 mL versus 97mL; P = 0.26). A PVR 100 mL was not associated with an increased risk of developing UTI`s (P = 0.59).In paper III, 118 (77 %) used absorbent pads. Residents that used absorbent pads were at increased risk of developing UTIs compared to residents that did notviiiuse pads (41 % versus 11 %; P = 0.001). Daily fluid intake was not associated with UTIs (P = 0.46). The number of pad shifts had no relation with the risk of developing UTIs (P = 0.62). Residents with a given pad per day (PPD) presented a wide range of incontinence volumes.In paper IV, three topics and eight categories were identified. The first topic, Perceptions and barriers associated with residents, consisted of one category: ‘physical and cognitive problems’. The second topic, Perceptions and barriers associated with nursing staff, consisted of three categories: ‘lack of knowledge’, ‘attitudes and beliefs’ and ‘lack of accessibility’. The third topic, Perceptions and barriers associated with organizational culture, consisted of four categories: ‘rigid routines’, ‘lack of resource’, ‘lack of documentation’ and ‘lack of leadership’.The results of the thesis show that the prevalence of urinary incontinence in nursing homes is high. Absorbent products are frequently used without a history of urinary incontinence. Physical impairment, dementia and urinary tract infections are associated with urinary incontinence. is common in nursing home residents. No association between PVR and UTI was found. The use of absorbent pads is associated with an increased risk of developing UTIs. PPD and daily fluid intake are not correlated with the risk of developing UTIs. PPD is an unreliable measure of urinary incontinence in nursing home residents. The findings from the qualitative study shows that there are many barriers that might influence the possibilities of nursing staff to provide appropriate incontinence care to residents in nursing homes. However, it can nevertheless seem like opinions and the attitude of nursing staff, together with a lack of knowledge about urinary incontince, are the most important barriers to provide appropriate incontinence care.

1 - 7 of 7
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