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Andersson, Henrik
Publications (10 of 41) Show all publications
Sterner, A., Sköld, R. & Andersson, H. (2023). Effects of Blended Simulation on Nursing Students’ Critical Thinking Skills: A Quantitative Study. Sage Open Nursing, 9
Open this publication in new window or tab >>Effects of Blended Simulation on Nursing Students’ Critical Thinking Skills: A Quantitative Study
2023 (English)In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 9Article in journal (Refereed) Published
Abstract [en]

Introduction

Critical thinking is regarded as imperative to healthcare quality and patient outcomes; therefore, effective strategies in nursing education are required to promote students’ critical thinking abilities, leading to their success in clinical work. Accordingly, simulation-based education has been suggested as a measure for achieving this goal.

Objective

The aim of this study was to explore whether a nursing education course with blended simulation activities (hands-on simulations with high-fidelity manikins and a web-based interactive simulation program) could increase nursing students’ critical thinking skills.

Method

A quasiexperimental, one-group pretest and post-test design was utilized. Data were collected through premeasurement and postmeasurement using a critical thinking questionnaire and were analyzed using paired sample t-tests, independent sample t-tests, and the nonparametric Wilcoxon signed-rank test. The effect size was calculated using Cohen's d formula.

Results

Sixty-one nursing students (57 women and four men, mean age 30 years) participated in the study. Findings of the paired sample t-test showed a significantly higher mean score for posteducation than pre-education, indicating a significant change in nurses’ critical thinking capabilities (p < .001). The results for Cohen's d formula ( − 0.87) of the mean scores between pre-education and posteducation indicated a large effect size. The Wilcoxon signed-rank test also showed a statistically significant increase in the students’ critical thinking abilities between pre-education and posteducation measures (p < .001). No statistically significant differences were found in the mean score according to age or sex.

Conclusion

This study concluded that blended simulation-based education can increase nursing students’ critical thinking capabilities. As a result, this study builds on the use of simulation as a measure for developing and promoting critical thinking abilities during nursing education.

 

Place, publisher, year, edition, pages
SAGE Publications Inc, 2023
Keywords
simulation training, education, blended simulation, critical thinking, nursing education research
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29825 (URN)10.1177/23779608231177566 (DOI)000989528100001 ()2-s2.0-85160443301 (Scopus ID)
Available from: 2023-05-19 Created: 2023-05-19 Last updated: 2024-02-01Bibliographically approved
Falchenberg, Å., Sterner, A., Norberg Boysen, G. & Andersson, H. (2023). Emergency care at home - care that limps. In: Emergency Care Delivery at Home – An innovative approach for taking care of patients needs for emergency care: . Paper presented at CISA (Centrum för interprofessionell samverkan och sambruk i akut vård) conference, Linneuniversitet Växjö, 19-20 oktober, 2023..
Open this publication in new window or tab >>Emergency care at home - care that limps
2023 (English)In: Emergency Care Delivery at Home – An innovative approach for taking care of patients needs for emergency care, 2023Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Introduction: The number of patients who perceive themselves to have need for emergency care needs has increased over time. Some of these care needs can be addressed at patients' home (1). Emergency care delivery at home can be better for some patients (2). This arises questions how to provide high-quality and cost-effective emergency care (3). Therefore, it is needed to explore how delivery models can be changed for taking care of patients needs for emergency care. 

Aim: To explore emergency health care professionals’ experiences in caring for patients with emergency care needs in their homes.

Methods: A qualitative study based on observations and interviews was used. Data was analyzed by content analysis.  Results: No results are currently available as data collection is ongoing. The poster will present preliminary results at the conference. 

Conclusion: The findings can be assumed to contribute and stimulate to a continued discussion and development of new and additional models of emergency care delivery based on patient’s emergency care needs.

National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30869 (URN)
Conference
CISA (Centrum för interprofessionell samverkan och sambruk i akut vård) conference, Linneuniversitet Växjö, 19-20 oktober, 2023.
Available from: 2023-11-16 Created: 2023-11-17 Last updated: 2023-12-01Bibliographically approved
Falchenberg, Å., Sterner, A., Norberg Boysen, G. & Andersson, H. (2023). Emergency Care Delivery at Home – An innovative approach for taking care of patients needs for emergency care. In: Emergency Care Delivery at Home – An innovative approach for taking care of patients needs for emergency care: . Paper presented at 4th global conference on emergency nursing & trauma care, Gothenburg, Sweden, 9-11 November, 2023..
Open this publication in new window or tab >>Emergency Care Delivery at Home – An innovative approach for taking care of patients needs for emergency care
2023 (English)In: Emergency Care Delivery at Home – An innovative approach for taking care of patients needs for emergency care, 2023Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Introduction: The number of patients who perceive themselves to have need for emergency care needs has increased over time. Some of these care needs can be addressed at patients' home (1). Emergency care delivery at home can be better for some patients (2). This arises questions how to provide high-quality and cost-effective emergency care (3). Therefore, it is needed to explore how delivery models can be changed for taking care of patients needs for emergency care. 

Aim: To explore emergency health care professionals’ experiences in caring for patients with emergency care needs in their homes.

Methods: A qualitative study based on observations and interviews was used. Data was analyzed by content analysis.  Results: No results are currently available as data collection is ongoing. The poster will present preliminary results at the conference. 

Conclusion: The findings can be assumed to contribute and stimulate to a continued discussion and development of new and additional models of emergency care delivery based on patient’s emergency care needs.

National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30859 (URN)
Conference
4th global conference on emergency nursing & trauma care, Gothenburg, Sweden, 9-11 November, 2023.
Available from: 2023-11-16 Created: 2023-11-16 Last updated: 2023-11-27Bibliographically approved
Andersson, U., Maurin Söderholm, H., Andersson, H., Wireklint Sundström, B., Andersson Hagiwara, M. & Puaca, G. (2023). Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study. Paramedicine
Open this publication in new window or tab >>Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study
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2023 (English)In: Paramedicine, ISSN 2753-6386Article in journal (Refereed) Published
Abstract [en]

Introduction

Clinical reasoning (CR) among healthcare professionals working in emergency medical services (EMS) who focus on ambulance care is a vital part of ensuring timely and safe patient care. The EMS environment continually fluctuates, so clinicians constantly need to adapt to new situations. Organizational support is described as important for CR, but overall, research on organizational influences for CR in an EMS context is lacking. An increased understanding of these influencing factors can assist in the development of EMS by strengthening CR among clinicians. Therefore, the purpose of this study was to investigate the organizational factors influencing EMS clinicians’ CR.

Methods

Using a qualitative single case study design, an EMS organization in southwestern Sweden was explored. Data were collected from participant observations of patient encounters, individual and group interviews with clinicians and organizational representatives, and organizational document audits. Data were analyzed using qualitative content analysis and triangulation of data sources.

Results

The results revealed several organizational influencing factors. Collaboration and information sharing internally and externally were emphasized as essential components influencing CR. Additionally, the structure for the clinicians’ ‘room for action’ appeared confused and created uncertainties for CR related to decision mandates.

Conclusion

The conclusion is that organizational factors do play an important role in clinicians’ CR. Moreover, the EMS community needs to develop suitable forums for discussing and developing these influencing factors across organizational hierarchies. Finally, clarification is needed on clinicians’ ‘room for action’ within their own organization but also with possible collaborators.

 

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
health and well-being, qualitative analysis and interpretation, clinical reasoning, decision making, emergency medicalservices, work and healthcare environment
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30241 (URN)10.1177/27536386231189011 (DOI)2-s2.0-85175415486 (Scopus ID)
Available from: 2023-08-11 Created: 2023-08-11 Last updated: 2024-02-01Bibliographically approved
Olander, A., Magnusson, C., Sundler, A. J., Bremer, A., Andersson, H., Herlitz, J., . . . Andersson Hagiwara, M. (2023). Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study. Prehospital and Disaster Medicine, 38(2), 160-167
Open this publication in new window or tab >>Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study
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2023 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 38, no 2, p. 160-167Article in journal (Refereed) Published
Abstract [en]

Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. 

Study Objective: The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. 

Methods: A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. 

Results: A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. 

Conclusions: As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.

Keywords
ambulance clinician, ambulance service, glucose, lactate, sepsis
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29443 (URN)10.1017/s1049023x23000110 (DOI)000929336400001 ()2-s2.0-85150666227 (Scopus ID)
Available from: 2023-02-13 Created: 2023-02-13 Last updated: 2024-02-01Bibliographically approved
Andersson, U., Maurin Söderholm, H., Andersson Hagiwara, M. & Andersson, H. (2023). Situation awareness in Sweden’s emergency medical services: a goal-directed task analysis. Discover Health Systems, 2, Article ID 44.
Open this publication in new window or tab >>Situation awareness in Sweden’s emergency medical services: a goal-directed task analysis
2023 (English)In: Discover Health Systems, ISSN 2731-7501, Vol. 2, article id 44Article in journal (Refereed) Published
Abstract [en]

Situation awareness is knowing what is going on in the situation. Clinicians working in the emergency medical services (EMS) encounter numerous situations in various conditions, and to be able to provide efficient and patient safe care they need to understand what is going on and possible projections of the current situation. The design of this study encompassed a Goal-Directed Task analysis where situation awareness information requirements were mapped in relation to goals related to various aspects of the EMS mission. A group of 30 EMS subject matter experts were recruited and answered a web-based survey in three rounds related to what they though themselves or a colleague might need to achieve situation awareness related to the specific goals of various situations. The answers were analysed using content analysis and descriptive statistics. Answers reached consensus at a predetermined level of 75%. Those who reached consensus were entered into the final goal-directed task analysis protocol. The findings presented that EMS clinicians must rely on their own, or their colleagues prior experience or knowledge to achieve situation awareness. This suggests that individual expertise plays a crucial role in developing situation awareness. There also seems to be limited support for situation awareness from organizational guidelines. Furthermore, achieving situation awareness also involves collaborative efforts from the individuals involved in the situation. These findings could add to the foundation for further investigation in this area which could contribute to the development of strategies and tools to enhance situation awareness among EMS clinicians, ultimately improving patient care and safety.

National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30937 (URN)10.1007/s44250-023-00061-7 (DOI)
Available from: 2023-11-28 Created: 2023-11-28 Last updated: 2024-01-18Bibliographically approved
Olander, A., Andersson, H., Sundler, A. J., Andersson Hagiwara, M. & Bremer, A. (2023). The onset of sepsis as experienced by patients and family members: A qualitative interview study. Journal of Clinical Nursing, 1-10
Open this publication in new window or tab >>The onset of sepsis as experienced by patients and family members: A qualitative interview study
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2023 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, p. 1-10Article in journal (Refereed) Published
Abstract [en]

Aims and Objectives: To explore the onset of sepsis based on patients' and family members' experiences.

Background: Knowledge about the onset of sepsis is limited among patients and their families, which makes early recognition of sepsis difficult. Previous studies argue that their stories are important to recognising sepsis and reduced suffering and mortality.

Design: A descriptive design with a qualitative approach was used.Methods: In total, 29 patients and family members participated in 24 interviews with open-ended questions, including five dyadic and 19 individual interviews. The interviews were conducted during 2021, and participants were recruited from a sepsis group on social media. A thematic analysis based on descriptive phenomenology was performed. The study followed the COREQ checklist.

Findings: Two themes emerged from the experiences: (1) When health changes into something unknown, including the two subthemes; Bodily symptoms and signs being vague but still tangible and Feelings of uncertainty, and (2) Turning points when warnings signs are deemed as serious, including the two subthemes Passing borders when feeling out of control and Difficulties understanding the seriousness.

Conclusions: Patients' and family members' stories of the onset of sepsis indicate that symptoms and signs appeared insidiously and then noticeably worsen. The symptoms and signs seemed not be attributed to sepsis; instead, there was uncertainty about what the symptoms and signs meant. It was mainly family members who possibly understood the seriousness of the disease.

Implications for the profession and patient care: Patients' experiences of their symptoms and signs and family members' unique knowledge of the patient, indicate that healthcare professionals should listen and try to understand what the patient and family members are telling and take their concerns seriously. How the condition appears, and family members' concerns are important pieces of the assessment to recognise patients with sepsis.

Patient or public contribution: Patients and family members contributed to the data collected.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2023
Keywords
experience, family member, interviews, onset, patient, sepsis, sign, symptom
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:hb:diva-29881 (URN)10.1111/jocn.16785 (DOI)001002252000001 ()2-s2.0-85161467777 (Scopus ID)
Available from: 2023-06-06 Created: 2023-06-08 Last updated: 2024-02-01Bibliographically approved
Andersson, U., Andersson Hagiwara, M., Wireklint Sundström, B., Andersson, H. & Maurin Söderholm, H. (2022). Clinical Reasoning among Registered Nurses in Emergency Medical Services: A Case Study. Journal of Cognitive Engineering and Decision Making
Open this publication in new window or tab >>Clinical Reasoning among Registered Nurses in Emergency Medical Services: A Case Study
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2022 (English)In: Journal of Cognitive Engineering and Decision Making, ISSN 1555-3434, E-ISSN 2169-5032Article in journal (Refereed) Published
Abstract [en]

In emergency medical services (EMS), the clinical reasoning (CR) of registered nurses (RNs) working in ambulance care plays an important role in providing care and treatment that is timely, accurate, appropriate and safe. However, limited existing knowledge about how CR is formed and influenced by the EMS mission hinders the development of service provision and decision support tools for RNs that would further enhance patient safety. To explore the nature of CR and influencing factors in this context, an inductive case study examined 34 observed patient–RN encounters in an EMS setting focusing on ambulance care. The results reveal a fragmented CR approach involving several parallel decision-making processes grounded in and led by patients’ narratives. The findings indicate that RNs are not always aware of their own CR and associated influences until they actively reflect on the process, and additional research is needed to clarify this complex phenomenon.

Keywords
Clinical reasoning, decision-making, problem-solving, naturalistic studies, field study, healthcare delivery, emergency medical services
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-27921 (URN)10.1177/15553434221097788 (DOI)000800553600001 ()2-s2.0-85131073033 (Scopus ID)
Projects
Bedömning och beslutsfattande i ambulanssjukvård
Available from: 2022-05-25 Created: 2022-05-25 Last updated: 2023-10-03Bibliographically approved
Olsson, M., Svensson, A., Andersson, H., Dehre, A., Elmqvist, C., Rask, M., . . . Norberg Boysen, G. (2022). Educational intervention in triage with the Swedish triage scale RETTS©, with focus on specialist nurse students in ambulance and emergency care – A cross-sectional study. International Emergency Nursing, 63, Article ID 101194.
Open this publication in new window or tab >>Educational intervention in triage with the Swedish triage scale RETTS©, with focus on specialist nurse students in ambulance and emergency care – A cross-sectional study
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2022 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 63, article id 101194Article in journal (Refereed) Published
Abstract [en]

Aim

To determine the reliability of application of the RETTS© triage scale after an educational intervention using paper-based scenarios in emergency care education.

Background

Knowledge about and education in triage are important factors in triagescale implementation. Presenting students with a large number of triage scenarios is a common part of triage education.

Methods

In this prospective cross-sectional study at two universities students undergoing education in emergency care used RETTS© to assess triage level in 46 paper-based scenarios.

Results

57 students in the study made 2590 final triage decisions. Fleiss Kappa for final triage was 0.411 which is in the lower range of moderate agreement. In 25 of 46 (53.4%) scenarios, final triage levels did not agree about whether the case was stable or unstable.

Conclusion/Implications

Application of the RETTS© triage scale after an educational intervention with paper-based simulation in emergency care education resulted in moderate agreement about the final levels of triage.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
RETTS©, Triage, Cross-sectional, Educational intervention, Emergency care education, Paper-based simulation, Reliability, Registered Nurse
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-28355 (URN)10.1016/j.ienj.2022.101194 (DOI)000836194400001 ()35802957 (PubMedID)2-s2.0-85133642537 (Scopus ID)
Available from: 2022-08-12 Created: 2022-08-12 Last updated: 2022-08-23Bibliographically approved
Andersson, H., Svensson, A., Frank, C., Rantala, A., Holmberg, M. & Bremer, A. (2022). Ethics education to support ethical competence learning in healthcare: an integrative systematic review. BMC Medical Ethics, 23(1), Article ID 29.
Open this publication in new window or tab >>Ethics education to support ethical competence learning in healthcare: an integrative systematic review
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2022 (English)In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 23, no 1, article id 29Article in journal (Refereed) Published
Abstract [en]

Background: Ethical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.

Methods: In this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.

Results: The review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.

Conclusions: The review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations.

Keywords
ethical competencies, ethical problems, ethics education, healthcare professionals, integrative systematic review, students
National Category
Medical Ethics
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-27664 (URN)10.1186/s12910-022-00766-z (DOI)000770756900002 ()35305627 (PubMedID)2-s2.0-85126766822 (Scopus ID)
Available from: 2022-03-21 Created: 2022-03-21 Last updated: 2023-01-18Bibliographically approved
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