Logo: to the web site of Uppsala University

Background: Surgical site infections (SSIs) after intracranial neurosurgical procedures derive from both endogenous and exogenous factors, and are associated with increased morbidity, mortality and additional socio-economic costs. The addition of mobile laminar airflow (MLAF) units to the operating room ventilation decreases bacteria-carrying particles, but their influence on the incidence of SSIs, and concurrence with other factors, is unclear. This is a continuation study of a previous study using MLAF units. Aim: To explore factors associated with SSIs after intracranial procedures during a period when MLAF units were used. Methods: This retrospective register study had an explorative design. The electronic medical records of patients undergoing intracranial neurosurgical procedures were reviewed retrospectively for signs or symptoms of SSIs using a 45-item protocol. Demographic, patient-specific and procedure-specific variables were collected, as well as exogenous factors and SSI variables regarding depth of SSI, type of bacteria, time to infection, and treatment. Data were analysed using univariate and multi-variate logistic regression. Findings: An SSI occurred in 55 of 800 included patients (6.9%). On univariate and multivariate analysis, only remote infections during the hospital stay were associated with risk of SSI (odds ratio 2.02, 95% confidence interval 1.07-3.82; P1/40.031). Superficial SSIs were most common, the median time to infection was 18 days, and the most common causative micro-organism was Staphylococcus aureus. Conclusions: In the clinical context, considerations are recommended for neurosurgical patients with ongoing remote infections during their hospital stay. Further peri-operative studies are needed in the field of surgical infection prevention.

Aim

To determine the level of knowledge and explore the difference of hand hygiene between nursing students and nurses.

Background

Annually, 3.8 million people in Europe acquire healthcare-associated infections, highlighting the importance of hand hygiene. Despite WHO's emphasis on the fact that greater hand hygiene knowledge correlates with improved hand hygiene compliance, several studies have shown knowledge gaps among nurses and nursing students regarding hand hygiene.

Design

Descriptive cross-sectional comparative survey.

Methods

A version of the WHO “Hand Hygiene Knowledge Questionnaire”, translated into Swedish, was used for data collection among nursing students in the first and last semester, and registered nurses from a university and associated hospital. Data were analyzed by descriptive statistics, and comparison between groups with Fisher's exact test, one-way ANOVA, and post-hoc tests (Pairwise Z-Tests, Tukey HSD).

Results

The survey, conducted between December 2020 and January 2021, received responses from 201 participants, including 71 first semester students, 46 last semester students and 84 registered nurses, showing moderate (55.7% [50–74% correct answers]) to good (43.8% [75–100% correct answers]) knowledge levels. First-semester students scored lower (17.0 ± 2.1) than last-semester students (18.8 ± 1.8) and registered nurses (18.3 ± 2.1) out of 25 questions.

Discussion

It is necessary for all groups to receive proper education on hand hygiene knowledge and to have an educational program that does not separate the groups but combines them with continuing education, since the students will someday be influencing future hand hygiene knowledge as a peer, together with the nurse.

Dataprogrammet ChatGPT är en bott som utför automatiska uppgifter. Denna chattbott skapade rubriker under hösten på grund av dess förmåga att med artificiell intelligens (AI) skapa svar på riktade frågor och texter utifrån ett beskrivet syfte. I slutet av december 2022 lades 16 frågor från en hemtentamen i palliativ vård vid sjuksköterskeprogrammet in i AI-botten för att få dem besvarade och testa bottens förmåga att besvara frågorna korrekt. Vi ville även testa om man kunde se någon skillnad på svaren i rättningsmallen och på studenternas svar och på de svar som genererats från AI-botten. En bedömning av bottens svar visade på att den hade klarat examinationen. Somliga svar var mycket bra och resonerande till sin natur, något gav reducerade poäng pga. bristande innehåll och ett par svar felaktiga. Ett svar stack ut då det var på engelska. Svaren hade ibland smärre grammatiska fel, men var främst betydligt längre och bättre strukturerade än studerandes. Möjligheten att upptäcka försök till vilseledande i examination hade varit svårt. Det finns skillnad i svarens diskurs, där svaren från botten har en mer amerikansk stil i sin formulering.

The ChatGPT computer program is a bot that performs automatic tasks. This chatbot made headlines during the fall due to its ability to use Artificial Intelligence (AI) to create answers to targeted questions and texts based on a described purpose. At the end of December 2022, 16 questions from a home exam in palliative care at the nursing program were put into the AI bot to get them answered and test its ability to answer the questions correctly but also an assessment of whether the answers could be detected. An evaluation of the bot’s answers showed it had passed the examination. Some answers were excellent and reasoned, some gave reduced points due to lack of content, and some were incorrect. One answer stood out as it was in English. The answers sometimes had minor grammatical errors but were significantly more prolonged and better structured than the students’ answers. The possibility of detecting attempts at deception in the examination had been difficult. There is a difference in discourse in the answers, with the answers from the bot having a more American style.

The aim of this study was to psychometrically evaluate the Swedish operating room version of PUKAT 2.0. In total, 284 Swedish operating room nurses completed the survey of whom 50 completed the retest. The item difficulty P-value of 14 items ranged between 0.38 and 0.96 (median 0.65). Three items were found to be too easy (0.90-0.96). The D-value of 14 items ranged between 0.00 and 0.42 (median 0.46). Three items had a D-value lower than 0.20 (0.11-0.16) and eight items scored higher than 0.40 (0.45-0.61). The quality of the response alternatives (a-value) ranged between 0.00 and 0.42. This showed that nurses with a master's degree had a higher knowledge than nurses with a professional degree (respectively 9.4/14 versus 8.6/14; t = -2.4, df = 199, P = 0.02). The ICC was 0.65 (95% CI 0.45-0.78). The ICCs for the domains varied from 0.12 (95% CI = -0.16-0.39) to 0.59 (95% CI = 0.38-0.75). Results indicated that 11 of the original items contributed to the overall validity. However, the low participation in the test-retest made the reliability of the instrument low. An extended evaluation with a larger sample should be considered in order to confirm aspects of the psychometric properties of this instrument.

Background: Evaluation of a complex intervention are often described as being diminished by difficulties regarding acceptability, compliance, delivery of the intervention, recruitment and retention. Research of peer learning for nursing students have found several positive benefits while studies of peer learning for newly graduated nurses are lacking. This study aimed (1) to investigate the study process in terms of (a) first-line managers' perspectives on the intervention study, the difficulties they face and how they handle these and (b) new graduates' fidelity to the intervention and (2) to examine the effect of the peer learning intervention in workplace introduction for newly graduated nurses.

Methods: A mixed-methods approach using semi-structured interviews with eight managers, repeated checklist for fidelity and questionnaires conducted with 35 new graduates from June 2015 and January 2018, whereof 21 in the intervention group. The peer learning intervention's central elements included pairs of new graduates starting their workplace introduction at the same time, working the same shift and sharing responsibility for a group of patients for 3 weeks. The intervention also included 3 months of regular peer reflection.

Results: Managers offered mostly positive descriptions of using peer learning during workplace introduction. The intervention fidelity was generally good. Because of recruitment problems and thereby small sample size, it was difficult to draw conclusions about peer learning effects and, thus, the study hypothesis could either be accepted or rejected. Thereby, the study should be regarded as a pilot.

Conclusions: The present study found positive experiences of, from managers, and fidelity to the peer learning intervention; regarding the experimental design, there were lessons learned.

Purpose: To explore the experiences of nurses and coordinators in the PRIMROSE childhood obesity prevention trial, and to understand the factors that might help to improve the outcome of future primary prevention of obesity.

Methods: Using a qualitative approach, data were obtained by interviewing nine intervention nurses and three regional study coordinators. All participants were female. The interviews were transcribed and analysed using content analysis.

Results: Two themes emerged: The nurses experienced that it was rewarding to participate in the trial, but challenging to combine the intervention with regular work; and The study coordinators experienced that they were in a difficult position handling the conflicting needs of the research group and the nurses' commitment to usual child health care services. The importance of support, encouragement, briefer and simpler intervention, and adaptation of the training in motivational interviewing to the setting was emphasized. Stress and lack of time were major barriers to deliver the intervention as intended.

Conclusions: Although the PRIMROSE intervention was developed in collaboration with representatives from the child health services, and additional research funding was provided to compensate for time spent working with the trial, nurses experienced stress and time constraints.

Introduction: To assess operating room (OR) nurses' attitudes towards pressure ulcer prevention, the Attitude towards Pressure Ulcer Prevention (APuP) instrument was developed. Aim: The aim of this study was to psychometrically evaluate the Attitude towards Pressure Ulcer Prevention (APuP) instrument in a Swedish OR context. Materials and methods: A psychometric evaluation study was conducted, using a convenience sample, between February and August 2020. Validity (content, construct, discriminatory power) and reliability (stability and internal consistency) were evaluated. Results: The first survey (test) was completed by 284 Swedish OR nurses, of whom n = 50 (17.6%) completed the second survey (retest). A Principal Component Analysis was conducted for the 13-item instrument. The KMO value for this model was 0.62. Bartlett's test for sphericity was statistically significant (p 0.001). Five factors were identified which accounted for 56% of the variance in responses related to attitudes toward pressure ulcer prevention. The Cronbach's a for the instrument "attitude towards Pressure Ulcer Prevention" was 0.66. The intraclass correlation coefficient was 0.49 (95% CI = 0.25-0.67). Conclusion: This Swedish version of the APuP- OR is the first step in the development of an instrument to measure OR nurses' attitudes towards PU prevention in a Swedish OR context. The reliability of the instrument was low and the validity moderate. A larger sample and the revision or addition of items related to the context of the operating room should be considered in order to confirm aspects of the psychometric properties.

För att personer som utsatts för våld samt deras barn ska få skydd och stöd krävs att yrkesverksamma har evidensbaserad kunskap om våld. Idag är det obligatoriskt för studenterna på åtta utbildningsprogram att kunna visa på kunskap om ”Mäns våld mot kvinnor och våld i nära relationer”, sedan detta kunskapsmål införts i högskoleförordningen. Sjuksköterskeprogrammet vid Uppsala universitet undervisade tidigt om kunskapsområdet och har sedan 2006 utvecklat en sammanhållen undervisning fördelat på flera terminer, från 2019 med möjlighet till fördjupning genom en valbar kurs. Kunskapsmålet har brutits ned till mindre delar som exempelvis belyser särskilda sårbarheter för våld. En tvärvetenskaplig ansats, undervisning om lagstiftning och erfarenheter från praktisk verksamhet, kombinerat med reflektion ger studenterna förutsättningar att omsätta kunskapen i professionell praktik. 

The purpose of this observational study was to describe the collaboration between first-year nursing students using peer learning during their first clinical practice education. In earlier, predominantly interview studies, peer learning has been described as a model with several positive outcomes. However, no studies on how students act in collaboration in a real-life context have been found. The present study observed sixteen arbitrarily paired nursing students (eight pairs) on three to five occasions per pair, in total 164 h from September 2015 to March 2016. Repeated unstructured observations including informal conversations were used. Using qualitative content analysis, one theme 'Involuntary collaboration leads to growth in different competencies' emerged and three categories 'Practising nursing skills and abilities when working together', 'Establishing knowledge by helping each other to understand' and 'Sharing thoughts, feelings, and knowledge and put them into words'. In conclusion, nursing students using peer learning were observed practising several competencies, some of them not so easily elicited according to earlier research as organization, nursing leadership, teaching, and supervision.

Background:Healthcare-associated infections (HCAIs) have a large negative impact onmorbidity, mortality, and quality of life. Approximately 9% of all patients hospitalized inSweden suffer from HCAI. Hand hygiene plays a key role and is considered the single mostimportant measure to reduce HCAI. The hospital organization works actively to reduceHCAI. Implementing electronic systems to remind and/or notify healthcare workers raisesawareness of and adherence to hand hygiene. However, there is a paucity of studiesaddressing individuals’ perceptions of having such a system and how the organizationworks.

Aim:To investigate healthcare workers’ perceptions of infection prevention in thehealthcare organization and perceptions and acceptance of an electronic reminder systemthat encourages good hand hygiene.

Methods:Qualitative descriptive design with data collected in eight focus group inter-views including assistant nurses, nurses, and physicians (N¼38). Content analysis wasapplied and data were related to the Theory of Planned Behaviour.

Findings:Healthcare workers perceive lack of feedback from the hospital organizationand are positive towards an electronic reminder system to increase adherence to handhygiene. The electronic reminder system should not register data at an individual levelsince it could be used as an instrument for control by the management that could bestressful for staff.

Conclusion:In general, there is positive acceptance of the electronic reminder system,and the respondents perceived it as having the ability to change behaviour. However, theconcept has to be further developed to protect the individual’s integrity and needs to beused with feedback on a group level