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  • 1.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    "Bara" ett venprov?2011Conference paper (Other academic)
  • 2.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Correct venous blood sampling for increased patient safety2011Conference paper (Other academic)
  • 3.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Improving venous blood specimen collection practices: method development and evaluation of an educational intervention program2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: About 60%–80% of decisions regarding diagnosis and treatment are based on laboratory test results. Low adherence to venous blood specimen collection (VBSC) guidelines may lead to erroneous or delayed test results, causing patient harm and high healthcare costs. Educational intervention programs (EIPs) to update, improve and sustain VBSC practices are seldom evaluated. After testing a self-reported venous blood sampling questionnaire, the overall aim of this thesis was to evaluate the impact of a large-scale EIP on healthcare personnel’s VBSC practices.

    Methods: The study settings were primary healthcare centres (PHCs) in northern Sweden. Participants were VBSC personnel. Data consisted of a VBSC questionnaire of self-reported practices, records of low-level haemolysis index in serum samples (specimen quality indicator), and interviews reflecting VBSC practices. First, experts on questionnaires and VBSC were consulted, and test-retest statistics were used when testing the VBSC questionnaire for validity and reliability. Thereafter, we evaluated the impact of a short, large-scale EIP with a before-after approach comparing self-reported VBSC questionnaire of two county councils. The personnel of the county councils (n = 61 PHCs) were divided into an intervention group (n = 84) and a corresponding control group (n = 79). In order to test changes in blood specimen quality we monitored haemolysis in serum samples (2008, n = 6652 samples and 2010, n = 6121 samples) from 11 PHCs. Finally, 30 VBSC personnel from 10 PHCs reported their experiences. The interview questions were open-ended with reflective elements and the interviews were analysed by qualitative content analysis.

    Results: The VBSC questionnaire was found to be valid and could be used to identify risk of errors (near misses) and evaluate the impact of an EIP emphasising VBSC guideline adherence. The intervention group demonstrated several significant improvements in self-reported practices after the EIP, such as information search, patient rest, test request management, patient identification, release of venous stasis, and test tube labelling. The control group showed no significant improvements. In total, PHCs showed minor differences in blood specimen quality. Interviews summarized VBSC personnel experiences in the overall theme: education opened up opportunities for reflection about safety.  

    Conclusion: This thesis is, to our knowledge, the first to evaluate the impacts of a large-scale EIP on VBSC practices. The VBSC questionnaire and monitoring for low-level haemolysis reflected VBSC practices. The frequently occurring near-miss markers made it possible to compare and benchmark VBSC practices down to the healthcare unit and hospital ward. The short, general EIP opened up opportunities for reflection about safety and improved VBSC practices in PHCs with larger deviations from guidelines. EIPs that provide time for reflection and discussion could improve VBSC further. Directed EIPs focused on specific VBSC flaws might be more effective for some near misses in VBSC practices, while some near misses must be changed at a different level in the system.

    Clinical relevance: Our results indicate that monitoring and counteracting the near misses in VBSC practices is a well-functioning preventive action. We propose that the VBSC monitoring instruments (VBSC questionnaire & haemolysis index) we used and the EIP strategy proposed should be tested in additional countries with different healthcare settings. It is suggested that a national program intended to identify near misses and prevent VBSC errors be developed in the healthcare system. General e-learning programs may be cheaper than, and as effective as, the EIP program and may be performed everywhere and any time. Systematic planning, useful for reflection and with focus on the specific elements in a skill, together with VBSC guidelines, could probably increase improvements. Our studies have led to deeper and extended knowledge of the impact of an EIP on VBSC practices. Our results can be used when considering future VBSC practice interventions. Using a model for practical skills in nursing to describe VBSC in a more holistic and less technical way might highlight VBSC as a practical nursing skill.

  • 4.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Söderberg, Johan
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    A content validated questionnaire for assessment of self reported venous blood sampling practices2012In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 5, p. 39-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Venous blood sampling is a common procedure in health care. It is strictly regulated by national and international guidelines. Deviations from guidelines due to human mistakes can cause patient harm. Validated questionnaires for health care personnel can be used to assess preventable "near misses"--i.e. potential errors and nonconformities during venous blood sampling practices that could transform into adverse events. However, no validated questionnaire that assesses nonconformities in venous blood sampling has previously been presented. The aim was to test a recently developed questionnaire in self reported venous blood sampling practices for validity and reliability.

    FINDINGS: We developed a questionnaire to assess deviations from best practices during venous blood sampling. The questionnaire contained questions about patient identification, test request management, test tube labeling, test tube handling, information search procedures and frequencies of error reporting. For content validity, the questionnaire was confirmed by experts on questionnaires and venous blood sampling. For reliability, test-retest statistics were used on the questionnaire answered twice. The final venous blood sampling questionnaire included 19 questions out of which 9 had in total 34 underlying items. It was found to have content validity. The test-retest analysis demonstrated that the items were generally stable. In total, 82% of the items fulfilled the reliability acceptance criteria.

    CONCLUSIONS: The questionnaire could be used for assessment of "near miss" practices that could jeopardize patient safety and gives several benefits instead of assessing rare adverse events only. The higher frequencies of "near miss" practices allows for quantitative analysis of the effect of corrective interventions and to benchmark preanalytical quality not only at the laboratory/hospital level but also at the health care unit/hospital ward.

  • 5.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hällgren Graneheim, Ulla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Personnel's Experiences of Phlebotomy Practices after Participating in an Educational Intervention Programme2014In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, p. 1-8, article id 538704Article in journal (Refereed)
    Abstract [en]

    Background. Blood specimen collection is a common procedure in health care, and the results from specimen analysis have essential influence on clinical decisions. Errors in phlebotomy may lead to repeated sampling and delay in diagnosis and may jeopardise patient safety. This study aimed to describe the experiences of, and reflections on, phlebotomy practices of phlebotomy personnel working in primary health care after participating in an educational intervention programme (EIP). Methods. Thirty phlebotomists from ten primary health care centres participated. Their experiences were investigated through face-to-face interviews. Findings were analysed using qualitative content analysis. Results. The participants perceived the EIP as having opened up opportunities to reflect on safety. The EIP had made them aware of risks in relation to identification procedures, distractions from the environment, lack of knowledge, and transfer of information. The EIP also resulted in improvements in clinical practice, such as a standardised way of working and increased accuracy. Some said that the training had reassured them to continue working as usual, while others continued as usual regardless of incorrect procedure. Conclusions. The findings show that EIP can stimulate reflections on phlebotomy practices in larger study groups. Increased knowledge of phlebotomy practices improves the opportunities to revise and maximise the quality and content of future EIPs. Educators and safety managers should reflect on and pay particular attention to the identification procedure, distractions from the environment, and transfer of information, when developing and implementing EIPs. The focus of phlebotomy training should not solely be on improving adherence to practice guidelines.

  • 6.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hällgren Graneheim, Ulla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Personnel’s experiences of venous blood specimen collection practices after participating in an educational intervention programmeManuscript (preprint) (Other academic)
    Abstract [en]

    Aim: The aim of this study was to describe primary healthcare personnel’s experiences of venous blood specimen collection practices after participating in an educational intervention programme.

    Background: Venous blood specimen collection is one of the most frequent procedures in healthcare, and the results from specimen analysis have essential influence on clinical decisions. Errors in specimen collection may lead to repeated sampling and delay in diagnosis, and may jeopardise patient safety.

    Design: This is a qualitative, descriptive study based on individual interviews subjected to qualitative content analysis.

    Methods: A convenient sample of 30 venous blood specimen collection personnel from ten primary healthcare centres participated in this study. Their experiences were investigated through face-to-face interviews and analysed using qualitative content analysis.

    Results: In this study we found that the participants experienced that the education opened up opportunities for reflections on safety. They became aware of risks in relation to identification procedures, environmental disturbances, lack of knowledge and transfer of information. They had also achieved improvements in clinical practice such as standardised ways of working and increased accuracy. However, some described that they felt strengthened in working as usual and worked as usual in a correct way or as usual in an incorrect way.

    Conclusions: Our findings indicate that a short educational programme opens up opportunities for reflections about safety. Education is needed to improve and maintain a good quality of venous blood specimen collection practices.

    Relevance to clinical practice: Developers of education should reflect on and pay attention to the identification procedure, environmental disturbances, and transferral of information, when developing educational intervention programmes, and not focus solely on improving adherence to guideline practices.

  • 7.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Nilsson, Karin
    Umeå University, Faculty of Medicine, Department of Nursing. Institutionen för omvårdnad i Örnsköldsvik.
    Söderberg, Johan
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Impact of a large-scale educational intervention program on venous blood specimen collection practices2013In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, article id 463Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Phlebotomy performed with poor adherence to venous blood specimen collection (VBSC) guidelines jeopardizes patient safety and may lead to patient suffering and adverse events. A first questionnaire study demonstrated low compliance to VBSC guidelines, motivating an educational intervention of all phlebotomists within a county council. The aim was to evaluate the impact of a large-scale educational intervention program (EIP) on primary health care phlebotomists' adherence to VBSC guidelines. We hypothesised that the EIP would improve phlebotomists' VBSC practical performance.

    METHODS: The present study comprise primary health care centres (n = 61) from two county councils in northern Sweden. The final selected study group consisted of phlebotomists divided into an intervention group (n = 84) and a corresponding control group (n = 79). Both groups responded to a validated self-reported VBSC questionnaire twice. The EIP included three parts: guideline studies, an oral presentation, and an examination. Non-parametric statistics were used for comparison within and between the groups.

    RESULTS: Evaluating the EIP, we found significant improvements in the intervention group compared to the control group on self-reported questionnaire responses regarding information search (ES = 0.23-0.33, p < 0.001-0.003), and patient rest prior to phlebotomy (ES = 0.27, p = 0.004). Test request management, patient identity control, release of venous stasis, and test tube labelling had significantly improved in the intervention group but did not significantly differ from the control group (ES = 0.22- 0.49, p = < 0.001- 0.006). The control group showed no significant improvements at all (ES = 0--0.39, p = 0.016-0.961).

    CONCLUSIONS: The present study demonstrated several significant improvements on phlebotomists' adherence to VBSC practices. Still, guideline adherence improvement to several crucial phlebotomy practices is needed. We cannot conclude that the improvements are solely due to the EIP and suggest future efforts to improve VBSC. The program should provide time for reflections and discussions. Furthermore, a modular structure would allow directed educational intervention based on the specific VBSC guideline flaws existing at a specific unit. Such an approach is probably more effective at improving and sustaining adherence to VBSC guidelines than an EIP containing general pre-analytical practices.

  • 8.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Division of Caring Sciences, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University.
    Effects and meanings of a person-centred and health-promoting intervention in homecare services: a study protocol of a non-randomised controlled trial2017In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 57Article in journal (Refereed)
    Abstract [en]

    Background: The literature indicates that current home care service are largely task oriented with limited focus on the involvement of the older people themselves, and studies show that lack of involvement might reduce older people's quality of life. Person-centred care has been shown to improve the satisfaction with care and quality of life in older people cared for in hospitals and nursing homes, with limited published evidence about the effects and meanings of person-centred interventions in home care services for older people. This study protocol outlines a study aiming to evaluate such effects and meanings of a person-centred and health-promoting intervention in home aged care services. Methods/design: The study will take the form of a non-randomised controlled trial with a before/after approach. It will include 270 older people >65 years receiving home care services, 270 relatives and 65 staff, as well as a matched control group of equal size. All participants will be recruited from a municipality in northern Sweden. The intervention is based on the theoretical concepts of person-centredness and health-promotion, and builds on the four pedagogical phases of: theory apprehension, experimental learning, operationalization, and clinical supervision. Outcome assessments will focus on: a) health and quality of life (primary outcomes), thriving and satisfaction with care for older people; b) caregiver strain, informal caregiving engagement and relatives' satisfaction with care: c) job satisfaction and stress of conscience among care staff (secondary outcomes). Evaluation will be conducted by means of self-reported questionnaires and qualitative research interviews. Discussion: Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services, and the results can point the way to establishing a more person-centred and health-promoting model for home care services for older people.

  • 9.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Division of Caring Sciences, Depart Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden..
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia..
    Perceptions of self-determination and quality of life among Swedish home care recipients - across-sectional study2019In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, article id 142Article in journal (Refereed)
    Abstract [en]

    Background: It is acknowledged that preservation of self-determination is very important in order for older adults to experience good quality of life, but to what degree and in what areas people receiving help from home care service experience self-determination is unknown. Few studies have examined the perception of self-determination in relation to quality of life among older adults living at home with help from home care services. Thus, the aim of this study was to explore perceptions of self-determination among older adults living at home with the support of home care services, and to test whether older adults who perceive a higher degree of self-determination also feel they have a better quality of life.

    Methods: This cross-sectional study was conducted in one municipality in northern Sweden. A total of 134 older adults (≥ 65 years) were included. Data were collected by means of a survey including questionnaires about background characteristics, self-determination, and health-related quality of life. Descriptive statistics regarding background characteristics for groups with high and low self-determination respectively were presented and the differences between the groups were analyzed using the Chi-square test and the Mann-Whitney U test.

    Results: Our main finding shows that the majority of older adults with support from home care services experience self-determination in the dimensions use of time, and self-care. However, a wide variation was found in self-reported self-determination in all dimensions. Results also show that the group with higher self-reported self-determination also reported a greater degree of experienced quality of life in comparison with the group with lower self-reported self-determination.

    Conclusions: In line with earlier research, our results found a positive relation between self-determination and quality of life. The results are relevant for the care of older adults and indicate a need of further research. The results presented in this paper could serve as a guide when planning for improved self-determination among older adults in home care service.

  • 10.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nilsson, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Variations in the system influencing venous blood specimen collection practices: sources of pre-analytical errors2018In: Journal of Laboratory and Precision Medicine, ISSN 2519-9005, Vol. 3, article id 39Article, review/survey (Refereed)
    Abstract [en]

    Incorrect venous blood specimen collection (VBSC) practices might influence results from blood analyses and thus jeopardize patient safety. A large amount (60–80%) of important decisions in diagnosis, administration and medication are based on laboratory test results, therefore correct VBSC is of most importance. A harmonization of VBSC can lead to accurate collection procedures, rapid and correct diagnosis, and treatment. Correct test results contribute to increased patient safety and enhanced healthcare economy. VBSC errors might be consequences of both human mistakes and cultural factors in relation to the overall system. Variations in the system influencing VBSC practices might originate from international and national structures, local organizational and work cultures, and humans working in the frontline. In order to succeed in reducing sources of errors, it is of utmost importance that leaders and managers take the whole system into consideration when planning interventions in their mission to enhance practice. Thus, the aim of this article was to discuss variation in VBSC practices and how the variation might be a source of VBSC errors.

  • 11.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Johan
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Hultdin, Johan
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Minor improvement of venous blood specimen collection practices in primary health care after a large-scale educational intervention2013In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 51, no 2, p. 303-310Article in journal (Refereed)
    Abstract [en]

    Background: Venous blood specimen collection is a common health care practice that has to follow strict guidelines, non-compliance among sampling staff may compromise patient safety. We evaluated a large-scale 2 h educational intervention that emphasised guideline adherence to assess possible improvements of venous blood specimen collection practices.

    Methods: Blood specimen haemolysis is usually caused by inadequate venous blood specimen collection and handling, reflecting overall pre-analytical handling. We monitored haemolysis of serum samples with haemolysis index corresponding to ≥150 mg/L of free haemoglobin for specimens sent from 11 primary health care centres and analysed on a Vitros 5,1 clinical chemistry analyser before (2008, n=6652 samples) and after (2010, n=6121 samples) the intervention.

    Results: The total percentage of haemolysed specimens was 11.8% compared to 10.5% (p=0.022) before the intervention. As groups, rural primary health care centres demonstrated a significant reduction [Odds ratios (OR)=0.744] of haemolysed specimens after intervention, whereas urban primary health care centres demonstrated a significant increase (OR=1.451) of haemolysis.

    Conclusions: A large-scale 2 h educational intervention to make venous blood specimen collection staff comply with guideline practices had minor effects on collection practices. Educational interventions may be effective in wards/care centres demonstrating venous blood specimen collection practices with larger deviations from guidelines.

  • 12.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vestin, Christin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gyllencreutz, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Validating a questionnaire - prehospital preparedness for pediatric trauma patients2017In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 34, p. 2-6Article in journal (Refereed)
    Abstract [en]

    In recent decades, prehospital emergency care has undergone extensive development. Today, prehospital emergency nurses (PENs) are well trained and provide advanced care to patients of all ages. Caring for pediatric trauma patients is considered to be particularly demanding. However, in Sweden and internationally, there is a lack of research regarding PENs' preparedness for caring for pediatric trauma patients.

    Objective: The development and testing of a questionnaire on self-reported preparedness among PENs caring for pediatric trauma patients in a prehospital emergency setting.

    Methods: Questionnaire development included face and content validity tests resulting in 38 questions. Eighteen of these questions were analyzed by test-retest. The content of the questionnaire was statistically analyzed.

    Results: Fifteen questions were considered valid after reliability and validity tests. Three questions did not fulfill the stability criteria. The content analyses show a low degree of experience with pediatric trauma patients and half of the participants reported stress symptoms when responding to such alarms.

    Conclusion: The questionnaire assessing PENs preparedness caring for pediatric trauma patients in Sweden is considered to be suitable for research and clinical practice to improve the care of pediatric trauma patients and the health of PENs, although further testing of the questionnaire is required.

  • 13.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Australia.
    Backman, Annica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bergland, Ådel
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kirkevold, Marit
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lood, Qarin
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Australia.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden; Department of Health Sciences, Luleå University of Technology, Sweden.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sköldunger, Anders
    Umeå University, Faculty of Medicine, Department of Nursing.
    Wimo, Anders
    Winblad, Bengt
    The Umeå Ageing and health research programme (U-age): exploring person-centred care and health promoting living conditions for an ageing population2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 3, p. 168-174Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to describe the Umeå ageing and health research programme that explores person-centred care and health-promoting living conditions for an ageing population in Sweden, and to place this research programme in a national and international context of available research evidence and trends in aged care policy and practice. Contemporary trends in aged care policy includes facilitating ageing in place and providing person-centred care across home and aged care settings, despite limited evidence on how person-centred care can be operationalised in home care services and sheltered housing accommodation for older people. The Umeå ageing and health research programme consists of four research projects employing controlled, cross-sectional and longitudinal designs across ageing in place, sheltered housing, and nursing homes. The research programme is expected to provide translational knowledge on the structure, content and outcomes of person-centred care and health-promoting living conditions in home care, sheltered housing models, and nursing homes for older people and people with dementia.

  • 14.
    Gyllencreutz, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Pedersen, Ida
    Umeå University, Faculty of Medicine, Department of Nursing.
    Enarsson, Elisabeth
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    The experience of healthcare staff of incident reporting with respect to venous blood specimen collection practices’2019In: Policy and Practice in Health and Safety, ISSN 1477-3996, E-ISSN 1477-4003, Vol. 17, no 2, p. 146-155Article in journal (Refereed)
    Abstract [en]

    Venous blood specimen collection is an important practical task that results in an analysis response that often leads to a clinical decision. Errors due to inaccurate venous blood specimen collection are frequently reported and can jeopardize patient safety because inaccurate specimens may result in a delayed or incorrect diagnosis and treatment. However, few healthcare personnel have written an error report regarding venous blood specimen collection practices. The aim of this study is to describe the experiences of healthcare personnel with incident reporting of venous blood specimen collection practices in primary health care. Our study is based on 30 individual interviews with healthcare personnel from 10 primary health care centres. Data were analysed using qualitative content analyses. Personnel experiences of incident reporting were summarized in three categories; Uncertainties in the planning and organization, High workload and low priority and, A need for support and guidance. More specifically, barriers hinder personnel in reporting mistakes. An interpretation based on the results is that surrounding circumstances within the organization influence whether personnel report mistakes or not. The result indicates a need for parallel systems, to identify and report errors or near-misses to prevent mistakes. Processed incidents should be returned promptly to the personnel to use as a learning experience. Having a valid questionnaire and a key person to write an incident report, might reduce the burden on the health care staff and increase the numbers of incident reports and patient safety.

  • 15.
    Lippi, Giuseppe
    et al.
    University Hospital of Verona.
    Baird, Geoffrey S.
    University of Washington, Seattle, WA, USA.
    Banfi, Giuseppe
    San Raffaele University, Milano, Italy.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Cadamuro, Janne
    Medical University, Salzburg, Austria.
    Church, Stephen
    Preanalytical Systems, Oxford, UK.
    Cornes, Michael P.
    Worcester, UK.
    Dacey, Anna
    North Bristol NHS Trust, Bristol, UK.
    Guillon, Antoine
    Tours, France.
    Hoffmann, Georg
    University Hospital of Verona.
    Nybo, Mads
    University Hospital of Verona.
    Premawardhana, Lakdasa Devananda
    University Hospital of Verona.
    Salinas, María
    University Hospital of Verona.
    Sandberg, Sverre
    Biochemistry, University Hospital of Verona.
    Slingerland, Robbert
    University Hospital of Verona.
    Stankovic, Ana
    University Hospital of Verona.
    Sverresdotter, Sylte Marit
    University Hospital of Verona.
    Vermeersch, Pieter
    University Hospital of Verona.
    Simundic, Ana-Maria
    University Hospital of Verona.
    Improving quality in the preanalytical phase through innovation, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE)2017In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 55, no 4, p. 489-500Article in journal (Refereed)
    Abstract [en]

    It is now undeniable that laboratory testing is vital for the diagnosis, prognostication and therapeutic monitoring of human disease. Despite the many advances made for achieving a high degree of quality and safety in the analytical part of diagnostic testing, many hurdles in the total testing process remain, especially in the preanalytical phase ranging from test ordering to obtaining and managing the biological specimens. The Working Group for the Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has planned many activities aimed at mitigating the vulnerability of the preanalytical phase, including the organization of three European meetings in the past 7 years. Hence, this collective article follows the previous three opinion papers that were published by the EFLM WGPRE on the same topic, and brings together the summaries of the presentations that will be given at the 4th EFLM-BD meeting “Improving quality in the preanalytical phase through innovation” in Amsterdam, 24–25 March, 2017.

  • 16.
    Lämås, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden; Department of Health Sciences, Luleå University of Technology, Sweden.
    Bergland, Ådel
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia.
    Thriving among older people living at home with home care services-A cross-sectional study2020In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIM: To explore the level of thriving and associated factors among older adults living at home with support from home care services.

    DESIGN: An exploratory, cross-sectional survey design.

    METHOD: A sample of 136 participants (mean 82 years) responded to a survey about thriving, health, psychosocial and care-related factors in 2016. Descriptive analysis and multiple logistic regression analysis with a stepwise backwards elimination procedure were performed.

    RESULT: The results showed that the level of thriving was relatively high among adults living at home with support from home care services, with dimensions concerning engaging in activities and peer relations and keeping in touch with people and places being rated the lowest. Regression analysis showed that participating in social relations and experiencing self-determination in activities in and around the house were associated with thriving.

    CONCLUSION: Facilitating social relations and creating opportunities for self-determination seem necessary to support thriving among older adults living at home with support from home care services.

    IMPACT: The findings in this study add important knowledge about place-related well-being when living at home with home care services.

  • 17.
    Nilsson, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Juthberg, Christina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Johan
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Associations between workplace affiliation and phlebotomy practices regarding patient identification and test request handling practices in primary healthcare centres: a multilevel model approach2015In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, article id 503Article in journal (Refereed)
    Abstract [en]

    Background: Clinical practice guidelines aim to enhance patient safety by reducing inappropriate variations in practice. Despite considerable efforts to enhance the use of clinical practice guidelines, adherence is often suboptimal. We investigated to what extent workplace affiliation explains variation of self-reported adherence to venous blood specimen collection regarding patient identification and test request handling practices, taking into consideration other primary healthcare centre and individual phlebotomist characteristics. Methods: Data were collected through a questionnaire survey of 164 phlebotomy staff from 25 primary healthcare centres in northern Sweden. To prevent the impact of a large-scale education intervention in 2008, only baseline data, collected over a 3-month period in 2006-2007, were used and subjected to descriptive statistics and multilevel logistic analyses. Results: In two patient identification outcomes, stable high median odds ratios (MOR) were found in both the empty model, and in the adjusted full model including both individual and workplace factors. Our findings suggest that variances among phlebotomy staff can be largely explained by primary healthcare centre affiliation also when individual and workplace demographic characteristics were taken in consideration. Analyses showed phlebotomy staff at medium and large primary healthcare centres to be more likely to adhere to guidelines than staff at small centres. Furthermore, staff employed shorter time at worksite to be more likely to adhere than staff employed longer. Finally, staff performing phlebotomy every week or less were more likely to adhere than staff performing phlebotomy on a daily basis. Conclusion: Workplace affiliation largely explains variances in self-reported adherence to venous blood specimen collection guidelines for patient identification and test request handling practices among phlebotomy staff. Characteristics of the workplace, as well as of the individual phlebotomist, need to be identified in order to design strategies to improve clinical practice in this and other areas.

  • 18.
    Willman, Britta
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Evaluation of the clinical implementation of a large-scale online e-learning program on venous blood specimen collection guideline practices2018In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 56, no 11, p. 1870-1877, article id /j/cclm.ahead-of-print/cclm-2018-0051/cclm-2018-0051.xmlArticle in journal (Refereed)
    Abstract [en]

    BACKGROUND: When performed erroneously, the venous blood specimen collection (VBSC) practice steps patient identification, test request management and test tube labeling are at high risk to jeopardize patient safety. VBSC educational programs with the intention to minimize risk of harm to patients are therefore needed. In this study, we evaluate the efficiency of a large-scale online e-learning program on personnel's adherence to VBSC practices and their experience of the e-learning program.

    METHODS: An interprofessional team transformed an implemented traditional VBSC education program to an online e-learning program developed to stimulate reflection with focus on the high-risk practice steps. We used questionnaires to evaluate the effect of the e-learning program on personnel's self-reported adherence to VBSC practices compared to questionnaire surveys before and after introduction of the traditional education program. We used content analysis to evaluate the participants free text experience of the VBSC e-learning program.

    RESULTS: Adherence to the VBSC guideline high-risk practice steps generally increased following the implementation of a traditional educational program followed by an e-learning program. We however found a negative trend over years regarding participation rates and the practice to always send/sign the request form following the introduction of an electronic request system. The participants were in general content with the VBSC e-learning program.

    CONCLUSION: Properly designed e-learning programs on VBSC practices supersedes traditional educational programs in usefulness and functionality. Inclusion of questionnaires in the e-learning program is necessary for follow-up of VBSC participant's practices and educational program efficiency.

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