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  • 1.
    Bjørk, Ida Torunn
    et al.
    University of Oslo, Oslo, Norway.
    Larsen, Karin
    Aarhus University Hospital, Aarhus N, Denmark.
    Ravik, Monika
    University of South-Eastern Norway, Porsgrunn, Norway.
    Reierson, Inger Åse
    University of South-Eastern Norway, Porsgrunn, Norway.
    Sommer, Irene
    Aarhus University Hospital, Aarhus N, Denmark.
    Stenholt, Britta
    VIA University College, Nurse Education, Aarhus N, Denmark.
    Brynildsen, Grethe
    Lovisenberg Diaconal University College, Oslo, Norway.
    Blomberg, Karin
    Örebro University, Örebro, Sweden.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Husebø, Sissel Eikeland
    University of Stavanger, Stavanger, Norway.
    Lämås, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hagtvet, Knut Arne
    Department of Psychology, University of Oslo, Oslo, Norway.
    Development and testing of an instrument for summative assessment of practical skill performance: A generalizability theory approach2021Inngår i: Journal of Nursing Measurement, ISSN 1061-3749, E-ISSN 1945-7049, Vol. 29, nr 3, s. E162-E191Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: Many newly graduated nurses lack proficiency in practical skill performance. Presently, nursing students' practical skill is assessed by summative instruments with overarching items. The purpose of this study was to develop a more detailed instrument to use in summative assessment of nursing students' practical skill performance and to assess its psychometric properties.

    METHODS: A 50-item instrument was developed. Video-recorded performances were rated by experienced clinical supervisors. A multifacet measurement design was developed. Relevant parameters were estimated by generalizability analysis.

    RESULTS: Findings indicated that error of measurement were mainly caused by raters far more than by items.

    CONCLUSIONS: The present study suggested that summative assessment in realistic settings may not apply one rater only. Two to three/four raters appear necessary to dependably measure most skills.

  • 2.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    "Bara" ett venprov?2011Konferansepaper (Annet vitenskapelig)
  • 3.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Correct venous blood sampling for increased patient safety2011Konferansepaper (Annet vitenskapelig)
  • 4.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Improving venous blood specimen collection practices: method development and evaluation of an educational intervention program2014Doktoravhandling, med artikler (Annet vitenskapelig)
    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.

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  • 5.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Söderberg, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    A content validated questionnaire for assessment of self reported venous blood sampling practices2012Inngår i: BMC Research Notes, E-ISSN 1756-0500, Vol. 5, s. 39-Artikkel i tidsskrift (Fagfellevurdert)
    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.

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  • 6.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Personnel's Experiences of Phlebotomy Practices after Participating in an Educational Intervention Programme2014Inngår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, s. 1-8, artikkel-id 538704Artikkel i tidsskrift (Fagfellevurdert)
    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.

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  • 7.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Personnel’s experiences of venous blood specimen collection practices after participating in an educational intervention programmeManuskript (preprint) (Annet vitenskapelig)
    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.

  • 8.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Härgestam, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lämås, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Implementering av ett pedagogiskt verktyg för praktiskfärdighetsutövning: en effektiv lärprocess2017Inngår i: Universitetspedagogiska konferensen 2017: undervisning i praktiken – föreläsning, flexibelt eller mitt emellan?, Umeå: Universitetspedagogik och lärandestöd (UPL), Umeå universitet , 2017, s. 19-23Konferansepaper (Annet vitenskapelig)
  • 9.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Nilsson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Institutionen för omvårdnad i Örnsköldsvik.
    Söderberg, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Impact of a large-scale educational intervention program on venous blood specimen collection practices2013Inngår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 13, artikkel-id 463Artikkel i tidsskrift (Fagfellevurdert)
    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.

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  • 10.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lämås, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia; Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
    Older adults' experiences of self-determination when needing homecare services—an interview study2023Inngår i: BMC Geriatrics, E-ISSN 1471-2318, Vol. 23, nr 1, artikkel-id 824Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Self-determination has been shown to be an important factor in mental health and wellbeing, but from the homecare recipients' point of view, autonomy and self-determination is not fully integrated into homecare services. The aim of this study was to explore older adults’ experiences of self-determination when needing homecare services.

    Methods: In 2018, a qualitative descriptive study was conducted and a convenience sample of 15 older adults from 3 homecare service facilities were invited to participate in individual interviews. Data were analysed using qualitative content analyse.

    Results: The theme Transitioning from self-determination as independence towards self-determination as shared decision-making emerged through the older adults' narratives. This ‘transition’ is one in which older adult’s understanding of self-determination and self-esteem was transitioning towards the acceptance of shared decision-making. The person's inner strength and willingness to make decisions was promoting to enact and preserve independence. Accepting one's dependence on others and being in a positive atmosphere were described as promoting self-determination and shared decision-making, and vice versa. The above overarching theme permeated all subthemes, which included: mobilising inner strength to enact independence; accepting increasing dependence on others; and being influenced by the atmosphere.

    Conclusions: The study contributes increased understanding of older adults' experiences of self-determination. The results can act as a guide when planning future person-centred care interventions in the context of homecare services and help improve homecare services' ability to meet the needs of older adults. To summarise, older adults' reflections on their own self-determination highlighted relationships with other people as important for shared decision-making, which could help preserve older adults’ autonomy and self-esteem.

    Fulltekst (pdf)
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  • 11.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lämås, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Division of Caring Sciences, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University.
    Effects and meanings of a person-centred and health-promoting intervention in home care services: a study protocol of a non-randomised controlled trial2017Inngår i: BMC Geriatrics, E-ISSN 1471-2318, Vol. 17, artikkel-id 57Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
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  • 12.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lämås, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Division of Caring Sciences, Depart Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden..
    Lindkvist, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. 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 study2019Inngår i: BMC Geriatrics, E-ISSN 1471-2318, Vol. 19, artikkel-id 142Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
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  • 13.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Nilsson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Variations in the system influencing venous blood specimen collection practices: sources of pre-analytical errors2018Inngår i: Journal of Laboratory and Precision Medicine, ISSN 2519-9005, Vol. 3, artikkel-id 39Artikkel, forskningsoversikt (Fagfellevurdert)
    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.

  • 14.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Söderberg, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Hultdin, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Minor improvement of venous blood specimen collection practices in primary health care after a large-scale educational intervention2013Inngår i: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 51, nr 2, s. 303-310Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 15.
    Bölenius, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Vestin, Christin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Gyllencreutz, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Validating a questionnaire - prehospital preparedness for pediatric trauma patients2017Inngår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 34, s. 2-6Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 16.
    Cadamuro, Janne
    et al.
    Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria.
    Baird, Geoffrey
    Department of Laboratory Medicine and Pathology, University of Washington, WA, Seattle, United States.
    Baumann, Gabriele
    Department of Laboratory Medicine, Pyhrn-Eisenwurzen Klinikum, General Hospital Steyr, Steyr, Austria.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. The Unit of Research and Education, The County Council of Västerbotten, Umeå, Sweden.
    Cornes, Michael
    Clinical Chemistry Department, Worcester Acute Hospitals Nhs Trust, Worcester, United Kingdom.
    Ibarz, Mercedes
    Laboratory Medicine Department, University Hospital Arnau de Vilanova, IRBLleida, Lleida, Spain.
    Lewis, Tom
    North Devon District Hospital, Devon, United Kingdom.
    Oliveira, Gabriel Lima
    Clinical Laboratory, Carlo Poma Hospital, Mantua, Italy; Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM), Latin America Confederation of Clinical Biochemistry (COLABIOCLI), Montevideo, Uruguay.
    Lippi, Giuseppe
    Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy.
    Plebani, Mario
    Honorary Professor of Clinical Biochemistry and Clinical Molecular Biology, School of Medicine, University of Padova, Padova, Italy.
    Simundic, Ana-Maria
    Department of Medical Laboratory Diagnostics, University Hospital "sveti Duh", Zagreb, Croatia; Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia.
    Von Meyer, Alexander
    Institute for Laboratory Medicine and Medical Microbiology, Munich Clinics, Munich, Germany.
    Preanalytical quality improvement - an interdisciplinary journey, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE)2022Inngår i: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 60, nr 5, s. 662-668Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Since the beginning of laboratory medicine, the main focus was to provide high quality analytics. Over time the importance of the extra-analytical phases and their contribution to the overall quality became evident. However, as the initial preanalytical processes take place outside of the laboratory and mostly without its supervision, all professions participating in these process steps, from test selection to sample collection and transport, need to engage accordingly. Focusing solely on intra-laboratory processes will not be sufficient to achieve the best possible preanalytical quality. The Working Group for the Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has provided several recommendations, opinion papers and scientific evidence over the past years, aiming to standardize the preanalytical phase across Europe. One of its strategies to reach this goal are educational efforts. As such, the WG-PRE has organized five conferences in the past decade with the sole focus on preanalytical quality. This year's conference mainly aims to depict the views of different professions on preanalytical processes in order to acquire common ground as basis for further improvements. This article summarizes the content of this 6th preanalytical conference.

  • 17.
    Edvardsson, David
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Australia.
    Backman, Annica
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bergland, Ådel
    Björk, Sabine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Kirkevold, Marit
    Lindkvist, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lood, Qarin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Australia.
    Lämås, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. 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 universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sköldunger, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    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 population2016Inngår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, nr 3, s. 168-174Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 18.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Pedersen, Ida
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Enarsson, Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    The experience of healthcare staff of incident reporting with respect to venous blood specimen collection practices’2019Inngår i: Policy and Practice in Health and Safety, ISSN 1477-3996, E-ISSN 1477-4003, Vol. 17, nr 2, s. 146-155Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 19.
    Kallerhult Hermansson, Stina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hilli, Yvonne
    Nord University, Norway.
    Norström, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Solbakken, Rita
    Nord University, Norway.
    Rennemo Vaag, Jonas
    Nord University, Norway.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    The impact of a mentorship program with digital solutions: Mentors' experiences, self-reported self-efficacy, and clinical teaching behavior2023Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Background: In 2021, a two-fold mentorship program was developed in collaboration with new and experienced registered nurses and leaders in healthcare units and municipalities in two regions in northern Sweden and northern Norway. The mentorship program aimed to support newly qualified nurses into working life as well as support mentors and was tested in intervention units from October-21 to April-22. The aim of this sub-study was to evaluate the mentors´ experiences, self-reported self-efficacy, and clinical teaching behavior.

    Methods: A mixed methods design was used where data was collected via focus-group interviews (n=5) directly after the intervention. A follow-up, self-reported questionnaire study was conducted at three different time points: pre-test, baseline, and post-test I, directly after the intervention, and post-test II, eight months after the intervention. Transcribed interview data will be analyzed using qualitative content analysis, and self-reported answers will be analyzed using suitable statistical methods.

    Results and conclusion: Preliminary results will be presented at the conference. The evaluation will highlight the potential effects and meaning of the mentorship program from the mentors´ perspective as well as what it means to be a mentor.

    Fulltekst (pdf)
    fulltext
  • 20.
    Kallerhult Hermansson, Stina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Kasén, Anne
    Faculty of Nursing and Health Sciences, Nord University, Bodö, Norway .
    Hilli, Yvonne
    Faculty of Nursing and Health Sciences, Nord University, Bodö, Norway .
    Norström, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Vaag, Jonas Rennemo
    Faculty of Nursing and Health Sciences, Nord University, Bodö, Norway .
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Exploring registered nurses’ perspectives as mentors for newly qualified nurses: a qualitative interview study2024Inngår i: BMJ Open, E-ISSN 2044-6055, Vol. 14, nr 5, artikkel-id e082940Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Existing research has focused mostly on mentees’ experiences of mentoring rather than mentors’ experiences. Therefore, this study describes registered nurses’ experiences of being a mentor for newly qualified nurses.

    Design: A qualitative interview study based on semistructured individual interviews. Interviews were analysed using qualitative content analysis.

    Participants and setting: A purposive sample of experienced registered nurses (n=21) from healthcare units in northern Sweden and northern Norway. Inclusion criteria were to have been a mentor to at least one newly qualified nurse, hold permanent employment of 75%–100% as a registered nurse and to be able to communicate in Swedish or Norwegian.

    Results: Our study’s findings suggest that being a mentor plays a crucial role in establishing safety in complex work environments. The main theme consists of three themes: feeling motivated in being a mentor; continuously developing the learning environment; and navigating obstacles and cultivating support.

    Conclusion: Being a mentor is a complicated role for registered nurses. The mentoring role is beneficial—ie, positive and rewarding—if facilitated sufficiently in the context of a structured organisation. This study brings a more profound understanding of and provides new insights into registered nurses’ perspectives and needs regarding being a mentor and the study’s findings make an important contribution to the field of nursing regarding the facilitation of mentoring.

    Fulltekst (pdf)
    fulltext
  • 21.
    Kallerhult Hermansson, Stina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Norström, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Hilli, Yvonne
    Faculty of Nursing and Health Sciences, Nord University, Bodø 8049, Norway.
    Rennemo Vaag, Jonas
    Faculty of Nursing and Health Sciences, Nord University, Bodø 8049, Norway.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway2024Inngår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, nr 1, artikkel-id 734Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Healthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses.

    Methods: This multicenter cross-sectional study survey was part of a larger overarching Swedish-Norwegian project, and was conducted among registered nurses (n = 1137) in September 2021. The participants worked in a variety of health care units, e.g., hospital units, primary health care, and home care. Data was subjected to descriptive and comparative statistical analysis; chi-square test, one-way between-groups analysis of variance (ANOVA) and Kruskal-Wallis test.

    Results: The findings show that job satisfaction is reported as lowest in registered nurses with medium-term work experience as compared to newly qualified and long-term work-experienced registered nurses. Professional competence and self-efficacy are reported as higher among registered nurses with long-term work experience as compared to those with medium-term work experience and newly qualified registered nurses. However, the participants reported their professional competence as highest in relation to the same factor – “Value-based nursing care” – regardless of their work experience.

    Conclusions and implications: This study underscores the need for continuous support and professional development for registered nurses throughout their careers. Proactive support for newly qualified nurses may improve job satisfaction as they progress to being registered nurses with medium-term work experience. Tailored interventions to address the distinct needs of both newly qualified and medium-term work-experienced registered nurses are crucial for nurturing a sustainable nursing workforce.

    Fulltekst (pdf)
    fulltext
  • 22.
    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 universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    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)2017Inngår i: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 55, nr 4, s. 489-500Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 23.
    Lämås, Kristina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. 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 universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. 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 study2020Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, nr 4, s. 999-1008Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 24.
    Lämås, Kristina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Effects of a person-centred and health-promoting intervention in home care services – a non-randomized controlled trial2021Inngår i: BMC Geriatrics, E-ISSN 1471-2318, Vol. 21, nr 1, artikkel-id 720Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Home care recipients have reported little self-determination and opportunity to influence their own care. Person-centred care focusing on involvement has improved the quality of life of older adults in health care and nursing homes; however, knowledge about the effects of person-centred interventions in aged care at home is sparse. The aim of this study was to study the effects of a person-centred and health-promoting intervention, compared with usual care, on health-related quality of life, thriving and self-determination among older adults, and on job satisfaction, stress of conscience and level of person-centred care among care staff.

    Methods: This is a non-randomized controlled trial with a before/after design. Participants from five home care districts in one municipality in northern Sweden were recruited to an intervention or control group. We evaluated health-related quality of life, thriving and self-determination among older home care recipients, and job satisfaction, person-centred care and stress of conscience among care staff. Evaluation was performed by questionnaires and responses were analysed using parametric and non-parametric statistical analyses.

    Results: Eighty-one older adults and 48 staff were included in the study. A clinically moderate and statistically significant difference between the intervention and control groups was found in thriving and negative emotions among older adults. The intervention contributed to maintaining high thriving levels, in contrast to decreased thriving in the control group (intervention: + 1, control: − 4, p 0.026, CI: − 10. 766, − 0.717). However, the intervention group rated an increase in negative emotions, while the control group was unchanged (intervention: − 7 control: + − 0, p 0.048, CI: − 17.435, − 0.098). No significant effects were found among staff.

    Conclusions: The intervention contributed to maintaining high levels of thriving in contrast to low levels found in the control group, and it seems reasonable to consider the intervention focus on staff as more person-centred and health-promoting. The finding that the intervention group had increase in negative emotions is difficult to interpret, and warrants further exploration. Even though the results are sparse, the challenges discussed may be of importance for future studies in the context of HCS.

    Trial registration: NCT02846246. Date of registration: 27 July 2016.

    Fulltekst (pdf)
    fulltext
  • 25.
    Lämås, Kristina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Härgestam, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Jonsson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Students’ performance in venous blood specimen collection practice before internship: an observation study2022Inngår i: Creative Education, ISSN 2151-4755, E-ISSN 2151-4771, Vol. 13, nr 07, s. 2340-2353Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Newly trained nurses experience a lack of preparedness in practical skills, and research shows  that students and newly trained nurses have deficiencies in performing practical skills such as venous blood specimen collection. There is a lack of knowledge regarding the level of accuracy reached by students after training at clinical training centres and before entering clinical practice. The aim of this study was to assess the performance of venous blood specimen collection among nursing students after regular education and training at the clinical training centre but before starting an internship. 

    Methods: Twenty-three nursing students were observed and video-recorded. An observation protocol was developed based on a validated questionnaire measuring adherence to valid guidelines, and a model for practical skills performance. Data were analysed using descriptive statistics. 

    Results: A large variation was found in students’ performance with respect to information provided to the patient, patient identification procedures, and tourniquet procedures. The students gave adequate information in 39% of cases, accurately performed patient identification in 83% of cases, and accurately performed the tourniquet procedure in 22% of cases. 

    Conclusions: Many nursing students are not prepared to practice on real patients. It is therefore important for university lecturers to develop more efficient teaching methods and to communicate students’ skill levels to the supervisor at the clinic, in order for the clinical training to be adapted to a suitable level. There is a need for further research on how to close the gap between the university and internship in order to ensure patient safety.

    Fulltekst (pdf)
    fulltext
  • 26.
    Ndile, Menti
    et al.
    Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
    Lukumay, Gift G.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Outwater, Anne H.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Backteman-Erlandson, Susanne
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Impact of a postcrash first aid educational program on knowledge, perceived skills confidence, and skills utilization among traffic police officers: a single-arm before-after intervention study2020Inngår i: BMC Emergency Medicine, E-ISSN 1471-227X, Vol. 20, artikkel-id 21Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: An overwhelming proportion of road traffic deaths and injuries in low- and middle-income countries(LMICs) occur in prehospital environments. Lay first responders such as police officers play an important role inproviding initial assistance to victims of road traffic injuries either alone or in collaboration with others. The presentstudy evaluated a postcrash first aid (PFA) educational program developed for police officers in Tanzania.

    Method: A 16-h PFA educational program was conducted in Dar es Salaam, Tanzania, for 135 police officers. Participantscompleted training surveys before, immediately and 6months after the training (before, N = 135; immediately after, N=135;after 6 months, N=102). The primary outcome measures were PFA knowledge, perceived skills confidence, and skillsutilization. Parametric and nonparametric tests were used to analyse changes in outcome.

    Results: The mean PFA knowledge score increased from 44.73% before training (SD = 20.70) to 72.92% 6months aftertraining (SD = 18.12), p < .001, N = 102. The mean PFA perceived skills confidence score (measured on a 1–5 Likert scale)increased from 1.96 before training (SD = 0.74) to 3.78 6months after training (SD=0.70), p < .001, N = 102. Followingtraining, application of the recovery position skill (n = 42, 46%) and application of the bleeding control skill (n = 45, 49%) werereported by nearly half of the responding officers. Less than a quarter of officers reported applying head and neckimmobilization skills (n = 20, 22%) following training.

    Conclusion: A PFA educational program has shown to improve police officers’ knowledge and perceived skills confidenceon provision of first aid. However qualitative research need to be conducted to shed more light regarding reasons for lowutilization of trained first aid skills during follow-up.

    Fulltekst (pdf)
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  • 27.
    Nilsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Juthberg, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Söderberg, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Associations between workplace affiliation and phlebotomy practices regarding patient identification and test request handling practices in primary healthcare centres: a multilevel model approach2015Inngår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 15, artikkel-id 503Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 28.
    Norström, Fredrik
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Zingmark, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden; Department of Health Sciences, Lund University, Lund, Sweden.
    Pettersson-Strömbäck, Anita
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Sahlen, Klas-Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Öhrling, Malin
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    How does the distribution of work tasks among home care personnel relate to workload and health-related quality of life?2023Inngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 96, nr 8, s. 1167-1181Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The work for Swedish home care workers is challenging with a variety of support and healthcare tasks for home care recipients. The aim of our study is to investigate how these tasks relate to workload and health-related quality of life among home care workers in Sweden. We also explore staff preferences concerning work distribution.

    Methods: A cross-sectional study was conducted in 16 municipalities in Northern Sweden. Questionnaires with validated instruments to measure workload (QPSNordic) and health-related quality of life (EQ-5D), were responded by 1154 (~ 58%) of approximately 2000 invited home care workers. EQ-5D responses were translated to a Quality-adjusted life-year (QALY) score. For 15 different work task areas, personnel provided their present and preferred allocation. Absolute risk differences were calculated with propensity score weighting.

    Results: Statistically significantly more or fewer problems differences were observed for: higher workloads were higher among those whose daily work included responding to personal alarms (8.4%), running errands outside the home (14%), rehabilitation (13%) and help with bathing (11%). Apart from rehabilitation, there were statistically significantly more (8–10%) problems with anxiety/depression for these tasks. QALY scores were lower among those whose daily work included food distribution (0.034) and higher for daily meal preparation (0.031), both explained by pain/discomfort dimension. Personnel preferred to, amongst other, spend less time responding to personal alarms, and more time providing social support.

    Conclusion: The redistribution of work tasks is likely to reduce workload and improve the health of personnel. Our study provides an understanding of how such redistribution could be undertaken.

    Fulltekst (pdf)
    fulltext
  • 29.
    Reierson, Inger Åse
    et al.
    Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway.
    Ravik, Monika
    Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway.
    Blomberg, Karin
    School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Bjørk, Ida Torunn
    Department of Public Health Science, Institute of Health and Society, Medical Faculty, University of Oslo, Oslo, Norway.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Vesterager Stenholt, Britta
    School of Health Sciences (Nursing), VIA University College, Aarhus, Denmark.
    Husebø, Sissel Eikeland
    Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
    Comparing didactic approaches for practical skills learning in Scandinavian nursing simulation centres: a qualitative comparative study2024Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To explore and compare the didactic approaches to practical skills learning at simulation centres in Scandinavian universities and university colleges.

    Background: Academic simulation centres are an important arena for learning practical nursing skills which are essential to ensure competent performance regarding patient safety and quality of care. Knowledge of didactic approaches to enhance learning is essential in promoting the provision and retention of students' practical nursing skills. However, research on didactical approaches to practical nursing skills learning is lacking.

    Design: A qualitative comparative design was used.

    Methods: During November and December 2019, interviews were conducted with a total of 37 simulation centre directors or assistant directors, each of whom possessed in-depth knowledge of practical skills in teaching and learning. They represented bachelor nursing education in Denmark, Norway and Sweden. A qualitative deductive content analysis was conducted.

    Results: The results revealed all five predetermined didactical components derived from the didactical relationship model. Twenty-two corresponding categories that described a variation in didactic approaches to practical skills learning in Scandinavian nursing simulation centres were identified. The didactical components of Learning process revealed mostly similarities, Setting mostly differences and Assessment showed only differences in didactic approaches.

    Conclusion: Although various didactic approaches were described across the countries, no common approach was found. Nursing educational institutions are encouraged to cooperate in developing a shared understanding of how didactic approaches can enhance practical skills learning.

    Implications for Profession and/or Patient Care: Cross-country comparisons of practical nursing skills learning in Scandinavian countries highlight the importance of educator awareness concerning the impact diverse didactic approaches may have on competent performance in nursing education. Competent performance is pivotal for ensuring patient safety and the provision of high-quality care.

    Patient or Public Contribution: No Patient or Public Contribution.

    Reporting Method: This study followed the Consolidated Criteria for Reporting Qualitative Research reporting guidelines.

    Fulltekst (pdf)
    fulltext
  • 30.
    Simundic, Ana-Maria
    et al.
    Department of Medical Laboratory Diagnostics, Clinical Hospital “Sveti Duh”, Zagreb, Croatia.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Cadamuro, Janne
    Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria.
    Church, Stephen
    BD Life Sciences - Preanalytical Systems, Reading, United Kingdom.
    Cornes, Michael P.
    Department of Clinical Biochemistry, Worcester Acute Hospitals NHS Trust, Worcester, United Kingdom.
    Van Dongen-Lases, Edmée C.
    Department of Clinical Chemistry, Academic Medical Center, Amsterdam, Netherlands.
    Eker, Pinar
    ümraniye Research and Training Hospital, Istanbul, Turkey.
    Erdeljanovic, Tanja
    Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Guimaraes, Joao Tiago
    Department of Clinical Pathology, São João Hospital Center, Department of Biomedicine, Faculty of Medicine, Porto, Portugal; EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal.
    Hoke, Roger
    National Association of Phlebotomists, London, United Kingdom.
    Ibarz, Mercedes
    Department of Clinical Laboratory, University Hospital Arnau de Vilanova, Lleida, Spain.
    Ivanov, Helene
    Greiner Bio-One GmbH, Kremsmuenster, Austria.
    Kovalevskaya, Svetlana
    Clinical Laboratory, Diagnostic and Pathomorphology Department, Autonomous non-profit Organization of Additional Professional Education “Institute of Laboratory Medicine”, Moscow, Russian Federation.
    Kristensen, Gunn B.B.
    Norwegian Quality Improvement of Laboratory Examinations, Bergen, Norway.
    Lima-Oliveira, Gabriel
    Section of Clinical Biochemistry, University of Verona, Verona, Italy; Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM), Latin America, Confederation of Clinical Biochemistry (COLABIOCLI), Verona, Italy.
    Lippi, Giuseppe
    Section of Clinical Chemistry, University of Verona, Verona, Italy.
    Von Meyer, Alexander
    Institute of Laboratory Medicine, Kliniken Nordoberpfalz AG and Klinikum St. Marien, Weiden, Amberg, Germany.
    Nybo, Mads
    Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
    De La Salle, Barbara
    West Hertfordshire Hospitals NHS Trust, Operating UK NEQAS for Haematology and Transfusion, Watford, United Kingdom.
    Seipelt, Christa
    Sarstedt GmbH and Co.KG, Nümbrecht, Germany.
    Sumarac, Zorica
    Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia.
    Vermeersch, Pieter
    Department of Laboratory Medicine, University of Leuven, Leuven, Belgium.
    Raccomandazione congiunta EFLM-COLABIOCLI per il prelievo di sangue venoso: [Joint EFLM-COLABIOCLI recommendation for venous blood sampling]2019Inngår i: Biochimica Clinica, ISSN 0393-0564, Vol. 43, nr 2, s. 204-227Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    This document provides a joint recommendation for venous blood sampling of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). It offers guidance on the requirements for ensuring that blood collection is a safe and patient-centered procedure and provides practical guidance on how to successfully overcome potential barriers and obstacles to its widespread implementation. The target audience for this recommendation are healthcare staff members directly involved in blood collection. This recommendation applies to the use of a closed blood collection system and does not provide guidance for the blood collection with an open needle and syringe and catheter collections. Moreover, this document neither addresses patient consent, test ordering, sample handling and transport nor collection from children and unconscious patients. The recommended procedure is based on the best available evidence. Each step was graded using a system that scores the quality of the evidence and the strength of the recommendation. The process of grading was done at several face-to-face meetings involving the same mixture of stakeholders stated previously. The main parts of this recommendation are: 1) Pre-sampling procedures, 2) Sampling procedure, 3) Postsampling procedures and 4) Implementation. A first draft of the recommendation was circulated to EFLM members for public consultation. WG-PRE-LATAM was also invited to comment the document. A revised version has been sent for voting on to all EFLM and COLABIOCLI members and has been officially endorsed by 33/40 EFLM and 21/21 COLABIOCLI members. We encourage professionals throughout Europe and Latin America to adopt and implement this recommendation to improve the quality of blood collection practices and increase patient and workers safety.

    Fulltekst (pdf)
    fulltext
  • 31.
    Tast, Anette
    et al.
    Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Kasén, Anne
    Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hilli, Yvonne
    Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Being a newly qualified nurse: a Nordic focus group study2024Inngår i: Sage Open Nursing, E-ISSN 2377-9608, Vol. 10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: The transition to working life as a newly qualified nurse (NQN) can be challenging, leading to heightened stress levels. While NQNs are generally enthusiastic about starting their careers, they often express concerns about various responsibilities and a perceived lack of experience in independently dealing with clinical care in complex environments.

    Objective: To acquire an in-depth understanding, from a caring science perspective, of what it means to be an NQN during the transition period of the first 18 months in the profession.

    Methods: This study relied on an exploratory qualitative design. The methodological approach followed Gadamer's hermeneutic philosophy. Six focus group interviews were conducted in northern Norway (n = 3) and northern Sweden (n = 3) from January through May 2021. The interpretation of the data was inspired by Fleming et al. Nineteen female and seven male NQNs working in different contexts, including hospitals and municipalities, participated in the study. The consolidated criteria for qualitative research were used to report the results.

    Results: Perspectives on NQNs are presented as three themes: a) the responsibility was perceived as a significant challenge, b) being a nurse is complex and demanding, and c) a desire for personal and professional development. Learning to be a nurse shouldering responsibility necessitates support and guidance from caring and compassionate colleagues and leaders.

    Conclusions:  This study sheds light on the importance of creating a workplace culture where NQNs’ learning is promoted and supported by designated mentors during their transition to working life. The responsibilities should be aligned with their level of knowledge. It is important that leaders hold developmental dialogues and ensure a career plan for NQNs to continuously develop their knowledge and skills. Intervention studies designed to evaluate the meaning of the support from appointed mentors within structured mentorship programs are needed.

    Fulltekst (pdf)
    fulltext
  • 32.
    Willman, Britta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Evaluation of the clinical implementation of a large-scale online e-learning program on venous blood specimen collection guideline practices2018Inngår i: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 56, nr 11, s. 1870-1877Artikkel i tidsskrift (Fagfellevurdert)
    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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