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Carlström, E. D. D. & Fredén, L. (2017). The first single responders in Sweden: Evaluation of a pre-hospital single staffed unit. International Emergency Nursing, 32(S1), 15-19
Open this publication in new window or tab >>The first single responders in Sweden: Evaluation of a pre-hospital single staffed unit
2017 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 32, no S1, p. 15-19Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Single responder (SR) systems have been implemented in several countries. When the very first SR system in Sweden was planned, it was criticised because of concerns about sending single emergency nurses out on alerts. In the present study, the first Swedish SR unit was studied in order to register waiting times and assess the working environment.

METHOD: Quantitative data were collected from the ambulance dispatch register. Data on the working environment were collected using a questionnaire sent to the SR staff.

RESULTS: The SR system reduced the average patient waiting time from 26 to 13min. It also reduced the number of ambulance transports by 35% following triage of patient(s) priority determined by the SR. The staff perceived the working environment to be adequate.

CONCLUSION: The SR unit was successful in that it reduced waiting times to prehospital health care. Contrary to expectations, it proved to be an adequate working environment. There is good reason to believe that SR systems will spread throughout the country. In order to enhance in depth the statistical analysis, additional should be collected over a longer time period and from more than one SR unit.

Place, publisher, year, edition, pages
Elsevier Science Limited, 2017
Keywords
Single responder, Ambulance delays, Low-priority cases, Waiting times, Sweden Working environment, Emergency nurse
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-9683 (URN)10.1016/j.ienj.2016.05.003 (DOI)000402650700004 ()27282963 (PubMedID)2-s2.0-84973169064 (Scopus ID)
Note

Available online 6 June 2016

Available from: 2016-12-16 Created: 2016-08-10 Last updated: 2017-12-15Bibliographically approved
Alverbratt, C., Berlin, J., Åström, S., Kauffeldt, A. & Carlström, E. (2016). A New Working Method in Psychiatric Care: the impact of implementation. International Journal of Public Administration, 40(3), 295-304
Open this publication in new window or tab >>A New Working Method in Psychiatric Care: the impact of implementation
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2016 (English)In: International Journal of Public Administration, ISSN 0190-0692, E-ISSN 1532-4265, Vol. 40, no 3, p. 295-304Article in journal (Refereed) Published
Abstract [en]

An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

Keywords
Empowerment, implementation, organizational culture, patient participation, psychiatric care
National Category
Nursing Psychiatry
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-7935 (URN)10.1080/01900692.2015.1072557 (DOI)000415696000007 ()2-s2.0-84962129556 (Scopus ID)
Note

Ingår i avhandling. Published online: 30 Mar 2016

Available from: 2015-08-19 Created: 2015-08-19 Last updated: 2019-02-05Bibliographically approved
Olsson, M., Carlström, E. D., Marklund, B., Helldin, L. & Hjärthag, F. (2015). Assessment of Distress and Quality of Life: A Comparison of Self-Assessments by Outpatients with a Schizopsychotic Illness and the Clinical Judgment of Nurses. Archives of Psychiatric Nursing, 29(5), 284-289
Open this publication in new window or tab >>Assessment of Distress and Quality of Life: A Comparison of Self-Assessments by Outpatients with a Schizopsychotic Illness and the Clinical Judgment of Nurses
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2015 (English)In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 29, no 5, p. 284-289Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate how self-assessments of perceived distress and quality of life in patients with schizopsychotic illness are associated with nurse assessments of symptoms, function and life situation. Data were obtained through interviews that used evidence-based rating and visual analogue self-rating scales. Descriptive statistics, correlation and regression analyses were used to process the data. The results demonstrated that the patient self-ratings did not correlate with the nurse assessments, and the perceived distress was not affected by remission status. The findings indicate that patient self-assessments are not a sufficient basis for decisions regarding appropriate treatment interventions.

National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-7661 (URN)10.1016/j.apnu.2015.05.001 (DOI)000362155700005 ()26397430 (PubMedID)
Note

Available online 29 May 2015

Available from: 2015-06-02 Created: 2015-06-02 Last updated: 2017-12-04Bibliographically approved
Berlin, J. & Carlström, E. (2015). Learning and usefulness of collaboration exercises: A study of the three level collaboration (3LC) exercises between the police, ambulance and rescue services. International Journal of Mass Emergencies and Disasters, 33(3), 428-467
Open this publication in new window or tab >>Learning and usefulness of collaboration exercises: A study of the three level collaboration (3LC) exercises between the police, ambulance and rescue services
2015 (English)In: International Journal of Mass Emergencies and Disasters, ISSN 0280-7270, Vol. 33, no 3, p. 428-467Article in journal (Refereed) Published
Abstract [en]

In this article, we studied collaboration exercises (3LC) between the rescue services, ambulance services, and police force, which were developed to enhance learning and usefulness. The exercises’ structure was based on identified deficiencies in previous collaboration exercises. The purpose was to test the exercise model in terms of learning and usefulness. Ten 3LC exercises were observed. A total of 65 semi-structured interviews were conducted (2011–2014) in connection with the exercises. The exercises contained across-boundary elements, seminars, and interactive documentation. The participants were given the opportunity to discuss, analyze, and critically reflect on their efforts. During the seminars, the individual actions were analyzed, which led to alternative strategies that were subsequently tested in a repeated exercise. Our results demonstrate that repetitive features and seminars during collaboration exercises promote learning toward an organic behavior and usefulness in the actual incident work.

Place, publisher, year, edition, pages
Research Committee on Disasters, International Sociological Association, 2015
Keywords
Three Level Collaboration (3LC), Exercise, Learning, Usefulness, Sweden
National Category
Public Administration Studies Sociology (excluding Social Work, Social Psychology and Social Anthropology) Business Administration Work Sciences
Research subject
SOCIAL SCIENCE, Public administration; SOCIAL SCIENCE, Business administration; Work Integrated Learning; SOCIAL SCIENCE, Sociology
Identifiers
urn:nbn:se:hv:diva-8830 (URN)
Funder
Swedish Civil Contingencies Agency
Available from: 2015-12-20 Created: 2015-12-20 Last updated: 2017-12-11Bibliographically approved
Berlin, J. & Carlström, E. (2015). Samverkansövningar: Om lärande och nytta (1ed.). Göteborg: Bokförlaget BAS
Open this publication in new window or tab >>Samverkansövningar: Om lärande och nytta
2015 (Swedish)Book (Other academic)
Alternative title[en]
Collaboration Exercises : about learning and usefulness
Abstract [sv]

Den här studien handlar om samverkansövningar med särskilt fokus på fullskaleövningar mellan polis, räddningstjänst och ambulans. För att lyckas i en komplex situation behöver personalens förmåga att samverka organisationsövergripande utvecklas och förfinas.

Det övergripande syftet med denna studie var att studera hur samverkan övas och hur övningarna leder till lärande och nytta. I studien gjordes inledningsvis en forskningsöversikt. Utifrån den har ett antal centrala begrepp tagits fram som varit till hjälp när vi följt svenska samverkansövningar genom intervjuer och observationer. Den samlade analysen har sedan legat till grund för konstruktionen av en ny övningsmodell, 3NS, trenivåsamverkan. Den bygger på erfarenheter vi gjort i studier av traditionella övningar.

De 3NS-övningar som genomfördes bestod av två praktiska moment och tre seminarier. Varje moment följdes av ett utvärderande seminarium som syftade till att deltagarna själva skulle reflektera och utveckla sitt handlingsmönster. De båda praktiska momenten var identiska. Det gav de övande tillfälle att repetera och metodiskt prova nya angreppssätt. Det första övningsmomentet genomfördes enligt de rutiner som normalt tillämpas och styr handlandet vid en skarp händelse. Det andra övningsmomentet föregicks av ett självkritiskt seminarium där deltagarna själva identifierade vad som kunde förbättras till nästa övningsomgång.

Forskningsprojektet har genomförts 2011-2014. Totalt har 19 samverkansövningar studerats, varav 16 fullskaleövningar. I studien har totalt 97 intervjuer och 125 timmar observation genomförts. En enkät (CLU-instrument) har utvecklats, vilken besvarats av 272 övningsdeltagare.

Studien visar att kollaborativa moment vid övningar bidrar till att deltagarna lär sig mer och har större nytta av övningar. 3NS-övningarna uppfattades förbättra lärandet med 26 procent och nyttan med 17 procent jämfört med traditionella övningar. Samverkansövningar gynnas av att de övande själva analyserar sina svagheter. Repetitiva inslag där de övande prövar alternativa strategier förbättrar beredskapen inför skarpa händelser.

Abstract [en]

This study relates to collaboration exercises, with particular focus on the full-scale exercises between the police, rescue services and ambulance. To succeed in a complex situation, it requires that the personnel’s ability to collaborate across organisations be developed and refined.

The overall aim of this study was to examine how collaboration is practised and how exercises lead to learning and usefulness. A research summary was initially done in this study. Based on that, a number of key concepts were developed that proved helpful when we followed the Swedish collaboration exercises through interviews and observations. The collected analysis has since been the basis for the design of a new exercise model, 3LC, three-level collaboration. It is based on the experiences we have had in studies of traditional exercises.

The 3LC exercises that were conducted consisted of two practical sessions and three seminars. Each session was followed by an evaluative seminar with the aim that participants themselves would reflect and develop their patterns of behaviour. The two practical sessions were identical. It gave the participants the opportunity to rehearse and methodically try new approaches. The first exercise session was carried out according to the procedures that normally apply and govern the actions at an actual event. The second exercise session was preceded by a self-critical seminar where participants themselves identified what could be improved for the next exercise session.

The research project was carried out from 2011 to 2014. A total of 19 collaboration exercises were studied, including 16 full-scale exercises. A total of 97 interviews and 125 hours of observation were carried out in this study. A questionnaire (CLU instrument) was developed, which was answered by 272 exercise participants.

The study shows that collaborative sessions in the exercises contributed to the participants learning more and having greater usefulness from the exercises. 3LC exercises were perceived to enhance learning by 26 per cent and usefulness by 17 per cent, compared with traditional exercises. Collaborative exercises are benefitted when participants analyse their weaknesses themselves. Repetitive elements where participants try out alternative strategies improve preparedness prior to actual events.

Place, publisher, year, edition, pages
Göteborg: Bokförlaget BAS, 2015. p. 544 Edition: 1
Keywords
Collaboration, exercise, police, rescue services, ambulance, three-level collaboration, synchronous collaboration, repetition, improvisation, learning, usefulness, interactive protocols, accident, crisis., Samverkan, övning, polis, räddningstjänst, ambulans, trenivåsamverkan, synkron samverkan, repetition, improvisation, lärande, nytta, interaktivt protokoll, olycka, kris.
National Category
Business Administration Public Administration Studies Health Care Service and Management, Health Policy and Services and Health Economy Work Sciences
Research subject
SOCIAL SCIENCE, Public administration; SOCIAL SCIENCE, Business administration; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-7735 (URN)978-91-7246-331-8 (ISBN)
Funder
Swedish Civil Contingencies Agency
Available from: 2015-06-16 Created: 2015-06-16 Last updated: 2015-07-09Bibliographically approved
Berlin, J. & Carlström, E. D. (2015). The Three-Level Collaboration Exercise: Impact of Learning and Usefulness. Journal of Contingencies and Crisis Management, 23(4), 257-265
Open this publication in new window or tab >>The Three-Level Collaboration Exercise: Impact of Learning and Usefulness
2015 (English)In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 23, no 4, p. 257-265Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to examine the emergency personnel’s perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other’s tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasi-experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).

Keywords
Exercises, learning, benefits, effect, police, ambulance, emergency services, Sweden
National Category
Other Social Sciences not elsewhere specified Business Administration Health Care Service and Management, Health Policy and Services and Health Economy Other Health Sciences Nursing Public Administration Studies
Research subject
SOCIAL SCIENCE, Business administration; SOCIAL SCIENCE, Public administration; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science; Work Integrated Learning
Identifiers
urn:nbn:se:hv:diva-7288 (URN)10.1111/1468-5973.12070 (DOI)000363694000008 ()2-s2.0-8494543809 (Scopus ID)
Note

Article first published online: 28 JAN 2015

Available from: 2015-01-22 Created: 2015-01-22 Last updated: 2017-12-05Bibliographically approved
Johansson, C., Åström, S., Kauffeldt, A., Helldin, L. & Carlström, E. D. (2014). Culture as a predictor of resistance to change: A study of competing values in a psychiatric nursing context.. Health Policy, 114(2-3), 156-162
Open this publication in new window or tab >>Culture as a predictor of resistance to change: A study of competing values in a psychiatric nursing context.
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2014 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, ISSN 1872-6054 (Online), Vol. 114, no 2-3, p. 156-162Article in journal (Refereed) Published
Abstract [en]

It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions.

Place, publisher, year, edition, pages
Elsevier Ireland Ltd, Irland, 2014
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-5644 (URN)10.1016/j.healthpol.2013.07.014 (DOI)000331159300007 ()23932351 (PubMedID)2-s2.0-84892680385 (Scopus ID)
Note

Available online 7 August 2013

Available from: 2013-10-17 Created: 2013-10-17 Last updated: 2017-12-06Bibliographically approved
Andersson, A., Carlström, E. D., Åhgren, B. & Berlin, J. (2014). Managing boundaries at the accident scene: a qualitative study of collaboration exercises. International Journal of Emergency Services, 3(1), 77-94
Open this publication in new window or tab >>Managing boundaries at the accident scene: a qualitative study of collaboration exercises
2014 (English)In: International Journal of Emergency Services, ISSN 2047-0894, Vol. 3, no 1, p. 77-94Article in journal (Refereed) Published
Abstract [en]

Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.

Design/methodology/approach Interviews with 23 participants from four exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis.

Findings Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision-making.

Originality/value The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.

Place, publisher, year, edition, pages
Emerald Group Publishing Ltd. United Kingdom, 2014
Keywords
Collaboration, Exercise, Police, Ambulance, Accident, Fire department
National Category
Pedagogical Work Public Administration Studies Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Public health science; SOCIAL SCIENCE, Business administration; SOCIAL SCIENCE, Public administration; SOCIAL SCIENCE, Sociology
Identifiers
urn:nbn:se:hv:diva-6143 (URN)10.1108/IJES-02-2013-0003 (DOI)
Available from: 2014-04-08 Created: 2014-04-08 Last updated: 2016-06-27Bibliographically approved
Forsgren, S., Forsman, B. & Carlström, E. (2014). Working with Manchester triage: job satisfaction in nursing. In: International Emergency Nursing: Oral abstracts – 1st Global Conference on Emergency Nursing & Trauma Care: Dublin, Ireland, 18–21 September 2014. Paper presented at 1st Global Conference on Emergency Nursing & Trauma Care, 2014 (pp. 254-254). Elsevier, 22(4)
Open this publication in new window or tab >>Working with Manchester triage: job satisfaction in nursing
2014 (English)In: International Emergency Nursing: Oral abstracts – 1st Global Conference on Emergency Nursing & Trauma Care: Dublin, Ireland, 18–21 September 2014, Elsevier, 2014, Vol. 22, no 4, p. 254-254Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Introduction: This study covers nurses' job satisfaction during triage at emergency departments in Western Sweden. Method: Data were collected from 74 triage nurses using a questionnaire containing 37 short form open questions. The answers were analysed descriptively and by measuring the covariance. Two open questions were analysed by content analysis. Results: The results showed a high degree of job satisfaction (88%). Triage as a method, the interesting nature of the work, and a certain freedom in connection with the triage tasks contributed to job satisfaction (R2 = 0.40). The nurses found their work interesting and stimulating, although some reported job dissatisfaction due to a heavy workload and lack of competence. Most of the nurses thought that Manchester Triage System (MTS) was a clear and straightforward method but in need of development. One result from the content analysis was difficulties in decision-making during the assessment of patients with multiple diseases. Since this patient group had increased in number, greater demands were placed on the nurses' competence. Conclusions: The rational modelling structure by which the triage method is constructed is unable to distinguish all the parameters that an experienced nurse takes into account. When the model is allowed to take precedence over experience, it can be of hindrance and contribute to certain estimates not corresponding with the patient's needs. The participants requested regular exercises solving and discussing patient scenarios, which can contribute to develop the instrument.

Place, publisher, year, edition, pages
Elsevier, 2014
National Category
Nursing Work Sciences
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-7206 (URN)10.1016/j.ienj.2014.08.006 (DOI)000347098200065 ()
Conference
1st Global Conference on Emergency Nursing & Trauma Care, 2014
Note

Oral abstract, nummer O18.1.

Available from: 2014-12-22 Created: 2014-12-18 Last updated: 2016-02-04Bibliographically approved
Johansson, C., Åström, S., Kauffeldt, A. & Carlström, E. D. (2013). Daily Life Dialogue Assessment in Psychiatric Care—Face Validity and Inter-Rater Reliability of a Tool Based on the International Classification of Functioning, Disability and Health. Archives of Psychiatric Nursing, 27(6), 306-311
Open this publication in new window or tab >>Daily Life Dialogue Assessment in Psychiatric Care—Face Validity and Inter-Rater Reliability of a Tool Based on the International Classification of Functioning, Disability and Health
2013 (English)In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, no 6, p. 306-311Article in journal (Refereed) Published
Abstract [en]

This article describes the development of an assessment tool based on the International Classification of Functioning Disability and Health (ICF) adapted to a psychiatric nursing context where both the patient and the nurse assess the patient's ability to participate in various spheres of life. The aim was to test psychometric properties, focusing on face validity and inter-rater reliability. Three Swedish expert groups participated. Analysis of inter-rater reliability was conducted through simulated patient cases. The results of an unweighted kappa value of 0.38, a linear weighted kappa value of 0.65 and a quadratic weighted kappa value of 0.73 were considered as acceptable when using simulated patient cases.

National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-5650 (URN)10.1016/j.apnu.2013.08.005 (DOI)000327415500008 ()24238011 (PubMedID)2-s2.0-84887618647 (Scopus ID)
Available from: 2013-10-17 Created: 2013-10-17 Last updated: 2017-12-06Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9463-7341

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