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Hur samverkan mellan primärvård och hemsjukvård fungerar i praktiken: Sjuksköterskors upplevelser
University West, Department of Health Sciences, Section for nursing - graduate level.
University West, Department of Health Sciences, Section for nursing - graduate level.
2018 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
How collaboration between primary care and home healthcare works in practice : Nurses’ experiences (English)
Abstract [en]

Background: During the last decades, advancements has been made in medicine and medical technology which has made it possible to care for elderly persons with multi morbidity in their own homes. The fact that the average length of in-hospital stay has become shorter is also a factor in that home health care has become more common. The medical responsibility for patients in home health care is divided between the home health care organization and the primary care provider, which makes collaboration between these two organizations an important and necessary part of the nurses' job. Ongoing care coordination and collaboration between primary care and home health care is generally described as poor and as an area that requires improvement. Therefore it is important to study nurses' experiences of collaboration in practice.

Aim: To describe nurses' experiences of collaboration between primary care and home health care. Method: A semi-structured interview study was conducted with eleven nurses from four health centers and five home health care units in western Sweden. Qualitative content analysis was used to analyze the data.Results: The nurses' experiences of collaboration in practice showed that the medical rounds were a central part of collaboration, that there was a lack of distinct ways of communication and that both organizations were dependent on each other. The results also showed that regulatory systems affected collaboration, that there were boundaries and grey zones between the organizations, that the organizations used different solutions to replace collaboration and that it was important to have knowledge of the other organization.

Conclusion: Because the organizations were dependent on each other to give care to the patient and there was a lack of distinct ways of communication, personal relationships became a facilitator for collaboration. Different strategies were used to bypass the obstacles in collaboration.

Abstract [sv]

Andelen äldre personer och personer med kroniska sjukdomar i befolkningen ökar, samtidigt som vårdtiderna i slutenvården förkortas. På grund av den medicintekniska utvecklingen finns det ökade möjligheter att få avancerad sjukvård i hemmet. Hemsjukvården delar det medicinska ansvaret för dessa patienter med primärvården och samverkan dem emellan är därför grundläggande för att kunna ge en god och sammanhållen vård till patienten. Skyldigheten att samverka är reglerat genom lagar och författningar. Trots detta finns det betydande brister i samverkan och vårdkoordinering mellan primärvård och hemsjukvård. För att få en ökad förståelse av detta är det av vikt att ta reda på sjuksköterskors upplevelse av hur samverkan fungerar i praktiken. Resultatet i den här studien bygger på intervjuer med elva sjuksköterskor inom primärvård och hemsjukvård, där de fått beskriva sina upplevelser av samverkan mellan primärvård och hemsjukvård. Resultatet av studien visade att ronden var en central del av samverkan. Det framkom också att sjuksköterskorna ansåg att det saknades tydliga formella kommunikationsvägar, vilket i kombination med att de var beroende av varandra för att ge vård till patienterna gjorde att personliga relationer och olika strategier användes för att förenkla samverkan. Organisationerna kunde också skapa olika alternativa lösningar för att ersätta samverkan mellan primärvården och hemsjukvården. I resultatet framkom att sjuksköterskorna även ansåg att regelverk påverkade samverkan. De tyckte att det var nödvändigt att ha en ram att förhålla sig till, men de ville också kunna vara flexibla vid behov. Detta eftersom de ansåg att det fanns ett gränsland mellan primärvård och hemsjukvård som upplevdes som en gråzon där uppgifter och behov ibland överlappade varandra.

Place, publisher, year, edition, pages
2018. , p. 25
Keywords [en]
Care coordination, collaboration, home health care, nurses’ experiences, primary care
National Category
Nursing
Identifiers
URN: urn:nbn:se:hv:diva-12921Local ID: EXD800OAI: oai:DiVA.org:hv-12921DiVA, id: diva2:1250079
Subject / course
Nursing science
Educational program
Specialist nursing programme
Supervisors
Examiners
Available from: 2018-10-02 Created: 2018-09-21 Last updated: 2018-10-12Bibliographically approved

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