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.
Background: Triage is the sorting of patients according to the severity of medical assessment. Triage has a long history of use in Anglo-Saxon countries but is a fairly new method in Sweden. Researchers have described the Manchester triage group method (MTS) and a literature review of the concept; working contentment and competence focusing on triage. Aim: The ambition with this study was to describe a number of triage nurses working conditions. The research questions were; working with MTS- does it bring work contentment? What kind of competence is needed? Method: Data was collected from 74 triage nurses by a questionnaire containing 37 questions and two questions provided the nurses the opportunities to describe their triage experiences. Findings: The nurses found their job interesting and stimulating, but some reported unsatisfactory work environment due to lack of education, competence, support and high work load. The informants ask for more education; to solve and discuss patient scenarios and to participate in the developing of MTS. Sixty-three percent thought MTS was a difficult method with some disadvantages. The majority found triage to be a nurse task.
Background
There is in Sweden an ongoing debate about the extent to which the practice of triage contributes to patient safety. This paper reports the findings of a study of nurses’ perceptions of the impact of experience and safety of the Manchester Triage System (MTS) within emergency departments in Western Sweden.
Methods
Data was collected from 74 triage nurses using a questionnaire containing 37 short form questions of Likert-type, analyzed descriptively and measured the covariance. Data was also collected with two open questions by using the critical incident technique and content analysis.
Results
The results described that the combination of the MTS method, the nurses’ experience and organizational factors accounted for 65% of patient safety. The study indicated that nurses’ experience contributed to higher patient safety than the model itself. A standardized assessment model, like MTS, can rarely capture all possible symptoms, as it will always be constrained by a limited number of keywords and taxonomies. It cannot completely replace the skills an experienced nurse develops over many years in the profession.
Conclusions
The present study highlights the value of triage nurse's experience. The participants considered experience to contribute to patient safety in emergency departments. A standardized triage model should be considered as additional support to the skills an experienced nurse develops.
The aim of this paper is to describe frail older persons' experiences of hospital care of information and participation when being an inpatient at a hospital. A qualitative method was used. Data were collected at the hospital from 20 interviews with frail older patients, together with observations in the environment at the hospital ward. A content analysis was performed. Patients experienced not receiving information about their care and rehabilitation, or receiving such information in noisy surroundings. They experienced situations of misunderstanding related to their medication, which indicates the need for appropriate discharge calls for frail older patients. They expressed feelings of distress concerning the future, caused by hasty admissions or relatives' problems to handle the situation. The results highlight the need to receive appropriate information and to participate in decision-making. The level of health literacy should be taken notice of when giving information, using peaceful and quiet environments when informing frail older persons. Person-centered care should be recognized to a greater extent in order for healthcare professionals to give information to frail older people in a health literacy-friendly way. This might make it easier for frail older persons to participate in a partnership in care.
The research question of the article is to explore whether the method dialogue meetings could be relevant for collaboration reflective learning among researchers and practitioners when welfare technology should be implemented in municipalities, or not. A testbed was planned to be implemented in a retirement home in a Swedish municipality, and the practitioners worked with a pre-study of that testbed. The aim of the article is to describe the collaboration and dialogue between the researchers and the practitioners in the dialogue meetings, and to reflect upon the potential of dialogue meetings as an arena for democratic collaboration and reflection among researchers and practitioners. The research methodology approach is participatory action research with mixed methods (dialogue meetings, focus groups,participant observations). During the dialogue meetings, the researchers learned more about the use of traditional research methods, and the practitioners learned more about how they could improve their use of the methods in order to facilitate change processes in their organization. Dialogue meetings could be relevant for reflective learning among researchers and practitioners in different organizational contexts, as a method to promote bridging the gap between practice and research in a democratic way; create inter-professional collaboration and reflection, and contribute to work change processes and sense-making.
Bakgrund Flera svenska rapporter visar att de mest sjuka äldre ofta far illa på grund av bristande samordning och oklar ansvarsfördelning mellan olika behandlingsinstanser. Primärvården, hemtjänsten och den kommunala hemsjukvården anses i otillräcklig omfattning ta över ansvaret efter utskrivningen av de sjuka äldre från sjukhuset. Svenska erfarenheter stämmer väl med vad man funnit i flera internationella studier: sjukvården är illa rustad för att möta de mest sjuka äldres komplexa behov av vård och omsorg.
Aims: Frail elderly patients who have multiple illnesses do not fare well in modern health care systems, mainly due to a lack of care planning and flawed communication between health professionals in different care organisations. This is especially noticeable when patients are discharged from hospital. The aim of this study was to explore health care professionals’ experience of obstacles and opportunities for collaboration. Methods: Health professionals were invited to participate in three focus groups, each consisting of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist and a patient or a family member representative. These individual people were then asked to discuss the obstacles and opportunities for communication between themselves and with the patients and their relatives when presented with the case report of a fictitious patient. Content analysis was used to identify categories. Results: Several obstacles were identified for effective communication and care planning: insufficient communication with patients and relatives; delayed collaboration between care-givers; the lack of an adequate responsible person for care planning; and resources not being distributed according to the actual needs of patients. The absence of an overarching responsibility for the patient, beyond organisational borders, was a recurring theme. These obstacles could also be seen as opportunities. Conclusions: Obstacles for collaboration were found on three levels: societal, organisational and individual. As health care professionals are well aware of the problems and also see solutions, management for health care should support employees’ own initiatives for changes that are of benefit in the care of frail elderly patients with multiple illnesses.