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Biomedical subjects

I Thorell-Ekstrand

Publications and source records attributed to I Thorell-Ekstrand.

12 recordsLinked to original sources
PubMed2002

Long-term increase in quality of nursing documentation: effects of a comprehensive intervention.

This study aimed to evaluate the longitudinal effects of a nursing-documentation intervention on the quantity and quality of the nursing documentation in a sample of patient records at a university hospital in Stockholm, Sweden. In this quasi-experimental longitudinal study, two hospital wards participated in a 2-year intervention and a third ward was used for comparison. The intervention consisted of organizational changes and education regarding nursing documentation in accordance with the VIPS model, a model designed to structure nursing documentation. To evaluate the effect, patient records were audited at three different time points: before the intervention, directly after the intervention and 3 years after the intervention. A total of 269 patient records were used. The findings showed a significant score increase in quantity as well as in quality of the nursing documentation, in the intervention wards directly after the intervention, as compared with those from the comparison ward. The results suggests that a comprehensive intervention based on the VIPS model and including organizational support for registered nurses (RN) may improve nursing documentation in an acute care hospital setting.

Adult↗
PubMed2000

Development of an audit instrument for nursing care plans in the patient record.

OBJECTIVES: To develop, validate, and test the reliability of an audit instrument that measures the extent to which patient records describe important aspects of nursing care. MATERIAL: Twenty records from each of three hospital wards were collected and audited. The auditors were registered nurses with a knowledge of nursing documentation in accordance with the VIPS model--a model designed to structure nursing documentation. (VIPS is an acronym formed from the Swedish words for wellbeing, integrity, prevention, and security.) METHODS: An audit instrument was developed by determining specific criteria to be met. The audit questions were aimed at revealing the content of the patient for nursing assessment, nursing diagnosis, planned interventions, and outcome. Each of the 60 records was reviewed by the three auditors independently and the reliability of the instrument was tested by calculating the inter-rater reliability coefficient. Content validity was tested by using an expert panel and calculating the content validity ratio. The criterion related validity was estimated by the correlation between the score of the Cat-ch-Ing instrument and the score of an earlier developed and used audit instrument. The results were then tested by using Pearson's correlation coefficient. RESULTS: The new audit instrument, named Cat-ch-Ing, consists of 17 questions designed to judge the nursing documentation. Both quantity and quality variables are judged on a rating scale from zero to three, with a maximum score of 80. The inter-rater reliability coefficients were 0.98, 0.98, and 0.92, respectively for each group of 20 records, the content validity ratio ranged between 0.20 and 1.0 and the criterion related validity showed a significant correlation of r = 0.68 (p < 0.0001, 95% CI 0.57 to 0.76) between the two audit instruments. CONCLUSION: The Cat-ch-Ing instrument has proved to be a valid and reliable audit instrument for nursing records when the VIPS model is used as the basis of the documentation.

Documentation↗
PubMed2000

Evaluation by nurses and students of a new assessment form for clinical nursing education.

An assessment form was developed, based on Swedish higher education regulations and international guidelines for nursing education, to be used during clinical education regardless of the level of the programme or clinical specialty. Nurses who acted as supervisors for students used the form for continuous and formal assessment, and students used it for self-assessment. Once developed, the assessment form covered 18 professional and academic areas. After one semester nurses (n = 323) and students (n = 154) from two university colleges evaluated their experiences of using the form by answering a questionnaire. In addition, the completed assessment forms filled in by the nurses were reviewed and analysed. The evaluation showed that the nurses and the students considered the assessment form highly valuable. Both groups believed that the form highlighted the requirements for clinical education and was useful in assessing the students' development. Almost all 18 factors were found to be important to assess. Least important and most difficult to assess were 'the use of research and developmental work' and 'the ability to inform and teach co-workers and students'. Some areas that were regarded as difficult to assess were also marked by the nurses in the assessment form as 'not possible or relevant to assess'. The form was found to be useful in assessing students' development towards the goals of nursing education. The study also revealed that essential areas in nursing education have unclear educational demands for those involved.

Curriculum↗
PubMed1997

Education of clinical nurses in nursing documentation in accordance with the VIPS-model.

The purpose of this study is to describe some effects on the clinical nursing documentation after registered nurses (RN) had participated in a three-day course in nursing documentation in accordance with the VIPS-model. Between November 1993 and December 1996, 4594 registered nurses participated in the course. In order to evaluate the effects of the course two questionnaires were sent out to 900 participants, one concerning the degree of development in their nursing documentation and another concerning what they perceived as inhibitors and facilitators to the development of nursing documentation. The result will be presented at the conference.

Computer User Training↗
PubMed1997

The VIPS model--implementation and validity in different areas of nursing care.

The development of common concepts and terms for nursing practice is crucial for the effective use of nursing-information systems. In Sweden, the VIPS model has been developed to support the systematic and common documentation of nursing care in patient records. The model has been widely used in different areas of nursing practice. This literature review was conducted as a part of a larger project to study the validity and reliability of the VIPS model, as well as its dissemination into the Swedish health-care system. The findings showed in general good reliability and content validity for the keywords in the VIPS model. The implications for the further development of the model are discussed.

Humans↗
PubMed1996

Nursing documentation in patient records: experience of the use of the VIPS model.

The VIPS model for the documentation of nursing care in patient records was scientifically developed and published in 1991, with the aim of supporting the systematic documentation of nursing care and promoting individualized care. As the model seemed to be accepted and used in many parts of Sweden, a study was conducted in order to gather further information on the validity of the model, to describe the clinical and educational experience of its use and to refine it. Experience of the use of the model was gathered from a review of the scientific papers and other reports on it, from questionnaires addressed to nurses (n = 514), from comments by key informants, and from interviews with faculty members at all the nursing schools in the country. The findings showed that an intense process of change and development was occurring regarding nursing documentation. However, there were limitations in the use of the entire nursing process, especially in the specification of patient problems and the formulation of nursing diagnoses and nursing interventions. The keywords (Swedish spelling) of the VIPS model had good content validity in different areas of nursing care. The findings also indicated the need for further elaboration and revision of some of the keywords. A revised version of the VIPS model based on these findings is presented.

Health Knowledge, Attitudes, Practice↗
PubMed1995

Nursing students' experience of care planning activities in clinical education.

This paper summarises a research study inquiring into the experiences of nursing students of their practice of individualised care planning as a learning activity. The survey was conducted in the final stage of the students' education and concerned three groups of students in the years 1990, 1992 and 1993 who were asked to evaluate their main clinical placements in surgical, medical and long-term care wards with regard to care planning activities. The answers to the questions showed a pattern that was persistent over the different health care specialties as well as over the years when the investigation was made. Some of the activities, such as oral reporting and writing progress notes, were done many times by all the students. Other activities, such as writing care plans and discharge notes, were trained only a few times or never. There were very small positive differences over the years, and there were overall lower scores from the students' training in long term care wards. Possible factors affecting the result from an educational and theoretical point of view are discussed.

Adult↗
PubMed1994

Preparedness for clinical nursing education.

The identification of individualized patient care planning as a core element in clinical nursing training showed the need to evaluate how nursing students perceive themselves to be prepared for implementing the concept into patient care. Ninety-five nursing students, with a mean age of 27 years, participated in this study at the end of their first theoretical block. Three questionnaires were used; 1) One questionnaire designed for the study concerning demographic data, attitudes and valuation of the theoretical education of the nursing process, 2) Rosenbaum's Self-Control Schedule, and 3) Antonowsky's Sense of Coherence test. The results showed that the students' pre-educational health care experience, which varied from one to twenty years, significantly (p < 0.05) influenced the evaluation of their preparedness for clinical training. Attitudes towards nursing research and development of nursing care were negatively correlated (p < 0.05) to their years of previous experience of health care and positively correlated to a more theoretical school background. The students' personal preparedness to develop independence varied greatly as measured by the Self-Control Schedule and the Sense of Coherence test independently of age, work experience and earlier education. It was concluded that students might be favoured by individualized study planning as a parallel model to individualized care planning.

Adolescent↗
PubMed1994

The VIPS-model used by nursing students--review of educational care plans.

The VIPS-model developed by Ehnfors et al. (1991) for nursing documentation and writing of care plans was used and evaluated by nursing students in connection with their final assignments. In addition to their evaluation by the use of a questionnaire, the students' written care plans were reviewed. Three instruments were used, two were tested in earlier studies when reviewing registered nurses' care plans, and one was developed especially for this review of the quality of the students' care plan assignments. The results showed that the key words for nursing assessment were evaluated as both useful and easy to use while the key words for nursing interventions were considered useful but more difficult and were used to a less extent. Many students did not document any outcome or any discharge notes. The instruments that were used for the review of the care plans were of great help in analyzing the use of the model as well as the content and comprehension of the key words.

Adult↗
PubMed1993

Preceptorship in clinical nursing education in Sweden: aspects of quality assurance.

Nursing education in Sweden is in a changing phase and the aim of this study is to describe a group of nurse preceptors and explore some of the factors that are believed to be of importance to clinical teaching according to the current model. Staff nurses (N = 86) who served as preceptors to students during their main clinical training in the areas of surgical, medical and long-term care participated in the study. Data were collected by means of a questionnaire designed for the study and the Nurse Self Description Form (NSDF). The results revealed that 39% of the preceptors had less than two years experience as Registered Nurses and 30% were less than 26 years old. These less experienced preceptors evaluated the amount of education they had received concerning the nursing process and related subjects as significantly higher when compared to the more experienced nurses. Approximately one fourth of the preceptors (N = 23) were using care planning in their ordinary work and another 29 had prior experience, but many preceptors (N = 34, 39%) had no direct experience of individualized care planning. Although there was a great deal of variance, the preceptors' estimation of their own professionalism such as in teaching, leadership and knowledge mastery as measured by the NSDF did not reveal any significant differences from ordinary nurses in a reference group. It is concluded that the quality of the important clinical part of nurse education may vary according to individual experience and knowledge of the preceptors.

Adult↗
PubMedDate not supplied

Towards basic nursing information in patient records.

Four key concepts for good nursing care and a list of key words for nursing documentation in patient records were established and to some extent tried in clinical practice in Sweden. The method consisted of the following steps: extensive literature review, review of nursing records, development of a list of key words on two levels, a first level corresponding to the nursing process, and a second level consisting of subdivisions for possible use in practice, use and assessment in clinical practice by nurses and students, expert panel judgement and refinement of the key words including an examination of semantic accuracy of the Swedish key words by an expert in Nordic languages. The proposed key words are presented both in English and Swedish and explanations, comments and references are given. The version of key words presented here is subject to further testing for possible modifications.

Documentation↗