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Ingrid Egerod

Publications and source records attributed to Ingrid Egerod.

7 recordsLinked to original sources
PubMed2006

Nursing documentation audit--the effect of a VIPS implementation programme in Denmark.

AIM AND OBJECTIVES: The aim of this paper is to present a study describing nurses' adherence to the VIPS model by evaluating the quality of nursing assessment, and the quantity of completed nursing care plans. BACKGROUND: Numerous efforts have been made over the years to improve nursing documentation in Denmark. Hospitals have traditionally based nurses' charting on a rudimentary version of the nursing process and on Virginia Henderson's theory of human needs. In 2002-2004 the Copenhagen University Hospital, Rigshospitalet, introduced the Swedish VIPS model for nursing documentation. VIPS is an acronym for well being, integrity, prevention and safety, all of which are seen as major goals for nursing care. The model organizes nursing data according to a system of keywords, which facilitates storage and retrieval of data. DESIGN AND METHODS: The design in this part of the study was retrospective, wherein 50 journals from each of the departments of cardiology, neurology, oncology and urology were audited annually for three years using the Cat-ch-Ing instrument (n=600). All nursing journals were randomly selected by including the first 50 journals at each site given a specific date. RESULTS: The nursing documentation significantly improved during the course of the study. After the second year the participants used the keywords appropriately and correctly according to the VIPS model. Application of primary nursing increased during the study. Initial, ongoing and discharge patient status improved. The nurses' familiarity with nursing diagnoses, goals and interventions increased. CONCLUSIONS: The structured implementation programme significantly improved nursing documentation, and the simultaneous training of the entire nursing staff shows promise. The VIPS model has prepared the nurses for more complex computerized taxonomies and classification systems in the future by improving the nurses' analytical skills. Relevance to clinical practice. New strategies for improving nursing documentation have been demonstrated.

Adult↗
PubMed2005

Trends in sedation practices in Danish intensive care units in 2003: a national survey.

OBJECTIVE: The aim of the study was to explore trends and changes in sedation practices for mechanically ventilated patients in Danish intensive care units (ICUs) and to compare sedation practices in 1997 and 2003. DESIGN: The study was a follow-up survey with a descriptive and comparative cross-sectional multicenter design. SETTING: Questionnaires were mailed in January 2003 to all Danish ICUs providing mechanical ventilation (n=48). PARTICIPANTS: One head physician at each ICU in Denmark. INTERVENTIONS, MEASUREMENTS, AND RESULTS: Thirty-nine questionnaires were returned, yielding a response rate of 81%, representing 82% of Danish ICU beds. The main findings were a significant increase in the use of sedation scoring systems and a significant reduction of sedation and analgesia in relation to various modalities of mechanical ventilation and disease groups. Other important findings were a significant reduction in the use of benzodiazepines and opioids and a significant increase in the use of propofol in relation to all ventilator modes. The administration routes of sedative agents remained unchanged. CONCLUSIONS: Sedatives and analgesics are still widely used in Danish ICUs. The trend is toward lighter sedation along with a shift from benzodiazepines toward propofol and from morphine toward fentanyl given by continuous infusion. More attention needs to be directed toward sedation standards and scoring systems in order to reduce the risk associated with sedation in mechanically ventilated patients.

Analgesics↗
PubMed2005

Nurses' and physicians' sedation practices in Danish ICUs in 2003 A national survey.

OBJECTIVE: The aim of the study was to describe and compare physicians' and nurses' estimated use of sedatives and analgesics in patients requiring mechanical ventilation in Danish Intensive Care Units (ICUs) in 2003. DESIGN: Questionnaires were mailed in January 2003 to all Danish ICUs providing mechanical ventilation (n = 48). One physician and one nurse at each site were included in the study. RESULTS: Thirty-nine questionnaires were returned by physicians (response rate 81%) and 43 by the nurses (response rate 90%). Physicians and nurses agreed that sedation related decisions are predominately made during rounds and that most decisions are made by physicians and nurses collaboratively. Only 9% of the nurses and 23% of the physicians reported using a written protocol for sedation, while 30% of the nurses and 44% of the physicians reported the use of sedation scoring systems. The study generally supported the hypothesis, that nurses' and physicians' would respond similarly, but there were, however, significant variations, regarding formal sedation practices. CONCLUSIONS: Sedation decisions are made collaboratively by nurses and physicians, while sedation protocols and scoring systems are still not systematically implemented in Danish ICUs. The most common drugs for sedation of the mechanically ventilated patient are propofol and fentanyl by continuous infusion. It is recommended that the ICUs collaborate on developing evidence-based standards for sedation and that clinical databases are introduced, which may be used to assess the efficacy of such standards.

Anesthetics, Intravenous↗
PubMed2005

Evidence-based practice among Danish cardiac nurses: a national survey.

AIMS: This paper presents a survey of evidence-based practice among cardiac nurses exploring nurses' attitudes towards evidence-based practice and the types of knowledge they employ in clinical practice. BACKGROUND: Research utilization and evidence-based practice are required at hospitals around the world, although the definition of evidence-based practice is still unclear. An ongoing debate exists about the sources of knowledge and the hierarchy of research evidence in clinical practice, and nursing research has been threatened by the dominance of randomized controlled trials. Evidence-based practice has been described as a new paradigm, which promotes patient-centred care by integrating external evidence and patient preferences. METHODS: The study was a cross-sectional survey with a descriptive and comparative design, using self-administered postal questionnaires. The questionnaires were sent to 33 head nurses and 51 bedside nurses representing one or two units in each cardiac department in Denmark (n = 28). The final response rate was 81%. The study was carried out in 2004. RESULTS: Respondents had a positive attitude towards evidence-based practice, although they relied upon personal clinical experience. Head nurses were statistically significantly more familiar with the concept of evidence-based practice than bedside nurses, and read scientific journals more frequently. Introductory courses to evidence-based practice are rare and seldom mandatory, and the data suggest that respondents lacked knowledge of the finer points of evidence-based practice and equated the concept with research utilization. CONCLUSIONS: Barriers to evidence-based practice are inadequate education, unfamiliarity with English, and low organizational position. Facilitators include the implementation of guidelines, provision of continuing education, and an increase in the accountability of bedside nurses.

Adult↗
PubMed2004

The effect of a VIPS implementation programme on nurses' knowledge and attitudes towards documentation.

The Copenhagen University Hospital decided to adhere to the standards of the Joint Commission of International Accreditation in 2000. These standards require systematic assessment of patient care needs and include the use of written nursing care plans. In order to meet these standards, the hospital management decided to introduce the Swedish VIPS model, which is a model designed to structure nursing documentation (VIPS is an acronym for well-being, integrity, prevention and safety). The present study explores the nurses' knowledge and attitudes towards documentation and addresses the research questions: (a) what are the nurses' attitudes towards documentation of nursing care? and (b) do nurses have sufficient knowledge of the documentation system to systematically document their patient assessment and clinical decisions? The research design was prospective, comparative, and quasi-experimental (nonrandomized), including a study group (n=72) and a control group (n=57). A questionnaire was used to compare nurses' self-evaluated attitudes towards documentation, and a multiple-choice test was given in order to assess nurses' knowledge of the documentation system. The study group participated in a special implementation programme (response rate 82%), while the control group attended the regular 3-day documentation course at the hospital (response rate 79%). The study showed that the two groups responded similarly, but the nurses in the study group were significantly stronger in their conviction that they had the knowledge to make care plans and that they routinely made them. The study group demonstrated slightly less motivation than the control group, while the two groups shared a positive attitude towards nursing documentation. The study group did consistently better on the knowledge tests. The findings show that the implementation programme had a positive impact on nursing documentation, and that the VIPS model increased the nurses' understanding of the nursing process.

Adult↗
PubMed2002

Uncertain terms of sedation in ICU. How nurses and physicians manage and describe sedation for mechanically ventilated patients.

Sedation which is used for intubated patients may prolong mechanical ventilation by increasing the risk of complications. The aim of the study was to illuminate the specific terminology and unrecognized contextual factors which may influence nurses' and physicians' sedation practices. The main research questions were: How do nurses and physicians describe sedation? and How does the level of nursing skill relate to the level of sedation? The hypotheses were that sedation practices are inconsistent and that experienced nurses provide a better quality of sedation than less experienced nurses. The hypotheses were supported by the study. The research strategy was case study research with triangulation of sources and methods and a multicentre multiple-case design. Four university hospitals in Copenhagen, Denmark, and 14 cases were included in the study. The findings were based on secondary analysis of observation, interviews and chart review. The theoretical framework for the study was the problem-solving model, in which sedation was assumed to be provided according to indication (clinical problem), intervention (clinical decision) and expected outcome (clinical end-point). Indications could be patient-related, ventilator-related, or patient-ventilator related. Interventions could be related to the choice of agent, dose or administration method and the outcome was the level of sedation. Sedative therapy was prescribed by physicians and administered by nurses. The four sites in the study did not use guidelines for sedation and did not use sedation level assessment tools. The study shows that when the terminology is unclear, the indications, interventions and outcomes become unclear.

Adult↗