Sammendrag:Dementia is recognized as being a major risk for falls that cause suffering and increase dependency for the individual. The purpose of this study was to explore registered nurses' and nurse assistants' experiences of caring for elderly people with dementia who are at risk of falling, and factors that contribute or reduce falls in this group. A phenomenographic design was chosen. Ten nurses and 18 nurse assistants with experience of fall events were strategically selected for a recorded interview. The informants were chosen from 10 nursing homes in Sweden and Norway. They were asked to describe a fall situation they had been involved in when caring for elderly people with dementia. The findings shed light on an ethical dilemma in the main category 'Balancing integrity and autonomy versus risk of falling' which was comprehensively related to two descriptive categories. The first one was 'Adjusting to the older person's condition' with the concepts of forgetfulness, anxiety and confusion, ability to express oneself and understand, bodily build and function. The second category was 'Adjusting the care environment', comprising these conceptions: the physical environment, the psychosocial environment, organization and human resources. Based on the staff's perceived difficulties in preventing falls in elderly people with dementia, there is a need for additional support or professional supervision in their work to enhance possibilities for successful fall prevention.Omsorgsbiblioteket har ikke tilgang til å publisere dette dokumentet i fulltekst. Kanskje ditt lokale bibliotek kan hjelpe deg, eller kanskje du kommer videre med lenken nedenfor.
Introduction Requirements for Patient Safety suggest that students encounter patients well prepared. In clinical laboratory practice (CLP), the students simulate patient situations as a preparation for internship. Various CLP models have been tried out to meet the students' prerequisites and learning strategies. Objectives The purpose of this study was to try out two different learning sessions related to the bed bath procedure. Design and Methods The study has a descriptive, quantitative design with elements from clinically controlled trials. Sample The population of 160 first-year students was randomly divided into two classes. Questionnaires Two questionnaires were answered with six-month intervals: Form 1 immediately after the first training session and Form 2 a short time after clinical practice. Findings A majority of the nursing students reported that the exercises in the clinical lab were a good way to prepare for the practice, although most of them did not perceive that the procedure conducted at the university resembled how it is conducted in clinical practice. Age or level of discomfort related to organization of the skills training did not have impact on the students' confidence in mastering bed bath in clinical practice. Students without previous experience were less confident to master the procedure in clinical practice, but the results evened out during the internship. Conclusions The results from this study could indicate that the students' age to a larger extent should be considered in the universities' facilitation of nursing students' clinical preparations, to improve the transition to “real life” as smoothly and meaningfully as possible to nursing students.
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