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1.  Nursing documentation of pressure ulcers in nursing homes: comparison of record content and patient examinations 
Nursing Open  2016;3(3):159-167.
The aim of this study was to describe the accuracy and quality of nursing documentation of the prevalence, risk factors and prevention of pressure ulcers, and compare retrospective audits of nursing documentation with patient examinations conducted in nursing homes.
This study used a cross‐sectional descriptive design.
A retrospective audit of 155 patients' records and patient examinations using the European Pressure Ulcer Advisory Panel form and the Braden scale, conducted in January and February 2013.
The prevalence of pressure ulcers was 38 (26%) in the audit of the patient records and 33 (22%) in patient examinations. A total of 17 (45%) of the documented pressure ulcers were not graded. When comparing the patient examinations with the patient record contents, the patient records lacked information about pressure ulcers and preventive interventions.
PMCID: PMC5047344  PMID: 27708826
Electronic health records; nursing home; patient examination; pressure ulcer
2.  The construction of a subset of ICNP® for patients with dementia: a Delphi consensus and a group interview study 
BMC Nursing  2015;14:49.
The International Classification for Nursing Practice (ICNP®) 2013 includes over 4000 concepts for global nursing diagnoses, outcomes and interventions and is a large and complex set of standardised nursing concepts and expressions. Nurses may use subsets from the ICNP as concepts and expressions for research, education and clinical practice. The objective of this study was to identify and validate concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia.
The process model for developing ICNP subsets was followed, according to the guidelines adopted by the International Council of Nursing (ICN). To identify relevant and useful concepts for the subset, a modified form of the Delphi method was used. Six nurses working in healthcare services in three municipalities in Norway with postgraduate education in geriatric psychiatry and dementia care participated in two Delphi sessions. The participants reviewed and scored the concepts included in the suggested subset and had an opportunity to rewrite them and offer alternatives. To validate the subset after the Delphi study, a group interview was conducted with six other nurses with postgraduate education in geriatric psychiatry and dementia care. The group interview was recorded and transcribed, and summative content analysis was used.
Suitable concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia were identified. In total, 301 concepts were identified, including 77 nursing diagnoses, 78 outcomes and 146 nursing interventions. An increased focus on concepts to describe basic psychosocial needs such as identity, comfort, connection, inclusion and engagement was recommended by nurses in the validation process.
Relevant and pre-formulated nursing diagnoses, goals and interventions were identified, which can be used to develop care plans and facilitate accuracy in the documentation of individuals with dementia. The participants believed that it may be difficult to find formulations for all steps of the nursing process. In particular, nursing diagnoses and psychosocial needs are often inadequately documented. The participants highlighted the need for the subset to contain essential information about psychosocial needs and communication.
PMCID: PMC4596372  PMID: 26446570
3.  It Is Not That Simple nor Compelling! 
Healthcare decisions are often made under pressure, with varying levels of information in a changing clinical context. With limited resources and a focus on improving patient outcomes, healthcare managers and health professionals strive to implement both clinical and cost-effective care. However, the gap between research evidence and health policy/clinical practice persists despite our best efforts. In an attempt to close the gap through behaviour change interventions, there has been a strong held belief that ‘more is better,’ without understanding the mechanisms and circumstances of knowledge translation (KT). We argue that even a single intervention or strategy in translating evidence into healthcare policy or practice is rarely simple to implement. Nor is the evidence compelling on the best approach. As Harvey and Kitson argued, designing and evaluating KT interventions requires flexibility and responsiveness. If we are to move forward in translation science then we need to use rigorous designs such as randomised controlled trials to test effectiveness of interventions or strategies with embedded process evaluations to understand the reason interventions do or do not work!
PMCID: PMC4629709  PMID: 26673344
Clinical Decision-Making; Evidence-Based Healthcare; Knowledge Translation (KT); Multi-faceted Interventions; Process Evaluation
4.  Translation and testing of the Risk Assessment Pressure Ulcer Sore scale used among residents in Norwegian nursing homes 
BMJ Open  2012;2(5):e001575.
The purpose of this study was to translate and test the psychometric properties of the Norwegian-language version of the Risk Assessment Pressure Sore (RAPS) scale.
Risk assessment scales for pressure ulcer (PU) prevention have become an aspect of quality improvement in healthcare, but their effectiveness depends on the reliability and validity of the scale.
 A convenience sample of 481 residents in 15 nursing homes in rural Norway was included between January and June 2007. The English-language version of the RAPS scale was translated into Norwegian, and this scale was used to collect the data, including a skin examination. The number of PUs and grades were documented. Reliability was assessed in a small group of 26 residents and construct validity in the total study group.
Equivalence between two assessments regarding total scores of the RAPS scale was reflected in an intraclass correlation coefficient (ICC) of 0.95. Construct validity was supported, and the RAPS scale could define groups with expected low and high scores. Further evidence of construct validity was shown in a confirmatory factor analysis.
The Norwegian version of the RAPS scale has shown sufficient psychometric properties to be considered a reliable and valid scale for identifying risk of PUs among nursing home residents. However, further testing is needed.
PMCID: PMC3488716  PMID: 23100445
5.  Experiences of Nursing Personnel Using PDAs in Home Health Care Services in Norwegian Municipalities 
Although nursing personnel have used personal digital assistants (PDAs) to support home health care services for the past ten years, little is known about their experiences. This study was conducted to examine experiences of nursing personnel using a specialized home health care computer software application called Gerica. In addition, this research analyzed how well this application aligned with the workflow of the nursing personnel in their daily care of patients. The evaluation methods included user observations and learnability testing. Nursing personnel from two different municipalities were observed while performing real tasks in natural settings. This study shows that the nursing personnel were satisfied with the PDA user interface and the Gerica software; however, they identified areas for improvement. For example, the nursing personnel were concerned about trusting the reliability of the PDA in order to eliminate the need for handwritten documentation. Solutions to meet these shortcomings for nursing managers and vendors are discussed.
PMCID: PMC3799085  PMID: 24199073
6.  The Experiences of Using a Computerized Decision Support System 
The aim was to describe the facilitators and barriers influencing the ability of nursing personnel to effectively use a CDSS for planning and treating pressure ulcers and malnutrition in nursing homes. Usability evaluations and group interviews were conducted. Facilitators were ease of use, usefulness and a supportive work environment. Lack of training, resistance to using computers and limited integration of the CDSS with the electronic health record system were reported.
PMCID: PMC3799172  PMID: 24199144

Results 1-6 (6)