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Israelsson, Johan
Publications (6 of 6) Show all publications
Stevenson, J. E., Israelsson, J., Petersson, G. & Bath, P. A. (2018). Factors influencing the quality of vital sign data in electronic health records: A qualitative study. Journal of Clinical Nursing, 27(5-6), 1276-1286
Open this publication in new window or tab >>Factors influencing the quality of vital sign data in electronic health records: A qualitative study
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1276-1286Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To investigate reasons for inadequate documentation of vital signs in an electronic health record.

BACKGROUND: Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent.

DESIGN: Qualitative study.

METHODS: Qualitative study. Data were collected by observing (68 hr) and interviewing nurses (n = 11) and doctors (n = 3), and analysed by thematic analysis to examine processes for measuring, documenting and retrieving vital signs in four clinical settings in a 353-bed hospital.

RESULTS: We identified two central reasons for inadequate vital sign documentation. First, there was an absence of firm guidelines for observing patients' vital signs, resulting in inconsistencies in the ways vital signs were recorded. Second, there was a lack of adequate facilities in the electronic health record for recording vital signs. This led to poor presentation of vital signs in the electronic health record and to staff creating paper "workarounds."

CONCLUSIONS: This study demonstrated inadequate routines and poor facilities for vital sign documentation in an electronic health record, and makes an important contribution to knowledge by identifying problems and barriers that may occur. Further, it has demonstrated the need for improved facilities for electronic documentation of vital signs.

RELEVANCE TO CLINICAL PRACTICE: Patient safety may have been compromised because of poor presentation of vital signs. Thus, our results emphasised the need for standardised routines for monitoring patients. In addition, designers should consult the clinical end-users to optimise facilities for electronic documentation of vital signs. This could have a positive impact on clinical practice and thus improve patient safety.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2018
Keywords
electronic health records, patient safety, qualitative study, vital signs
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-146120 (URN)10.1111/jocn.14174 (DOI)000428419400087 ()29149483 (PubMedID)2-s2.0-85044258923 (Scopus ID)
Available from: 2018-03-28 Created: 2018-03-28 Last updated: 2018-05-17Bibliographically approved
Al-Dury, N., Rawshani, A., Israelsson, J., Stromsoe, A., Aune, S., Agerstrom, J., . . . Herlitz, J. (2017). Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age. American Journal of Emergency Medicine, 35(12), 1839-1844
Open this publication in new window or tab >>Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age
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2017 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 35, no 12, p. 1839-1844Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age. Methods: Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18-49 years), middle-aged (5064 years) and older (65 years and above). Comparisons between men and women were age adjusted. Results: The mean age was 72.7 years and women were significantly older than men. Renal dysfunction was the most prevalent co-morbidity. Myocardial infarction/ischemia was the most common condition preceding IHCA, with men having 27% higher odds of having MI as the underlying etiology. A shockable rhythm was found in 31.8% of patients, with men having 52% higher odds of being found in VT/VF. After adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30 days. Older individuals were managed less aggressively than younger patients. Increasing age was associated with lower 30-day survival but not with poorer cerebral function among survivors. Conclusion: When adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30 days after in-hospital cardiac arrest. Older individuals were managed less aggressively than younger patients, despite a lower chance of survival. Higher age was, however, not associated with poorer cerebral function among survivors. (C) 2017 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
W B SAUNDERS CO-ELSEVIER INC, 2017
Keywords
Cardiac arrest; Cardiopulmonary resuscitation
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-143923 (URN)10.1016/j.ajem.2017.06.012 (DOI)000417337100009 ()28624147 (PubMedID)
Available from: 2017-12-29 Created: 2017-12-29 Last updated: 2018-04-18
Israelsson, J., Bremer, A., Herlitz, J., Axelsson, Å. B., Cronberg, T., Djärv, T., . . . Årestedt, K. (2017). Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender. Resuscitation, 114, 27-33
Open this publication in new window or tab >>Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender
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2017 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 114, p. 27-33Article in journal (Refereed) Published
Abstract [en]

Aim: To describe health status and psychological distress among in -hospital cardiac arrest (IHCA) survivors in relation to gender. Methods: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS). Results: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQVAS among survivors were 0.78 (ql-q3 = 0.67-0.86) and 70 (ql -q3 = 50-80) respectively. The values were significantly lower (p amp;lt; 0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self -care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p amp;lt; 0.001) and symptoms of depression (p amp;lt; 0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found. Conclusions: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed. (C) 2017 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2017
Keywords
Anxiety; Depression; Health status; Heart arrest; Hospitals; Gender
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-138921 (URN)10.1016/j.resuscitation.2017.02.006 (DOI)000402487800021 ()28216089 (PubMedID)
Note

Funding Agencies|Swedish Heart and Lung Association; Medical Research Council of Southeast Sweden

Available from: 2017-06-27 Created: 2017-06-27 Last updated: 2018-04-18
Semark, B., Årestedt, K., Israelsson, J., von Wangenheim, B., Carlsson, J. & Schildmeijer, K. (2017). Quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation. European Journal of Cardiovascular Nursing, 16(5), 453-457
Open this publication in new window or tab >>Quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 5, p. 453-457Article in journal (Refereed) Published
Abstract [en]

Introduction: A high quality of chest compressions, e.g. sufficient depth (5-6 cm) and rate (100-120 per min), has been associated with survival. The patients underlay affects chest compression depth. Depth and rate can be assessed by feedback systems to guide rescuers during cardiopulmonary resuscitation. Aim: The purpose of this study was to describe the quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation. Method: An observational descriptive study was performed including 63 cardiac arrest events with a resuscitation attempt. Data files were recorded by Zoll AED Pro, and reviewed by RescueNet Code Review software. The events were analysed according to depth, rate, quality of chest compressions and underlay. Results: Across events, 12.7% (median) of the compressions had a depth of 5-6 cm. Compression depth of amp;gt;6 cm was measured in 70.1% (median). The underlay could be identified from the electronic patient records in 54 events. The median compression depth was 4.5 cm (floor) and 6.7 cm (mattress). Across events, 57.5% (median) of the compressions were performed with a median frequency of 100-120 compressions/min and the most common problem was a compression rate of amp;lt;100 (median=22.3%). Conclusions: Chest compression quality was poor according to the feedback system. However, the distribution of compression depth with regard to underlay points towards overestimation of depth when treating patients on a mattress. Audiovisual feedback devices ought to be further developed. Healthcare professionals need to be aware of the strengths and weaknesses of their devices.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD, 2017
Keywords
Cardiopulmonary resuscitation; chest compression; feedback devices; mattresses; quality
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-138902 (URN)10.1177/1474515117701060 (DOI)000402662800012 ()28565967 (PubMedID)
Available from: 2017-06-27 Created: 2017-06-27 Last updated: 2018-04-18
Israelsson, J., von Wangenheim, B., Årestedt, K., Semark, B., Schildmeijer, K. & Carlsson, J. (2017). Sensitivity and specificity of two different automated external defibrillators. Resuscitation, 120, 108-112
Open this publication in new window or tab >>Sensitivity and specificity of two different automated external defibrillators
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2017 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 120, p. 108-112Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to investigate the clinical performance of two different types of automated external defibrillators (AEDs). Methods: Three investigators reviewed 2938 rhythm analyses performed by AEDs in 240 consecutive patients (median age 72, q1-q3 = 62-83) who had suffered cardiac arrest between January 2011 and March 2015. Two different AEDs were used (AED A n = 105, AED B n = 135) in-hospital (n = 91) and out-of-hospital (n = 149). Results: Among 194 shockable rhythms, 17 (8.8%) were not recognized by AED A, while AED B recognized 100% (n = 135) of shockable episodes (sensitivity 91.2 vs 100%, p amp;lt; 0.01). In AED A, 8 (47.1%) of these episodes were judged to be algorithm errors while 9 (52.9%) were caused by external artifacts. Among 1039 non-shockable rhythms, AED A recommended shock in 11 (1.0%), while AED B recommended shock in 63 (4.1%) of 1523 episodes (specificity 98.9 vs 95.9, p amp;lt; 0.001). In AED A, 2 (18.2%) of these episodes were judged to be algorithm errors (AED B, n = 40, 63.5%), while 9 (81.8%) were caused by external artifacts (AED B, n = 23, 36.5%). Conclusions: There were significant differences in sensitivity and specificity between the two different AEDs. A higher sensitivity of AED B was associated with a lower specificity while a higher specificity of AED A was associated with a lower sensitivity. AED manufacturers should work to improve the algorithms. In addition, AED use should always be reviewed with a routine for giving feedback, and medical personnel should be aware of the specific strengths and shortcomings of the device they are using. (C) 2017 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2017
Keywords
Arrhythmia; AED; Defibrillation; Sensitivity; Specificity
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-142973 (URN)10.1016/j.resuscitation.2017.09.009 (DOI)000413760500025 ()28923243 (PubMedID)
Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-04-18
Nord, A., Lundgren, J., Bremer, A., Carlsson, J. & Israelsson, J. (2016). HLR och rätten till en värdig död. Läkartidningen (20), Article ID 2016;113:DZEH.
Open this publication in new window or tab >>HLR och rätten till en värdig död
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2016 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, no 20, article id 2016;113:DZEHArticle in journal, Editorial material (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2016
National Category
Medical Ethics
Identifiers
urn:nbn:se:liu:diva-130829 (URN)
External cooperation:
Available from: 2016-08-26 Created: 2016-08-26 Last updated: 2017-11-28Bibliographically approved
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