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dc.contributor.authorFrödin, Maria
dc.date.accessioned2022-10-26T11:54:17Z
dc.date.available2022-10-26T11:54:17Z
dc.date.issued2022-10-26
dc.identifier.isbn978-91-8009-985-1 (TRYCK)
dc.identifier.isbn978-91-8009-978-8 (PDF)
dc.identifier.urihttps://hdl.handle.net/2077/72563
dc.description.abstractAdverse events such as hospital-acquired infections and bladder distension are largely preventable if evidence-based recommendations are adhered to. The overall aim of this thesis was to promote healthcare workers’, involved in the care of patients with hip fracture, ownership of postoperative infections, especially urinary catheter associated urinary tract infections (UC-UTIs), and bladder distension prevention. Methods: Process evaluations of two theory driven interventions, the Safe Hands, Study I and the Safe Bladder, Study II-IV, spanning over 5 years. In studies I and IV, a qualitative approach was used to describe fidelity and mechanism of impact. In Study II and III, quantitative data analysis was performed to describe the interventions effectiveness on patient outcomes. The implementation strategies were integrated knowledge translation, facilitation and were underpinned by theories of organizational culture, leadership and dialogue. Findings: The theories and strategies used were important mechanism of impact and affected not only participants response to the intervention but also the co-creation of new innovations that might promote ownership of UC-UTI and bladder distension prevention. The interventions were associated with a decreased incidence of both UC-UTIs and bladder distension. Study II, UC UTI decreased from 18.5% (n=75/406) to 4.2% (n=27/647) (P<0.0001). When adjusting for confounders, patients in phase 4 were 74% less likely to contract an UC-UTI, OR 0.26 (95% CI 0.15-0.45). Bladder distension decreased from 40.6 % (n=165/406) to 9.1% (n=57/626), P<0.0001). When adjusting for confounders the yearly reduction in odds of bladder distension was 39%, OR 0.61 (95% CI 0.57-0.64). Conclusion: Theory driven interventions and strategies that involves facilitation, co-creation and educations can promote the uptake of preventive measures and showed to be associated with a reduced incidence of two of the most common and preventable adverse eventsen_US
dc.language.isoengen_US
dc.relation.haspartStudy I. Erichsen Andersson, A., Frödin, M., Dellenborg, L., Wallin, L., Hök, J., Gillespie, B. M. & Wikström M, E. Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study. BMC Health Services Research, 2018 Dec;18(1):1-2. ::doi::10.1186/s12913-017-2783-1en_US
dc.relation.haspartStudy II. Frödin M., Ahlstrom L., Gillespie BM., Rogmark C, Nellgård B, Wikström E, Erichsen Andersson A. Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients. Journal of Infection Prevention. 2022 Mar;23(2):41-8. https://doi.org/10.1177/17571774211060417en_US
dc.relation.haspartStudy III. Frödin M, Nellgård B, Rogmark C, Gillespie BM, Wikström E, Erichsen Andersson A. A co-created nurse-driven catheterisation protocol can reduce bladder distension in acute hip fracture patients – results from an observational study. BMC Nursing, 2022 21:276. https://doi.org/10.1186/s12912-022-01057-zen_US
dc.relation.haspartStudy IV. Frödin M, Nellgård B, Rogmark C, Gillespie BM, Wikström E, Erichsen Andersson A. What is in the black box? – Process evaluation of The Safe Bladder bundle. Worldviews on Evidence-Based Nursing, in manuscripten_US
dc.subjectInfection preventionen_US
dc.subjectPatient safetyen_US
dc.subjectImplementation scienceen_US
dc.subjectOrganizational cultureen_US
dc.subjectHip fractureen_US
dc.subjectBladder distensionen_US
dc.subjectUrinary catheters associated urinary tract infectionen_US
dc.titlePostoperative infections and bladder distension following hip fracture surgery Findings from implementing patient safety innovationsen_US
dc.typetexteng
dc.type.svepDoctoral thesiseng
dc.gup.mailmaria.frodin@vgregion.seen_US
dc.gup.mailmaria.frodin@gu.seen_US
dc.gup.mailmaria.frodin@vgregion.seen_US
dc.type.degreeDoctor of Philosophy (Health Care Sciences)en_US
dc.gup.originUniversity of Gothenburg. Sahlgrenska Academyen_US
dc.gup.departmentInstitute of Health and Care Sciencesen_US
dc.gup.defenceplaceFredagen den 18 november, kl. 9.00, Wallenbergsalen, Medicinaregatan 20 A, Göteborgen_US
dc.gup.defencedate2022-11-18
dc.gup.dissdb-fakultetSA


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