ORCID Profile
0000-0002-2541-5371
Current Organisations
Via University College
,
VIA University College Sygeplejerskeuddannelsen
,
VIA
,
Hospitalsenhed Midt
,
Regional Hospital Midt
,
Deakin University
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2012
Publisher: Wiley
Date: 29-05-2017
DOI: 10.1111/NIN.12196
Abstract: It is widely recognised that the delivery of services across health-care sectors faces multiple challenges related to incoherence in patient pathways. There are multiple reasons for this incoherence, which are often dealt with through national legislation and policy-making. This paper discusses policies as powerful actors and explores how effects of a concrete policy are adapted for intersectorial collaboration in Danish health-care. The paper is based on a critical discourse analysis of a central policy document in Danish health-care known as the 'Health Agreements'. Using Fairclough's three-dimensional model for discourse analysis, we explored the document to clarify the construction of actors participating in intersectorial collaboration. The analysis revealed the Health Agreement as a 'negotiated text', appearing as an overriding document legitimising one possible discourse regarding the premises of intersectorial collaboration. The premises of intersectorial collaboration are maintained through a specific presentation of actors leaving little room for discussion, where professionals are constructed as actors who are expected to develop ways of collaborating according to the Triple Aim approach in order to promote productivity and efficiency. Furthermore, this presentation constructs citizens and patients as active, participating in iduals who consciously prioritise and act with the purpose of controlling their life situation.
Publisher: Wiley
Date: 14-07-2020
DOI: 10.1111/NIN.12370
Publisher: Wiley
Date: 17-07-2023
DOI: 10.1111/NIN.12585
Abstract: Nowadays, it is common that newly built hospitals are designed with single‐room accommodation, unlike in the past, where shared accommodation was the favoured standard. Despite this change in hospital design, very little is known about how single‐room accommodation affects nurses' work environment and nursing care. This study evaluates how the single‐room design affects nurses and nursing care in the single‐room hospital design. Nurses working in the single‐room design predominantly work alone with little opportunity for peer training, interaction and reflection. In addition, the single‐room design affects the nurses' work environment due to changes in sensory stimulation and increased walking distances. Furthermore, a change in the discourse, namely, regarding the single room as the patient's home, makes the nurses react to queries, demands and tasks in a new way. Overall, the new hospital design forces the nurses into a more reactive role and affect their way of providing nursing care. Despite this, the nurses find single‐room accommodation beneficial for the patients and their nursing care.
Publisher: Wiley
Date: 08-07-2019
DOI: 10.1111/NIN.12310
Abstract: Several studies describe intersectoral collaboration in Western healthcare as h ered by lack of coordination of care and treatment and incoherent patient pathways. We performed an ethnographic study following elderly patients from admission to an emergency unit (EMU) to discharge and further treatment and care at other facilities in the healthcare system. The aim was to explore how health professionals work together across sectors in the Danish healthcare system and how they create patient pathways for elderly patients (+65) with multiple chronic illnesses. Intersectoral collaboration was identified as distant relations between large numbers of health professionals, where communication was conveyed by electronic health record (EHR) formats which promoted information delivery that focused on patients' immediate symptoms. Other significant 'mediators' of communication were the telephone that seemed to resemble face-to-face communication and the patient who delivered information from one professional to another. We suggest that the communication among professionals at various facilities interacts with the format and functionalities of the EHRs, which typically fall short in delivery of information across sectors, because the often complex needs of patients with multimorbidity do not fit in with the available functionalities of the EHR.
Publisher: Wiley
Date: 12-2022
DOI: 10.1111/IWJ.14026
Abstract: Diabetic foot ulcer (DFU) is a common, complex and severe complication of diabetes that is associated with severely decreased health‐related quality of life. Treatment of DFUs calls for a multi‐sectoral approach, incorporating interdisciplinary care pathways. Telemedicine (TM) may be used as a communication tool between caregivers across healthcare sectors to obligate the need for close follow‐up, including early intervention in preventing the recurrence of DFU. The objective of this review was to identify, examine and conceptually map the available literature on patients' experiences and views regarding the use of TM solutions among patients with DFUs. We identified the Population, Concept and Context to pinpoint the focus of this review, word the research question and title as well as facilitate the literature search strategy. The literature examined stems from 13 sources. We imposed no restrictions on the methodological approach of the included studies, neither on the format. During the review process, four main maps emerged: “A whole human not merely a hole in a human,” “Less of a burden on the family, the community and the environment,” “Competences and continuity of care are essential for high‐quality care” and “The quality and modality of the technology.” Further investigation from both the patients' and the multi‐sectoral caregivers' perspective is needed, focusing on whatever modifications of the TM intervention may fit the DFU care pathway better.
Publisher: SAGE Publications
Date: 03-02-2012
Abstract: Short-stay treatment has become a popular form of care as a strategy to cope with increased demands on health care. There is little research that considers children’s experiences of acute hospitalisation to a short-stay care facility such as a Paediatric Emergency and Assessment Unit (PEAU). This study explored the experiences of eight children aged 8–10 years. Semi-structured interviews were carried out to investigate the children’s own experiences of being hospitalised in a PEAU. Thematic content analyses were used. Three major themes were identified: the children’s understanding of disease, treatment and procedures the children’s experiences of health-care personnel and the PEAU and transformation of everyday life into the settings of the hospital. The children identified the hospital stay as an overall positive experience. The children took part in leisure activities as they would at home and enjoyed time together with their parents while in hospital. In their conversations with staff they adapted to professional terms that they did not necessarily understand. They did not differentiate between professionals. Further work should be considered to clarify the consequences of this. This study has provided some limited insight into the child’s experiences of acute hospitalisation, which should inform nursing care.
Publisher: Wiley
Date: 18-07-2023
DOI: 10.1111/JOCN.16824
Abstract: To evaluate evidence that examined nurses' work experiences in hospital wards with single rooms. The research question was ‘What does the research tell us about nurses’ work experiences in hospital wards with single rooms?’ In the last decades, new hospital builds have moved towards including a high proportion of single rooms. Yet, single rooms create ‘complex environments’ that impact the nurses. A structured integrative review was undertaken of empirical evidence. Original, peer‐reviewed articles, written in English, were sourced from four databases: CINAHL, PubMed, Embase and Web of Science. The initial searches were performed in April 2021 and repeated in December 2022. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool. A narrative synthesis approach was used to analyse the data. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Twelve studies, published between 2006 and 2022, with an international origin, and representing n = 826 nurses, were included in this review. The synthesis revealed mixed perspectives about nurses' work experiences in wards with single rooms. Whilst single rooms are ‘all good in theory (and) a good idea’, the reality was quite different. Synthesised findings are presented in four categories: (i) aesthetics and the physical space, (ii) privacy vs. isolation, (iii) safety, which includes situational awareness and (iv) communication and collaboration. This review describes how single rooms affects nurses' work experience. Whilst nurses shared multiple concerns about single rooms and the challenges they also acknowledged patient preference for the privacy and space afforded by single rooms. Findings from this review highlight the need for careful planning to maintain and strengthen teamwork, prevent nurses' sense of working in isolation, as well as creating opportunities for mentorship, and collaboration among nurses when working in single‐room settings.
Publisher: Wiley
Date: 25-08-2022
DOI: 10.1111/HEX.13574
Abstract: Persons with spinal cord injury have experienced a life‐changing event, and they need to engage in the rehabilitation process to adjust to their current situation and future living conditions. Due to the highly contextual and varying psychological and physical ability to participate from patient to patient during rehabilitation, this is difficult for the injured person and for health professionals to support. Therefore, the aim of the study was to develop and facilitate patient participation by engaging nursing staff and from this engagement in the process, disclose methods to support participation. The processes conducted were based on an action research approach, from problem identification to the development, test and evaluation of four new nursing initiatives. The initiatives were developed by eight nursing staff members who participated actively as co‐researchers in a 2‐year study conducted at a Spinal Cord Injury Centre in Denmark from 2016 to 2018. Data evolved from workshops, transcriptions of meetings and written evaluations and was further analysed using Ricoeur's phenomenological‐hermeneutic approach. Action research processes facilitated the development of four communicative initiatives and a shift in the nursing staff's support of the patient. In a collaborative process, the nursing staff acted as participants in the patient's rehabilitation. Awareness of the patient's perspective facilitated a caring, attentive and engaged approach from the nursing staff, which promoted rehabilitation tailored to the in idual. Patient participation was enhanced when nursing staff actively participated in the development of initiatives and a culture supporting a person‐to‐person approach involving the patient and themselves as equal participants in the collaborative rehabilitation process. Eight nursing staff members from the rehabilitation centre participated throughout the study as co‐researchers. Patients participated in observations and as informants in interviews during the first phase to identify challenges to patient participation. Patients also participated in testing the nursing initiatives during the action phase (Phase 3). Furthermore, a former patient was a member of the advisory board.
Publisher: SAGE Publications
Date: 11-06-2018
Abstract: When setting up patient pathways that cross health care sectors, professionals in emergency units strive to fulfill system requirements by creating efficient patient pathways that comply with standards for length of stay. We conducted an ethnographic field study, focusing on health professionals’ collaboration, of 10 elderly patients with chronic illnesses, following them from discharge to their home or other places where they received health care services. We found that clock time not only governed the professionals’ ways of collaborating, but acceleration of patient pathways also became an overall goal in health care delivery. Professionals’ efforts to save time came to represent a “monetary value,” leading to speedier planning of patient pathways and consequent risks of disregarding important issues when treating and caring for elderly patients. We suggest that such issues are significant to the future planning and improvement of patient pathways that involve elderly citizens who are in need of intersectoral health care delivery.
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/20552076231180521
Abstract: Since the 1990s, almost all healthcare organisations have had electronic health records (EHR) to organise and manage treatment, care and work routines. This article aims to understand how healthcare professionals (HCPs) make sense of digital documentation practice. Based on a case study design, field observations and semi-structured interviews were conducted in a Danish municipality. A systematic analysis based on Karl Weick's sensemaking theory was applied to investigate what cues HCPs extract from timetables in the EHR and how institutional logics frame the enactment of documentation practice. The analysis uncovered three themes: making sense of planning, making sense of tasks and making sense of documentation. The themes illustrate that HCPs make sense of the digital documentation practice as a dominant managerial tool designed to control resources and work routines. This sensemaking leads to a task-oriented practice which centres on delivering fragmented tasks according to a timetable. HCPs mitigate fragmentation by responding to a care professional logic, where they document to share information and carry out invisible work outside of timetables and scheduled tasks. However, HCPs are focused on solving specific tasks by the minute with the possible consequence that continuity and their overview of the service user's care and treatment disappear. In conclusion, the EHR system eliminates a holistic view of care trajectories, leaving it up to HCPs to collaborate in an effort to obtain continuity for the service user.
Publisher: SAGE Publications
Date: 12-10-2021
DOI: 10.1177/19375867211047548
Abstract: To identify, examine, and map literature on the experiences of single-room hospital accommodation, exploring what is known about how single-room accommodation in hospitals is viewed by patients and nurses. Worldwide, hospital design is changing to mainly single-room accommodation. However, there is little literature exploring patients’ and nurses’ experiences of single-room designs. Scoping review following the Joanna Briggs Institute guidance on scoping reviews. We conducted the search in medical databases for scientific and gray literature. The four authors independently used a data extraction tool to include sources from the searches. The sources were discussed during the process, and in case of a disagreement between two reviewers, the third and fourth reviewer would be invited to participate in the discussion until consensus was achieved. We included 22 sources published during the period 2002–2020, with a majority ( n = 16) during the period 2013–2020. The sources were distributed on 10 different countries however, England dominated with 14 publications. We found three main maps for reporting on patients’ experiences: (1) personal control, (2) dignity, and (3) by myself. For the nurses’ experiences, we found four main maps: (1) the working environment, (2) changes of nursing practice, (3) privacy and dignity, and (4) patient safety. We suggested that patients’ and nurses’ experiences are predominantly interdependent and that the implications of single-room accommodation is a large and complex issue which goes beyond hospital design.
Publisher: Scandinavian University Press / Universitetsforlaget AS
Date: 10-05-2023
DOI: 10.18261/KS.37.1.4
Publisher: Ubiquity Press, Ltd.
Date: 04-11-2022
No related grants have been discovered for Raymond Kolbaek.