RESUMEN
BACKGROUND: The growing concern about a dwindling healthcare workforce, exacerbated by demographic changes, calls for innovative solutions. One viable approach involves implementing new professional roles and restructuring existing healthcare teams within hospital care units. OBJECTIVES: To evaluate the implementation of an innovative task-shifting concept, care-related services (CRS), from the managers' perspective in somatic care units across the hospitals in a region in Sweden. METHODS: The qualitative study was conducted in 2022, after the implementation of CRS. Individual interviews were conducted with 24 key stakeholders, including 14 care unit managers, six CRS managers, and four process managers. A qualitative content analysis was performed, utilizing the Consolidated Framework of Implementation Research (CFIR). RESULTS: The implementation of CRS involved collaboration between care unit managers, CRS managers, and project managers, alongside CRS staff, registered nurses (RNs), and licensed vocational nurses (LVNs). In particular, their roles encompassed defining boundaries, establishing routines, and managing personnel. Throughout the implementation process, challenges emerged, stemming from undefined goals, difficulties in recruiting qualified CRS staff, and issues associated with seamlessly integrating CRS into existing work routines. These challenges arose due to a constrained timeframe, widespread team apprehension, shortcomings in the training of CRS staff, unclear task allocation, and an increased workload for care unit managers. Factors associated with successful CRS implementation included effective cooperation among managers and an open-minded approach. CONCLUSIONS: Our findings highlight the crucial role of clear communication, effective recruitment, integration of CRS staff, clarification of roles, responsibilities, and defined goals for successful CRS implementation.
Asunto(s)
Entrevistas como Asunto , Investigación Cualitativa , Humanos , Suecia , Grupo de Atención al Paciente/organización & administración , Femenino , MasculinoRESUMEN
Many industrial workers are exposed to air contaminants. A significant proportion of this exposure is found to occur as short peaks, a fact that has received limited attention in the literature. The present study focuses on short-term variation in air contaminant exposure measured at the level of seconds, linking exposure peaks to typical work situations in selected Swedish industries. The video exposure monitoring method was used to characterize this variation. Ten different videos were analyzed, from recordings varying in length between 15 and 34 minutes. Cumulative exposure for sampling intervals ranked from high to low, relative to the total exposure was calculated as a function of time. Measures of exposure variation included geometric standard deviation and maximum exposure divided by arithmetic mean. The results show that the characteristics of the variation differ between industrial situations. Samples from the stone, wood, and pharmaceutical industries generated the highest variation, implying that exposure peaks of short duration explain a large proportion of the total exposure. It can be concluded that video monitoring of exposure, combined with calculation of exposure variation as percentage of time accounting for given percentages of exposure, can help to reduce exposure to air contaminants in industrial situations by introducing more targeted control measures.