Ann-Chatrin Linqvist Leonardsen

Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide, accounting for 27% of all maternal deaths occurring, with outcomes heavily dependent on timely and effective inter...

Background: Artificial intelligence-based decision support systems have been suggested as possible aids for decision makers in emergency care. To balance patient safety, cost, efficiency, and professional integrity, we need to understand the views and arguments health professionals have for and against the implementation of such systems. The current study aimed to explore emergency primary care personnel’s perspectives on artificial intelligence-based decision support systems in emergencies in the municipality. Method: This study used a qualitative design with online, semistructured interviews with 12 primary emergency health care personnel. A purposive sampling strategy was used, and participants were recruited either from EPC center or municipal healthcare institutions receiving services from the EPCRU. The data were analyzed following thematic analysis. Results: Four main themes were identified, namely, “Human need, clinical evaluations,” “Balancing skepticism and confidence,” “Digital sparring partner and alternative hypotheses,” and “Health personnel’s role in procurement and development.” The participants emphasized a need for human and clinical assessments to detect illness and initiate appropriate actions. Aspects of skepticism and confidence were also discussed. However, they perceived that AI-based decision support systems could be ideal digital sparring partners. Moreover, all the participants underlined the importance of involving intended users when developing and implementing decision support systems. Conclusions: This study emphasizes the essential role of health personnel in decision-making processes in emergency primary care, as well as in the implementation processes of AI in these services. AI is suggested as a supportive tool that provides safe and trustworthy solutions. These aspects are useful for managers and other decision makers in the transformation of health services for the future.

Incarcerated women face significantly elevated cervical cancer risks compared to the general population due to higher human papillomavirus (HPV) prevalence

Studies have found that a mixed staffing model where nurses and nurse assistants work as a team can deliver better care quality than standard nurse staffing models. However, there are issues related to communication gaps, unclear job descriptions, hierarchical barriers, resource limitations, cultural and systemic factors that need to be solved. The aim of the current study was to explore nurses’ and nurse assistants’ experiences with an educational intervention to bridge the gap between nurses and nurse assistants. The educational intervention involved nurses and nurse assistants and comprised a lecture of 90 min, followed by 60 min of simulation in the respective subject ‘respiratory issues’ and ‘sepsis’. A qualitative study design, with six focus group interviews (N = 23), was used. Data were analyzed using thematic analysis in-line with recommendations from Braun and Clarke. Through analysis, two themes were identified, namely (1) Simulation; a love-hate relationship and (2) Increased insight into each other’s competence and understanding of each other’s focus. Both nurses and nurse assistants were sceptic to simulation as an educational intervention. However, all appreciated the combination of theory and simulation. The level seemed appropriate for nurse assistants, while nurses perceived the level as mostly repetition. The education day increased insight into each other’s competence and understanding of each other’s focus across wards and specialties, and across nurses and nurse assistants. Educational interventions between nurses and nurse assistants may be appropriate to decrease communication and collaboration gaps across occupations. Combining theoretical lectures and simulations also seemed to support this. Not applicable.

Background: Stroke is a large and increasing health challenge, leading to acquired physical disability and mortality. A rapid diagnostic assessment in the acute phase of a stroke is crucial and highly time dependent. Studies suggest that artificial intelligence (AI) could contribute for prognostication, prediction and resource optimization in suspected stroke cases in prehospital emergency care. The objective of the current study was to explore Emergency Medical Services providers’ perspectives on using AI in the prehospital assessment of patients with a suspected stroke diagnosis. Methods: A qualitative study design following stroke case simulation with an AI-based diagnostic tool was used. One focus group and ten dyadic interviews were conducted comprising 24 participants from three ambulance stations in Norway and Sweden respectively. Data were analyzed following Braun and Clarke’s steps for thematic analysis. Results: Three themes were identified, namely (1) Another tool in the toolkit, (2) Trust is essential, and (3) The devil is in the details. The participants underlined that the AI-based tool was just an addition to their usual assessment, including symptoms, anamnesis, and vital parameters, as well as their own ‘clinical eye’. Moreover, trust was needed from various stakeholders for the tool to have a function in the patient pathway. Finally, size and weight, as well as the ability to differentiate between hemorrhagic and thrombotic stroke were central aspects for the tool to be feasible. Conclusion: Emergency Medical Services providers mainly rely on their own clinical eye, combining symptoms, anamnesis and measurement of vital parameters when assessing suspected stroke patients. AI-based tools may be used as support in the decision-making process, however this depends on the establishment of trust in the tool across EMS providers, neurologists and other health professionals.

Endotracheal intubation may be performed using deep anesthesia, neuromuscular blocks, or the topical application of anesthetics on the vocal cords. The null hypothesis in this study was that there is no difference in hoarseness one hour after extubation between patients receiving neuromuscular blocks versus lidocaine sprayed on the glottis for endotracheal intubation. A randomized, controlled, double-blinded study was conducted. A total of 114 patients were included. Group I (n = 58) received rocuronium 0.6 mg/kg. Group II (n = 56) received lidocaine spray 4 ml (20 mg/ml) on the vocal cords. The primary outcome measure was hoarseness one hour after extubation. Secondary outcomes were hoarseness at 24 and 48 h after extubation, sore throat at 1, 24, and 48 h after extubation, and intubation and extubation conditions. There was no statistically significant difference between groups in hoarseness one hour after extubation. At 24 h, Group I had significantly more reported hoarseness (27.6%) and observed hoarseness (1.7%) than Group II (12.5% reported) (p = 0.03). Group II had a significantly sorer throat (21.4%) than Group I (1.7%) (p < 0.001) at one hour. Beyond this, there were no differences between groups. Even though some differences were observed in hoarseness and sore throat 24 h after extubation, there were few differences between topical lidocaine spray and the use of neuromuscular blocks before intubation for patient-reported and observed outcomes. Consequently, clinicians should choose an approach based on considerations other than those included in this study, such as the need for muscle relaxation or minimizing the number of laryngoscopies. NCT05614609

Background: Parental satisfaction with anesthetic care is utilized as a proxy for child satisfaction. The evidence base regarding parent satisfaction with pediatric anesthesia care is limited. The aim of the current study was to assess (1) parent satisfaction with pediatric anesthesia in three hospitals, (2) potential differences across hospitals, and (3) potential associations between parent satisfaction and the child's age, surgical specialty, hospital, whether the parent previously had followed a child to surgery, and relation to the patient.Methods: The Norwegian version of the “pediatric anesthesia parent satisfaction survey” questionnaire (NPAPS) was used. Descriptive statistics, Kruskal–Wallis test and linear regression analysis were used to analyze the data.Results: In total, 234 parents responded. Most respondents agreed that their child had received the highest quality care during the surgical experience (96.4%–97.4%). Nearly all respondents agreed that their questions were responded to (94.6%–97.6%), information was understandable (96.4%–97.4%), the amount of information was appropriate (96.4%–97.4%), the child's integrity was respected (94.6%–97.4%), the child was treated respectfully and professionally (96.45%–97.6%), and that personnel paid attention to the parent's concerns (93.8%–94.7%). Respondents disagreed with being explained how the child might feel physically and emotionally after anesthesia (9.5%–10.5%) and also disagreed with being satisfied with the way the child fell asleep and woke up from anesthesia (5.3%–7.1%). No factors were associated with the level of parent satisfaction, and there were few differences between hospitals.Conclusion: Even if parents are overall satisfied with anesthesia care, improvement areas regarding the preparation of parents and control of postoperative symptoms were detected.

Betydelig fagutviklings- og forskningsarbeid som blir utført i praksis blir ikke publisert, og blir dermed ikke delt med andre. Dette kan være arbeid som gjøres innenfor en profesjon, eller også på tvers av profesjoner. Fagutvikling og forskning som gjøres innenfor spesialitetene intensiv-, operasjons- og anestesisykepleie bør publiseres slik at andre kan lære av og bygge videre på resultatene. For å skrive en artikkel, bør forfatteren ha både motivasjon, inspirasjon og tro på eget arbeid og arbeidets betydning, men også tid til å skrive. For å stimulere medlemmene til å publisere egne resultater fra fagutviklings- eller forskningsprosjekter arrangerte Intensivsykepleierne Norsk Sykepleierforbund (INSF), Operasjonssykepleierne NSF (ONSF) og Anestesisykepleierne NSF (ANSF) en felles workshop.

Introduction: The majority of hospitalized patients require vascular access for intravenous medical treatment. A peripherally inserted central catheter (PICC) may be indicated for long-term treatment. In many Norwegian hospitals, this is a nurse anesthetist-led initiative. Objective: The aim of this study was to examine the use of PICCs from insertion to completed treatment and to assess potential risk factors for the development of catheter-related complications. Methods: A quantitative prospective, longitudinal design was used. Data were collected via electronic patient records, as well as through telephone surveys with patients every fourth week until the catheter was discontinued. The Statistical Package for the Social Sciences version 28 was used for analysis. Results: In total, 401 PICCs were included. The primary indications were antibiotic treatment ( n = 272), nutrition ( n = 46), or chemotherapy ( n = 42). A total of 163 PICCs were used for a period of over 30 days. Overall, 41 catheter-related complications were identified through patient records. Erythema at the insertion site ( n = 12) was the most common complication, and the most severe complications were deep venous thrombosis ( n = 5) and confirmed catheter-related infection ( n = 4). After 4 weeks, 12 patients reported complications, with pain/numbness ( n = 4) being the most frequent. The study demonstrated no statistically significant covariation between the occurrence of complications and age, length of time the catheter was in use, primary indication, venous diameter, or the number of insertion attempts. Conclusion: The study showed a low incidence of severe PICC-related complications. Peripherally inserted central catheters were inserted and used according to local guidelines. The study indicates that nurse anesthetists’ knowledge and experience can be utilized in the future selection and insertion of vascular access for patients, as well as in training and education on PICCs.