Bjørg Oftedal

Introduction: Birth asphyxia–related deaths is a major global concern. Rapid initiation of ventilation within the “Golden Minute” is important for intact survival but reported to be challenging, especially in low-/middle-income countries. Helping Babies Breathe (HBB) is a simulation-based training program for newborn resuscitation. The aim of this HBB quality improvement (QI) intervention was to decrease time from birth to ventilation and document potential changes in perinatal outcomes. Method: Prospective observational QI study in a rural Tanzanian hospital, October 1, 2017, to August 31, 2021, first-year baseline, second-year QI/simulation intervention, and 2-year postintervention. Trained research assistants observed wide-ranging information from all births (N = 12,938). The intervention included monthly targeted HBB simulation training addressing documented gaps in clinical care, clinical debriefings, and feedback meetings. Results: During the QI/simulation intervention, 68.5% nonbreathing newborns were ventilated within 60 seconds after birth compared with 15.8% during baseline and 42.2% and 28.9% during the 2 postintervention years (P < 0.001). Time to first ventilation decreased from median 101 (quartiles 72–150) to 55 (45–67) seconds (P < 0.001), before increasing to 67 (49–97) and 85 (57–133) seconds after intervention. More nonbreathing newborns were ventilated in the intervention period (12.9%) compared with baseline (8.5%) and the postintervention years (10.6% and 9.4%) (P < 0.001). Assumed fresh stillborns decreased significantly from baseline to intervention (3.2%–0.7%) (P = 0.013). Conclusions: This QI study demonstrates an increase in nonbreathing newborns being ventilated within the Golden Minute and a significant reduction in fresh stillborns after introduction of an HBB QI/simulation intervention. Improvements are partially reversed after intervention, highlighting the need for continuous simulation-based training and research into QI efforts essential for sustainable changes.

Background: Previous research indicates a link between what nurses receive for themselves and their remaining in practice. In Norway, school nurses tend to remain in practice, but what it is they receive for themselves has been scarcely studied. The aim of this study, therefore, was to describe and interpret what it is school nurses receive for themselves that influences their remaining in practice. Method: The study has a qualitative design with a hermeneutic approach. Data were collected through individual interviews on two separate occasions with 15 Norwegian school nurses. The data were analysed using a phenomenological hermeneutic method. Results: Two themes demonstrate what it is the school nurses receive for themselves: (1) ‘Gaining interesting workdays for yourself’ and (2) ‘Attaining pleasure for yourself’. Each theme has two sub-themes. The first theme involved the school nurses ‘having an attractive scope of practice’ and ‘having varied tasks’. The second theme involved ‘being trusted’ and ‘being given a response’. The study themes can be comprehensively understood as an expression of what the school nurses identify as the main locus of the good work-life. The school nurses’ remaining seems to revolve around what it is they receive on their own behalf: an affirmation for their ordinary life and what they do as a nurse. Conclusion: This study highlights that what school nurses receive on their own behalf may influence their remaining in practice. It adds to previous research with a more specific understanding of nurses remaining in practice by stating that in identifying the main locus of the good work-life, the school nurses received affirmation for their ordinary life and what they do as a nurse. Thus, it is important that nurses identify the main locus of a good work-life for themselves, as receiving affirmation for what they do in their ordinary workdays may influence their remaining in practice. Registration of clinical trial and registration identification number: The study was approved by the Norwegian Centre for Research Data (project 59195). National Research Ethics Committee approval was not required, as the study only involved health professionals and did not ask for sensitive information.

Aim: This study aims to describe and interpret what it is school nurses strive to achieve for themselves in order to remain in practice. Design: A qualitative study with a hermeneutic approach. Method: The data were collected by means of in-depth interviews with 15 Norwegian school nurses on two separate occasions and analysed using a phenomenological hermeneutic method. Results: The analysis resulted in the following themes: (1) trusting your own professional ability, (2) aspiring to appreciation and (3) accomplishing self-care. These themes were reflected in the school nurses' choices and actions and were regarded as an expression of what was of value to them as a nurse. Thus, the nurses' realizing what they strived to achieve for themselves can comprehensively be understood as a good of higher value for their remaining in nursing practice.

Globally, intrapartum-related complications account for approximately 2 million perinatal deaths annually. Adequate skills in neonatal resuscitation are required to reduce perinatal mortality. NeoNatalie Live is a newborn simulator providing immediate feedback, originally designed to accomplish Helping Babies Breathe training in low-resource settings. The objectives of this study were to describe changes in staff participation, skill-training frequency, and simulated ventilation quality before and after the introduction of “local motivators” in a rural Tanzanian hospital with 4000–5000 deliveries annually. Midwives (n = 15–27) were encouraged to perform in situ low-dose high-frequency simulation skill-training using NeoNatalie Live from September 2016 through to August 2018. Frequency and quality of trainings were automatically recorded in the simulator. The number of skill-trainings increased from 688 (12 months) to 8451 (11 months) after the introduction of local motivators in October 2017. Staff participation increased from 43% to 74% of the midwives. The quality of training performance, measured as “well done” feedback, increased from 75% to 91%. We conclude that training frequency, participation, and performance increased after introduction of dedicated motivators. In addition, the immediate constructive feedback features of the simulator may have influenced motivation and training quality performance.

Aims and objectives: To describe and interpret what it means for school nurses to realise themselves so that they remain in nursing practice.Background: Self‐realisation seems to influence on nurses remaining in nursing practice. School nurses report aspects (i.e. autonomy and professional development) which can be linked to self‐realisation as important for themselves, but few studies describe what it means for school nurses to realise themselves so that they remain in practice.Design and method: This study used a qualitative design, conducting two individual in‐depth interviews with 15 school nurses. The interviews were analysed with a phenomenological hermeneutic method. The COREQ checklist has been used in reporting this study.Results: The following themes were emerged: (a) being attentive to yourself, (b) acting true to yourself and (c) making independent choices.Conclusion: This study offers insight into what it means for school nurses to realise themselves so that they remain in nursing practice, that is to practise their originality and take a stand for what they consider important. Self‐realisation was embedded within nursing practice and consequently seems to impact on nurses remaining in practice.Relevance to clinical practice: Nurses who practise their originality and take a stand for what they identify as important realise self. This implies being themselves and practising nursing in a way they find relevant. Nursing leaders who encourage nurses to articulate what this entails facilitate their self‐realisation. A clinical practice where nurses can be attentive and act true to themselves, and have opportunities to make independent choices, will be a practice where nurses can realise self. We suggest that clinical practice which emphasises opportunities for nurses' self‐realisation may facilitate their remaining in practice.

Aim: The aim of this study was to explore the discourses of PhD students concerning the performance of practice‐relevant research in health and social work.Design: An explorative, qualitative design and a discourse analytical approach were used to collect data.Methods: Participants were recruited from a national research school for practice‐relevant research in Norway. Group interviews with ten PhD students (five health and five social work professionals) with extensive, wide‐ranging work experience as practitioners were used to collect data. The data were analysed by discourse analysis.Results: The analysis revealed three discourses: (a) the professional knowledge discourse; (b) the promoting partnership discourse; and (c) the using research knowledge discourse. The discourses are explicit concerning how systematically formed practice‐relevant research in health and social work is linked to dominant discourses about knowledge in the scientific field. Professional knowledge, promoting partnership and using research knowledge are fundamental features of practice‐relevant research.

Purpose Although it is well-known that persons with COPD experience lower health related quality of life (HRQoL), little is known about the importance of self-management related domains on HRQoL in persons with COPD. Therefore, the purpose of this study is to examine associations between self-management related domains and HRQoL, adjusting for sociodemographic and clinical characteristics, self-efficacy, and sense of coherence. Methods Cross-sectional data of 225 persons with COPD, recruited from a hospital register, were analyzed. Self-management related domains were measured using the Health education impact questionnaire (heiQ) and HRQoL was measured using the St. George’s Respiratory Questionnaire (SGRQ). Multiple linear regression analysis was used. Results The final models showed significant associations between the self-management domains constructive attitudes and approaches and emotional distress and HRQoL. Dyspnea, number of comorbidities, self-efficacy, and the various self-management related domains explained 51.3 to 55.1% of the variance in HRQoL. Conclusions The findings suggest that addressing self-management related domains, in addition to self-efficacy, dyspnea, and comorbidities, may be of importance for enhancement of HRQoL in persons with COPD.

Background: A constructive patient–nurse relationship is beneficial in self‐management support approaches. Research indicates eHealth interventions hold a potential for self‐management support for adults with type 2 diabetes. However, eHealth may change the patient–nurse relationship. No studies to date have addressed how eHealth self‐management support interventions with written asynchronous communication can influence the relationship between patients and nurses.Aim: The aim of this study was to explore how an eHealth intervention based on the Guided Self‐Determination program (eGSD) influences the patient‐nurse relationship from the perspective of patients participating and the nurses conducting the intervention.Methods: A qualitative approach with individual semi‐structured interviews was used. Ten patients with type 2 diabetes who completed the eGSD and four nurses who delivered the intervention participated. The data were transcribed verbatim, and qualitative content analysis was used to analyse the text.Results: The findings revealed two themes: ‘eGSD facilitates a reciprocal understanding and a flexibility in the relationship’ and ‘eGSD creates a more fragile relationship’, reflecting ambiguous experiences with the eGSD.Conclusion and relevance to clinical practice: The findings indicate that eGSD influences the patient–nurse relationship by facilitating reciprocal understanding and flexibility. Both patients and RNs acknowledged these outcomes as beneficial. Nevertheless, familiar in‐person consultations were expressed as integral for the patient–nurse relationship. As written communication in eHealth is a novelty, it demands new knowledge and expertise that RNs must master. Findings from this study may therefore be acknowledged when developing and implementing eHealth interventions. Education programs in written eHealth communication, as well as guidelines and frameworks on how to professionally and effectively conduct eHealth services while maintaining supportive patient–nurse relationships, should be a priority for institutions that educate healthcare personnel, health institutions and other stakeholders.

Aim: This study expands on an earlier study about diabetes nurses’ experiences of the Guided Self‐Determination intervention in face‐to‐face consultations among people with type 2 diabetes. This current study investigates Guided Self‐Determination in an electronic format with the aim to explore what can be learned about the written form for health communication from the perspectives of diabetes nurses in primary care.Design: The study has an explorative, qualitative design.Method: Four diabetes nurses were individually interviewed after completing the electronic intervention. The analysis was guided by Interpretive Description.Results: Small sample size apart, the rich empirical data and quality of dialogue point to the interviewees’ earlier contact, comfort and trust with the researcher. The written electronic communication could disrupt nurses’ possibilities for using basic and advanced communication skills. Findings also indicate that written electronic communication can foster thoughtful responses to patients and increase possibilities for a transparent counselling delivery process.