Sjuksköterskans rutiner och omvårdnad kring perifera venkatetrar samthur komplikationer kan undvikas : -En litteraturstudie-

Syftet med litteraturstudien var att beskriva sjuksköterskans rutiner i samband med insättande och omvårdnad av perifera venkatetrar samt att beskriva observationer och åtgärder som sjuksköterskan gör för att undvika komplikationer. Artikelsökningen har skett i databaserna: Elin@Dalarna, Blackwell Synergy, EBSCO-host och Elsevier. De sökord som använts i olika kombinationer var: peripheral, intravenous, catheter/line/cannula, handhygiene, nurse, infections, phlebitis, routine och technique. Artiklarna skulle vara vetenskapligt skrivna på engelska och fick inte vara publicerade före år 1996. Sammanlagt inkluderades 20 artiklar i litteraturstudien varav 16 kvantitativa, 2 kvalitativa och 2 där båda designerna fanns representerade. Resultatet av litteraturstudien visade att de flesta sjuksköterskor inte tar hänsyn till hygieniska aspekter vid inläggning av en perifer venkateter (PVK) och det vanligaste stället för venpunktion var handryggen. Symtomen på komplikationer av en PVK var smärta, rodnad, ömhet, värmeökning, svullnad och hårda, stela vener. Flera sjuksköterskor bad patienterna att informera dem om de upptäckte rodnad, smärta eller svullnad kring PVK:erna, sjuksköterskorna drog dagligen handen över PVK:ernas bandage och frågade patienterna hur det kändes. De flesta sjuksköterskor spolade PVK:erna dagligen med natriumkloridlösning som en preventiv åtgärd. Den vanligaste komplikationen var tromboflebit. För att förebygga tromboflebit rekommenderas den minsta möjliga storleken på en PVK. Det förekommer olika riktlinjer världen över om hur lång tid en PVK bör vara placerad i en ven. Studierna visade olika resultat från 24 timmar upp till 92 timmar och däröver.

Flexibilitetens frammarsch, en studie om den intermittenta anställningen

Flexible working conditions is used extensively in organizations today as a way to create flexibility for the employer. Recently we’ve been reading in the newspapers that this approach is a growing problem and the EU has warned Sweden twice that abuse of these forms of employment must be stopped. The Government has recently submitted a proposed rule change to reduce the possibility of stacking one temporary contract after another. Borlänge kommun makes themselves more flexible with the intermittent employments. This study aims to examine why infrequent employments, such as the intermittent employment is used and preferred by Borlänge kommun and how it’s perceived by affected employees in the organization. The questions related, besides why the intermittent employment is used by the organization and how its perceived by those involved, also includes the management of intermittent employment and how the organization is handling work contracts. The background information on the employment law implications gives the reader an insight into how the regulatory framework works surrounding the topic. The theory section highlights the main theories about flexibility and its different shapes and perspectives. For the study a qualitative approach is used. A case study with semi-structured interviews was performed. The respondents were employees involved in the staffing of intermittent employees and also members of the staff with an intermittent employment. The results show that the employment and contracts is correctly handled by labour law regulations. This study shows that Borlänge kommun uses intermittent employments extensively, with its 1 320 intermittently employees. If this is abuse, or not, is not clear from the result. The authors discuss, however, if that is the case. The intermittent employment is used mainly because of the great needs. This is because society is changing and the average age is increasing, both by those using the services and the employees. All respondents perceive the intermittent employment as most flexible for the employees. Respondents working in the staffing department say that they are not flexible enough. The intermittent employees’ working today does not cover the great need. Borlänge kommun think that the flexibility should benefit them more and is currently trying to become more flexible. The employees were generally satisfied with their work situation. Some tendencies of insecurity and uncertainty could be inferred from the intermittent employees answers. The author’s conclusions are that flexibility and the intermittent employment contracts mainly benefit the employer and the employees who actively choose this type of work, such as students. This kind of employment affects, however, the society and those who need a secure lifestyle. The necessary permanent contracts are becoming fewer and replaced by precarious and flexible employment conditions.