Eva Joelsson-Alm

• PhD
• Professor (Associate) at Karolinska Institutet

Aim To evaluate the quality of care from the patients' perspective after receiving either person‐centred, nurse‐led follow‐up or standard care after surgical treatment of intermittent claudication. Design Secondary analysis of a randomised controlled trial. Methods Patients at two centres for vascular surgery in Stockholm, Sweden were randomised...

Our aim was to design and validate a software application, based on the Sepsis-3 criteria, capable of retrospectively identifying community-onset sepsis among emergency department patients requiring hospital admission.The application was developed using QlikView (Qlik, King of Prussia, PA, USA) software, and accessed data from the electronic health...

Background Early in the pandemic, corticosteroids became standard treatment for patients with critical COVID-19 infections. This study aimed to investigate the possible long-term pulmonary consequences after corticosteroid treatment in patients with critical COVID-19 requiring ventilatory support. Methods This observational single-center cohort st...

Objectives This study aimed to compare mortality rates and length of hospital stay between patients with critical COVID-19 transferred to another hospital due to capacity constraints and those who remained at their initial admission hospital. Design Single-centre cohort study. Setting and participants 665 patients were treated for SARS-CoV-2 at t...

Background Acute respiratory failure is the predominant presentation of intensive care unit (ICU) patients with COVID‐19, and lung protective strategies are recommended to mitigate additional respiratory complications such as air‐leak syndrome. The aim of this study is to investigate the prevalence, type, and timing of air‐leak syndrome with regard...

Aim To explore the impact of age on the discriminative ability of the National Early Warning Score (NEWS) 2 in prediction of unanticipated Intensive Care Unit (ICU) admission, in-hospital cardiac arrest (IHCA) and mortality within 24 hours of Rapid Response Team (RRT) review. Furthermore, to investigate 30- and 90-day mortality, and the discriminat...

Background Patients with indwelling urinary catheters (IUC) are common in geriatric care. Catheterization increases the risk of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI). The prevalence of ASB after IUC-removal is only sparsely studied. This study aimed to compare the occurrence of ASB and UTI in geriatric patients with and w...

Purpose: To describe experiences of the ward nurse in relation to extended physiotherapy and mobilising of post-ICU patients. Methods: Individual semi-structured interviews were conducted with 17 registered nurses working on surgical wards in a Swedish regional hospital. Qualitative content analysis was used to analyse the data. The study was re...

Background First-line managers have a unique role and potential in encouraging the use of evidence-based clinical practice guidelines (CPGs) and thus serve the provision of safe patient care. In acute and planned hospital care, effective yet safeguarded nursing procedures are a necessity. Little is currently known about how first-line managers enga...

Background During the COVID‐19 pandemic, intensive care units (ICUs) were under heavy pressure, with a significantly increased number of severely ill patients. Hospitals introduced restrictions, and families could not visit their ill and dying family members. Patients were cared for without privacy, and several died in shared patient rooms, leaving...

Background Conflicts with patients and relatives occur frequently in intensive care units (ICUs), driven by factors that are intensified by critical illness and its treatments. A majority of ICU healthcare professionals have experienced verbal and/or physical violence. There is a need to understand how healthcare professionals in ICUs experience an...

Urinary retention is a healthcare complication putting patients at risk of unnecessary suffering and harm. Orthopaedic patients are known to face an increased such risk, calling for evidence-based preoperative assessment and corresponding measures to prevent bladder problems. The aim of this study was to evaluate healthcare professionals’ adherence...

Aim(s) To explore first‐line managers' experience of guideline implementation in orthopaedic care during the COVID‐19 pandemic. Design A descriptive, qualitative study. Methods Semi‐structured interviews with 30 first‐line nursing and rehabilitation managers in orthopaedic healthcare at university, regional and local hospitals. The interviews wer...

BACKGROUND Perioperative treatment of hypotension by intravenous administration of norepinephrine in a peripheral vein can lead to adverse events, for example, tissue necrosis. However, the incidence and severity of adverse events during perioperative administration are unknown. METHODS This was a prospective observational study conducted at 3 Swe...

Purpose To develop and validate a software application able to identify cases of community-onset sepsis based on Sepsis-3 criteria among patients visiting an emergency department. Methods An application, developed with the software QlikView®, accessed data from the electronic health record systems TakeCare® and CliniSoft®. It utilized indicators li...

Background Patients with critical COVID-19 have a high risk of thromboembolism, but intensified thromboprophylaxis has not been proven beneficial. The activity of low-molecular-weight heparins can be monitored by measuring anti-Factor Xa. We aimed to study the association between anti-Factor Xa values and death, thromboembolism, and bleeding in pat...

Background: During the COVID-19 pandemic, patients cared for in the intensive care unit were exposed to many risk factors for developing delirium and subsequent distorted memories. Further, seeing healthcare professionals who have been dressed in personal protective equipment and face masks could have affected the patients' memories. Therefore, th...

Objective We aimed to compare long-term outcomes in intensive care unit (ICU) survivors between the first and second/third waves of the COVID-19 pandemic. More specifically, to assess health-related quality of life (HRQL) and respiratory health 6 months post-ICU and to study potential associations between patient characteristic and treatment variab...

Objective: The aim was to evaluate the effect of a person centred, nurse led follow up programme on health related quality of life (HRQoL), health literacy, and general self efficacy in comparison with standard care for patients undergoing revascularisation for intermittent claudication (IC), and to describe factors associated with HRQoL one year...

Objectives: Critical illness is a life-threatening condition for the patient, which affects their family members as a traumatic experience. Well-known long-term consequences include impact on mental health and health-related quality of life. This study aims to develop a grounded theory to explain pattern of behaviours in family members of critical...

PurposeTo assess long-term outcomes of restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock included in the European Conservative versus Liberal Approach to Fluid Therapy in Septic Shock in Intensive Care (CLASSIC) trial.Methods We conducted the pre-planned analyses of mortality, h...

Aim To describe healthcare workers' experiences of preconditions and patient safety risks in intensive care units during the COVID‐19 pandemic. Background Healthcare workers' ability to adapt to changing conditions is crucial to promote patient safety. During the COVID‐19 pandemic, healthcare workers' capacity to maintain safe care was challenged...

Background: Urinary retention is a common complication associated with hip surgery. There are easily available, evidence-based clinical practice guidelines prescribing how to prevent both urinary retention and other voiding issues, by means of bladder monitoring and risk assessments. A detected lack of adherence to such guidelines increases risks...

Numerous endeavours to ensure that day-to-day healthcare is both evidence-based and person-centred have generated extensive, although partial, comprehension of what guarantees quality improvement. To address quality issues, researchers and clinicians have developed several strategies as well as implementation theories, models, and frameworks. Howev...

Purpose To assess long-term outcomes of restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock included in the European Conservative versus Liberal Approach to Fluid Therapy in Septic Shock in Intensive Care (CLASSIC trial). Methods We conducted the pre-planned analyses of mortality...

Background Hyperoxemia may aggravate reperfusion brain injury after cardiac arrest. The aim of this study was to study the associations between different levels of hyperoxemia in the reperfusion period after cardiac arrest and 30-day survival. Methods Nationwide observational study using data from four compulsory Swedish registries. Adult in- and...

Background: Thromboembolism is more common in patients with critical COVID-19 than in other critically ill patients, and inflammation has been proposed as a possible mechanism. The aim of this study was to investigate if 12 mg vs. 6 mg dexamethasone daily reduced the composite outcome of death or thromboembolism in patients with critical COVID-19....

Objective To examine whether extended compared to standard level of physiotherapy is feasible and has beneficial effects on physical function in ICU survivors. Methods This prospective pilot study with a before and after design included patients discharged from ICU to a surgical ward. The comparison group were recruited between January and April 2...

Background The transfer from an intensive care unit (ICU) to a regular ward often causes confusion and stress for patients and family members. However, little is known about the patients' perspective on preparing for the transfer. Aim The purpose of the study was to describe patients' experiences of preparing for transfer from an ICU to a ward. S...

Background: Management of intermittent claudication should include secondary prevention to reduce the risk of cardiocerebrovascular disease. Patient adherence to secondary prevention is a challenge. The aim of this study was to investigate whether a person-centred, nurse-led follow-up programme could improve adherence to medication compared with s...

Background: Intravenous fluids are recommended for the treatment of patients who are in septic shock, but higher fluid volumes have been associated with harm in patients who are in the intensive care unit (ICU). Methods: In this international, randomized trial, we assigned patients with septic shock in the ICU who had received at least 1 liter o...

Aim Early identification of patients at risk of serious adverse events (SAEs) is of vital importance, yet it remains a challenging task. We investigated the predictive power of National Early Warning Score (NEWS) 2, as compared to NEWS, among patients assessed by a Rapid response team (RRT). Methods Prospective, observational cohort study on 898 c...

Background Critically ill COVID-19 patients have a high reported incidence of thromboembolic complications and the optimal dose of thromboprophylaxis is not yet determined. The aim of this study was to investigate if 90-day mortality differed between patients treated with intermediate or high dose thromboprophylaxis. Method In this retrospective s...

Introduction Claudication is the most usual symptom of peripheral artery disease, it is described as painful contractions in the leg when walking and alleviated upon resting. People with claudication have an added risk of cardiocerebrovascular events, amputation, and death. Adherence to medical treatment and changes in lifestyles can lower this ris...

Objectives The full range of long‐term health consequences in intensive care unit (ICU) survivors with COVID‐19 is unclear. This study aims to investigate the role of ventilatory support for long‐term pulmonary impairment in critically ill patients and further to identify risk factors for prolonged radiological recovery. Methods A prospective obse...

Background Informal caregivers to intensive care unit (ICU) survivors may develop post-intensive care syndrome family (PICS-F), including depression, anxiety and post-traumatic stress (PTS). Our primary aim was to investigate associations between caregiver burden in informal caregivers cohabiting with ICU survivors and patients’ physical and psycho...

Objectives The experience of critical illness among patients is both complex and multifaceted. It can make patients vulnerable to long-term consequences such as impairment in cognition, mental health and physical functional ability which affects health related quality of life. This study aims to explore patients’ patterns of behaviour during the pr...

Background The Onset PrevenTIon of urinary retention in Orthopaedic Nursing and rehabilitation, OPTION, project aims to progress knowledge translation vis-à-vis evidence-based bladder monitoring in orthopaedic care, to decrease the risk of urinary retention, and voiding complications. Urinary retention is common whilst in hospital for hip surgery....

Background To support a uniform and evidence-based practice for indwelling urinary catheterization in adults The European association of Urology Nurses (EAUN) published guidelines for this procedure in 2012. The Swedish national guidelines are based on the sterility precautions advocated by EAUN. Some hospitals have local guidelines with other requ...

Background COVID-19 can cause severe disease with need of treatment in the intensive care unit (ICU) for several weeks. Increased knowledge is needed about the long-term consequences. Methods This is a single-center prospective follow-up study of COVID-19 patients admitted to the ICU for respiratory organ support between March and July 2020. Patie...

Background Informal caregivers to intensive care unit (ICU) survivors may develop post-intensive care syndrome family (PICS-F), including psychological problems such as depression, anxiety and post-traumatic stress (PTS). Our primary aim was to investigate associations between caregiver burden in informal caregivers cohabiting with ICU survivors an...

Background: To support a uniform and evidence-based practice for indwelling urinary catheterization in adults The European association of Urology Nurses (EAUN) published guidelines for this procedure in 2012. The Swedish national guidelines are based on the sterility precautions advocated by EAUN. Nevertheless, some hospitals have local guidelines...

Background: To support a uniform and evidence-based practice for indwelling urinary catheterization in adults The European association of Urology Nurses (EAUN) published guidelines for this procedure in 2012. The Swedish national guidelines are based on the sterility precautions advocated by EAUN. Nevertheless, some hospitals have local guidelines...

Background: Intermittent claudication (IC) is a classic symptom of peripheral arterial disease, and strongly associated with coronary heart disease and cerebrovascular disease. Treatment of IC and secondary prevention of vascular events include best medical treatment (BMT), changes in lifestyle, most importantly smoking cessation and increased phy...

Background: Methods to identify patients at risk for incomplete physical recovery after intensive care unit (ICU) stay are lacking. Our aim was to develop a method for prediction of new-onset physical disability at ICU discharge. Methods: Multinational prospective cohort study in ten general ICUs in Sweden, Denmark and the Netherlands. Adult pat...

Objectives The objective of this study was to explore firefighters’ and police officers’ experiences of responding to out-of-hospital cardiac arrest (OHCA) in a dual dispatch programme. Design A qualitative interview study with semi-structured, open-ended questions where critical incident technique (CIT) was used to collect recalled cardiac arrest...

Peer-assessment in nursing education using an OSCE protocol is an increasing educational activity that complements that of teachers. However, little is known about how students' and teachers’ assessments correspond. The study aimed to compare OSCE assessments made by student examiners and faculty examiners during examinations of clinical skills in...

OBJECTIVE: To test the hypothesis that changes in cardiac index and mean arterial pressure (MAP) during and after a fluid bolus (FB) are altered by fluid temperature. DESIGN: Randomised, controlled, crossover trial. SETTING: Research laboratory at Swedish teaching hospital. PARTICIPANTS: Twenty-one healthy adult volunteers. INTERVENTIONS: Subjects...

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre,...

The effect of hemodynamic optimization in critically ill patients has been challenged in recent years. The aim of the meta-analysis was to evaluate if a protocolized intervention based on the result of hemodynamic monitoring reduces mortality in critically ill patients. We performed a systematic review and meta-analysis according to the Cochrane Ha...

Background Impaired mental and physical health are common complications after intensive care that could influence the patient's health‐related quality of life (HRQoL). Earlier research has mainly focused on HRQoL in mixed surgical and medical ICU populations. This study aimed to describe and analyze factors associated with HROoL after discharge fro...

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Poster

Background: Several studies have shown an association between a positive fluid balance and increased mortality in patients with septic shock. This may have led to a more restrictive use of intravenous fluids. The association between fluid accumulation and mortality in the setting of a more restrictive use of intravenous fluids, however, is uncerta...

Background: Urinary retention is a common complication following hospital care, which can result in overdistension of the bladder and, at worst, chronic bladder damage and persistent micturition difficulties. Objectives: The purpose of this study was to explore patients' experiences of micturition problems after bladder distension and their effe...

The aim of this study was to explore whether close preoperative ultrasound monitoring starting in the emergency room (ER) could prevent postoperative bladder distension among acute orthopaedic patients. A randomized controlled trial was conducted at a 650-bed level-2 centre in Sweden. Inclusion criteria were admittance via ER to an orthopaedic ward...

Postoperative urinary retention and bladder distension are frequent complications of surgery. The aim of this study was to determine the incidence of perioperative bladder distension in a surgical setting and to identify predisposing factors among patients undergoing common general and orthopaedic procedures. This was a prospective observational st...