title: A longitudinal qualitative study of health care personnel's perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers.
abstract: OBJECTIVE
  In this study, the aim was to understand health care personnel's expectations and experiences of participating in an intervention aimed at the implementation of three assessment scales for fall injuries, malnutrition and pressure ulcers, and the performance of preventive measures in these areas over the period of 18 months.
  
  
  BACKGROUND
  Fall injuries, malnutrition and pressure ulcers among older people are challenging issues for caregivers at different levels in the health care system.
  
  
  METHODS
  A descriptive design with a qualitative approach was used to follow health care personnel before, during and after implementation of a care prevention intervention.
  
  
  METHODS
  Twelve health care personnel with different professions at the hospital, primary care and municipal care levels participated in a preventive care introduction. Seminars were held at four occasions, with assignments to be completed between seminars. Lectures and group discussions were performed, and three risk assessment scales were introduced. The participants were interviewed before, during and after the introduction. Manifest and latent content analysis were used.
  
  
  RESULTS
  The main results are presented in the theme 'Patient needs are visualised through a gradually developed shared understanding' and in five categories. The work approach of performing three risk assessments simultaneously was perceived as positive and central to ensuring quality of care; it was not, however, perceived as unproblematic.
  
  
  CONCLUSIONS
  The participants as well as health care team members showed a positive attitude towards and described the advantages of being given opportunities for shared understanding to improve patient safety and to provide structure for the provision of good care.
  
  
  CONCLUSIONS
  The managerial approach of listening to and acting on issues stressed by health care personnel is important to ensure ongoing and future improvement initiatives.
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.|Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Bernice
authors.initials: B
authors.lastname: Skytt
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.|Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Engström
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.|Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Mårtensson
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.|Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Anna-Greta
authors.initials: AG
authors.lastname: Mamhidir
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000451:nursing / Q000517:prevention & control; D008875:Middle Aged; D024802:Nurse's Role; D061214:Patient Safety; D003668:Pressure Ulcer / Q000451:nursing / Q000517:prevention & control; D018570:Risk Assessment; D013548:Sweden
keywords: interview; older people; risk assessments