Departments In Denmark Research Articles

Association between number of medications and mortality in geriatric inpatients: a Danish nationwide register-based cohort study.

To explore the association between the number of medications and mortality in geriatric inpatients taking activities of daily living and comorbidities into account. A nationwide population-based cohort study was performed including all patients aged ≥ 65years admitted to geriatric departments in Denmark during 2005-2014. The outcome of interest was mortality. Activities of daily living using Barthel Index (BI) were measured at admission. National health registers were used to link data on an individual level extracting data on medications, and hospital diseases. Patients were followed to the end of study (31/12/2015), death, or emigration, which ever occurred first. Kaplan-Meier survival curves were used to estimate crude survival proportions. Univariable and multivariable analyses were performed using Cox regression. The multivariable analysis were adjusted for age, marital status, period of hospital admission, BMI, and BI (model 1), and additionally either number of diseases (model 2) or Charlson comorbidity index (model 3). We included 74,603 patients (62.8% women), with a median age of 83 (interquartile range [IQR] 77-88) years. Patients used a median of 6 (IQR 4-9) medications. Increasing number of medications was associated with increased overall, 30-day, and 1-year mortality in all three multivariable models for both men and women. For each extra medication, the mortality increased by 3% in women and 4% in men in the fully adjusted model. Increasing number of medications was associated with mortality in this nationwide cohort of geriatric inpatients. Our findings highlight the importance of polypharmacy in older patients with comorbidities.

Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices.

Background: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice continues to be a concern. Methods: A cross-sectional survey was performed in Danish emergency department physicians in spring 2019. Prescribing practices were assessed by means of four clinical scenarios commonly encountered in the emergency department. Thirteen multiple-choice questions were used to measure knowledge. Results: 201 physicians responded corresponding to 55.4% of the total population of physicians working at emergency departments in Denmark. About a quarter reported that they would use hypotonic fluids in patients with increased intracranial pressure and 29.4% would use hypotonic maintenance fluids in children, both of which are against guideline recommendations. Also, 29.4% selected the correct fluid, a 3% hypertonic saline solution, for a patient with hyponatraemia and severe neurological symptoms, which is a medical emergency. Most physicians were unaware of the impact of hypotonic fluids on plasma sodium in acutely ill patients. Conclusion: Inappropriate prescribing practices and limited knowledge of a large number of physicians calls for further interventions to minimise the risk of hospital-acquired hyponatraemia.

Self-reported immunity and opinions on vaccination of hospital personnel among paediatric healthcare workers in Denmark

BackgroundDenmark has no general recommendations for vaccination of healthcare workers (HCWs). We explored the self-reported immunity to varicella, measles, mumps, and rubella, reasons for receiving the influenza vaccine or not, and opinions on vaccination of HCWs against varicella, MMR, pertussis, diphtheria, and influenza among staff from departments with a high risk of exposure to infectious agents. MethodsFrom May 2019 to August 2019, a structured questionnaire was distributed to clinical and non-clinical HCWs at a tertiary and a general paediatric department in Denmark. Self-reported immunity was defined as either previous infection or vaccination against the disease. ResultsOf 619 employed HCWs, 555 (90%) were included. A large proportion were unsure of or denied previous vaccination or infection with measles (20.1%), mumps (30.2%), rubella (21.4%), varicella (12.1%), pertussis (44.1%), and diphtheria (32.1%). Non-clinical personnel and employees born in 1974–1983 had the lowest level of self-reported immunity. Mandatory vaccination of non-immune HCWs was approved by 54–68.9% of participants, and any kind of vaccination (mandatory or as an offer at hospitals) was approved of up to 95.3% of all participants depending on the disease. During the season 2018/19, 214 (38.6%) HCWs received the influenza vaccine, including 20.3% of non-clinical staff, 34.8% of nurses and 56.5% of doctors (P < 0.001). Reasons for lack of vaccine uptake were mainly employees considering themselves rarely sick, the vaccine was not regarded as necessary, forgetfulness or lack of time. Only 37.8% was in favour of mandatory influenza vaccination. ConclusionsA large proportion of paediatric HCWs were not aware of their immune status against important vaccine-preventable diseases. >90% supported vaccination of HCWs, with two out of three supporting mandatory MMR, pertussis and diphtheria vaccination. Better information and an official immunisation policy of non-immune HCWs in Denmark is warranted.

The DaBlaCa-13 Study: Short-term, Intensive Chemoresection Versus Standard Adjuvant Intravesical Instillations in Non–muscle-invasive Bladder Cancer—A Randomised Controlled Trial

BackgroundInstillation therapy for non–muscle-invasive bladder cancer (NMIBC) reduces recurrences but is associated with side effects. Preoperative instillation of chemotherapy could potentially be associated with fewer side effects compared with adjuvant instillations and in some patients make tumour resection (transurethral resection of the bladder tumour [TURBT]) superfluous. ObjectiveTo investigate tumour response and adverse events related to short-term, intensive chemoresection with mitomycin C compared with adjuvant instillations in patients with recurrent NMIBC. Design, setting, and participantsA randomised, controlled trial was conducted in two urological departments in Denmark from January 2018 to June 2019. In total, 120 participants with a history of Ta bladder tumours, low grade or high grade, were included upon recurrence. InterventionIntravesical mitomycin C (40 mg/40 ml) three times a week for 2 wk in the intervention group (59 patients) was compared with TURBT and six weekly adjuvant instillations in the control group (61 patients). Outcome measurements and statistical analysisTumour response was evaluated in the intervention group by flexible cystoscopy after 4 wk. Side effects were prospectively registered in both groups using the National Cancer Institute’s Common Terminology Criteria for Adverse Events. Groups were compared using χ2 or Fisher's exact test. Results and limitationsComplete tumour response was seen in 33 participants (57%) in the intervention group. Fewer adverse events were reported in the intervention group than in the control group. Two patients in each group ceased instillation treatment due to adverse events. The main limitation is the current lack of long-term follow-up. ConclusionsShort-term, intensive chemoresection yields a tumour response of 57%. Hence, only half of those treated with chemoresection needed TURBT. The treatment was furthermore associated with fewer clinically significant side effects. Owing to small numbers, further investigations on Ta high-grade tumours are needed. Patient summaryWe compared a nonsurgical treatment with standard treatment in patients with superficial bladder tumours. We found it to be safe and able to avoid surgery in more than half of the patients.

Paediatric hepatitis B and hepatitis C virus infections: An observational study of a Danish cohort.

The aim of this study was to describe the epidemiological and clinical characteristics in children with either chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection in Denmark. In this observational study, children and adolescents with either chronic HBV or HCV infection followed at the largest paediatric departments in Denmark between 2001 and 2013 were included. Data collection included as well epidemiological data as clinical data like virus genotype, viral load, serological markers, liver biochemistry, liver elastography and histology if available. The study included 131 children. None of the patients had decreased liver function or end-stage liver disease during follow-up. Ten of the 18 children who underwent liver biopsy had signs of fibrosis. Thirteen (11%) children with HBV and one (7%) child with HCV received treatment. Different indications and different treatment regimens were used. This study confirms that chronic HBV and HCV infections are often mild diseases during childhood. Nevertheless, children are at higher risk of serious liver disease early in life because of the early time of infection and probably also because of the high viral loads.

Use of PROM during follow-up of patients with ovarian cancer: the PROMova study protocol

BackgroundThere is a paucity of high-level evidence on the optimal follow-up of patients with ovarian cancer after primary treatment. A debate is ongoing on the extent to which follow-up should...

COVID‐19 and dermatologic surgery: Hazards of surgical plume

Dermatologic TherapyVolume 33, Issue 4 e13593 Letter COVID-19 and dermatologic surgery: Hazards of surgical plume Firas Al-Niaimi, Corresponding Author Firas Al-Niaimi firas55@hotmail.com orcid.org/0000-0002-0684-4322 Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark Department of Skin Cancer and Laser, Guy's and St. Thomas Hospital, London, UK Correspondence Firas Al-Niaimi, Dermatological Surgery and Laser Unit, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RS, UK. Email: firas55@hotmail.comSearch for more papers by this authorFaisal R. Ali, Faisal R. Ali Department of Skin Cancer and Laser, Guy's and St. Thomas Hospital, London, UKSearch for more papers by this author Firas Al-Niaimi, Corresponding Author Firas Al-Niaimi firas55@hotmail.com orcid.org/0000-0002-0684-4322 Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark Department of Skin Cancer and Laser, Guy's and St. Thomas Hospital, London, UK Correspondence Firas Al-Niaimi, Dermatological Surgery and Laser Unit, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RS, UK. Email: firas55@hotmail.comSearch for more papers by this authorFaisal R. Ali, Faisal R. Ali Department of Skin Cancer and Laser, Guy's and St. Thomas Hospital, London, UKSearch for more papers by this author First published: 15 May 2020 https://doi.org/10.1111/dth.13593Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URLThe site is currently under maintenance and this functionality is not available right now. Please try later. Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume33, Issue4July/August 2020e13593 This article also appears in:Dermatologic Therapy COVID-19 Articles RelatedInformation

National data with high validity and completeness showed that only 0.04% of Danish children had been registered with diagnosed hypertension.

Hypertension has been reported in up to 4.0% of American children, but no national data exist in Europe. We studied the frequency of registered hypertension in Danish children and evaluated the data. This 2014-2015 study focused on patients under the age of 16 registered with hypertension in the Danish National Patient Register and 10 paediatric departments in central and eastern Denmark. The diagnoses were coded according to the International Classification of Diseases, 10th revision. All the subjects' medical records were reviewed, including any confirmed diagnoses. There were 55784 children under 16 in the study regions at 30 April 2014. By May 2015, 222 of those had been registered with hypertension: 200 in the Danish National Patient Register and 191 in the 10 paediatric departments. Their medical records confirmed hypertension in 187 and 185 cases, respectively. The prevalence of registered and confirmed hypertension was 222/553784 (0.04%). The positive predictive values of hypertension were 187/200 (94%) and 185/191 (97%), and the completeness of diagnosed hypertension was 187/222 (84%) and 185/222 (83%). The registers had high-quality positive predictive values and completeness, but only 0.04% of the Danish children were registered with a verified diagnosis of hypertension.

The Danish Multidisciplinary Hip Fracture Registry 13-Year Results from a Population-Based Cohort of Hip Fracture Patients.

Aim of the RegistryThe aim of the Danish Multidisciplinary Hip Fracture Registry (DMHFR) is to collect data on processes of treatment, nursing care and rehabilitation as well as outcomes for patients with hip fracture in Denmark, and thereby monitor and improve the quality.Study PopulationHip fracture patients at age 65 or older that have undergone surgery with arthroplasty or internal fixation since 2004.Main VariablesDMHFR collects quality indicators and descriptive variables. Quality indicators include eight process performance measures within treatment, nursing care and rehabilitation, reflecting recommendations from the national clinical guideline for hip fracture patients, and three outcome measures including survival within 30-days, unplanned acute readmission within 30 days and reoperation within 2 years. Descriptive variables include a number of patient- and surgery-related characteristics. All data are collected prospectively.ResultsBy the end of 2018, the DMHFR included 86,438 hip fracture patients. Since 2006, all hospital departments in Denmark, treating patients with hip fracture, have reported improvement in quality of care and improvement in survival, and reoperation over time as well as high completeness of variables registration.ConclusionThe DMHFR is a well-established nationwide clinical registry, which plays a key role for monitoring and improving hip fracture care in Denmark. The registry can further be linked to a range of other nationwide registries in order to answer a number of relevant clinical research questions.

Increasing incidence of Acanthamoeba keratitis in a large tertiary ophthalmology department from year 1994 to 2018.

Acanthamoeba (AA) keratitis is a rare and severe infection with poor prognosis. The aim was to investigate the incidence and risk factors of AA keratitis in a large tertiary ophthalmology department in Denmark. A search was performed in our electronic patient records by the keywords: 'PHMB/polyhexanid', 'Brolene' or 'amoeba and chlorhexidine' from year 1994 to 2018, and afterwards medical records were reviewed. A total of 65 cases of AA keratitis were hereby identified. Patients were relatively young, median (range) age of 38 (15-70)years. A significant increase of diagnosing AA keratitis occurred from 0.13 cases per million per year in the first 5years to 2.7 cases per million per year the last 5years. Eighty-nine per cent of patients were contact lens users, and 49% had received corticosteroids before the diagnosis was established. Severe pain was present in 34% of patients. Prognosis was poor with final visual acuity of logMAR (mean, 95% CI) 0.30 (0.18-0.41), 18% had transplantation à chaud, and 2% were enucleated. The study indicates that the incidence of AA keratitis is increasing, also in Denmark. Most patients were young contact lens users. The course of the disease is long and often painful, and the prognosis is poor despite relevant treatment.

DaBlaCa-11: Photodynamic Diagnosis in Flexible Cystoscopy—A Randomized Study With Focus on Recurrence

ObjectiveTo examine whether photodynamic diagnosis (PDD) in addition to flexible cystoscopy in the outpatient clinic can reduce risk of tumor recurrence in patients with previous nonmuscle invasive bladder cancer. PDD is an optical technique that enhances the visibility of pathologic tissue and helps guidance tumor resection. MethodsFrom February 2016 to December 2017, 699 patients from 3 urologic departments in Denmark were enrolled in a randomized controlled trial. Four months after transurethral resection of bladder tumor patients were randomized 1:1 to either an intervention group (hexaminolevulinate was instilled in the bladder before flexible cystoscopy with PDD video cystoscope) or a control group (white light flexible cystoscope), only. Primary endpoint was tumor recurrence within 8 months from the randomization. Secondary outcomes were numbers of procedures in general anesthesia, time to the first recurrence, differences in tumor size, risk of tumor progression, and identification of carcinoma in situ. ResultsA total of 351 patients were allocated to the intervention group (flexible PDD), and 348 to the control group (flexible white light). Throughout the following 8 months after randomization, only 117 patients in the intervention group had at least 1 tumor recurrence compared to 143 patients in the control group (P = .049). Odds ratio of 0.67 (P = .02, 95% CI: 0.48-0.95) correlates with a tumor reduction of 33% in favor of the intervention group. ConclusionUse of PDD in a routine surveillance cystoscopy first time after transurethral resection of bladder tumor for nonmuscle invasive bladder cancer reduces subsequent risk of tumor recurrence compared to WL cystoscopy alone.

Identifying Technical Procedures in Orthopaedic Surgery and Traumatology That Should Be Integrated in a Simulation-Based Curriculum: A National General Needs Assessment in Denmark.

Simulation-based training is emerging within the orthopaedic field to alleviate the challenges that trainees face such as work-hour restrictions, limited exposure to procedures, and increasing pressures to reduce risk to patients. This training modality has grown increasingly popular over the last 2 decades. However, integration into the curriculum often fails to follow a structured educational plan. The development of simulation-based curricula should follow a structured and stepwise approach that starts with a general needs assessment. This study aimed to identify and prioritize procedures within orthopaedic surgery to be included in a simulation-based curriculum on a national basis. A national needs assessment was conducted using the Delphi method. Ninety-five experts who are involved in the training of orthopaedic surgeons from all orthopaedic departments in Denmark were selected to participate in the assessment. Round 1 was a brainstorming phase to identify technical procedures that are relevant for orthopaedic surgeons in training. Round 2 was performed on a departmental basis; it explored the frequency of procedures, the number of surgeons performing each procedure, the risk and/or discomfort to patients, and the feasibility for simulation-based training to prioritize and eliminate some of the procedures that were determined in round 1. During round 3, the experts eliminated and reprioritized procedures from round 2 to produce a final prioritized list. During the first round, 194 procedures were identified. These were reduced to 62 in round 2, and the final list after round 3 consisted of 33 prioritized procedures that are relevant for simulation-based training in orthopaedic surgery. The response rates were 63 of 95 physicians for round 1, 26 of 26 departments for round 2, and 64 of 97 physicians for round 3. The highest prioritized procedures were basic surgical techniques and principles for osteosynthesis, osteosynthesis of proximal femoral fracture, and surgical exposure of the upper and lower extremities. The prioritized list of technical procedures in orthopaedic surgery that are suitable for simulation-based training can aid in the development of a simulation-based curriculum. This article offers insights into needs assessment and curriculum development of simulation-based training in orthopaedic surgery and traumatology.

Inter‐ and intrarater reliability of Hurley staging

Staging disease when the patient comes for their consultation is an important part of estimating the disease's subsequent course (prognosis) and the likely effectiveness of any treatment. Staging means formally assessing the disease's severity including its extent, such as how much of the skin is affected. Hidradenitis suppurativa (HS) is a chronic skin inflammation in the body folds, such as the groin or armpit areas, in which large boils and pustules form, which can cause scarring. There are at least 4 different scoring methods in use to stage the disease, the most popular of which is known as the Hurley staging scheme. This study, which was an international co‐operation between departments in Germany, Denmark and Poland, was designed to check the agreement between different dermatologists, including those in training, on their rating of the stage of HS in 5 different patients on two separate occasions. The exercise showed how difficult it is to obtain consistent assessments both between different physicians and with the same physician on separate occasions. The scoring method, in which there was the highest level of agreement, both between different doctors or by the same doctor on different occasions was the one known as the International Hidradenitis Suppurative Scoring System as well as the HS physicians Global Assessment scale. The authors emphasise the importance of training doctors on how to use of these scoring systems in order to maximise their benefits.

Correlation of virtual reality performance with real-life cataract surgery performance

To investigate the correlation between performance on a virtual reality simulator and real-life cataract surgical performance. Nine ophthalmology departments in Denmark and Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark. Prospective multicenter study. Cataract surgeons with different experience levels were included. The participants performed 3 consecutive video-recorded phacoemulsification surgeries that were rated by masked raters using the Objective Structured Assessment of Cataract Surgical Skills (OSACSS) scoring system. Thereafter, the participants performed a previously validated test on an Eyesi virtual reality simulator. Primary outcomes were the mean OSACSS score from all 3 surgeries and the simulator score from the participants' first repetition of the performance test. Nineteen surgeons participated. There was a statistically significant correlation between the simulator performance score and the mean OSACSS score across all experience levels, with a Pearson correlation of 0.65 (P=.003, R2=0.42). Simulator performance was significantly correlated with real-life cataract surgical performance.

Implementing ethics reflection groups in hospitals: an action research study evaluating barriers and promotors

BackgroundAn ethics reflection group (ERG) is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments.MethodsThe implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers.ResultsThe implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician’s job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges.ConclusionThe study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services.

Utilization of a Novel Patient Monitoring Dashboard in Emergency Departments.

To study the clinical use of a novel patient monitoring dashboard at two Emergency Departments in Denmark in order to evaluate the clinician's perspective and their use of the dashboard. Data was gathered by participatory observations of the clinicians' workflow and dashboard interaction, as well as interviews about the clinicians' attitudes towards the system. The data collection process took place during the system's intervention process from September to December 2018. 65 nurses, 28 physicians and two assistants were observed in total for 62 hours. The 59 hours of the observation was focused on the interaction with the systems. Additionally, 10 nurses and two project nurses were interviewed, giving their statements about the use of the dashboard. Based on observation, it is concluded that the temporal use of the dashboard is 3 minutes and 10 seconds, out of the 59 hours system interaction. Furthermore, the nurses claimed that they needed further training, as an explanation of the minimal interaction with the system.

Risk factors for violence-related injuries in emergency departments: a Danish linkage study

ABSTRACT Background: Interpersonal violence is a pervasive global public health problem associated with myriad health, social and economic consequences. In recent years the rates of interpersonal violence have decreased, however, high numbers of individuals continue to present to emergency departments for non-fatal violence-related injuries. Objective: This study aimed to examine a range of risk factors associated with violence-related injuries in an emergency department in Denmark. Method: A case-control study was conducted on a sample of 3,940 victims of violence collected by the Accident Analysis Center for Aarhus County Municipality. Using the Danish Civil Registry System, controls were matched 10:1 on age, gender and municipality. Risk factors were rendered from Danish health and social registers five years prior to the violent assault. These included marital status, educational qualification, employment status, national origin, involvement with child protective services (CPS), prior convictions, and a diagnosis of adjustment disorder and alcohol and/or substance use disorders. Results: Multivariate logistic regression identified that being male, divorced, unmarried, non-Danish origin, attending compulsory education, being outside the labour force, students, involvement with CPS, prior criminal conviction and a diagnosis of alcohol and/or substance use disorders were associated with an increased likelihood of being exposed to violence. The dominant risk factors were alcohol and/or substance use disorders (OR = 3.62) and prior criminal conviction (OR = 3.54). Attainment of tertiary education was associated with a reduced likelihood of being a victim of violence. Conclusion: These findings highlight that research into effective interventions offered in emergency departments may help the public health effort to reduce the health, social and economic burden of interpersonal violence.

The Effect of Patient-Controlled Oral Analgesia for Acute Abdominal Pain after Discharge

BackgroundDuring hospitalization, patients who were admitted with acute abdominal pain must be prepared to care for themselves at home after discharge to continue established treatment, promote recovery, and avoid readmission. AimsOur aim was to investigate the quality of pain management after discharge, when patient-controlled oral analgesia was compared with standard care for patients admitted to hospital with acute abdominal pain. The primary outcome measures were pain intensity and patient perception of care. The secondary outcome measures were pain interference with activity, affective experiences, side effects, and use of analgesics. DesignA questionnaire study measuring the effect of an intervention on patient-controlled oral analgesics. SettingsAn emergency department and a surgical department in Denmark. ParticipantsPatients admitted to hospital with acute abdominal pain. MethodsA pre- and postintervention study was conducted in an emergency department and a surgical department with three subunits. Data were collected using a Danish modified Revised American Pain Society Patient Outcome Questionnaire with five subscales (scale 0-10) completed in weeks 1 and 4 after discharge. ResultsIn total, 117 patients were included. The median scores at week 1 and week 4 in the control and intervention groups were, respectively, 2/1 and 1/0 on the pain subscale (p = .11/.16), 3/0 and 3/0 on the activity subscale (p = .19/.80), 1/0 and 0/0 on the emotional subscale (p = .02/.72), 1/0 and 1/0 on the side effect subscale (p = .95/.99), and 8/5 and 7/7 on the patient perception subscale (p = .35/.49). There was no significant difference in the use of analgesics at week 1. ConclusionsPatient-controlled oral analgesia during the hospital stay did not improve the quality of pain management after discharge.

Help Me Breathe, Please

Background: The aim was to gain insight into how patients with chronic obstructive pulmonary disease (COPD) experience being acutely admitted to an emergency department in Denmark. The Department is characterized by a large number of acute patients, which means that the focal point for the healthcare professionals may be to ensure vacant beds. This may be at the expense of caring for the patients sufficiently due to their individual needs. Focus on the flow culture may be contrary to the need for e.g. silence, safety, continuity in care and time with the healthcare professionals.&#x0D; Methods: This study has a qualitative design with a phenomenological hermeneutic approach. The empirics consist of qualitative semi-structured interviews with fourteen patients admitted to an emergency department in Denmark. The data has been analysed through the four steps about meaning condensation and meaning interpretation as described by Kvale and Brinkmann.&#x0D; Results: The preliminary analyses indicated that patients being admitted to the Emergency Department experience a strong need for getting help to breathe and rest. They have struggled with their breathing when they were at home and therefore feel extremely tired. Thus, the chaos that often exists in the Emergency Department may affect the patients’ well-being. In addition, the healthcare professionals’ way of communicating with the patients has a great impact on patient´s feeling safe and comfortable.&#x0D; Conclusion: By focusing on the patients´ individual fundamental care needs in a busy department, it may qualify continuity of care for patients with COPD.

Reporting through smartphone application results in detailed data on acquired and hereditary angioedema attacks

AllergyVolume 74, Issue 9 p. 1800-1802 LETTER TO THE EDITOR Reporting through smartphone application results in detailed data on acquired and hereditary angioedema attacks Kristian Buur Kreiberg, Corresponding Author Kristian Buur Kreiberg [email protected] orcid.org/0000-0002-7826-6293 HAE Centre Denmark, Odense University Hospital, Odense, Denmark Department of Dermatology and Allergy Centre, Faculty of Health, University of Southern Denmark, Odense, Denmark Correspondence Kristian Buur Kreiberg, HAE Centre Denmark, Odense University Hospital, Odense, Denmark. Email: [email protected]Search for more papers by this authorAnette Bygum, Anette Bygum HAE Centre Denmark, Odense University Hospital, Odense, DenmarkSearch for more papers by this author Kristian Buur Kreiberg, Corresponding Author Kristian Buur Kreiberg [email protected] orcid.org/0000-0002-7826-6293 HAE Centre Denmark, Odense University Hospital, Odense, Denmark Department of Dermatology and Allergy Centre, Faculty of Health, University of Southern Denmark, Odense, Denmark Correspondence Kristian Buur Kreiberg, HAE Centre Denmark, Odense University Hospital, Odense, Denmark. Email: [email protected]Search for more papers by this authorAnette Bygum, Anette Bygum HAE Centre Denmark, Odense University Hospital, Odense, DenmarkSearch for more papers by this author First published: 25 March 2019 https://doi.org/10.1111/all.13792Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume74, Issue9September 2019Pages 1800-1802 RelatedInformation