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Background: Faecal incontinence (FI) and constipation affects a significant amount of the nursing home (NH) patients. In addition, many of the patients use laxatives regularly. Both faecal incontinence and constipation are bothersome conditions associated with increased risk of morbidity and reduced quality of life. There is a lack of studies investigating bowel problems among NH patients using validated and comprehensive instruments able to capture the complexity in NH patients. The level of awareness among health care staff regarding assessment and treatment options for FI seems limited. Aim: The aim of this thesis was to investigate prevalence and associations of faecal incontinence, constipation and laxative use among NH patients using the standardized and comprehensive Resident Assessment Instrument for Long-Term Care Facilities (interRAI LTCF). Secondly, the aim was to develop an implementation strategy for change in FI care in order to achieve a reduction in FI prevalence rates among patients. Results: Study I and II had a cross-sectional design including 261 patients in NHs in one Norwegian municipality. Study I showed prevalence rate of FI was 42.1 % or 54 %, depending on the chosen cut-off on the scale measuring FI in interRAI LTCF. In order to get some additional information on FI St. Mark’s Incontinence score was used, resulting in a prevalence rate of 70.1 %. This illustrates the importance of using clear definitions together with standardized instruments when investigating FI. Deficiencies in ADL, cognitive impairment, urinary incontinence and diarrhea were identified as risk factors, and involvement in activities and instability in health/frailty were identified as protective factors. In study II the prevalence of constipation was 23.4 % and 67.1 % of the patients used laxatives regularly. Balance problems, urinary incontinence, hypothyroidism, and Parkinson’s disease were identified as risk factors for constipation. Risk factors for laxative use were reduced ability to communicate and number of drugs other than laxatives, while anti-dementia drugs and being involved in activities were protective factors. Analyses using mixed effects models showed that most of the total variance in prevalence rates of faecal incontinence (88 %), constipation (90.3 %) and laxative use (97 %), was due to differences in individual patient characteristics, not variance between NH units. Study III was a pilot study preceding a cluster-randomized controlled trial (C-RCT). The pilot was designed as a three armed external pilot study investigating feasibility, acceptability, and adherence of two educational programmes for care staff concerning NH patients’ FI. Data was collected at baseline (t0) and after 3 months (t1). The study included patients (t0 n = 62, t1 n = 57) and registered nurses (t0 n = 7, t1 n = 7) in NHs. Quantitative data was analysed by descriptive statistics. Qualitative data from one focus group interview and four individual interviews were analysed by qualitative content analyses. The pilot study found the planned C-RCT to be feasible with one major and some minor modification. The major modification was the necessity to reduce the main study from a three-armed design to a two-armed design. Important barriers identified were sub-optimal use of skill-mix, problems of communicating assessments and care plans, and isolated RNs with an indistinct nurse identity. Paper IV is the protocol describing the C-RCT evaluating a multifaceted educational programme for care staff on assessment and treatment of patients’ FI. Conclusion: Prevalence of FI, constipation and laxative use are confirmed high. Variance in prevalence rates is mainly explained by different patient characteristics/ health deficiencies. Hence, individualized care matching the patients’ deficiencies might be a key to managing bowel problems. There is a need for studies evaluating interventions targeting bowel problems in NHs. Further, there is a need for studies evaluating different implementation strategies. The interRAI LTCF is a useful instrument by its combination of a comprehensive range of individual items and scales that make it possible to capture a holistic picture of the complex NH patient, allowing for comparison of immediate and long-term change in patients across settings

Background Fecal incontinence has a high prevalence in the older population, which cannot be explained by comorbidity or the anatomical or psychological changes of aging alone. Fecal incontinence leads to a high economic burden to the healthcare system and is an important cause of institutionalization. In addition, fecal incontinence is associated with shame, social isolation and reduced quality of life. The importance of identifying treatable causes in the frail elderly is strongly emphasized. It is recommended that an assessment of fecal incontinence should be implemented as part of an evaluation of older patients. Although there is a substantial evidence base to guide choice of implementation activities targeting healthcare professionals, little implementation research has focused on the care of older people nor involved care processes or care personnel. This study is based on the assumption that fecal incontinence among nursing home patients can be prevented, cured or ameliorated by offering care staff knowledge of best practice through a multifaceted educational program. The primary objective is to test the hypothesis that a multifaceted educational program for nursing home care staff on assessment and treatment of fecal incontinence reduces patients’ frequency of fecal incontinence. Methods/design The study is a two-armed, parallel cluster-randomized controlled trial. Primary outcome is the frequency of fecal incontinence among patients. Sample size calculations resulted in a need for a total sample of 240 patients. Twenty nursing home units in one city in Norway will be recruited and allocated to intervention or control by an independent statistician using computer-generated tables. The intervention is a multifaceted educational program. Units in the control arm will provide care as usual. The intervention period is 3 months. Data will be collected at baseline, 3, and 6 months. Data will be analyzed using mixed effect models with the cluster treated as a random effect. Discussion This study is the first randomized controlled trial specifically focusing on this neglected area. The result of the study will give evidence for best practice for continence care in nursing homes, and organizational advice concerning implementation strategies. Trial registration ClinicalTrials.gov: NCT02183740, registered June 2014. © 2015 Blekken et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)

Background Fecal incontinence has a high prevalence in the nursing home population which cannot be explained by co-morbidity or anatomic and physiological changes of aging alone. Our hypothesis is that fecal incontinence can be prevented, cured, or ameliorated by offering care staff knowledge of best practice. However, it is not clear which educational model is most effective. To assess the effect of two educational programs for care staff, we planned a three armed cluster-randomized controlled trial. There is a lack of research reporting effects of interventions targeting improved continence care processes in older patients. Thus, to improve the quality of the planned trial, we decided to carry out a pilot study to investigate the feasibility of the planned design, the interventions (educational programs) and the outcome measures, and to enable a power calculation. This paper reports the results from the pilot study. Methods Three nursing homes, representing each arm of the planned trial, were recruited. Criteria for assessing success of feasibility were pre-specified. Methods, outcome measures, acceptability, and adherence of the components of the intervention were evaluated by descriptive statistical analyses and qualitative content analysis of one focus group interview (n = 7) and four individual interviews. Results The main study is feasible with one major and some minor modifications. Due to challenges with recruitment and indications supporting the assumption that a single intervention with one workshop is not sufficient as an implementation strategy, the main study will be reduced to two arms: a multifaceted education intervention and control. The components of the multifaceted intervention seemed to work well together and need only minor modification. Important barriers to consider were sub-optimal use of skill-mix, problems of communicating important assessments and care plans, and isolated nurses with an indistinct nurse identity. Conclusions Overall, the main study is feasible. The pedagogical approach needs to consider the identified barriers. Thus, it is essential to empower nurses in their professional role, to facilitate clinical reasoning and critical thinking among care staff, and to facilitate processes to enable care staff to find, report, and utilize information in the electronic patient record. Trial registration ClinicalTrials.gov: NCT01939821 © 2015 Blekken et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)

Sammendrag Introduksjon Væskebalanse handler om innholdet av væske i kroppen, og omsetningen av denne. Ubalanse i kroppens væske- og elektrolyttbalanse kan forårsake komplikasjoner, forlengede sykehusopphold og i verste fall død. Pasienter er spesielt utsatt for komplikasjoner knyttet til væskebalanse postoperativt. Forebyggende tiltak som observasjon og registrering av væskebalanse er derfor viktige sykepleieoppgaver i denne fasen. Studiens hensikt var å undersøke sykepleiere på kirurgisk sengepost sine erfaringer knyttet til væskebalanse og føring av væskeregnskap til postoperative pasienter. Metode I denne studien er det brukt kvantitativ metode i form av et spørreskjema. Skjemaet ble sendt ut til sykepleiere ved tre kirurgiske sengeposter ved et universitetssykehus i Norge. Datamaterialet ble eksportert til Excel og det ble gjennomført frekvensanalyser. Funnene er fremstilt i diagrammer med tilhørende prosatekst. Svar fra fritekstspørsmål er også inkludert. Resultater Resultatene fra vår studie viser at flertallet av sykepleierne har kjennskap til den enhetsinterne retningslinjen for føring av væskebalanse. Derimot opplever kun et fåtall av sykepleierne at etterlevelsen av retningslinjen er god. Hverken oppfølgingen eller opplæringen knyttet til væskebalanse fremstår som tilstrekkelig. Alle sykepleierne opplever barrierer for korrekt væskeføring. I tillegg erfarer flere av sykepleierne at væskeføring har liten nytteverdi for pasientbehandlingen. Konklusjon Sykepleierne i studien erfarer mange utfordringer knyttet til registrering og oppfølging av væskebalanse, noe som sammenfaller med tidligere studier. Dette kan resultere i upålitelige væskeregnskap og få konsekvenser for pasientsikkerheten. Et kunnskapsløft gjennom ytterligere opplæring, gode rammebetingelser, samt en felles rutine for hvordan væskeføring skal utføres kan øke påliteligheten til væskeregnskapet. Abstract Introduction Fluid balance translate to the amount of fluid in the body and its circulation. An imbalance in the body's fluid and electrolyte balance can cause complications, prolonged hospital stays or in worst case death. Patients are particularly vulnerable to complications related to fluid balance postoperatively. Preventive measures such as observation and fluid balance registration seem to therefore be important nursing tasks during this phase. The purpose of this study was to investigate surgical ward nurses' experiences related to fluid balance and monitoring for postoperative patients. Method This study used quantitative methods in form of a questionnaire, which was sent to nurses at three surgical wards in a teaching hospital in Norway. The data was further exported to Excel and frequency analyzes were conducted. The findings are presented in diagrams with prose text. Responses from open-ended questions have also been included. Results This study demonstrates that most nurses were aware of the unit's internal guideline for fluid balance. However, only a few nurses experienced a satisfactory compliance with the guidelines. The general consensus was that neither follow-up nor training related to fluid balance appear to be sufficient. All nurses experienced challenges with correct fluid monitoring. In addition, several nurses reported that fluid monitoring has limited benefit in patient care. Conclusion The nurses in this study experienced several challenges related to registration and monitoring of fluid balance. These results are consistent with what other studies have previously shown. Consequently, these challenges may result in unreliable fluid balance charts, which can further have major repercussions for patient safety. Thus, an increase in knowledge through further training, good framework conditions, as well as a common routine for how fluid monitoring should be performed can increase the reliability of fluid balance charts.

Sammendrag Innledning: Å kunne forstå og anvende helsefaglig terminologi er viktig for både leseforståelse og læring i utdanningen, men også videre i arbeidet som sykepleier. Det digitale verktøyet «Termer» har blitt utviklet for å gjøre læring av fagterminologi raskere og mer effektiv. Verktøyet gir direkte ordforklaringer på nettsiden eller pdf-filen man er inne på, samt gjør det mulig å oversette teksten direkte på siden. Studien undersøker hvordan læringsutbyttet kan påvirkes ved å benytte seg av verktøyet. Hensikt: Å kartlegge sykepleierstudenters erfaringer med verktøyet «Termer», og hvordan verktøyet kan påvirke læringsutbyttet. Metode: For å undersøke erfaringene sykepleierstudentene har med «Termer», ble det valgt en kvalitativ forskningsmetode. Det ble gjennomført ett semistrukturert parintervju med sykepleierstudenter med norsk som morsmål, samt ett semistrukturert individuelt intervju med en sykepleierstudent med norsk som andrespråk. Intervjuene ble gjennomført i mars 2022 og analysert ved hjelp av tematisk inndeling og tolkning. Resultater: Resultatene viser både positive og negative erfaringer med verktøyet. De positive erfaringene tar utgangspunkt i velfungerende oversettelsesfunksjon, samt opplevelse av økt flyt, fokus og effektivitet i lesingen. De negative erfaringene dreier seg om introduksjonstidspunkt- og måte, samt at verktøyet til tider ga ordforklaringer av hverdagslige ord fremfor helsefaglig terminologi. Det har også vært fravær av implementering av verktøyet på skolen, noe som har resultert i at studentene ikke har benyttet seg av verktøyet. Respondentene ser nytteverdi i verktøyet, særlig i forbindelse med eksamensforberedelser, oppgaveskriving, under case-arbeid på skolen, og ved lesing og forståelse av forskning. Konklusjon: Studien har vist at verktøyet har potensiell stor nytteverdi for studentene på grunnlag av økt opplevelse av flyt, fokus, effektivitet og forståelse. Dette er faktorer som kan øke læringsutbyttet. Implementering fra utdanningen ser ut til å ha noe å si for om studentene tar verktøyet i bruk. Resultatene viser at introduksjonsmåte- og tidspunkt kunne forbedres, samt noen tekniske problemer i forbindelse med mangel på understrekning av relevant fagterminologi. Abstract Introduction: Being able to understand and use medical terminology is important for both reading comprehension and learning in education, but also further in the work as a nurse. The digital tool "Terms" has been developed to make learning terminology faster and more efficient. The tool provides direct word explanations on the website or pdf file you on, as well as making it possible to translate texts directly on the page. The study examines how the learning outcome can be affected by using the tool. Purpose: To map nursing students' experiences with the tool «Terms», and how the tool can affect the learning outcome. Method: A qualitative research method was chosen to investigate the nursing students’ experiences with "Terms". A semi-structured couple interview was conducted with nursing students with Norwegian as their native language, as well as a semi-structured individual interview with a nursing student with Norwegian as a second language. The interviews were conducted in March 2022 and analyzed using thematic division and interpretation. Results: The results show both positive and negative experiences with the tool. The positive experiences are based on a well-functioning translation function, as well as the experience of increased flow, focus and efficiency in reading. The negative experiences are about the time and manner of introduction, and that the tool sometimes gave word explanations of everyday words rather than health terminology. There has also been an absence of implementation of the tool during the education, which has resulted in the students not using the tool. The respondents see the usefulness of the tool, especially in connection with exam preparations, writing assignments, during case work at school, and when reading and understanding research. Conclusion: The study has shown that the tool has potential great value for the students on the basis of increased experience of flow, focus, efficiency and understanding. These are factors that can increase learning outcomes. Implementation from the school seems to have a bearing on whether the students use the tool. The results show that the introduction method and time could be improved, as well as some technical problems in connection with the lack of emphasis on relevant subject terminology.

Bakgrunn: Frivillige tilbod er ein del av det tverrfaglege folkehelsearbeidet. Caritas er eit eksempel på ein organisasjon som tilbyr ulike frivillige tilbod for innvandrarar, mellom anna norskopplæring og fysisk aktivitet. Det er ulikskap i helse blant innvandrarar og befolkninga elles og ulikskapen vert tydelegare ved auka alder. Helseutfordringar før- under og etter utvandring, er nokre eksempel på innvandrarspesifikke påverknadsfaktorar på helse. Samstundes kan det vere utfordrande å finne sin identitet mellom kulturar. I denne oppgåva handlar identitet om å finne sin plass i eit fellesskap. Målet med studien var å utforske eldre innvandrarkvinner sine opplevingar kring deltakinga i frivillige tilbod, og undersøke frivillige organisasjonar sine styrker og utfordringar i arbeidet kring innvandrarbefolkninga si helse. Metode: Analyser av 12 kvalitative forskingsintervju var grunnlaget for data i studien. I intervjua vart det teken i bruk delvis strukturert intervju, saman med ein tolk dersom deltakar ynskja dette. Analysetilnærminga som er brukt for å svare på problemstillinga er fortolkande fenomenologi. Slik legg studien vekt på å forstå sosiale fenomen ut frå deltakarane sine opplevingar og vidare beskrive verda slik den opplevast av deltakarane. Resultat: Analysane resulterte i tre hovudtema og seks subtema. Eit tema handlar om at kvinnene tek ansvar, med subtema helse og fysisk aktivitet, lære norsk og rekruttere andre personar til aktivitet. Deltakarane opplevde ulike gevinstar og barrierar for deltaking i fysisk aktivitet. Kvinnene opplevde at å lære norsk var viktig for ei vellukka integrering. Det var viktig å informere andre personar om aktivitetar, slik at fleire kunne nytte tilboda. Tema to handlar om arena for myndiggjering med subtema autonome ynskjer, forventningar og identitet vert utfordra. Fleire deltakarar hadde autonome ynskjer kring frivillige tilbod, samstundes vart ulike barrierar for deltaking nemnd. Ulike opplevingar blant deltakarane, kan ha påverka identiteten på ulike måtar. Tema tre handlar om at fellesskap motiverer med subtema sosiale relasjonar. Kvinnene opplevde at det var viktig med sosiale relasjonar for betre sjølvopplevd helse. Avslutting: Denne oppgåva er eit bidrag til å få ei innsikt i frivillige tilbod sine styrker og utfordringar kring eldre innvandrarkvinner si helse. Mangelfull informasjon og barrierar for deltaking er utfordringar i frivillige organisasjonar. Folkehelsekompetanse kan bidra til hensiktsmessige tilbod. Søkeord eldre innvandrarkvinner, folkehelsearbeid, helse-årsaksmodell, frivilligheit, identitet Background: Voluntary services are a part of interdisciplinary public health work. Caritas is an example of an organization offering a variety of voluntary services to immigrants, including Norwegian language training and physical activity. There is inequality in health between the immigrant population and the population at large, and this inequality grows more evident with age. Health issues present before and after emigration are examples of immigrant-specific factors affecting health. In addition, it may be challenging to establish a personal identity between cultures. In this thesis, identity is about finding one’s place in a community. The aim of this study was to explore elderly immigrant women’s experiences of participation in voluntary services in order to discover the strengths and challenges of voluntary organizations in health work pertaining to the health of the immigrant population. Method: Analysis from 12 qualitative research interviews was the source of data in this study. This was done through semi-structured interviews, and an interpreter was present when desired by the participant. The analytic approach used to answer the research question is interpretive phenomenology. In this manner, the thesis emphasizes the understanding of social phenomena based on the participants’ experiences, and further describes how the world is perceived by the participants. Results: The analysis resulted in three main topics, and six sub-topics. One topic is about women taking responsibility, with subtopics being health and physical activity, learning Norwegian and recruiting other people for activity. The participants experienced different gains and barriers through participation in physical activities. The women experienced that learning Norwegian was important for a successful integration. Informing others about these activities was important, so more people could benefit from the services. The second topic is an arena for empowerment with the sub-topics being autonomous desires, expectations and identity being challenged. Several participants had autonomous desires for voluntary services, while at the same time, different barriers to participation were mentioned. Different experiences among the participants may have affected their identity in different ways. Topic number three is community motivation with the sub-topic social relations. The women felt that social relationships were important for better self-perceived health. Conclusion: This thesis is a contribution towards gaining insight into voluntary services’ strengths and challenges working in elderly immigrant women’s health. Efforts to increase information and reduce participation barriers are some of the challenges faced in voluntary organizations. Public health competence could increase the knowledge about facilitating health-promoting services. Keywords: elderly immigrant women, public health, model of the determinants of health, voluntary services, identity.

Innledning: Studien ble utført i mars 2021 og inkluderer sykepleiere på ortopedisk avdeling ved St. Olavs hospital. Hensikten med studien er å kartlegge etterlevelsen av basale smittevernrutiner i prosedyren for tilberedning av antibiotika. Studien ser også på hvordan etterlevelsen av samme prosedyre kan påvirkes av indre faktorer hos den enkelte sykepleier. Metode: Studien bruker kvantitativ metode i form av en spørreundersøkelse. Denne ble sendt per e-post til sykepleierne som blander antibiotika på arbeid. Undersøkelsen ble utformet i Questback og resultatet ble analysert ved bruk av Excel. Resultat: Undersøkelsen er basert på 57 anonyme besvarelser. Respondentene rapporterte å ha generelt gode smittevernrutiner, men det ble også meldt om enkelte avvik. Respondentene var særlig dårlig på etterlevelsen av rutiner for hanskebruk og desinfisering av arbeidsbenk. Når det kommer til indre påvirkningsfaktorer, viser undersøkelsen at få av sykepleierne er oppdaterte på prosedyren, men at de likevel er trygge på egen kunnskap. 43% (n=24) rapporterte at de vet de burde følge prosedyren, men at de ofte slurver med det. Konklusjon: Funnene i studien sammenfaller med annen forskning som sier at etterlevelsen av basale smittevernrutiner har et forbedringspotensial i forbindelse med prosedyren for blanding av antibiotika. Etterlevelsen er god, men ikke optimal. Den enkelte sykepleier kan påvirkes både positivt og negativt av indre faktorer som kunnskap, holdninger, vaner og motivasjon. Nøkkelord: Etterlevelse, basale smittevernrutiner, antibiotika, indre faktorer, sykepleier. Introduction: This study was carried out at an orthopedic department at St. Olavs hospital in March 2021. The purpose of this study is to map the adherence to infection control within the procedure of preparing antibiotics. The study also covers how adherence may be influenced by internal factors within the individual nurse. Method: To survey the conditions, a qualitative method in the form of a questionnaire were used. It was sent per e-mail to the nurses who prepare antibiotics at work. The survey was designed through Questback and the collected data were analyzed using Excel. Result: The survey is based on 57 anonymous respondents who reportedly had a generally good adherence in terms of infection control. However, some anomalies were reported as well. The respondents had especially poor adherence to the use of gloves and disinfection of the work area. When it comes to internal factors, the survey shows that a minority of the nurses were up to date on the procedure. However, they were still confident in their own knowledge. 43% (n=24) of the nurses reported that they are aware that they should follow the procedure, but that deviations happen frequently. Conclusion: The result in this study coincides with another research that concludes in the potential for improvement when it comes to adherence to infection control during the procedure of preparing antibiotics. The adherence is good, but not good enough. Each nurse can be both positively and negatively affected by inner factors such as knowledge, motivation, attitude and habits. Key-words: Compliance, adherence, infection control, antibiotics, internal factors.

Koronapandemien har herjet landet i over ett år, og det norske helsevesenet har gjennomgått store endringer i blant annet kapasitet, arbeidsoppgaver og bemanningsbehov. Hensikten med denne studien er å undersøke i hvilken utstrekning koronapandemien har påvirket det psykososiale arbeidsmiljøet blant sykepleierne ved en interkommunal legevakt. For å belyse dette er det gjennomført en kvantitativ tverrsnittsundersøkelse, som baserer seg på et elektronisk spørreskjema utsendt til samtlige ansatte. Undersøkelsen viser at sykepleierne ved legevakta opplever store endringer i det psykososiale arbeidsmiljøet, særlig når det gjelder sosiale arbeidsfaktorer. Psykologiske arbeidsfaktorer viser seg også å være vesentlig påvirket under pandemien, dog ikke i like stor grad som de sosiale. Funnene i studien svarer til forventningene tidligere forskning på området skaper, på tross av geografiske og kulturelle forskjeller. The corona pandemic has ravaged the country for over a year, and the norwegian health care sector has seen massive changes in capacity, tasks and staffing, among other things. This study aims to examine to which extent the pandemic has influenced the psychosocial work environment amongst nurses at an intermunicipal casualty department. To investigate this, a quantitative cross-sectional survey was conducted using a digital survey sent out to all employees. The survey shows that the nurses are experiencing major changes in the psychosocial work environment, especially regarding social work-factors. Psycological work-factors are also significally affected, though not to the same extent as the social ones. The findings on the study correspond to the expectations set by previous reasearch in the field, despite geographical and cultural differences.

SAMMENDRAG Innledning: Denne fagartikkelen tar for seg hvordan organisasjonskulturen og dens egenskaper kan påvirke hvordan sykepleiere etterlever den kunnskapsbaserte prosedyren for å administrere legemiddelet Amiodaron. Metode: For å undersøke sykepleiernes tanker og meninger om etterlevelsen av prosedyren, ble det gjennomført fire kvalitative semistrukturerte intervjuer i mars 2021. Data ble analysert ved hjelp av prinsippene for systematisk tekstkondensering. Resultater: Alle informanter snakket varmt om avdelingens organisasjonskultur. De trakk frem god kommunikasjon og at sykepleierne har tillit til hverandres faglige dømmekraft og arbeidet de utfører. De mente avdelingen også har en god læringskultur, hvor terskelen for å få veiledning eller stille spørsmål er lav. Informantenes svar på hvordan de tok imot den nye prosedyren var imidlertid svært selvmotsigende. Informantene fortalte at endringer respekteres og følges, men det fortelles også om motstand og privatpraktisering blant sykepleierne i kollegagruppen. Ingen av informantene fortalte at de har blitt inkludert i å utarbeide den kunnskapsbaserte prosedyren for administrering av Amiodaron. Informasjonen i forkant av implementeringen virker også å ha vært mangelfull, da to av informantene ikke visste at det hadde blitt gjort endringer i prosedyren. Konklusjon: Denne fagartikkelen kommer frem til samme konklusjon som allerede eksisterende forskning på samme tema. Etterlevelse av kunnskapsbaserte prosedyrer er komplekst og det er mange forhold som må legges til rette for å lykkes med denne prosessen. Organisasjonskulturen og dens egenskaper påvirker etterlevelsen av prosedyren for administrering av Amiodaron både fremmende og hemmende. Videre forsøk på å introdusere kunnskapsbaserte prosedyrer blant sykepleiere på den aktuelle avdelingen, bør fokusere på å inkludere sykepleiere i prosessen og tilstrebe å informere godt nok. ABSTRACT Introduction: This study examines how the organizational culture and its features can affect nurses’ compliance of the evidence-based procedure for administration of Amiodarone. Method: In order to examine nurses’ thoughts and opinions related to the compliance of the procedure, four qualitative semi-structured interviews were conducted in March 2021. The data were analyzed using the principles of systemic text condensation. Results: All informants spoke well about the ward’s organizational culture. Good communication and that the nurses have confidence in each other’s professional judgment and the work they perform was emphasized. They also thought that the ward has a good culture for learning, where the threshold for receiving guidance or asking questions is low. When asked how the ward reacted to the new procedure, the informants’ statements were very contradictory. The informants stated that changes are respected and followed, but there is also talk of opposition and private practice among the ward’s nurses. None of the informants said that they had been included in the development of the evidence-based procedure for administrating Amiodarone. The information prior to the introduction of the new guidelines seems to have been inadequate, as two of the informants didn’t know that changes had been made to the procedure. Conclusion: This study comes to the same conclusion as existing research within same subject. Compliance with evidence-based procedures is complex and there are many conditions that must be met in order to succeed in this process. The organizational culture and its features can act as both a barrier and a facilitator with compliance of the procedure for administrating Amiodarone. Future attempts to introduce evidence-based procedures, among nurses at the ward in question, should focus on including nurses in the process and emphasize to provide good enough information beforehand.