Telenursing pp 131-142 | Cite as

Telenursing in Sweden

  • Inger Holmström
Part of the Health Informatics book series (HI)


The number of call centers staffed with telenurses in Sweden has rapidly increased during the last decade, as well as the number of calls per center.24 Telenursing is, although more and more centralized, a diversified activity in Sweden, based on, e.g., geographical conditions and the population in the local area. The Swedish health-care system is tax financed and private health-care providers are still rare outside the larger cities. There is a strong emphasis on equal health care for all within the Swedish health-care system, established in the Swedish Health and Medical Service Act (1982:763). Sweden has a decentralized health-care system where services to a large extent are based on decisions made by local politicians in the 20 counties. The citizens pay taxes to local authorities, which have a great deal of freedom to organize health-care services in their area.


Medical Safety Computerize Decision Support System Alarm Number Swedish Nurse Nursing Specialty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Computerized Decision Support System


European Credit Transfer System (1.5 ECTS is equivalent to 1 week studies)


General Practitioner


International Council of Nurses


Information Technology


Swedish Healthcare Direct



I am indebted to the telenurses who willingly shared their experiences with us. A special thank to Sara Holmström for invaluable help with transcriptions and administrative work. Grants were received from The Swedish Research Council (Vetenskapsrådet), The Swedish Council for Social Research, and the Faculty of Medicine, Uppsala University.


Cost-effective –

Productive relative to the cost.

Patient centeredness –

Patient centeredness could be defined as: partnership between practitioners and patient, so that patient can make decisions and participate in their own care.


  1.  1.
    Andersson Bäck M. Conceptions, conflicts and contradictions: in the introduction of a Swedish health call centre. Institutionen för arbetsvetenskap, University of Gothenburg, Gothenburg; 2008.Google Scholar
  2.  2.
    Arnetz B. Psychosocial challenges facing physicians of today. Soc Sci Med. 2001;52:203-213.PubMedCrossRefGoogle Scholar
  3.  3.
    Barnard A, Sandelowski M. Technology and human nursing care: (ir)reconcilable or invented difference? J Adv Nurs. 2001;34(3):367-375.PubMedCrossRefGoogle Scholar
  4.  4.
    Bondo Christensen M, Olesen F. Out of hour’s service in Denmark: evaluation five years after reform. BMJ. 1998;316:1502-1505.Google Scholar
  5.  5.
    Derkx H, Rethans J-JE, Maiburg BH, et al. Quality of communication during telephone triage at Dutch out-of-hours centres. Patient Educ Couns. 2009;74:174-178.PubMedCrossRefGoogle Scholar
  6.  6.
    Ernesäter A, Engström M, Holmström I, Winblad U. Incident reporting in nurse-led national telephone triage in Sweden: the reported errors reveal a pattern that needs to be broken. J Telemed Telecare. 2010;16(5):243-247.PubMedCrossRefGoogle Scholar
  7.  7.
    Ernesäter A, Holmström I, Engström M. Telenurses’ experiences of working with computerized decision support: supporting, inhibiting and quality improving. J Adv Nurs. 2009;65(5):1074-1083.PubMedCrossRefGoogle Scholar
  8.  8.
    Höglund A, Holmström I. “It’s easier to talk to a woman” – aspects of gender in Swedish telenursing. J Clin Nurs. 2008;17(22):2979-2986.PubMedCrossRefGoogle Scholar
  9.  9.
    Holmström I. Decision aid software programs in telenursing: not used as intended? Experiences of Swedish telenurses. Nurs Health Sci. 2007;9(1):23-28.PubMedCrossRefGoogle Scholar
  10. 10.
    Holmström I, Dall’Alba G. “Carer and gatekeeper” – conflicting demands in nurses’ experiences of telephone advisory services. Scand J Caring Sci. 2002;16(2):142-148.PubMedCrossRefGoogle Scholar
  11. 11.
    Holmström I, Höglund AT. The faceless encounter. Ethical dilemmas in telephone nursing. J Clin Nurs. 2007;16(10):1865-1871.PubMedCrossRefGoogle Scholar
  12. 12.
    Ipsos-Eureka. Vårdråd per telefon. Utvärdering av sjukvårdsrådgivningen i fyra landsting [Health care direct. Evaluation of the Swedish Health Direct in four counties]. Landstings­förbundet, Vårdråd per telefon, Stockholm; 2004.Google Scholar
  13. 13.
    Kaminsky E, Rosenqvist U, Holmström I. Telenurses’ understanding of work: detective or educator? J Adv Nurs. 2009;65(2):382-390.PubMedCrossRefGoogle Scholar
  14. 14.
    Leppänen V. Telefonsamtal till Primärvården: Problem – Utforskning – Åtgärd (Telephone Calls to Primary Health Care: Problems – Investigation – Measures). Lund: Studentlitteratur; 2002.Google Scholar
  15. 15.
    Marklund B. Symtom, Råd, Åtgärd. Vårdutveckling AB, Vänersborg; 2000.Google Scholar
  16. 16.
    Marklund B, Ström M, Månsson J, et al. Computer-supported telephone nurse triage: an evaluation of medical quality and costs. J Nurs Manag. 2007;15(2):180-187.PubMedCrossRefGoogle Scholar
  17. 17.
    Mead N, Bower P. Patient-centred consultations and outcomes in primary care: a review of the literature. Patient Educ Couns. 2002;48:51-61.PubMedCrossRefGoogle Scholar
  18. 18.
    Snooks H, Williams AM, Griffith LJ, et al. Real nursing? The development of telenursing. J Adv Nurs. 2008;61:631-640.PubMedCrossRefGoogle Scholar
  19. 19.
    Strom M, Marklund B, Hilding C. Nurses’ perceptions of providing advice via a telephone care line. Br J Nurs. 2006;15(20):1119-1124.PubMedGoogle Scholar
  20. 20.
    Swedin B. Vårdråd direkt: sjukvårdsrådgivningar i samverkan: slutrapport från utredningen om nationellt samordnad sjukvårdsrådgivning. Landstingsförbundet, Stockholm; 2003.Google Scholar
  21. 21.
    Sveriges Kommuner och Landsting. Vårdbarometern: befolkningens syn på vården 2006 report. (The publics’ views on health care during 2006). Sveriges kommuner och landsting, Stockholm; 2007.Google Scholar
  22. 22.
    Tjora A. Calls for Care: Coordination, Competence, and Computers in Medical Emergency Call Centres. Saarbrücken: Verlag Dr. Müller; 2009.Google Scholar
  23. 23.
    Valsecchi R, Andersson M, Smith C, et al. Tele-nursing: the English and Swedish experiences. In: 25th Annual Labour Process Conference; 2007; AIAS, Amsterdam.Google Scholar
  24. 24.
    Wahlberg A. Telephone advice nursing. Callers’ perceptions, nurses experience of problems and basis for assessments. Department of Nursing, Karolinska Institute, Stockholm; 2004.Google Scholar
  25. 25.
    Wahlberg A, Wredling R. Telephone nursing: calls and caller satisfaction. Int J Nurs Pract. 1999;5:164-170.PubMedCrossRefGoogle Scholar
  26. 26.
    Wahlberg AC, Cedersund E, Wredling R. Factors and circumstances related to complaints in emergency medical dispatching in Sweden: an exploratory study. Eur J Emerg Med. 2003;10(4):272-278.PubMedCrossRefGoogle Scholar
  27. 27.
    Wahlberg A, Cedersund E, Wredling R. Telephone nurses’ experience of problems with telephone advice in Sweden. J Clin Nurs. 2003;12(1):37-45.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  1. 1.Department of Public Health and Caring SciencesUppsala University, Health Services ResearchUppsalaSweden

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