Publications by authors named "Merten H"

Background: Research indicates suboptimal uptake and impact of clinical practice guidelines in Dutch healthcare. Dutch guideline organizations, i.e.

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Background: The uptake of guidelines in care is inconsistent. This review focuses on guideline implementation strategies used by guideline organizations (governmental agencies, scientific/professional societies and other umbrella organizations), experienced implementation barriers and facilitators and impact of their implementation efforts.

Methods: We searched PUBMED, EMBASE and CINAHL and conducted snowballing.

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Objectives: Dutch hospitals are required to screen older patients for functional decline using 4 indicators: malnutrition, delirium, physical impairment, and falls, to recognize frail older patients promptly. The Functional Resonance Analysis Method was employed to deepen the understanding of work according to the protocols (work-as-imagined [WAI]) in contrast to the realities of daily practice (work-as-done [WAD]).

Methods: Data have been collected from 3 hospitals (2 tertiary and 1 general) and 4 different wards: an internal medicine ward, surgical ward, neurology ward, and a trauma geriatric ward.

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Article Synopsis
  • The study examined patient safety by comparing adverse events (AEs) in hospital patients with and without conditions relevant for palliative care, finding no significant differences in overall prevalence but noting variability in types of AEs.
  • Out of nearly 3,000 patient records reviewed from hospitals in the Netherlands, both groups had similar rates of potentially preventable AEs and deaths, with medication-related issues prevalent in palliative care patients and surgery issues more common in others.
  • The analysis highlighted that the majority of AEs were due to patient-related causes, suggesting a need for tailored prevention strategies, despite overall preventability rates being comparable across both groups.
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Background: Dutch hospitals are required to screen older patients for the risk of developing functional decline using the Safety Management System (VMS) which assesses four domains associated with functional decline; fall risk, risk of delirium, malnutrition, and physical impairment.

Purpose: The aim is twofold, first to compare the VMS frailty instrument as a frailty screener with existing frailty instruments and second to provide an overview of the available evidence.

Methods: We performed a literature search to identify studies that used the VMS instrument as frailty screener to asses frailty or to predict adverse health outcomes in older hospitalized patients.

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Objectives: Patient safety is a core component of quality of hospital care and measurable through adverse event (AE) rates. A high-risk group are femoral neck fracture patients. The Dutch clinical guideline states that the treatment of choice is cemented total hip arthroplasty (THA) or hemiarthroplasty (HA).

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Objective: To determine factors affecting inpatient sleep and assess the range and effectiveness of non-pharmacological interventions aimed at improving the sleep of patients admitted to regular care wards.

Methods: A systematic literature search was conducted in five scientific databases, including articles published from inception to June 23rd, 2023. Eligible studies evaluated sleep disturbing factors or the effect of non-pharmacological intervention(s).

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Introduction: The full impact of an acute illness on subsequent health is seldom explicitly discussed with patients. Patients' estimates of their likely prognosis have been explored in chronic care settings and can contribute to the improvement of clinical outcomes and patient satisfaction. This scoping review aimed to identify studies of acutely ill patients' estimates of their outcomes and potential benefits for their care.

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Objective: Emergency department (ED) crowding is a worldwide problem and one of the main causes internationally is an increase in presentations by older patients with complex and chronic care needs. Although there has been a 4,3% reduction in total ED visits from 2016-2019 in the Netherlands, the EDs still experience crowding. National crowding research has not focused on the older group in detail, hence their possible role remains ill defined.

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Article Synopsis
  • Delayed hospital discharges can hurt patients' health and make it harder for new patients to get care.
  • A study in Amsterdam looked at why some patients were staying in the hospital longer than needed, finding that 21% didn't really need to be there.
  • Most of the delays were because there weren't enough places in care homes or patients were waiting for doctors to make decisions.
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  • Hospitalized patients experience significant disturbances in both the quality and quantity of sleep, with most studies indicating poor sleep quality due to various factors.
  • A total of 203 studies involving nearly 18,000 patients were reviewed, revealing that hospitalized children average 7.2 hours of sleep, adults 5.7 hours, and older patients 5.8 hours, with a concerning 1.8 hours of wakefulness after initially falling asleep.
  • Key factors disrupting sleep include external elements like noise and the number of patients in a room, as well as internal factors such as pain and anxiety.
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Importance: Inadequate sleep negatively affects patients' physical health, mental well-being, and recovery. Nonpharmacologic interventions are recommended as first-choice treatment. However, studies evaluating the interventions are often of poor quality and show equivocal results.

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  • Sleep is really important for patients in the hospital to recover, but nurses often think their patients are sleeping better than they actually are.
  • The study looked at how well nurses and patients agreed on the quality of the patient's sleep and what was bothering it.
  • Results showed that nurses rated patients' sleep higher than the patients did, meaning nurses might not fully understand how much trouble patients have sleeping.
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Objectives: Unintended events (UEs) are prevalent in healthcare facilities, and learning from them is key to improve patient safety. The Prevention and Recovery Information System for Monitoring and Analysis (PRISMA)-method is a root cause analysis method used in healthcare facilities. The aims of this systematic review are to map the use of the PRISMA-method in healthcare facilities worldwide, to assess the insights that the PRISMA-method offers, and to propose recommendations to increase its usability in healthcare facilities.

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Background: Healthcare professionals are sometimes forced to adjust their work to varying conditions leading to discrepancies between hospital protocols and daily practice. We will examine the discrepancies between protocols, 'Work As Imagined' (WAI), and daily practice 'Work As Done' (WAD) to determine whether these adjustments are deliberate or accidental. The discrepancies between WAI and WAD can be visualised using the Functional Resonance Analysis Method (FRAM).

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Purpose: Up to 22% of older patients who visit the emergency department (ED) have a return visit within 30 days. To achieve patient-centered care for this group at the ED it is important to involve the patient perspective and strive to provide the best possible experience. The aim of this study was to gain insight into the experiences and perspectives of older patients from initial to return ED visit by mapping their patient journey.

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Sleeping disorders are a common complaint in patients who suffer from an acute COVID-19 infection. Nonetheless, little is known about the severity of sleep disturbances in hospitalized COVID-19 patients, and whether these are caused by disease related symptoms, hospitalization, or the SARS-CoV-2 virus itself. Therefore, the aim of this study was to compare the quality and quantity of sleep in hospitalized patients with and without COVID-19, and to determine the main reasons for sleep disruption.

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Purpose: The success rate of dental implants after graftless sinus augmentation versus conventional sinus augmentation surgery in atrophic maxillae in edentulous patients was investigated.

Methods: This randomized study was performed in ten edentulous patients with marked maxillary atrophy. On the graftless side, the sinus membrane was lifted by a resorbable membrane.

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Objective: More older patients are presenting to the emergency department (ED). It is important to know why these patients present and if the ED is the best place for them to receive the care they need. The primary aim of this study was to identify organisational-related, technical-related, healthcare worker-related and patient-related factors leading to ED presentations of older patients.

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Serum albumin shows slow clearance from circulation due to neonatal Fc receptor (FcRn)-mediated recycling and has been used for half-life extension. We report here fusions to a high-affinity DARPin, binding to Epithelial Cell Adhesion Molecule (EpCAM). We developed a novel, efficient expression system for such fusion proteins in Pichia pastoris with titers above 300 mg/L of lab-scale shake-flask culture.

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Protein nanomaterial design is an emerging discipline with applications in medicine and beyond. A long-standing design approach uses genetic fusion to join protein homo-oligomer subunits via α-helical linkers to form more complex symmetric assemblies, but this method is hampered by linker flexibility and a dearth of geometric solutions. Here, we describe a general computational method for rigidly fusing homo-oligomer and spacer building blocks to generate user-defined architectures that generates far more geometric solutions than previous approaches.

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Background: Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this.

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Aim: Use of tele-health programs and wearable sensors that allow patients to monitor their own vital signs have been expanded in response to COVID-19. We aimed to explore the utility of patient-held data during presentation as medical emergencies.

Methods: We undertook a systematic scoping review of two groups of studies: studies using non-invasive vital sign monitoring in patients with chronic diseases aimed at preventing unscheduled reviews in primary care, hospitalization or emergency department visits and studies using vital sign measurements from wearable sensors for decision making by clinicians on presentation of these patients as emergencies.

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The aim of this systematic review and meta-analysis was to critically evaluate the currently existing clinical evidence on the efficacy of graftless maxillary sinus membrane elevation for implantation in the atrophic posterior maxilla. A search protocol without limitations to November 2020 was followed by two independent researchers. Randomized controlled trials using the lateral window approach for graftless sinus membrane elevation were included.

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