What do we know about rheumatoid arthritis patients' support needs for self-management? A scoping review.

Background: Self-management support is essential to perform self-management behavior. To provide this support in an effective way, insight in the needs for self-management support is necessary.

Objective: To give an overview of self-management support needs from the perspective of rheumatoid arthritis patients to help nurses to improve self-management.

Determinants of students' willingness to accept a measles-mumps-rubella booster vaccination during a mumps outbreak: a cross-sectional study.

Background: Despite high vaccination coverage, a mumps outbreak that affected mainly vaccinated university students and their contacts took place in the Netherlands in the period 2009-2012. We presented university students with a hypothetical case in which we offered them a measles, mumps, and rubella (MMR) booster vaccination to control the mumps outbreak. The aim of this study was to get insight into the determinants of university students' willingness to accept this vaccination.

Why do high-volume hospitals achieve better outcomes? A systematic review about intermediate factors in volume-outcome relationships.

Objective: To assess the role of process and structural factors in volume-outcome relationships.

Data Sources: Pubmed electronic database, until March 2014.

Study Design: Systematic review.

Value of EGD in patients referred for cholecystectomy: a systematic review and meta-analysis.

Background: As many as 33% of patients with symptomatic cholelithiasis report persisting abdominal pain after cholecystectomy, suggesting alternative causes of these symptoms. EGD may serve as a tool to identify additional symptomatic abdominal disorders beforehand to avoid unnecessary gallbladder surgery. There is controversy as to whether routine EGD before cholecystectomy is appropriate.

Ethical problems in intensive care unit admission and discharge decisions: a qualitative study among physicians and nurses in the Netherlands.

Background: There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

Professional's Attitudes Do Not Influence Screening and Brief Interventions Rates for Hazardous and Harmful Drinkers: Results from ODHIN Study.

Aims: To determine the relation between existing levels of alcohol screening and brief intervention rates in five European jurisdictions and role security and therapeutic commitment by the participating primary healthcare professionals.

Methods: Health care professionals consisting of, 409 GPs, 282 nurses and 55 other staff including psychologists, social workers and nurse aids from 120 primary health care centres participated in a cross-sectional 4-week survey. The participants registered all screening and brief intervention activities as part of their normal routine.

Stigma and GPs' perceptions of dementia.

Objectives: General practitioners (GPs) are crucial to improving timely diagnosis, but little is reported about how they perceive dementia, and whether their perceptions display any elements of stigma. The aim of this study was to explore how GPs' perceptions of dementia map onto current conceptualizations of stigma and whether GPs feel that stigma affects timely diagnosis.

Methods: Twenty-three GPs from England were interviewed by telephone.

"The educating nursing staff effectively (TENSE) study": design of a cluster randomized controlled trial.

Background: Challenging behavior exhibited by people with dementia can have adverse outcomes, like stress, low morale, low work satisfaction and absenteeism for nursing staff in long-term care settings. Training nursing staff to manage challenging behavior may reduce its impact. Although much of the research into training nursing staff shows methodological limitations, several studies find some effect of training programs on knowledge about and on management of challenging behavior.

Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?

World-wide, shortages of primary care physicians and an increased demand for services have provided the impetus for delivering team-based primary care. The diversity of the primary care workforce is increasing to include a wider range of health professionals such as nurse practitioners, registered nurses and other clinical staff members. Although this development is observed internationally, skill mix in the primary care team and the speed of progress to deliver team-based care differs across countries.

Development and Evaluation of an Educational E-Tool to Help Patients With Non-Hodgkin's Lymphoma Manage Their Personal Care Pathway.

Background: An overload of health-related information is available for patients on numerous websites, guidelines, and information leaflets. However, the increasing need for personalized health-related information is currently unmet.

Objective: This study evaluates an educational e-tool for patients with non-Hodgkin's lymphoma (NHL) designed to meet patient needs with respect to personalized and complete health-related information provision.

Effectiveness of a training package for implementing a community-based occupational therapy program in dementia: a cluster randomized controlled trial.

Objective: Evaluate the effectiveness of a training package to implement a community occupational therapy program for people with dementia and their caregiver (COTiD).

Design: Cluster randomized controlled trial.

Subjects: A total of 45 service units including 94 occupational therapists, 48 managers, 80 physicians, treating 71 client-caregiver couples.

Effectiveness of improvement plans in primary care practice accreditation: a clustered randomized trial.

Background: Accreditation of healthcare organizations is a widely used method to assess and improve quality of healthcare. Our aim was to determine the effectiveness of improvement plans in practice accreditation of primary care practices, focusing on cardiovascular risk management (CVRM).

Method: A two-arm cluster randomized controlled trial with a block design was conducted with measurements at baseline and follow-up.

Am I my brother's keeper? A survey of 10 healthcare professions in the Netherlands about experiences with impaired and incompetent colleagues.

Background: Dealing with poor individual performance of healthcare professionals is essential in patient safety management. The objective of the current study was to explore potential differences regarding experiences with impaired and incompetent colleagues between a broad range of healthcare professions.

Methods: A survey of 10 legally regulated professions in the Netherlands on knowledge on dealing with impaired/incompetent colleagues, experiences with such colleagues, action taken upon an impaired and incompetent colleague and reasons for not taking action.

Evaluating the uptake and effects of the computerized decision support system NHGDoc on quality of primary care: protocol for a large-scale cluster randomized controlled trial.

Background: Computerized decision support systems (CDSSs) are increasingly used to improve quality of care. There is evidence for moderate to large effects from randomized controlled trials (RCTs), but evidence on their effectiveness when implemented at a national level is lacking. In the Netherlands, the Dutch College of General Practitioners (NHG) initiated their successful guideline program already 30 years ago.

Prevalence of inappropriate prescribing of inhaled corticosteroids for respiratory tract infections in the Netherlands: a retrospective cohort study.

Background: Inhaled corticosteroids (ICS) are recommended in prevailing guidelines for use in patients with persistent asthma or moderate-to-severe chronic obstructive pulmonary disease (COPD) and recurrent exacerbations. Recent data from Australia showed that 44% of patients with a single ICS dispensing and without other respiratory inhalation medications ('one-off ICS') were co-dispensed oral antibiotics. Evidence of the merit of ICS for treating respiratory infections in subjects without asthma or COPD is lacking.

[Emergency ambulance call-outs often provide primary care].

Objective: To examine patient and care characteristics of emergency ambulance call-outs and to determine how many of them were, in retrospect, effectively providing primary care.

Design: Retrospective cross-sectional study.

Method: We charted patient and care characteristics of 598 emergency ambulance call-outs in the Zuid-Gelderland region in the east of the Netherlands by applying a retrospective dossier analysis method.

An innovative peer assessment approach to enhance guideline adherence in physical therapy: single-masked, cluster-randomized controlled trial.

Background: Clinical practice guidelines (CPGs) are not readily implemented in clinical practice. One of the impeding factors is that physical therapists do not hold realistic perceptions of their adherence to CPGs. Peer assessment (PA) is an implementation strategy that aims at improving guideline adherence by enhancing reflective practice, awareness of professional performance, and attainment of personal goals.

Consensus on quality indicators to assess the organisation of palliative cancer and dementia care applicable across national healthcare systems and selected by international experts.

Background: Large numbers of vulnerable patients are in need of palliative cancer and dementia care. However, a wide gap exists between the knowledge of best practices in palliative care and their use in everyday clinical practice. As part of a European policy improvement program, quality indicators (QIs) have been developed to monitor and improve the organisation of palliative care for patients with cancer and those with dementia in various settings in different European countries.

Improving patient discharge and reducing hospital readmissions by using Intervention Mapping.

Background: There is a growing impetus to reorganize the hospital discharge process to reduce avoidable readmissions and costs. The aim of this study was to provide insight into hospital discharge problems and underlying causes, and to give an overview of solutions that guide providers and policy-makers in improving hospital discharge.

Methods: The Intervention Mapping framework was used.

Is the role as gatekeeper still feasible? A survey among Dutch general practitioners.

Introduction: In the 2012 International Health Policy Survey by the Commonwealth Fund, 57% of Dutch GPs indicated that Dutch patients receive too much health care. This is an unexpected finding, given the clear gatekeeper role of Dutch GPs and recent efforts strengthening this role.

Objectives: The study aims to explore where perceived overuse of care prevails and to identify factors associated with too much care at the entry point of Dutch health care.

Perspectives on Parkinson disease care in Dutch nursing homes.

Introduction: Parkinson's disease (PD) is a complex and disabling disorder. Ultimately, 20% to 40% of patients are admitted to a nursing home, and neurologists often lose track of these patients. Care and treatment of these institutionalized patients have not been addressed comprehensively, but anecdotal reports suggest it is suboptimal.

General practitioners' preferences for interventions to improve guideline adherence.

Rationale, Aims And Objectives: Interventions aimed at improving guideline adherence should take into account the specific features of the target users; however, it is unclear how general practitioners (GPs) evaluate the different types of interventions. The aim of this paper was to identify GPs' preferences for interventions to improve guideline adherence in practice and whether these differ across key guideline recommendations.

Method: An electronic survey was conducted among 703 GPs working in the south-western part of the Netherlands.

Unexpectedly long hospital stays as an indicator of risk of unsafe care: an exploratory study.

Objectives: We developed an outcome indicator based on the finding that complications often prolong the patient's hospital stay. A higher percentage of patients with an unexpectedly long length of stay (UL-LOS) compared to the national average may indicate shortcomings in patient safety. We explored the utility of the UL-LOS indicator.

Experiences of patients with borderline personality disorder with the brief admission intervention: a phenomenological study.

Brief admission is a crisis intervention for patients with borderline personality disorder (BPD), and refers to a clinical admission at a psychiatric hospital for a period of 1-5 nights. Patients formulate a treatment plan together with their community mental health nurse about the maximum frequency allowed for these brief admissions. The purpose of the study was to describe the lived experiences of patients with BPD with use of the brief admission intervention.

Cervical collar-related pressure ulcers in trauma patients in intensive care unit.

Introduction: The application of a cervical collar (C-collar) in trauma patients can be life-saving. Previous studies, however, describe development of pressure ulcers related to C-collars.

Objective: To retrospectively compare collar-related pressure ulcers (CRPUs) occurring in trauma patients admitted to the intensive care unit wearing a C-collar before and after implementation of preventive interventions and to identify risk factors for CRPU development.