Comparing Guidelines to Daily Practice When Screening Older Patients for the Risk of Functional Decline in Hospitals: Outcomes of a Functional Resonance Analysis Method (FRAM) Study.

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.

Preferred Conversation Topics with Respect to Treatment Decisions Among Individuals with Type 2 Diabetes.

Purpose: Greater knowledge of individuals' needs and preferences can enhance shared decision-making, which is associated with improved quality of decisions and increased satisfaction. This study aimed to identify and prioritize the attributes (ie conversation topics) that individuals with type 2 diabetes find it most important to discuss with their healthcare provider regarding treatment decisions.

Patients And Methods: First, small group interviews were organized with adults with type 2 diabetes (N=8) treated in primary care to identify the attributes that they find important to discuss regarding treatment decisions.

Using the Generic Analysis Method to Analyze Sentinel Event Reports Across Hospitals: A Retrospective Cross-Sectional Study.

Objectives: Improving patient safety by investigating sentinel events (SEs) is hampered by the focus on isolated events within hospitals and a narrow scope of traditional root cause analysis methods. We aimed to examine if performing cross-hospital aggregate analysis of SEs applying a novel generic analysis method (GAM) bearing a human factor perspective can enhance learning from SEs.

Methods: A retrospective cross-sectional review of SE reports from 28 Dutch general hospitals using the GAM to reanalyze events was performed.

Proficient until proven unproficient? Exploring attitudes and perceptions of medical specialists on proficiency, proficiency requirements and proficiency tests for electrosurgery.

Background: The correct and safe use of electrosurgery requires medical specialists to be proficient. Minimum proficiency requirements and proficiency tests are a manner to structurally assure proficiency. The objective of this study is to explore attitudes and perceptions of medical specialists on proficiency, proficiency requirements and proficiency tests for the safe use of electrosurgery.

A cross sectional study on the different domains of frailty for independent living older adults.

Background: With the ageing population, there is a stronger focus on supporting older people to live independently as long as possible. One of the important factors to take into consideration for independent living older adults is frailty. This manuscript aims to provide insight into the relation between the different domains of frailty (physical, social and psychological or a combination), health outcomes and wellbeing aspects for independent living older adults.

Influence of municipal policy and individual characteristics on the use of informal and formal domestic help in the Netherlands.

Background: The responsibility for care and social support in the Netherlands has been decentralized to the municipalities, on the assumption that they are able to organise care and social support more effectively and efficiently. Municipalities are responsible for offering citizens the social support they need. They have policy discretion to decide how and to what extent they encourage and support the use of informal help.

EXPLORING MEDICAL DEVICES: THE USE OF RISK ASSESSMENT TOOLS AND THEIR LINK WITH TRAINING IN HOSPITALS.

Objectives: The aim of this study was to explore the risk assessment tools and criteria used to assess the risk of medical devices in hospitals, and to explore the link between the risk of a medical device and how those risks impact or alter the training of staff.

Methods: Within a broader questionnaire on implementation of a national guideline, we collected quantitative data regarding the types of risk assessment tools used in hospitals and the training of healthcare staff.

Results: The response rate for the questionnaire was 81 percent; a total of sixty-five of eighty Dutch hospitals.

Do employees benefit from collaborations between out of hours general practitioners and emergency departments?

Background: In an attempt to redirect patients who are inappropriately attending hospital emergency departments (ED) and in doing so provide the right care at the right place, out-of-hours GP (General Practitioner) services and EDs increasingly collaborate in Urgent Care Collaborations (UCCs). Work satisfaction is an important factor in analysing the impact of this organisational change. The objective of this study is, firstly, to discover if there is a difference in the employee experiences between those working in UCCs and those in traditional out-of-hours services in which EDs and out-of-hours GP services operate separately (i.

Care and support for older adults in The Netherlands living independently.

The growth in the numbers of older adults needing long-term care has resulted in rising costs which have forced the Dutch government to change its long-term care system. Now, the local authorities have greater responsibility for supporting older adults and in prolonging independent living with increased support provided by the social network. However, it is unclear whether these older adults have such a network to rely upon.

A baseline assessment by healthcare professionals of Dutch pharmacotherapeutic care for the elderly with polypharmacy.

Background: Polypharmacy is common in the elderly population and is associated with an increased risk of adverse drug events. To diminish this risk, the guideline 'Polypharmacy in the Elderly' has been developed in 2012. This study examines, to what extent Dutch pharmacotherapeutic practice amongst elderly with polypharmacy mirrors the best practice described in this guideline and which barriers threaten it.

The impact of older person's frailty on the care-related quality of life of their informal caregiver over time: results from the TOPICS-MDS project.

Purpose: To examine the impact of changes in an older person's frailty on the care-related quality of life of their informal caregiver.

Methods: Five research projects in the TOPICS-MDS database with data of both older person and informal caregiver at baseline and after 12 months follow-up were selected. Frailty was measured in five health domains (functional limitations, psychological well-being, social functioning, health-related quality of life, self-rated health).

Effects of self-management support programmes on activities of daily living of older adults: A systematic review.

Background: The ability of older adults to carry out activities of daily living and to adapt and to manage their own life decreases due to deterioration of their physical and cognitive condition. Nurses and other health care professionals should support the self-management ability of older adults to prevent activities of daily living dependence and increase the ability to adapt and to self-manage the consequences of living with a chronic condition.

Objective: To gain insight into the evidence of the effects of self-management support programmes on the activities of daily living of older adults living at home.

Is patient flow more efficient in Urgent Care Collaborations?

Objective: Emergency Departments and out-of-hours General Practitioner services collaborate increasingly in Urgent Care Collaborations (UCCs) by sharing one combined entrance and joint triage. The aim of this study is to examine the difference between UCCs and providers who operate separately with respect to the efficiency of patient flow.

Methods: This study had a cross-sectional observational design comparing three regions with UCC with three regions with usual care.

Out-of-Hours Care Collaboration between General Practitioners and Hospital Emergency Departments in the Netherlands.

Objective: In the Netherlands, general practitioners (GPs) and emergency departments (EDs) collaborate increasingly in what is called an Urgent Care Collaboration (UCC). In UCCs, GPs and EDs share 1 combined entrance and joint triage. The objective of this study was to determine if GPs treat a larger proportion of out-of-hours patients in the UCC system, and how this relates to patient characteristics.

Living In A Country With A Strong Primary Care System Is Beneficial To People With Chronic Conditions.

In light of the growing pressure that multiple chronic diseases place on health care systems, we investigated whether strong primary care was associated with improved health outcomes for the chronically ill. We did this by combining country- and individual-level data for the twenty-seven countries of the European Union, focusing on people's self-rated health status and whether or not they had severe limitations or untreated conditions. We found that people with chronic conditions were more likely to be in good or very good health in countries that had a stronger primary care structure and better coordination of care.

Supervision of care networks for frail community dwelling adults aged 75 years and older: protocol of a mixed methods study.

Introduction: The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation.

Increased respiratory symptoms in COPD patients living in the vicinity of livestock farms.

Several studies have investigated the effect of livestock farm emissions on the respiratory health of local residents, but results are inconsistent. This study aims to explore associations between the presence of livestock farms and respiratory health in an area of high-density livestock farming in the Netherlands. We focused especially on associations between farm exposures and respiratory symptoms within subgroups of potentially susceptible patients with a pre-existing lung disease.

Cardiovascular disease-related hospital admissions of patients with inflammatory arthritis.

Objective: Patients with inflammatory arthritis (IA) have an increased risk of cardiovascular diseases (CVD), suggesting a high rate of CVD-related hospitalizations, but data on this topic are limited. Our study addressed hospital admissions for CVD in a primary care-based population of patients with IA and controls.

Methods: All newly diagnosed patients with IA between 2001 and 2010 were selected from electronic medical records of the Netherlands Institute for Health Services Research Primary Care database, representing a national network of general practices.

Dietetic treatment lowers body mass index in overweight patients: an observational study in primary health care.

Background: Greater insight into the effectiveness of usual dietetic care will contribute to the ongoing development of dietetic services. The present study examined the change in body mass index (BMI) in overweight patients after dietetic treatment in primary care, the sources of variability and factors associated with BMI change.

Methods: This population-based observational study was based on data from a Dutch registration network of dietitians in primary health care.

Informal caregivers of persons with dementia, their use of and needs for specific professional support: a survey of the National Dementia Programme.

Background: This paper describes both the use of and needs for informal caregivers of people with dementia, based on a questionnaire survey organized within the National Dementia Programme in the Netherlands. The National Dementia Programme is a quality collaborative of the Dutch Alzheimer's Association, the Institute of Quality of Healthcare (CBO) and the Knowledge Centre on Ageing (Vilans), instigated by the Ministry of Health, Welfare and Sport, to improve integrated care for people with dementia and their informal caregivers. The support needs of informal caregivers are important to improve caregiver well-being and delaying institutionalization of the person with dementia.

Attitudes of nursing staff towards electronic patient records: a questionnaire survey.

Background: A growing number of health care organizations are implementing a system of electronic patient records (EPR). This implies a change in work routines for nursing staff, but it could also be regarded as an opportunity to improve the quality of care.

Objective: The objective of this paper is to obtain more insight into the usefulness of EPR as perceived by nursing staff and to clarify the determinants of nursing staff's acceptance of EPR.

Health problems in children and adolescents before and after a man-made disaster.

Objective: The aims of this study were to examine health problems of children (4-12 years old at the time of the disaster) and adolescents (13-18 years old at the time of the disaster) before and after exposure to a fireworks disaster in the Netherlands (May 2000), to compare these health problems with a control group, and to identify risk factors for postdisaster psychological problems.

Method: Because the electronic medical records of family practitioners were used, longitudinal monitoring of health problems from 1 year predisaster until 2 years postdisaster for both victims (N=1,628) and controls (N=2,856) was possible. Health problems were classified according to the International Classification of Primary Care.