The Dutch Individualised Care Scale for patients and nurses : a psychometric validation study

Aims and objectives: Translating and psychometrically assessing the Individualised Care Scale (ICS) for patients and nurses for the Flemish and Dutch healthcare context. Background: Individualised care interventions have positive effects on health outcomes. However, there are no valid and reliable instruments for evaluating individualised care for the Flemish and Dutch healthcare context. Design: Psychometric validation study. Setting and participants: In Flemish hospitals, data were collected between February and June 2016, and in Dutch hospitals, data were collected between December 2014 and May 2015. Nurses with direct patient contact and a working experience of minimum 6 months on the wards could participate. Patient inclusion criteria were being an adult, being mentally competent, having an expected hospital stay of minimum 1 day, and being able to speak and read the Dutch language. In total, 845 patients and 569 nurses were included. Methods: The ICS was translated into Dutch using a forward–backward translation process. Minimal linguistic adaptations to the Dutch ICS were made to use the scale as a Flemish equivalent. Omega, Cronbach’s Alpha, mean inter-item correlations and standardised subscale correlations established the reliability and confirmatory factor analysis the construct validity of the ICS. Results: Internal consistency using Omega (Cronbach’s Alpha) ranged from 0.83 to 0.96 (0.82–0.95) for the ICSNurse and from 0.88 to 0.96 (0.87–0.96) for the ICSPatient. Fit indices of the confirmatory factor analysis indicated a good model fit, except for the root mean square error of approximation, which indicated only moderate model fit. Conclusion: The Dutch version of the ICS showed acceptable psychometric performance, supporting its use for the Dutch and Flemish healthcare context. Relevance to clinical practice: Knowledge of nurses’ and patients’ perceptions on individualised care will aid to target areas in the Dutch and Flemish healthcare context in which work needs to be undertaken to provide individualised nursing care

Implementation strategies used to implement nursing guidelines in daily practice: A systematic review

Objectives: Research specifically addressing implementation strategies regarding nursing guidelines is limited. The objective of this review was to provide an overview of strategies used to implement nursing guidelines in all nursing fields, as well as the effects of these strategies on patient-related nursing outcomes and guideline adherence. Ideally, the findings would help guideline developers, healthcare professionals and organizations to implement nursing guidelines in practice. Design: Systematic review. PROSPERO registration number: CRD42018104615. Data sources: We searched the Embase, Medline, PsycINFO, Web of Science, Cochrane, CINAHL and Google Scholar databases until August 2019 as well as the reference lists of relevant articles. Review methods: Studies were included that described quantitative data on the effect of implementation strategies and implementation outcomes of any type of a nursing guideline in any setting. No language or date of publication restriction was used. The Cochrane Effective Practice and Organisation of Care taxonomy was used to categorize the implementation strategies. Studies were classified as effective if a significant change in either patient-related nursing outcomes or guideline adherence was described. Strength of the evidence was evaluated using the ‘Cochrane risk of bias tool’ for controlled studies, and the ‘Newcastle-Ottawa Quality Assessment form’ for cohort studies. Results: A total of 54 articles regarding 53 different guideline implementation studies were included. Fifteen were (cluster) Randomized Controlled Trials or controlled before-after studies and 38 studies had a before-after design. The topics of the implemented guidelines were diverse, mostly concerning skin care (n = 9) and infection prevention (n = 7). Studies were predominantly performed in hospitals (n = 34) and nursing homes (n = 11). Thirty studies showed a positive significant effect in either patient-related nursing outcomes or guideline adherence (68%, n = 36). The median number of implementation strategies used was 6 (IQR 4–8) per study. Educational strategies were used in nearly all studies (98.1%, n = 52), followed by deployment of local opinion leaders (54.7%, n = 29) and audit and feedback (41.5%, n = 22). Twenty-three (43.4%) studies performed a barrier assessment, nineteen used tailored strategies. Conclusions: A wide variety of implementation strategies are used to implement nursing guidelines. Not one single strategy, or combination of strategies, can be linked directly to successful implementation of nursing guidelines. Overall, thirty-six studies (68%) reported a positive significant effect of the implementation of guidelines on patient-related nursing outcomes or guideline adherence. Future studies should use a standardized reporting checklist to ensure a detailed description of the used implementation strategies to increase reproducibility and understanding of outcomes

Effects of de-implementation strategies aimed at reducing low-value nursing procedures: A systematic review and meta-analysis

Background: In the last decade, there is an increasing focus on detecting and compiling lists of low-value nursing procedures. However, less is known about effective de-implementation strategie

European bedside nurses' perspective on the fundamentals of care framework and its application in clinical practice : a multi-site focus group interview study

Background. A changing nursing workforce and an increase in demands for care together with more complex care, raise arguments that leading and guiding nursing practice is more challenging than ever. Therefore, nurses need to have a shared agenda and a common language to show the importance of nursing care and the consequences of not addressing this in an appropriate way. In response to this the Fundamentals of Care framework was developed to also contribute to the delivery of person-centred care in an integrated way. However, to gain acceptance and applicability we need to ensure the framework's relevance to clinical practice from bedside nurses' perspectives. Objective. To describe bedside nurses' perspectives on the Fundamentals of Care framework and how it can be applied in clinical practice. Design. A descriptive qualitative design informed by the Fundamentals of Care framework. Setting(s). The study was undertaken at seven hospitals in Sweden, Denmark and the Netherlands during 2019. Participants. A total sample of 53 registered nurses working at the bedside participated. Participants had a wide variety of clinical experience and represented a range of different nursing practice areas. Methods. Twelve focus group interviews were used to collect data and analysed with a deductive content analysis approach. Results. Bedside nurses perceived that the Fundamentals of Care framework was adequate, easy to understand and recognised as representative for the core of nursing care. The definition for fundamental care covered many aspects of nursing care, but was also perceived as too general and too idealistic in relation to the registered nurses' work. The participants recognised the elements within the framework, but appeared not to be using this to articulate their practice. Three main categories emerged for implications for clinical practice; guiding reflection on one's work; ensuring person-centred fundamental care and reinforcing nursing leadership. Conclusions. The Fundamentals of Care framework is perceived by bedside nurses as a modern framework describing the core of nursing. The framework was recognised as having clinical relevance and provides nurses with a common language to articulate the complexity of nursing practice. This knowledge is crucial for nurses both in clinical practice and in leadership roles to be able to speak up for the need to integrate all dimensions of care to achieve person-centred fundamental care. Various activities for reflection, person-centred care and leadership to apply the framework in clinical practice were presented, together with minor suggestions for development of the framework

Nurse practitioners’ perceptions of their ability to enact leadership in hospital care

Aims and objective: To gain insight into nurse practitioners’ (NP) leadership roles in Dutch hospital care, by exploring the perceptions regarding their current leadership role and the differences with their previous role as a registered specialised nurse. Background: To meet today's challenges of the increasing healthcare demands, the employment of NPs is proliferating. NPs have the ideal position to play a pivotal role within healthcare reforms, yet full expansion of their scope of practi

Filling the Gaps in a Fragmented Health Care System:Development of the Health and Welfare Information Portal (ZWIP)

Background: Current health care systems are not optimally designed to meet the needs of our aging populations. First, the fragmentation of care often results in discontinuity of care that can undermine the quality of care provided. Second, patient involvement in care decisions is not sufficiently facilitated. Objective: To describe the development and the content of a program aimed at: (1) facilitating self-management and shared decision making by frail older people and informal caregivers, and (2) reducing fragmentation of care by improving collaboration among professionals involved in the care of frail older people through a combined multidisciplinary electronic health record (EHR) and personal health record (PHR). Methods: We used intervention mapping to systematically develop our program in six consecutive steps. Throughout this development, the target populations (ie, professionals, frail older people, and informal caregivers) were involved extensively through their participation in semi-structured interviews and working groups. Results: We developed the Health and Welfare Information Portal (ZWIP), a personal, Internet-based conference table for multidisciplinary communication and information exchange for frail older people, their informal caregivers, and professionals. Further, we selected and developed methods for implementation of the program, which included an interdisciplinary educational course for professionals involved in the care of frail older people, and planned the evaluation of the program. Conclusions: This paper describes the successful development and the content of the ZWIP as well as the strategies developed for its implementation. Throughout the development, representatives of future users were involved extensively. Future studies will establish the effects of the ZWIP on self-management and shared decision making by frail older people as well as on collaboration among the professionals involved. (JMIR Res Protoc 2012;1(2):e10) doi:10.2196/resprot.194

Development and psychometric evaluation of an instrument to assess venous leg ulcer lifestyle knowledge among nurses

Aim. Development and psychometric testing of an instrument to assess venous leg ulcer lifestyle knowledge. Background. Nurses often lack knowledge to provide adequate leg ulcer advice. No valid and reliable instruments are available to assess knowledge on venous leg ulcer advice among nurses. Methods. The instrument was developed based on a literature review and patient cases. Content validity was evaluated in a Delphi procedure by nine leg ulcer experts. Item-analysis, construct validity and stability were assessed. A sample of 350 nurses and student nurses participated. Data collection took place between February and April 2009. Results. The instrument included four topics: (1) Compression therapy, (2) Physical activity/leg exercises, (3) Leg elevation and (4) Pain management. Multiple-choice questions were developed to assess factual knowledge. Patient cases were developed to assess more complex cognitive skills. Content validity was established. The quality of the response alternatives varied between 0.01 and 0.68. The difficulty index for questions evaluating factual knowledge ranged from 0.12 to 0.78. Patient cases questions had a difficulty index between 0.07 and 0.60. The score of participants with (theoretically expected) more expertise was significantly higher than the score of participants with (theoretically expected) less expertise. The intraclass correlation coefficients ranged between 0.71 and 0.77. Eleven questions had moderate kappa-values (0.41-0.60), and in eight questions, there was fair agreement (0.30-0.40). Conclusion. An instrument with an acceptable content validity and construct validity was developed. The instrument can be applied in nursing education, nursing practice and nursing research to evaluate venous leg ulcer advice knowledge

Programmering van ontwikkeling, implementatie en actualisatie van kwaliteitsstandaarden voor de wijkverpleging: Eindrapportage

Het is voor de kwaliteit van zorg van groot belang dat verpleegkundigen en verzorgenden hun handelen baseren op actuele kennis en inzichten. Om dit te faciliteren worden onder meer vanuit het ZonMw-programma ‘Ontwikkeling Kwaliteitsstandaarden 2019-2022: Wijkverpleging’ kwaliteitsstandaarden ontwikkeld. Onder de koepelterm kwaliteitsstandaarden vallen richtlijnen die vooral de inhoudelijke elementen van zorg beschrijven, evenals zorgstandaarden die vooral gaan over het perspectief van zorggebruiker en de organisatie van zorg. Het is belangrijk om te weten voor welke onderwerpen en patiëntproblemen mogelijk een knelpuntanalyse of een kwaliteitsstandaard nodig is, of waar een kwaliteitsstandaard geactualiseerd dient te worden. Om dit helder te krijgen wordt in 2020-2021 de ‘Programmeringsstudie Ontwikkeling Kwaliteitsstandaarden 2019-2022: Wijkverpleging’ uitgevoerd. Het doel van deze programmeringsstudie is bijdragen aan een systematische en breed gedragen programmering voor het ZonMw-programma ‘Ontwikkeling Kwaliteitsstandaarden 2019- 2022: Wijkverpleging’. De programmeringsstudie bestond uit vier deelstudies. Het voorliggende rapport heeft betrekking op de vierde en laatste deelstudie. Dit onderdeel had als doel om een advies uit te brengen aan V&VN om de programmeringsagenda voor de ontwikkeling én implementatie van kwaliteitsstandaarden voor de wijkverpleging actueel te houden. Hiervoor werden als eerste knelpunten en wensen ten aanzien van het actueel houden van de programmeringsstudie opgehaald tijdens advies- en klankbordgroepen bijeenkomsten. Aanvullend werden gesprekken met andere beroepsorganisaties gevoerd om meer inzicht te krijgen in hoe zij hun programmeringsagenda’s actueel houden. Daarnaast werden resultaten uit de eerdere drie deelstudies vertaald naar aanbevelingen om de programmeringsagenda actueel te houden. Tot slot is gezocht naar aanvullende literatuur om de aanbevelingen waar mogelijk te onderbouwen