Learning as a way of achieving quality improvement in long-term care:A qualitative evaluation of The Story as a Quality Instrument

Aim/ObjectiveThis study aimed to evaluate the use of the narrative quality instrument ‘The Story as a Quality Instrument’ (or SQI) for learning as a way of achieving quality improvement.BackgroundLearning is a widespread aim in long-term care. If professionals share detailed information about their views on the quality of care, they can see it from each other’s perspective and create a new joint perspective that may generate a broader meaning in total. One useful source for learning and improvement is the narratives of older adults. These narratives enable reflection and learning, which encourages action. In care organizations, there is a drive to find methods that can be used to facilitate learning and encourage quality improvement.DesignA qualitative evaluation design.MethodsData collection was performed in 2021–2022 at six field sites of four large care organizations providing long-term care to older adults in the Netherlands. At each field site, SQI was applied: an action plan was formulated in a quality meeting and, 8–12 weeks later, the progress was evaluated in a follow-up meeting. The data collected was participants’ responses during focus groups: the verbatim transcripts of both meetings and the observation reports of the researchers. 46 participants took part in the quality meetings and 34 participants were present at the follow-up meetings. The data was analyzed using thematic analysis.ResultsThe results are mechanisms that help learning, participant responses, and practical challenges and conditions. Four mechanisms became visible that encourage learning among participants for achieving quality improvements: in-depth discussions, exchange of perspectives, abstraction, and concretization. The participants listed several outcomes regarding individual learning such as change of attitude, viewing older adults more holistically and the realization that possibilities for working on quality improvement could be just a small and part of everyday work. Participants learned from each other as they came to understand each other’s perspectives. The added value lay in getting insights into the individual perceptions of clients, the concrete areas for improvement as an outcome, and getting a picture of the perspectives of diverse people and functions represented. Time was found to be the main challenge when applying SQI.ConclusionsSQI is deemed promising for practice, as it allows care professionals to learn in their workplace in a structured way from narratives of older adults in order to improve the quality of care

Health impact of the first and second wave of COVID-19 and related restrictive measures among nursing home residents:A scoping review

Abstract Background and objectives COVID-19 disproportionally affects older adults living in nursing homes. The purpose of this review was to explore and map the scientific literature on the health impact of COVID-19 and related restrictive measures during the first and second wave among nursing home residents. A specific focus was placed on health data collected among nursing home residents themselves. Research design and methods In this study, best practices for scoping reviews were followed. Five databases were systematically searched for peer-reviewed empirical studies published up until December 2020 in which data were collected among nursing home residents. Articles were categorized according to the type of health impact (physical, social and/or psychological) and study focus (impact of COVID-19 virus or related restrictive measures). Findings were presented using a narrative style. Results Of 60 included studies, 57 examined the physical impact of COVID-19. All of these focused on the direct impact of the COVID-19 virus. These studies often used an observational design and quantitative data collection methods, such as swab testing or reviewing health records. Only three studies examined the psychological impact of COVID-19 of which one study focused on the impact of COVID-19-related restrictive measures. Findings were contradictory; both decreased and improved psychological wellbeing was found during the pandemic compared with before. No studies were found that examined the impact on social wellbeing and one study examined other health-related outcomes, including preference changes of nursing home residents in Advanced Care planning following the pandemic. Discussion and implications Studies into the impact of the first and second wave of the COVID-19 pandemic among nursing home residents predominantly focused on the physical impact. Future studies into the psychological and social impact that collect data among residents themselves will provide more insight into their perspectives, such as lived experiences, wishes, needs and possibilities during later phases of the pandemic. These insights can inform policy makers and healthcare professionals in providing person-centered care during the remaining COVID-19 pandemic and in future crisis periods

Becoming productive 21st century citizens: A systematic review uncovering design principles for integrating community service learning into higher education courses

Background: To prepare students to become productive 21st century citizens, universities have to be more engaged with society. Shifting towards community service learning (CSL) enables students to participate in, and reflect on, services that both benefit the public and also contribute to their own learning. There has been considerable research conducted on the improved student competencies, both academic and personal, resulting from CSL. There is, however, no consensus on how to integrate CSL into courses successfully, owing to the diverse contextual factors that influence implementation. Purpose: By means of conducting a review, this study aimed to establish general design principles to help guide course coordinators in implementing CSL in their academic courses. Design and methods: A systematic review was conducted of articles describing the implementation of CSL in academic courses within various disciplines. Implementation elements and principles were extracted from the articles and inductively grouped together, thereby identifying various design principles. Findings: Our analysis of the literature highlighted three steps that, according to the literature, are important in the implementation of CSL: (1) aligning course objectives and format; (2) establishing a relationship with the community partner; and (3) defining a reflection and evaluation strategy. We found that the nature of the design principles and specific approaches underlying these implementation steps should depend on the students’ capabilities, which include their pre-CSL experiences. Conclusion: The implementation steps and underlying design principles uncovered by this review may help guide and support course coordinators in their efforts to integrate CSL in their academic courses. The diverse range of design principles makes it possible to acknowledge students’ pre-CSL experiences and, thus, construct appropriate scaffolding, which i

Multicomponent Synthesis of 3,6-Dihydro-2H-1,3-thiazine-2-thiones

Non-fused 3,6-dihydro-2H-1,3-thiazine-2-thiones constitute a so far rather unexplored class of compounds, with the latest report dating back more than two decades. Thiazine-2-thiones contain an endocyclic dithiocarbamate group, which is often found in pesticides, in substrates for radical chemistry and in synthetic intermediates towards thioureas and amidines. We now report the multicomponent reaction (MCR) of in situ-generated 1-azadienes with carbon disulfide. With this reaction, a one-step protocol towards the potentially interesting 3,6-dihydro-2H-1,3-thiazine-2-thiones was established and a small library was synthesized