Development of the Surgical Patient safety Observation Tool (SPOT)

Background: A Surgical Patient safety Observation Tool (SPOT) was developed and tested in a multicentre observational pilot study. The tool enables monitoring and benchmarking perioperative safety performance across departments and hospitals, covering international patient safety goals. Methods: Nineteen perioperative patient safety observation topics were selected from Dutch perioperative patient safety guidelines, which also cover international patient safety goals. All items that measured these selected topics were then extracted from available local observation checklists of the participating hospitals. Experts individually prioritized the best measurement items per topic in an initial written Delphi round. The second (face to face) Delphi round resulted in consensus on the content of SPOT, after which the measurable elements (MEs) per topic were defined. Finally, the tool was piloted in eight hospitals for measurability, applicability, improvement potential, discriminatory capacity and feasibility. Results: The pilot test showed good measurability for all 19 patient safety topics (range of 8-291 MEs among topics), with good applicability (median 97 (range 11.8-100) per cent). The overall improvement potential appeared to be good (median 89 (range 72.5-100) per cent), and at topic level the tool showed good discriminatory capacity (variation 27.5 per cent, range in compliance 72.5-100 per cent). Overall scores showed relatively little variation between the participating hospitals (variation 13 per cent, range in compliance 83-96 per cent). All eight auditors considered SPOT a straightforward and easy-to-use tracer tool. Conclusion: A comprehensive tool to measure safety of care was developed and validated using a systematic, stepwise method, enabling hospitals to monitor, benchmark and improve perioperative safety performance

Verdiepen in warmer water: een modelstudie naar watertemperaturen en het effect van diepte

‘s Zomers zullen steeds vaker langere periodes van hitte gaan optreden. Wat heeft dit voor effect op de lokale watertemperatuur? En heeft het zin om waterpartijen te verdiepen? Met de Cool Water Tool is geprobeerd modelmatig greep te krijgen op deze vragen. De resultaten laten zien dat de watertemperaturen met klimaatverandering toenemen. Lokaal verdiepen heeft weinig effect op de gemiddelde watertemperatuur. Daarentegen neemt de lengte van de maximale aaneengesloten periode met watertemperaturen hoger dan 20 graden fors toe

Verdienmodellen Natuurinclusieve landbouw

Voor de sectoren akkerbouw en veehouderij zijn voorbeelden uitgewerkt hoe rekening gehouden kan worden met natuur. Bij natuurinclusieve landbouw zijn de negatieve effecten van de agrarische bedrijfsvoering op de natuur minimaal en de positieve effecten van de natuur op de bedrijfsvoering maximaal. Dit nieuwe perspectief op de relatie tussen economie en natuur biedt, zeker in de landbouw met zijn specifieke relatie tot natuur en omgeving, een andere kijk op bedrijfsvoering

Genetic programming of macrophages generates an in vitro model for the human erythroid island niche

In vitro differentiation of red blood cells (RBCs) is a desirable therapy for various disorders. Here the authors develop a culture system using stem cell-derived macrophages to show that inducible expression of a transcription factor, KLF1, enhances RBC production, potentially through the induction of three soluble factors, ANGPTL7, IL33 and SERPINB2

Velig opereren vraagt om eenduidige regels

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Maternity care experiences of women with physical disabilities: A systematic review

Contains fulltext : 232466.pdf (Publisher’s version ) (Open Access)OBJECTIVE: Fifteen percent of the world's population has some form of disability, the most common form being a physical disability. Ten percent of women with disabilities are of childbearing age; however, because women with disabilities are often deemed less likely to have children, accessibility to maternity care is limited. Women with disabilities experience problems during pregnancy and childbirth due to physical barriers and barriers to information, problems with communication and the attitude of providers. A recent World Health Organization statement calls for more action, dialogue, research and advocacy on disrespectful treatment during childbirth. To give substance to this, an overview of the experiences of women with a physical disability is essential. Therefore, the aim of this systematic review is to identify and provide an overview of reported maternity care experiences of women with physical disabilities, including sensory disabilities. DESIGN: This systematic review was conducted using a meta-aggregation approach for synthesis and the steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search strategy focused on qualitative studies in the databases PubMed, Embase and CINAHL. The Critical Appraisal Skills Programme checklist was used to evaluate methodological quality, and a best-evidence synthesis was performed. FINDINGS: Of the 4,486 studies screened, ten were included. The methodological quality of the studies ranged from high to moderate. The results indicated that women experience barriers related to accessibility of facilities, adapted equipment, lack of knowledge, and healthcare providers' dismissals of their concerns and unwillingness to assist. In contrast, support has a positive influence on women's experiences. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: There is evidence that women with physical disabilities continue to encounter barriers in accessing maternity care related to inaccessible care settings, lack of knowledge and the attitude of healthcare providers. Healthcare providers should be trained to be aware of women's special needs and to improve clinical practice

First-time fathers' experiences and needs during childbirth: A systematic review

Contains fulltext : 232435.pdf (Publisher’s version ) (Open Access)OBJECTIVE: Fathers have been increasingly involved in childbirth since 1990. Attendance at childbirth is considered to benefit fathers' health as well as that of their partner and children. However, childbirth is a life event that parents may experience differently. First-time fathers' experiences have been barely studied and may differ from those of fathers who have already had a child. In order to adapt support and care during childbirth to the needs of first-time fathers, a deeper insight must be gained into their experiences and needs during childbirth. DESIGN: A systematic review of qualitative studies was conducted using PubMed, Embase and CINAHL as well as the snowball method. Quality appraisal was performed and evaluated using the Critical Appraisal Skills Programme. A thematic best evidence synthesis was performed. FINDINGS: Of 821 articles, eight qualitative studies and the qualitative data of one mixed methods study were included. amongst other feelings, fathers experience a lack of knowledge and a need to be better prepared. First-time fathers want to be more involved and need guidance, information and honest answers to help them fulfil a supportive role. Fathers disregard their own needs to focus on the needs of the mother. Meeting the baby for the first time changes the focus from the mother to the child, and fathers need time and privacy for this special moment. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: To adapt support and care during childbirth to the needs of first-time fathers, professionals must be aware of their needs. Professionals must realise the significant influence of their professional behaviour on first-time fathers' experiences. Care for first-time fathers should be formalised. Follow-up research must be conducted on integrating the preparation of first-time fathers into prenatal care. Education and training of professionals must be improved

Verdiepen in warmer water: een modelstudie naar watertemperaturen en het effect van diepte

‘s Zomers zullen steeds vaker langere periodes van hitte gaan optreden. Wat heeft dit voor effect op de lokale watertemperatuur? En heeft het zin om waterpartijen te verdiepen? Met de Cool Water Tool is geprobeerd modelmatig greep te krijgen op deze vragen. De resultaten laten zien dat de watertemperaturen met klimaatverandering toenemen. Lokaal verdiepen heeft weinig effect op de gemiddelde watertemperatuur. Daarentegen neemt de lengte van de maximale aaneengesloten periode met watertemperaturen hoger dan 20 graden fors toe