Abstract Aims: To lower the threshold for applying ultrasound (US) guidance during peripheral intravenous cannulation, nurses need to be trained and gain experience in using this technique. The primary outcome was to quantify the number of procedures novices require to perform before competency in US-guided peripheral intravenous cannulation was achieved. Materials and methods: A multicenter prospective observational study, divided into two phases after a theoretical training session: a handson training session and a supervised life-case training session. The number of US-guided peripheral intravenous cannulations a participant needed to perform in the life-case setting to become competent was the outcome of interest. Cusum analysis was used to determine the learning curve of each individual participant. Results: Forty-nine practitioners participated and performed 1855 procedures. First attempt cannulation success was 73% during the first procedure, but increased to 98% on the fortieth attempt (p<0.001). The overall first attempt success rate during this study was 93%. The cusum learning curve for each practitioner showed that a mean number of 34 procedures was required to achieve competency. Time needed to perform a procedure successfully decreased when more experience was achieved by the practitioner, from 14±3 minutes on first procedure to 3±1 minutes during the fortieth procedure (p<0.001). Conclusions: Competency in US-guided peripheral intravenous cannulation can be gained after following a fixed educational curriculum, resulting in an increased first attempt cannulation success as the number of performed procedures increased.
MULTIFILE
Introduction: Peripheral intravenous cannulation is the preferred method to obtain vascular access, but not always successful on the first attempt. Evidence on the impact of the intravenous catheter itself on the success rate is lacking. Faster visualization of blood flashback into the catheter, as a result of a notched needle, is thought to increase first attempt success rate. The current study aimed to assess if inserting a notched peripheral intravenous catheter will increase first attempt cannulation success up to 90%, when compared to inserting a catheter without a notched needle. Design: In this block-randomized trial, adult patients in the intervention group got a notched peripheral intravenous catheter inserted, patients in the control group received a traditional non-notched catheter. The primary objective was the first attempt success rate of peripheral intravenous cannulation. Intravenous cannulation was performed according to practice guidelines and hospital policy. Results: About 328 patients were included in the intervention group and 330 patients in the control group. First attempt success was 85% and 79% for the intervention and control group respectively. First attempt success was remarkably higher in the intervention group regarding patients with a high risk for failed cannulation (29%), when compared to the control group (10%). Conclusion: This study was unable to reach a first attempt success of 90%, although first attempt cannulation success was higher in patients who got a notched needle inserted when compared to those who got a non-notched needle inserted, unless a patients individual risk profile for a difficult intravenous access.
MULTIFILE
Evidence-based insertion and maintenance strategies for neonatal vascular access devices (VAD) exist to reduce the causes of VAD failure and complications in neonates. Peripheral intravenous catheter failure and complications including, infiltration, extravasation, phlebitis, dislodgement with/without removal, and infection are majorly influenced by catheter securement methods.
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Supermarkets are essential urban household amenities, providing daily products, and for their social role in communities. Contrary to many other countries, including nearby ones, the Netherlands have a balanced distribution of supermarkets across villages and urban neighbourhoods. However, spatial supermarket patterns, are subject to influential developments. First, due to economies of scale, there is a tendency for supermarkets to increase their catchment areas and to disappear from peripheral villages. Second, supermarkets are now mainly located in residential areas, although the urban periphery appears to be attractive for the retail sector, perhaps including the rise of hypermarkets. Third, today, online grocery shopping is still lagging far behind on other online shopping products, but a breaks through will dilute population support for in-store supermarkets and can lead to dramatic ‘game changer’ shifts with major spatial and social effects. These three important trends will reinforce each other. Consequences are of natural community meeting places at the expense of social cohesion; reduced accessibility for daily products, leading to more travel, often by car; increasing delivery flows; real estate vacancies, and increasing suburban demand increase for retail and logistics. Expected changes in supermarket patterns require understanding, but academic literature on OGS is still scarce, and does hardly address household behaviour in changing spatial constellations. We develop likely spatial supermarket patterns, and model the consequences for travel demand, social cohesion and real estate demand, as well as the distribution between online and in-store grocery shopping, by developing a stated preference experiment, among Dutch households.
De samenwerking tussen de onderzoeksgroep FRIA van de Vrije Universiteit Brussel, afdeling oudergeneeskunde van het UMCG Groningen en de onderzoeksgroep (lectoraat) Healthy Ageing, Allied health Care and Nursing van de Hanzehogeschool Groningen is gericht op onderzoek naar bewegingsstoornissen bij veroudering. In het bijzonder wordt gekeken naar paratonic, een bewegingsstoornis bij dementie.The International Joint Research group ‘Move in Age’ concluded in a systematic review that paratonia still is a barely understood and devastating phenomenon in dementia and revealed the urgency of gaining more insight in the pathophysiology. Paratonia, a distinctive change in muscle tone, starts in early stages of dementia and develops further with progress of the disease. Resulting in severe discomfort for patients, but also affecting caregivers since daily care becomes increasingly difficult. It is hypothesized that changes in motor control due to dementia influences peripheral neurological control and biomechanical muscle structures (by crosslinking and inflammation caused by advanced glycation end-products (AGEs).This IJRG started in 2018 and aims to develop a long-term comprehensive research program on movement-related impairments at higher age. The three partners have a strong track record on research in the area of movement-related impairments in older persons; however, each focusing on a specific aspect. In fact, the Frailty in Ageing research group (FRIA) of the Vrije Universiteit Brussel (VUB) is running focused research program on the triad sarcopenia-dynapenia-inflammation with mainly a bio-gerontological and bio-psycho-medical approach; the department of General Practice and Elderly Care Medicine of the University Medical Center Groningen (UMCG) has anongoing research line on the medical aspects of mobility impairments in frail elderly persons and in elderly dementia patients; and finally Research Group Healthy Ageing, Allied Health Care and Nursing of the Hanze University of Applied Sciences Groningen (HUAS) developed a research program on physical, psycho-cognitive and social dimensions of frailty including the functional impact of mobility impairments. In the first 3-5 years, the focus will be on the movement-related impairments that occur in patients with dementia and in specific on paranoia. The programme will be extended towards movement-related impairments in the context of other geriatric syndromes.
The main aim of KiNESIS is to create a Knowledge Alliance among academia, NGOs, communities, local authorities, businesses to develop a program of multidisciplinary activities in shrinking areas with the aim of promoting and fostering ideas, projects, workforce, productivity and attractiveness. The problems affecting peripheral territories in rural or mountain areas of the interior regions, compared to small, medium or large population centres and large European capitals, are related to complex but clear phenomena: the emigration of young generations, abandonment and loneliness of elderly people, the loss of jobs, the deterioration of buildings and land, the closing of schools and related services, the disappearance of traditions and customs, the contraction of local governments, which in absence of adequate solutions can only generate worse conditions, leading to the abandonment of areas rich in history, culture and traditions. It is important that these communities - spread all over Europe - are not abandoned since they are rich in cultural traditions, which need to be preserved with a view to new developments, intended as "intelligent" rebirth and recovery.The focus of KiNESIS is to converge the interest of different stakeholders by recalling various skills around abandoned villages to make them "smart" and "attractive".Keeping in mind the triangular objectives of cooperation and innovation of research, higher education and business of the Knowledge Alliance action, the project aims are: i) revitalising depopulated areas by stimulating entrepreneurship and entrepreneurial skills; ii) creating local living laboratories, shared at European level, in which the exchange of knowledge, best practices, experiences can help promote social inclusion and entrepreneurial development;iii) experimenting new, innovative and multidisciplinary approaches in teaching and learning; iv) facilitating the exchange, flow and co-creation of knowledge at a local and global level.
