Background: Transmural palliative care interventions aim to identify older persons with palliative care needs and timely provide advance care planning, symptom management, and coordination of care. Nurses can have an important role in these interventions; however, their expertise is currently underused. A new transmural care pathway with a central role for the community care registered nurse in advance care planning aims to contribute to the quality of palliative care for older persons. Objective: To examine the perspectives of community nurses on the feasibility of a new transmural care pathway for advance care planning for older persons. Design: A qualitative study design using semi-structured interviews. Setting(s): Interviews were performed with community nurses of three participating homecare organizations in the Netherlands between March and May 2023. Participants: 19 community nurses. Methods: A topic guide was based on (1) challenges in advance care planning identified from the literature and (2) concepts that are important in assessing the feasibility of complex healthcare interventions provided by the Normalisation Process Theory framework. A combined inductive and deductive thematic analysis was performed. Results: Four themes were identified: views on the transmural care pathway, community nurses’ needs to fulfil their role, key points regarding implementation, and evaluation of the new practice. In general, community nurses were positive about the feasibility of the new practice as it provided a more structured work process that could facilitate interprofessional collaboration and improve the quality of palliative care. Overall, the feasibility of the new practice, from community nurses perspective, was determined by (1) clear roles and responsibilities in the transmural care pathway, (2) standardized registration of advance care planning, and (3) close involvement of community nurses in the whole implementation process. Conclusions: We highlighted important factors, from the perspectives of community nurses, that need to be considered in the implementation of a new transmural care pathway for advance care planning. A clear division of roles and responsibilities, standardized registration of advance care planning, and involvement of community nurses during the whole implementation process were mentioned as important enabling factors. This knowledge might contribute to successful implementation of a transmural care pathway that aims to enhance the quality of palliative care for older persons. Tweetable abstract: Community nurses’ perspectives on the feasibility of a transmural care pathway for advance care planning for older persons.
Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values, and (3) the accumulated views of care professionals with respect to the use of technology in the future. In total, 51 professionals were interviewed. Interpretative phenomenological analysis was applied. All care professionals highly valued being able to satisfy the needs of their care recipients. Mutual inter-collegial respect and appreciation of supervisors was also highly cherished. The opportunity to work in a careful manner was another important value. Conditions for the successful implementation of technology involved reliability of the technology at hand, training with team members in the practical use of new technology, and the availability of a help desk. Views regarding the future of health care were mainly related to financial cut backs and with a lower availability of staff. Interestingly, no spontaneous thoughts about the role of new technology were part of these views. It can be concluded that professionals need support in relating technological solutions to care recipients' needs. The role of health care organisations, including technological expertise, can be crucial here.
This paper is a case report of why and how CDIO became a shared framework for Community Service Engineering (CSE) education. CSE can be defined as the engineering of products, product-service combinations or services that fulfill well-being and health needs in the social domain, specifically for vulnerable groups in society. The vulnerable groups in society are growing, while fewer people work in health care. Finding technical, interdisciplinary solutions for their unmet needs is the territory of the Community Service Engineer. These unmet needs arise in local niche markets as well as in the global community, which makes it an interesting area for innovation and collaboration in an international setting. Therefore, five universities from Belgium, Portugal, the Netherlands, and Sweden decided to work together as hubs in local innovation networks to create international innovation power. The aim of the project is to develop education on undergraduate, graduate and post-graduate levels. The partners are not aiming at a joined degree or diploma, but offer a shared short track blended course (3EC), which each partner can supplement with their own courses or projects (up to 30EC). The blended curriculum in CSE is based on design thinking principles. Resources are shared and collaboration between students and staff is organized at different levels. CDIO was chosen as the common framework and the syllabus 2.0 was used as a blueprint for the CSE learning goals in each university. CSE projects are characterized by an interdisciplinary, human centered approach leading to inter-faculty collaboration. At the university of Porto, EUR-ACE was already used as the engineering education framework, so a translation table was used to facilitate common development. Even though Thomas More and KU Leuven are no CDIO partner, their choice for design thinking as the leading method in the post-Masters pilot course insured a good fit with the CDIO syllabus. At this point University West is applying for CDIO and they are yet to discover what the adaptation means for their programs and their emerging CSE initiatives. CDIO proved to fit well to in the authentic open innovation network context in which engineering students actively do CSE projects. CDIO became the common language and means to continuously improve the quality of the CSE curriculum.
