BACKGROUND: The use of drug round tabards is a widespread intervention that is implemented to reduce the number of interruptions and medication administration errors (MAEs) by nurses; however, evidence for their effectiveness is scarce.PURPOSE: Evaluation of the effect of drug round tabards on the frequency and type of interruptions, MAEs, the linearity between interruptions and MAEs, as well as to explore nurses' experiences with the tabards.STUDY DESIGN: A mixed methods before-after study, with three observation periods on three wards of a Dutch university hospital, combined with personal inquiry and a focus group with nurses.METHODS: In one pre-implementation period and two post-implementation periods at 2 weeks and 4 months, interruptions and MAEs were observed during drug rounds. Descriptive statistics and univariable linear regression were used to determine the effects of the tabard, combined with personal inquiry and a focus group to find out experiences with the tabard.FINDINGS: A total of 313 medication administrations were observed. Significant reductions in both interruptions and MAEs were found after implementation of the tabards. In the third period, a decrease of 75% in interruptions and 66% in MAEs was found. Linear regression analysis revealed a model R2 of 10.4%. The implementation topics that emerged can be classified into three themes: personal considerations, patient perceptions, and considerations regarding tabard effectiveness.CONCLUSIONS: Our study indicates that this intervention contributes to a reduction in interruptions and MAEs. However, the reduction in MAEs cannot be fully explained by the decrease in interruptions alone; other factors may have also influenced the effect on MAEs. We advocate for further research on complementary interventions that contribute to a further reduction of MAEs.CLINICAL RELEVANCE: We can conclude that drug round tabards are effective to improve medication safety and are therefore important for the quality of nursing care and the reduction of MAEs.
Het team van het Healthy Urban Living Lab heeft samen met veel studenten van de Hogeschool van Amsterdam een Health Impact Assessment (HIA) uitgevoerd op de plannen voor het Bajes Kwartier. Dat is een groene, gezonde, duurzameAmsterdamse stadswijk die wordt gebouwd op het terrein van de voormalige Bijlmerbajes, gelegen in Stadsdeel Oost nabij de Amstel. In deze nieuwe wijk komen ongeveer 1.350 koop- en huurwoningen, variërend van betaalbarestarterswoningen tot exclusieve huizen en zorgwoningen. De focus van de HIA lag op drie aspecten die an groot belang zijn voor de gezondheid van inwoners van Amsterdam: bewegen, gezonde voeding en ontmoeten. Daarmeesluit de HIA aan bij de grootste uitdagingen voor de gezondheid van de Amsterdammers, overgewicht en eenzaamheid. Een HIA is een kritische en systematische beschouwing van een project, met als doel de kansen voor gezondheid en onbedoelde aspecten (zoals gezondheidsrisico’s) in kaart te brengen. Om te onderzoeken hoe de ambitie ‘alle bewoners leven hier twee jaar langer en gezonder kan worden gerealiseerd, is het Behaviour Change Wheel van Susan Michie (2011) gebruikt als theoretisch kader. Dit wetenschappelijkonderbouwde gedragsveranderingsmodel wordt ingezet voor het systematisch ontwerpen en evalueren van interventies en voor beleid dat is gericht op gedragsverandering. Het wordt veelal toegepast in de gezondheidsbevordering. Daarbij spelen drie elementen de hoofdrol: Capabilities (fysieke en psychologische vaardigheden), Opportunities (aspecten in de fysieke of sociale leefomgeving) en Motivation (bewuste en onbewuste processen die tot gedrag leiden). Naast een scan van het masterplan voor het Bajes Kwartier – vanuit het oogpunt van gezondheid – is een doelgroepanalyse gemaakt door middelvan een vragenlijst die werd verspreid onder belangstellenden c.q. toekomstige bewoners, een groepsbijeenkomst en doelgroepenonderzoek door studenten. Er is ook een wetenschappelijke literatuurstudie verricht. Vanuit de volksgezondheid kent de gezonde leefomgeving een afwisseling van bebouwing met groen, aantrekkelijke, uitdagende en gevarieerde openbare ruimten die uitnodigen tot bewegen, spelen en sport, gezond eten, het ontmoeten vanbuurtgenoten, een breed voorzieningenaanbod (waaronder ook een openbare toiletten en een maximale bereikbaarheid en verkeersveiligheid met de fiets en het openbaar vervoer). Daarnaast is in de leefomgeving sociale steun en socialeveiligheid nodig. Het beschikbaar maken van een leefomgeving die deze elementen bevat, is op zich niet voldoende. Er zijn ook activiteiten en netwerkennodig die bevorderen dat deze wijkinfrastructuur daadwerkelijk wordt benut. Zowel uit de literatuur als uit het doelgroepenonderzoek kwam dit naar voren als een belangrijke sleutel tot het creëren van gezondheidswinst. De conclusies die volgen uit de resultaten van de HIA, resulteren in vijf basisaanbevelingen.1) Focus op de diverse groepen. Iedere bewoner heeft recht op een gezonde omgeving. De gezondheidswinst die te behalen valt is het grootst onder kwetsbare groepen zoals bewoners met een lage sociaal economische status, ouderen en kinderen. 2) Gezond gedrag vereist participatie van bewoners waarbij alle doelgroepen vertegenwoordigd zijn. 3) Verbind de hardware met de software, maak een koppeling tussen de inrichting van de fysieke en de sociale omgeving 4) Zet alle vormen en varianten van nudging in, het helpt bewoners een gezonde leefstijl aan te nemen. 5) Hanteer een integrale aanpak waarbij deverschillende verantwoordelijke stakeholders zoals ontwerpers, planologen, burgers, kennisinstellingen, private partijen (zoals startups), gemeentes, GGD’en, zorgverzekeraars en zorgverleners vanaf het begin in eenruimtelijk planproces samenwerken
Within European cross-border health care, recent studies have identified several types of international patients. Within the Anglo-Saxon setting, the specific terminology of medical tourism is used. The analytical purpose of the paper is to resolve this semantic difference by suggesting an alternative terminology, 'transnational health care' that is understood as a 'context-controlled and coordinated network of health services'. For demand-driven trans-border access seekers and cross-border access searchers, there is a need to opt for regional health-policy strategies. For supply-driven sending context actors and receiving context actors, there would be organizational benefits to these strategies.Applying the terminology of trans-border access seekers, cross-border access searchers, sending context and receiving context actors results in a transnational patient mobility typology of twelve types of international patients, based on the criteria of geographical distance, cultural distance and searching efforts, public/private/no cover and private/public provision of health services. Finally, the normative purpose of the paper is to encourage the use of this terminology to promote a policy route for transnational health regions. It is suggested that the development of transnational health regions, each with their own medical and supportive service characteristics, could enhance governmental context-controlled decision power in applying sustainable health destination management.
Due to societal developments, like the introduction of the ‘civil society’, policy stimulating longer living at home and the separation of housing and care, the housing situation of older citizens is a relevant and pressing issue for housing-, governance- and care organizations. The current situation of living with care already benefits from technological advancement. The wide application of technology especially in care homes brings the emergence of a new source of information that becomes invaluable in order to understand how the smart urban environment affects the health of older people. The goal of this proposal is to develop an approach for designing smart neighborhoods, in order to assist and engage older adults living there. This approach will be applied to a neighborhood in Aalst-Waalre which will be developed into a living lab. The research will involve: (1) Insight into social-spatial factors underlying a smart neighborhood; (2) Identifying governance and organizational context; (3) Identifying needs and preferences of the (future) inhabitant; (4) Matching needs & preferences to potential socio-techno-spatial solutions. A mixed methods approach fusing quantitative and qualitative methods towards understanding the impacts of smart environment will be investigated. After 12 months, employing several concepts of urban computing, such as pattern recognition and predictive modelling , using the focus groups from the different organizations as well as primary end-users, and exploring how physiological data can be embedded in data-driven strategies for the enhancement of active ageing in this neighborhood will result in design solutions and strategies for a more care-friendly neighborhood.
Developing a framework that integrates Advanced Language Models into the qualitative research process.Qualitative research, vital for understanding complex phenomena, is often limited by labour-intensive data collection, transcription, and analysis processes. This hinders scalability, accessibility, and efficiency in both academic and industry contexts. As a result, insights are often delayed or incomplete, impacting decision-making, policy development, and innovation. The lack of tools to enhance accuracy and reduce human error exacerbates these challenges, particularly for projects requiring large datasets or quick iterations. Addressing these inefficiencies through AI-driven solutions like AIDA can empower researchers, enhance outcomes, and make qualitative research more inclusive, impactful, and efficient.The AIDA project enhances qualitative research by integrating AI technologies to streamline transcription, coding, and analysis processes. This innovation enables researchers to analyse larger datasets with greater efficiency and accuracy, providing faster and more comprehensive insights. By reducing manual effort and human error, AIDA empowers organisations to make informed decisions and implement evidence-based policies more effectively. Its scalability supports diverse societal and industry applications, from healthcare to market research, fostering innovation and addressing complex challenges. Ultimately, AIDA contributes to improving research quality, accessibility, and societal relevance, driving advancements across multiple sectors.
Over the last couple of years there is a growing interest in the role of the bicycle in Western urban transport systems as an alternative to car use. Cycling not only has positive environmental impacts, but also positive health effects through increased physical activity. From the observation of the Urban Intelligence team that cycling data and information was limited, we have started the development of cycleprint. Cycleprint stands for Cycle Policy Renewal and INnovation by means of tracking Technology with the objective to enable more customer friendly cycle policy.The initial objective of Cycleprint was to translate GPS data into policy relevant insights to enable customer friendly cycle policy. The online toolkit what Cycleprint has become, answers the questions about:-route choice-speeds-delays at intersections -intensities Because of the success of Cycleprint in the Netherlands the range of features is still under development. As a result of the development of Cycleprint the Dutch organized the fietstelweek. In addition to Cycleprint the Urban Intelligence team developed the cyclescan to explore the effects of cycle network enhancement. The project is developed in direct collaboration with the Provincie Noord-Brabant and Metropoolregio Eindhoven to fulfill the ambition to become cycling region of the Netherlands in 2020.
