Assistive technology supports maintenance or improvement of an individual’s functioning and independence, though for people in need the access to assistive products is not always guaranteed. This paper presents a generic quality framework for assistive technology service delivery that can be used independent of the setting, context, legislative framework, or type of technology. Based on available literature and a series of discussions among the authors, a framework was developed. It consists of 7 general quality criteria and four indicators for each of these criteria. The criteria are: accessibility; competence; coordination; efficiency; flexibility; user centeredness, and infrastructure. This framework can be used at a micro level (processes around individual users), meso level (the service delivery scheme or programme) or at a macro level (the whole country). It aims to help identify in an easy way the main strengths and weaknesses of a system or process, and thus guide possible improvements. As a next step in the development of this quality framework the authors propose to organise a global consultancy process to obtain responses from stakeholders across the world and to plan a number of case studies in which the framework is applied to different service delivery systems and processes in different countries.
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Background and objective: Hospital and home care nurses and nursing assistants do not provide optimal nutritional care to older adults, which is due to several factors that influence their current behaviour. To successfully target these factors, we developed a microlearning intervention. The next step is to assess its feasibility to achieve the best fit with nursing practice. The aim of this study was to test the feasibility of the microlearning intervention about nutritional care for older adults provided by hospital and home care nurses and nursing assistants. Methods: In a multicentre study, we used a mixed-methods design. Feasibility was determined by assessing 1) recruitment and retention of the participants and 2) the acceptability, compliance and delivery of the intervention. Data about the use of the intervention (consisting of 30 statements), and data from a standardised questionnaire and two focus group interviews were used to measure the feasibility outcomes. Results: Fourteen teams with a total of 306 participants (response rate: 89.7%) completed the intervention and the median (Q1, Q3) score for completed statements per participant was 23 (12, 28). The mean proportion of correct answers was 72.2%. Participants were both positive and constructive about the intervention. They confirmed that they mostly learned from the intervention. Overall, the intervention was acceptable to the participants and compliance and delivery was adequate. Conclusions: The microlearning intervention is mostly feasible for hospital and home care nurses and nursing assistants. Based on participants’ constructive feedback, we consider that the intervention needs refinement to improve its feasibility.
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This chapter revisits the concept of internationalisation at home in light of the COVID pandemic and also of experiences and ongoing discourses on internationalisation. These include how internationalisation at home relates to diversity, inclusion and decolonisation of curricula. It discusses how the COVID pandemic has led to increased attention to internationalisation at home but also that confusion about terminology and the desire for physical mobility to be available to students may lead us to return to pre-COVID practices, in which internationalisation is mainly understood as mobility for a small minority of students and internationalisation of the home curriculum is a poor second best. A component of this chapter is how Virtual Exchange and Collaborative Online International Learning (COIL) have moved into the spotlight during the pandemic but were already in focus areas well before. This will be illustrated by some recent developments in internationalisation at home, mainly from non-Anglophone, European and particularly Dutch perspectives.
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The 'implementation' and use of smart home technology to lengthen independent living of non-instutionalized elderly have not always been flawless. The purpose of this study is to show that problems with smart home technology can be partially ascribed to differences in perception of the stakeholders involved. The perceptual worlds of caregivers, care receivers, and designers vary due to differences in background and experiences. To decrease the perceptual differences between the stakeholders, we propose an analysis of the expected and experienced effects of smart home technology for each group. For designers the effects will involve effective goals, caregivers are mainly interested in effects on workload and quality of care, while care receivers are influenced by usability effects. Making each stakeholder aware of the experienced and expected effects of the other stakeholders may broaden their perspectives and may lead to more successful implementations of smart home technology, and technology in general.
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Technological innovations such as parcel lockers can only contribute to reducing the negative impact of last mile logistics on people, planet and profit outcomes if consumers adopt them. Using the Unified Theory of Acceptance and Use of Technology (UTAUT) as a theoretical lens, the purpose of this study was to design effective interventions in the pre-delivery stage that stimulated consumers to choose to use parcel lockers, focusing on incentives and actions that online retailers and logistic service providers can easily implement. A vignette-based experiment was used to examine the impact of providing consumers with information about sustainability, information about parcel lockers and information about distance to nearest parcel locker on their choice to use a parcel locker instead of receiving their package at home. The originality of the study is twofold. The role of geographical context which is oftentimes overlooked was examined explicitly in this study by conducting the study with participants from the Netherlands and Lithuania. The present study used causal mediation analysis to study the combined effects of interventions and previous experience with parcel lockers through the UTAUT constructs. The findings showed that providing information about sustainability and information about the distance to the nearest parcel locker were effective interventions, however the effect of distance was country specific. Causal mediation analysis showed that familiarity with parcel lockers was positively associated with the choice to use parcel lockers by increasing perceived ease of use, expected performance, and reducing perceived risk.
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Background: Home care professionals regularly observe drug-related problems during home care provision. Problems related to the process of the medication therapy could involve discrepancies in medication prescriptions between the hospital discharge letter and the medication administration record lists (MARL) or insufficient drug delivery. The objective of this study is to determine the potential clinical consequences of medication process problems observed by home care professionals, since those consequences have not been assessed before. Methods: A retrospective descriptive study design was performed. An expert panel performed an assessment procedure on the clinical consequences of medication process problems. Such problems were reported by home care professionals during routine care (May 2016 until May 2017) using the eHOME system, which is a digital system developed to assist in the reporting and monitoring of drug-related problems. Using a three-point scale, an expert panel assessed the potential clinical consequences of those medication process problems among older home care patients (aged 65 years and over). Results: 309 medication process problems in 120 out of 451 patients were assessed for potential discomfort or clinical deterioration. The problems involved the following: medication discrepancies (new prescription not listed on the MARL [n = 69, 36.7%]; medication stopped by the prescriber but still listed on the MARL [n = 43, 22.9%]; discrepant time of intake [n = 25, 13.3%]; frequency [n = 24, 12.8%]; and dose [n = 21, 11.2%], therapeutic duplication listed on the MARL [n = 5, 2.6%]; and discrepant information on route of administration [n = 1, 0.5%]); an undelivered MARL [n = 103, 33.3%]; undelivered medication [n = 16, 5.2%]; and excessive medication delivery [n = 2, 0.7%]. Furthermore, 180 (58.2%) out of 309 medication process problems were assessed as having the potential for moderate or severe discomfort or clinical deterioration in patients. Conclusions: The majority of medication process problems may result in patient discomfort or clinical deterioration.
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To face the challenges of an ageing population, many Western countries nowadays stimulate an ageing in place policy to empower older adults to grow old in their own homes with the highest degree of self‐reliance. However, many community‐living older adults experience limitations in (instrumental) activities of daily living ((I)ADLs), which may result in a need for home‐care services. Unfortunately, home‐care workers often provide support by taking over tasks, as they are used to doing things for older adults rather than with them, which undermines their possibilities to maintain their self‐care capabilities. In contrast, reablement focuses on capabilities and opportunities of older adults, rather than on disease and dependency. Consequently, older adults are stimulated to be as active as possible during daily and physical activities. The 'Stay Active at Home' programme was designed to train home‐care workers to apply reablement in practice. To explore the experiences of home‐care workers with this programme an exploratory study was conducting in the Netherlands, between April and July, 2017. In total, 20 participants were interviewed: nine nurses (including a district nurse), 10 domestic support workers and the manager of the domestic support workers. The semi‐structured interviews focused on the experienced improvements with regard to knowledge, skills, self‐efficacy and social support. Furthermore, the most and least appreciated programme components were identified. The study has shown that home‐care workers perceived the programme as useful to apply reablement. However, they also need more support with mastering particular skills and dealing with challenging situations. Future implementation of the 'Stay Active at Home' programme can potentially benefit from small adaptions. Furthermore, future research is needed to examine whether the programme leads to more (cost‐) effective home care.
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Online winkelen is populair. Tussen 2010 en 2019 zijn de onlinebestedingen in Nederland volgens brancheorganisatie Thuiswinkel.org gestegen van circa 10 miljard tot bijna 26 miljard euro. In 2020 hebben de coronamaatregelen geleid tot een groei van 40 tot 60% in het aantal onlineaankopen (data CBS over 2020). De verwachting is dat ook na de coronacrisis sprake blijft van een verdere verschuiving van fysiek winkelen naar online winkelen; een verwachte groei per jaar van 15% bij multichannelwinkels en 7,5% bij pure webwinkels. Daarmee rijst de vraag wat de effecten van de bezorgeconomie zijn voor onder andere mobiliteit, logistiek, het milieu en de verkeersveiligheid.
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