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Review of ‘After Institutions’ by Karen Archey

Every few years, the question reappears: Whatever happened to institutional critique? Is today’s art capable of critiquing the injustices perpetuated within the art system, without becoming entirely subsumed into the system itself? In 2020, Karen Archey, an in-house curator at the Stedelijk Museum Amsterdam, confronted these questions and curated the exhibition After Institutions, exploring what institutional critique can be today.

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Balancing restrictions and access to maternity care for women and birthing partners during the COVID-19 pandemic

1 Maternity services across Europe during the pandemic has undergone changes to limit virus transmission; however, many changes are not evidence-based. 2 Although these changes were introduced to keep women, babies and healthcare staff safe, the exclusion of companions and the separation of mothers and babies is particularly antithetical to a human rights-based approach to quality care. 3 A poll of COST Action 18211 network members showed that inconsistency in the application of restrictions was high, and there were significant deviations from the recommendations of authoritative bodies. 4 Concerns have emerged that restrictions in practice may have longer term negative impacts on mothers and their families and, in particular, may impact on the long-term health of babies. 5 When practice changes deviate from evidence-based frameworks that underpin quality care, they must be monitored, appraised and evaluated to minimise unintended iatrogenic effects.

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Balancing restrictions and access to maternity care for women and birthing partners during the COVID-19 pandemic

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Advancing District Nursing Care

Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.

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Feasibility of a new transmural care pathway for advance care planning for older persons

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.

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Feasibility of a new transmural care pathway for advance care planning for older persons

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Assessing time use in long-term institutional care

BACKGROUND: Limited research has examined what is actually done in the process of care by nursing staff in long-term institutional care. The applied instruments employed different terminologies, and psychometric properties were inadequately described. This study aimed to develop and test an observational instrument to identify and examine the amount of time spent on nursing interventions in long-term institutional care using a standardized language.METHODS: The Groningen Observational instrument for Long-Term Institutional Care (GO-LTIC) is based on the conceptual framework of the Nursing Interventions Classification. Developmental, validation, and reliability stages of the GO-LTIC included: 1) item generation to identify potential setting-specific interventions; 2) examining content validity with a Delphi panel resulting in relevant interventions by calculating the item content validity index; 3) testing feasibility with trained observers observing nursing assistants; and 4) calculating inter-rater reliability using (non) agreement and Cohen's kappa for the identification of interventions and an intraclass correlation coefficient for the amount of time spent on interventions. Bland-Altman plots were applied to visualize the agreement between observers. A one-sample student T-test verified if the difference between observers differed significantly from zero.RESULTS: The final version of the GO-LTIC comprised 116 nursing interventions categorized into six domains. Substantial to almost perfect kappa's were found for interventions in the domains basic (0.67-0.92) and complex (0.70-0.94) physiological care. For the domains of behavioral, family, and health system interventions, the kappa's ranged from fair to almost perfect (0.30-1.00). Intraclass correlation coefficients for the amount of time spent on interventions ranged from fair to excellent for the physiological domains (0.48-0.99) and poor to excellent for the other domains (0.00-1.00). Bland Altman plots indicated that the clinical magnitude of differences in minutes was small. No statistical significant differences between observers (p > 0.05) were found.CONCLUSIONS: The GO-LTIC shows good content validity and acceptable inter-rater reliability to examine the amount of time spent on nursing interventions by nursing staff. This may provide managers with valuable information to make decisions about resource allocation, task allocation of nursing staff, and the examination of the costs of nursing services.

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People 1

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Eric Blaauw

Professor

Projects 11

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Aligning interprofessional education and collaboration in practice, using promising regional experiences for international exchange

The pressure on the European health care system is increasing considerably: more elderly people and patients with chronic diseases in need of (rehabilitation) care, a diminishing work force and health care costs continuing to rise. Several measures to counteract this are proposed, such as reduction of the length of stay in hospitals or rehabilitation centres by improving interprofessional and person-centred collaboration between health and social care professionals. Although there is a lot of attention for interprofessional education and collaborative practice (IPECP), the consortium senses a gap between competence levels of future professionals and the levels needed in rehabilitation practice. Therefore, the transfer from tertiary education to practice concerning IPECP in rehabilitation is the central theme of the project. Regional bonds between higher education institutions and rehabilitation centres will be strengthened in order to align IPECP. On the one hand we deliver a set of basic and advanced modules on functioning according to the WHO’s International Classification of Functioning, Disability and Health and a set of (assessment) tools on interprofessional skills training. Also, applications of this theory in promising approaches, both in education and in rehabilitation practice, are regionally being piloted and adapted for use in other regions. Field visits by professionals from practice to exchange experiences is included in this work package. We aim to deliver a range of learning materials, from modules on theory to guidelines on how to set up and run a student-run interprofessional learning ward in a rehabilitation centre. All tested outputs will be published on the INPRO-website and made available to be implemented in the core curricula in tertiary education and for lifelong learning in health care practice. This will ultimately contribute to improve functioning and health outcomes and quality of life of patients in rehabilitation centres and beyond.

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Developing Gerontological Nursing Education in China through Multidisciplinary Innovations

The GeNEdu project aims to renew nursing curricula through building capacities of the Chinese partner institutions to develop gerontological nursing education for future health care professionals to meet the needs of the ageing society in China. It is financed from the Erasmus+ Programme, Key Action 2, Capacity Building in the Field of Higher Education 2019.

Finished

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ELLAN-European Later Life Active Network

The ELLAN is a Lifelong Learning Programme project funded by the European Commission for the period September 2013 – September 2016. The consortium included 26 partners from 25 countries in Europe. The ELLAN project promotes European cooperation and exchange of innovation and good practice related to the ageing population and to the educational preparation of those professionals in health and social care that work with older people. The desired outcome of the ELLAN project is a better quality of higher education related to the care and services of people in later life. The project includes several research based workpackage with the main project result being the "European Core Competences Framework for health and social care professionals working with older people". The project directly targets educators and management staff at the partner organizations and other higher education institutions in Europe. The indirect target groups are the students, professional communities and older people themselves.

Finished

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Employer Branding as a Powerful Tool for Employee Recruitment and Retention

In our increasingly global society, organizations face many opportunities in innovation, improved productivity and easy access to talent. At the same time, one of the greatest challenges, businesses experience nowadays, is the importance of social and/or human capital for their effectiveness and success (Backhaus and Tikoo, 2004; Mosley, 2007; Theurer et al., 2018; Tumasjan et al., 2020). High-quality employees are crucial to the competitive strength of an organization in the global economy, as these employees have a major influence on organizational reputation (Dowling at al., 2012). An important question is how, under these global circumstances, organizations and companies in the Netherlands can best be stimulated to attract and preserve social capital.Several studies have suggested the scarcity of talent and the crucial importance of gaining competitive advantage with recruitment communication to find the fit between personal and fundamental organizational characteristics and values for employees (Cable and Edwards, 2004; Bhatnagar and Srivastava, 2008; ManPower Group, 2014; European Communication Monitor (ECM), 2018). In order to become an employer of choice, organizations have to not only stand out from the crowd during the recruitment process but work on developing loyalty and a culture of trust in their relationship with employees (ECM, 2018). Employer Branding focuses on the process of promoting an organization, as the “employer of choice” to a desired target group, which an organization aims to attract and retain. This process encompasses building an identifiable and unique employer identity or, more specifically, “the promotion of a unique and attractive image” as an employer (Backhaus 2004, p. 117; Backhaus and Tikoo 2004, p. 502).One of the biggest challenges in the North of the Netherlands at the moment is the urgent need for qualified labor in the IT, energy and healthcare sectors and the excess supply of international graduates who are able to find a job in the North of the Netherlands (AWVN, 2019). Talent development, as part of the regional labor market and education policy, has been an important part of government programs and strategies in the region (VNO-NCW Noord, 2018). For instance, North Netherlands Alliance (SNN) signed a Northern Innovation Agenda for the 2014-2020 period. SNN encourages, facilitates and connects ambitions focused on the development of the Northern Netherlands. Also, the Social Economic council North Netherlands issued an advice on the labour market in the North Netherlands (SER Noord Nederland, 2017). Knowledge institutions also contribute through employability programs. Another example is the Regional Talent Agreement (Talent Akkoord) framework issued by the Groningen educational institutions, employers and employees’ organizations and regional authorities in which they jointly commit to recruiting, training, retaining and developing talent for the Northern labor market. Most of the hires with a maximum of five year of experience at companies are represented by millennials. To learn what values make an attractive brand for employees in the of the North of the Netherlands, we conducted a first study. When ranking the most important values of corporate culture which matter to young employees, they mention creative freedom, purposeful work, flexibility, work-life balance as well as personal development. Whereas attractive workplace and job security do not matter to such a degree. A positive work environment and a good relationship with colleagues are valued highly (Hein, 2019).To date, as far as we know, no other employer branding studies have been carried out for the North of the Netherlands. Further insight is needed into the role of employer branding as a powerful tool to retain talent in Northern industry in particular.The goal of this study is to provide a detailed analysis of the regional industry in the Northern Netherlands and contribute to: 1) the scientific body of knowledge about whether and how employer branding can strengthen the attractiveness of a regional industry in the labor market; 2) the application of this knowledge and insights by companies and governments in local policy development in the North of the Netherlands.

Finished

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SURFSCAN Point-of-Care scanning of surfaces for bacterial loads in relation to infection prevention and hygiene management

To optimize patient care, it is vital to prevent infections in healthcare facilities. In this respect, the increasing prevalence of antibiotic-resistant bacterial strains threatens public healthcare. Current gold standard techniques are based on classical microbiological assays that are time consuming and need complex expensive lab environments. This limits their use for high throughput bacterial screening to perform optimal hygiene control. The infection prevention workers in hospitals and elderly nursing homes underline the urgency of a point-of-care tool that is able to detect bacterial loads on-site in a fast, precise and reliable manner while remaining with the available budgets. The aim of this proposal titled SURFSCAN is to develop a novel point-of-care tool for bacterial load screening on various surfaces throughout the daily routine of professionals in healthcare facilities. Given the expertise of the consortium partners, the point-of-care tool will be based on a biomimetic sensor combining surface imprinted polymers (SIPs), that act as synthetic bacterial receptors, with a thermal read-out strategy for detection. The functionality and performance of this biomimetic sensor has been shown in lab conditions and published in peer reviewed journals. Within this proposal, key elements will be optimized to translate the proof of principle concept into a complete clinical prototype for on-site application. These elements are essential for final implementation of the device as a screening and assessment tool for scanning bacterial loads on surfaces by hospital professionals. The research project offers a unique collaboration among different end-users (hospitals and SMEs), and knowledge institutions (Zuyd University of Applied Sciences, Fontys University of Applied Sciences and Maastricht Science Programme, IDEE-Maastricht University), which guarantees transfer of fundamental knowledge to the market and end-user needs.

Finished

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User-driven Path Verification and Control for Inter-domain Networks (UPIN)

The goal of UPIN is to develop and evaluate a scalable distributed system that enables users to cryptographically verify and easily control the paths through which their data travels through an inter-domain network like the Internet, both in terms of router-to-router hops as well as in terms of router attributes (e.g., their location, operator, security level, and manufacturer). UPIN will thus provide the solution to a very relevant and current problem, namely that it is becoming increasingly opaque for users on the Internet who processes their data (e.g., in terms of service providers their data passes through as well as what jurisdictions apply) and that they have no control over how it is being routed. This is a risk for people’s privacy (e.g., a malicious network compromising a user’s data) as well as for their safety (e.g., an untrusted network disrupting a remote surgery). Motivating examples in which (sensitive) user data typically travels across the Internet without user awareness or control are: - Internet of Things for consumers: sensors such as sleep trackers and light switches that collect information about a user’s physical environment and send it across the Internet to remote services for analysis. - Medical records: health care providers requiring medical information (e.g., health records of patients or remote surgery telemetry) to travel between medical institutions according to specified agreements. - Intelligent transport systems: communication plays a crucial role in future autonomous transportation systems, for instance to avoid freight drones colliding or to ensure smooth passing of trucks through busy urban areas. The UPIN project is novel in three ways: 1. UPIN gives users the ability to control and verify the path that their data takes through the network all the way to the destination endpoint, both in terms of hops and attributes of routers traversed. UPIN accomplishes this by adding and improving remote attestation techniques for on-path routers to existing path verification mechanisms, and by adopting and further developing in-packet path selection directives for control. 2. We develop and simulate data and control plane protocols and router extensions to include the UPIN system in inter-domain networking systems such as IP (e.g., using BGP and segment routing) and emerging systems such as SCION and RINA. 3. We evaluate the scalability and performance of the UPIN system using a multi-site testbed of open programmable P4 routers, which is necessary because UPIN requires novel packet processing functions in the data plane. We validate the system using the earlier motivating examples as use cases. The impact we target is: - Increased trust from users (individuals and organizations) in network services because they are able to verify how their data travels through the network to the destination endpoint and because the UPIN APIs enable novel applications that use these network functions. - More empowered users because they are able to control how their data travels through inter-domain networks, which increases self-determination, both at the level of individual users as well as at the societal level.

Ongoing

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Review of ‘After Institutions’ by Karen Archey

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