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.
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Introduction: Oral health care of older people in long-term care facilities is insufficient, stressing the need for clear evidence-based implementation strategies to improve oral care. In 2013, a systematic review was performed and new evidence was published. This study aimed to gain insights into implementation strategies used to promote or improve oral health care for older people in long-term care facilities, explore their effectiveness and uncover strategy content in behavioral change techniques, and report the differences between the current results and those of the 2013 study. Methods: A systematic review of the literature according to PRISMA guidelines and meta-analyses of implementation strategies were performed. Cochrane Library, PubMed, and CINAHL databases were searched for papers published between 2011 and 2023. Strategies were identified using the Coding Manual for Behavioral Change Techniques. Meta-analyses of oral health outcomes (“plaque” and “denture plaque”) were performed with random-effects models using R language for statistical computing. Results: 16 studies were included in the current results; 20 studies were included in the 2013 findings. More high-quality studies (67 %) were included in this review than in 2013 (47 %). Dental care professionals were involved in 14 of the 16 studies. Fourteen of the 16 studies used and/ or combined five or more different implementation strategies: knowledge, intention, awareness, self-efficacy, attitude, and facilitation of behavior. Implementation positively affected the knowledge and attitudes of the nursing staff; however, the oral health of older people did not necessarily improve. In the 2013 review, more studies indicated combined oral health measurements were effective (71 %) than in the current review (20 %–33 %). Meta-analysis of four studies on dental plaque (0—3 scale) showed a significant, statistically small mean difference of -.21 (CI -.36; -.07, Cohen's d -.29) between the control and treatment group. Meta-analysis of three studies on denture plaque (0—4 scale), showed a significant, statistically large mean difference of -.76 (CI -1.48; -.05, Cohen's d -.88). Conclusions: In this review, more implementation strategies and combinations were used to implement oral care in long-term care. Implementation strategies positively affected the knowledge and attitudes of nursing staff; however, the oral health of older people did not necessarily improve. Meta-analyses on plaque showed that oral care implementations are effective; for denture plaque, the effect size was large and thus may have more clinical value than for dental plaque.
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BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities. METHODS: We conducted a cross-sectional study among 282 wards and 6,145 residents from 95 Dutch long-term care facilities. The relationship between the presence of BRNs in wards and quality of care was assessed, controlling for background characteristics, i.e. ward size, and residents' age, gender, length of stay, comorbidities, and care dependency status. Multilevel logistic regression analyses, using a generalized estimating equation approach, were performed. RESULTS: 57% of the wards employed BRNs. In these wards, the BRNs delivered on average 4.8 min of care per resident per day. Among residents living in somatic wards that employed BRNs, the probability of experiencing a fall (odds ratio 1.44; 95% CI 1.06-1.96) and receiving antipsychotic drugs (odds ratio 2.15; 95% CI 1.66-2.78) was higher, whereas the probability of having an indwelling urinary catheter was lower (odds ratio 0.70; 95% CI 0.53-0.91). Among residents living in psychogeriatric wards that employed BRNs, the probability of experiencing a medication incident was lower (odds ratio 0.68; 95% CI 0.49-0.95). For residents from both ward types, the probability of suffering from nosocomial pressure ulcers did not significantly differ for residents in wards employing BRNs. CONCLUSIONS: In wards that employed BRNs, their mean amount of time spent per resident was low, while quality of care on most wards was acceptable. No consistent evidence was found for a relationship between the presence of BRNs in wards and quality of care outcomes, controlling for background characteristics. Future studies should consider the mediating and moderating role of staffing-related work processes and ward environment characteristics on quality of care.
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Fluorescence microscopy is an indispensable technique to resolve structure and specificity in many scientific areas such as diagnostics, health care, materials- and life sciences. With the development of multi-functional instruments now costing hundreds of thousands of Euros, the availability and access to high-tech instrumentation is increasingly limited to larger imaging facilities. Here, we will develop a cost-effective alternative by combining a commercially available solution for high-resolution confocal imaging (the RCM from confocal.nl) with an open-hardware microscopy framework, the miCube, developed in the Laboratory of Biophysics of Wageningen University & Research. In addition, by implementing a recent invention of the applicant for the spectral separation of different emitters, we will improve the multiplexing capabilities of fluorescence microscopy in general and the RCM in particular. Together, our new platform will help to translate expertise and know-how created in an academic environment into a commercially sustainable future supporting the Dutch technology landscape.
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.
