BackgroundWorking in the perioperative context is complex and challenging. The continual evaluation in this environment underscores the need for adaptability to technological advancements, and requires substantial allocation of resources for training and education. This study aimed to explore personality characteristics of nurse anesthetists and surgical nurses that are instrumental for sustainable employability in technologically advanced environment.MethodsExploratory, cross-sectional survey study including nurse anesthetists and surgical nurses, both certified and in training, and a sample of the normative Dutch population. Personality characteristics were identified with the Big Five Inventory, which consisted of 60 items answered on a five-point Likert scale (strongly disagree to strongly agree).ResultsSpecific personality traits were found for nurse anesthetists and surgical nurses when compared to the normative Dutch population. Traits of both nurse anesthetists and surgical nurses differed significantly on all domains of the Big Five Inventory, with the largest differences found within the dimension negative emotionally.ConclusionsThis study highlights the role of specific personality traits in maintaining employability within the rapidly evolving and technologically advanced landscape of healthcare. It emphasizes the relationship between individual traits and professional excellence, being crucial educational strategies for overall improvement in healthcare.
Background: Multimodal prehabilitation programs are effective at reducing complications after colorectal surgery in patients with a high risk of postoperative complications due to low aerobic capacity and/or malnutrition. However, high implementation fidelity is needed to achieve these effects in real-life practice. This study aimed to investigate the implementation fidelity of an evidence-based prehabilitation program in the real-life context of a Dutch regional hospital.Methods: In this observational cohort study with multiple case analyses, all patients who underwent colorectal surgery from January 2023 to June 2023 were enrolled. Patients meeting the criteria for low aerobic capacity or malnutrition were advised to participate in a prehabilitation program. According to recent scientific insights and the local care context, this program consisted of four exercise modalities and three nutrition modalities. Implementation fidelity was investigated by evaluating: (1) coverage (participation rate), (2) duration (number of days between the start of prehabilitation and surgery), (3) content (delivery of prescribed intervention modalities), and (4) frequency (attendance of sessions and compliance with prescribed parameters). An aggregated percentage of content and frequency was calculated to determine overall adherence.Results: Fifty-eight patients intended to follow the prehabilitation care pathway, of which 41 performed a preoperative risk assessment (coverage 80%). Ten patients (24%) were identified as high-risk and participated in the prehabilitation program (duration of 33-84 days). Adherence was high (84-100%) in five and moderate (72-73%) in two patients. Adherence was remarkably low (25%, 53%, 54%) in three patients who struggled to execute the prehabilitation program due to multiple physical and cognitive impairments.Conclusion: Implementation fidelity of an evidence-based multimodal prehabilitation program for high-risk patients preparing for colorectal surgery in real-life practice was moderate because adherence was high for most patients, but low for some patients. Patients with low adherence had multiple impairments, with consequences for their preparation for surgery. For healthcare professionals, it is recommended to pay attention to high-risk patients with multiple impairments and further personalize the prehabilitation program. More knowledge about identifying and treating high-risk patients is needed to provide evidence-based recommendations and to obtain higher effectiveness.
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Introduction: There are two surgical approaches to reconstruct a pressure ulcer (PU): one-stage reconstruction or two-stage reconstruction. One stage reconstruction consists of surgical debridement and flap reconstruction during one operation. Two-stage surgery consist of a surgical debridement and a final reconstruction in two different sessions, with approximately six weeks between both sessions. Objective: The aim of this study was to compare the results of single stage surgery and two-stage surgery on the PU recurrence rate and other important post operative complications. Method: A retrospective, comparative study in Spinal Cord Injured (SCI) individuals with a single- or two stage surgical reconstruction between 2005 and 2016 was designed. A total of 81 records were included for analysis. Results: The primary outcome, the difference in occurrence of a recurrent PU in the reconstructed area (33.3% versus 31.6%), is not statistically significant between one-and two-stages reconstruction. Also, the mean duration to develop a recurrent PU between both surgical reconstructions is not statistically significant. Other surgical complications in the reconstructed area like wound hematoma, hemorrhage, seroma or (partial) flap failure did not differ significantly between both groups, apart and in total. We calculated the additional costs in case of a two-stage approach compared with a single-stage reconstruction at EUR 16,362. Conclusions: There are no statistical significant differences in PU recurrence rate or other post operative complications between SCI patients who have undergone one- or two stage PU reconstructive surgery. The most obvious choice for a one-stage approach in case of PU reconstructive surgery has great positive implications for the patient, family, health care providers and the health care system.
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Since 2015, the research group Lifelong Learning in Music of Hanze University of Applied Sciences Groningen, together with the University Medical Center Groningen (UMCG), has developed and researched the MiMiC practice for patients and nurses on surgical wards. The musicians make tailor-made music in the patients' rooms in collaboration with patients and nurses. They do this on the basis of verbal and non-verbal contact with patients and nurses. Person-centred music-making turns out to be easy to realise in a medical setting and to be meaningful for all involved. People who have just had surgery experience less pain. Nurses feel more deeply involved with their patients. Musicians show sensitivity for the social context in which they carry out their artistic practice.In this project the research group is developing an innovative artistic practice with a focus on elderly patients. Musicians work with patients and the care staff that are taking care of these patients during their stay in hospital. The research should lead to insights in the effects of this practice and to a new training for master students and professional musicians who want wish to specialise themselves in this field. Pilots on six different wards of the UMCG with professional musicians and master students are part of the research which will last two years in its entirety. The project has been granted funding from the 'Banning de Jong Fonds' of the national 'Prins Bernhard Cultuurfonds' and the 'Fonds Sluyterman van Loo'.
In Nederland worden jaarlijks meer dan 2 miljoen operaties uitgevoerd waarbij 75% van de patiënten acute pijn krijgen. Bij één op de tien mensen ontwikkelt de acute pijn zich tot chronische pijn en bij één op de zeven mensen leidt dat tot langdurig opioïdengebruik. Mensen met beperkte gezondheidsvaardigheden hebben hierop een verhoogd risico. Deze problemen leiden niet alleen tot een traag herstel, de ontwikkeling van nieuwe ziekten of vermindering van de levenskwaliteit, maar maatschappelijk gezien neemt het werkvermogen af en de medische zorgconsumptie toe. Het is belangrijk dat zorgprofessionals deze potentiële problemen vroegtijdig herkennen en passende interventies uitvoeren, voor en na een operatie om ernstige gevolgen van pijn en langdurig gebruik van opioïden te verminderen. Een antwoord op deze problemen is de begeleiding van patiënten door zorgprofessionals, die werkzaam zijn in een zogenaamde Transitionele Pijn Service. Zij kunnen de multidisciplinaire pijnzorg coördineren, de patiënt (met beperkte gezondheidsvaardigheden) en naaste coachen en begeleiden in de pijnbehandeling, en opioïde pijnmedicatie tijdig helpen afbouwen, ook in de thuissituatie. Zorgprofessionals voelen zich echter handelingsverlegen ten aanzien van welke interventies en hulpmiddelen ze hierbij in kunnen zetten, en hoe ze daarbij patiënten met beperkte gezondheidsvaardigheden adequaat kunnen ondersteunen. Doel van dit project is om voor en door zorgprofessionals en samen met ervaringsdeskundigen een tool set van preventieve gepersonaliseerde interventies en hulpmiddelen te ontwikkelen om kwetsbare chirurgische patiënten met beperkte gezondheidsvaardigheden te ondersteunen. Hiermee kunnen patiënten vanaf de voorbereiding tot in de thuissituatie begeleiding ontvangen, gestimuleerd worden in zelfmanagement, en zal acute en chronische pijn en langdurig en ongewenst opioïdengebruik verminderen. Deze tool set, die ontwikkeld wordt via ontwerpgericht onderzoek, zal in een pilot getest worden op bruikbaarheid, acceptatie en toepasbaarheid. Tevens ontwikkelen we een onderwijsmodule voor zorgprofessionals in het initiële zorgonderwijs en voor bij-en nascholingstrajecten, zodat zorgprofessionals in het hele land hiermee gaan werken.
The clubfoot deformity is one of the most common congenital orthopaedic “conditions”. Worldwide approximately 100,000 children are born with unilateral or bilateral clubfoot every year. In the Netherlands the incidence is approximately 175 every year. This three dimensional deformity of the foot involves, equinus, varus, adductus, and cavus . Left untreated the clubfoot leads to deformity, functional disability and pain. Physical impairments of children with clubfoot might lead to limitations in activities and therefore impede a child’s participation. In clinical practice, the orthopaedic surgeon and physiotherapists are regularly consulted by (parents of) clubfoot patients for functional problems such as impaired walking and other daily activities. This does not only affect long-term and physical health of a child, it will also affect the development of social relationships and skills as well. Since walking is a main activity in children to be able to participate in daily life, our previous study (financially supported by SIA Raak Publiek) focussed on gait differences between children with clubfoot and controls. However, differences in gait characteristics do not necessarily lead to functional limitations and restricted participation. Therefore, providing insight in participation and a child’s performance in other activities than walking is necessary. Insight in a child’s participation will also indicate the functional outcome of the treatment, which on its turn could provide essential information concerning a possible relapse.. Early identification of a relapse is important since it could prevent the need for major surgical interventions. The occurrence of a relapse clubfoot will probably also lead to functional differences in the foot as well as problems during activity and participation. Therefore, the main focus of this study is the functional outcomes of physical activities and the characterisation of participation of children with clubfeet in daily activities of childhood.
