Aims and objectives To gain insight into the perceived added value of a decision support App for district nurses and case managers intended to support a problem assessment and the provision of advices on possible solutions to facilitate ageing in place of people with dementia, and to investigate how they would implement the App in daily practice. Background District nurses and case managers play an important role in facilitating ageing in place of people with dementia (PwD). Detecting practical problems preventing PwD from living at home and advising on possible solutions is complex and challenging tasks for nurses and case managers. To support them with these tasks, a decision support App was developed. Methods A qualitative study using semi‐structured interviews was conducted. A photo‐elicitation method and an interview guide were used to structure the interviews. The data were analysed according to the principles of content analysis. Results In five interviews with seven district nurses and case managers, the added value was described in terms of five themes: (a) providing a broader/better overview of possible solutions; (b) providing a guideline/checklist for problem assessment and advice on solutions; (c) supporting an in‐depth problem assessment; (d) being a support tool for unexperienced case managers/district nurses; and (e) providing up‐to‐date information. The participants regarded the App as complementary to their current work procedure, which they would use in a flexible manner at different stages in the care continuum. Conclusions The participants valued both parts, the problem assessment and the overview of possible solutions. An important requisite for the usage would be that the content is continuously updated. Before implementation of the App can be recommended, an evaluation of its effectiveness regarding decision‐making should be conducted. Relevance to clinical practice This study underpins the need of nurses and case managers for decision support with regard to problem assessment and providing advices on possible solutions to facilitate ageing in place of PwD. There results also show the importance of listening to users experience and their perceived added value of decision support tools as this helps to explain the lack of statistically significant effects on quantitative outcome measure in contrast to a high willingness to use the App in a previous study.
Abstract Review Article: Introduction: Registered nurses and students of the Bachelor of Nursing are improving the quality of healthcare by working together in a Learning and Innovation Network (LIN). A LIN is a powerful learning environment, where employees and students work together towards a common goal. Methods: In the Netherlands, Amsterdam UMC, location VUmc and Inholland University of Applied Sciences have set up a LIN on the internal medicine traumatology, oncology, cardiology and urology departments. On the LIN departments, the number of students has increased significantly. Because the students are supernumerary, space and time are created to optimize the learning process of the RNs without compromising the care to be provided. Within the LIN, students learn from the practical experience of RNs, which gives them tools to apply knowledge practically. On the other hand, students can contribute to the adaptation of long established practices, based on recently acquired knowledge. A bridge is built between acting according to recent scientific insights and experiences from practice. It is also important to take the patient’s wishes into account. This guarantees nursing action based on evidence based practice and best practice. Several projects aimed at increasing the quality of care have already been carried out within the LIN such as projects focused on removing a catheter and bandaging. Conclusion: The LIN is taking more and more shape within the VUmc. There is a broad support base between educational and healthcare institutions, both on management and executive level. In order to make the LIN activities even more attuned to the authentic development needs of the department, interprofessional learning and working should be encouraged by also enthusing other care disciplines and researchers to participate in the LIN. An EBP working group consisting of permanent team members can contribute to the safeguarding of the outcomes of the LIN projects.
STUDY DESIGN: Cross-sectional study.OBJECTIVES: This study: (1) investigated the accuracy of bioelectrical impedance analysis (BIA) and skinfold thickness relative to dual-energy X-ray absorptiometry (DXA) in the assessment of body composition in people with spinal cord injury (SCI), and whether sex and lesion characteristics affect the accuracy, (2) developed new prediction equations to estimate fat free mass (FFM) and percentage fat mass (FM%) in a general SCI population using BIA and skinfolds outcomes.SETTING: University, the Netherlands.METHODS: Fifty participants with SCI (19 females; median time since injury: 15 years) were tested by DXA, single-frequency BIA (SF-BIA), segmental multi-frequency BIA (segmental MF-BIA), and anthropometry (height, body mass, calf circumference, and skinfold thickness) during a visit. Personal and lesion characteristics were registered.RESULTS: Compared to DXA, SF-BIA showed the smallest mean difference in estimating FM%, but with large limits of agreement (mean difference = -2.2%; limits of agreement: -12.8 to 8.3%). BIA and skinfold thickness tended to show a better estimation of FM% in females, participants with tetraplegia, or with motor incomplete injury. New equations for predicting FFM and FM% were developed with good explained variances (FFM: R2 = 0.94; FM%: R2 = 0.66).CONCLUSIONS: None of the measurement techniques accurately estimated FM% because of the wide individual variation and, therefore, should be used with caution. The accuracy of the techniques differed in different subgroups. The newly developed equations for predicting FFM and FM% should be cross-validated in future studies.
