Objective To explore predictors of district nursing care utilisation for community-living (older) people in the Netherlands using claims data. To cope with growing demands in district nursing care, knowledge about the current utilisation of district nursing care is important. Setting District nursing care as a part of primary care. Participants In this nationwide study, claims data were used from the Dutch risk adjustment system and national information system of health insurers. Samples were drawn of 5500 pairs of community-living people using district nursing care (cases) and people not using district nursing care (controls) for two groups: all ages and aged 75+ years (total N=22 000). Outcome measures The outcome was district nursing care utilisation and the 114 potential predictors included predisposing factors (eg, age), enabling factors (eg, socioeconomic status) and need factors (various healthcare costs). The random forest algorithm was used to predict district nursing care utilisation. The performance of the models and importance of predictors were calculated. Results For the population of people aged 75+ years, most important predictors were older age, and high costs for general practitioner consultations, aid devices, pharmaceutical care, ambulance transportation and occupational therapy. For the total population, older age, and high costs for pharmaceutical care and aid devices were the most important predictors. Conclusions People in need of district nursing care are older, visit the general practitioner more often, and use more and/or expensive medications and aid devices. Therefore, close collaboration between the district nurse, general practitioner and the community pharmacist is important. Additional analyses including data regarding health status are recommended. Further research is needed to provide an evidence base for district nursing care to optimise the care for those with high care needs, and guide practice and policymakers’ decision-making.
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Background: Community learning is one approach to promote research competencies and to involve nurses and nursing students in research. This study examines the impact of community learning according to participants-both those inside and outside the community-in a joint nursing research project at a hospital. Method: A qualitative design was se-lected using a participatory approach. Data were col-lected through semistructured interviews, reflections, conversations, and patient input during 2 academic years. Results: Thematic analysis showed 11 themes, which were organized into three clusters: realization, transformation, and influencing factors. Participants perceived changes in practice and described how their perspectives have changed on care, education, and research. Reconsiderations led to some new or revised strategies, and influencing factors were associated with the contemporary context, degree of in-volvement, and design/facilitation. Conclusion: The impact of community learning emerged and extended beyond community boundaries, and the indicated influencing factors must be taken into account.
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Community care is becoming increasingly important. In the Netherlands, the percentage of people over the age of 65 is expected to increase to 22% by 2025, leading to more elderly patients, often with long-term and complex health problems (multimorbidity). Because many of these patients continue to live at home until a very old age, nurses are increasingly working outside of institutions. The 17 Dutch Bachelor nursing programmes responded to this development with a new national education profile 'Bachelor Nursing 2020 (BN2020)’ with more elements of community care. However, despite the increase in extramural care, the Dutch labour market has a shortage of community nurses with higher professional education qualifications, partly because most nursing students focus on the general hospital setting as the environment for their future career. Whether this is based on a perception of community care that deters making this choice has never been systematically investigated. It is also unclear whether a more community-oriented curriculum will better equip students for working in community care. In response to these issues, the nursing programme at the Amsterdam University of Applied Sciences (AUAS) redesigned its curriculum to include more elements of community care. Three perspectives were chosen for the redesign: (1) the influence of lecturers as role models, (2) positive placement experiences, and (3) five new ‘community-based’ themes in education. These new themes are as follows: patient self-management, shared decision-making, collaboration with the patients’ social system, healthcare technology, and allocation of care. The redesign also includes a ‘paved way’ into community care in the form of a coherent and attractive programme for interested students.This thesis describes whether and how the curriculum-redesign within higher professional education in nursing can be effective in terms of (1) stimulating a positive perception of community care and (2) realising a form of community care in line with the new themes in BN2020. In other words, that students will base choices in their actions/nursing interventions on these new themes in the education profile.
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The aim of the ProInCa project was to develop the sustainable innovation capacity of Kazakhstan’s Medical Universities for the modernization of nursing. The project was coordinated by JAMK University of Applied Sciences and consisted of a consortium of five Kazakhstani medical universities and four European higher education institutions. The project was co-funded by the Erasmus+ Capacity Building in the Field of Higher Education programme and supported by the Ministry of Education and Science and the Ministry of Healthcare of the Republic of Kazakhstan during 15.10.2017 – 31.01.2021.he wider objective of the ProInCa project is to develop the sustainable innovation capacity of Kazakhstan’s Medical Universities for the modernization of nursing. This wider objective is divided into four specific objectives, which are:1. Development of mechanisms for collaboration and knowledge sharing between academic national and international nursing community and society.2. To learn from best practices on implementing evidence-based nursing in nursing research, education and practice to promote the efficiency and quality of health care.3. Strengthen higher education institutes’ role in building evidence-based nursing research activities in health services to promote quality and safety of health care system.4. Promote the capacity and system of nursing leadership and management in health care transition to improve the quality of health care system
