Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action research. Method: The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. Results: A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of EBP were that nurses had little knowledge of EBP and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of EBP was adapted. Nurses worked according to the EBP discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Conclusions: Action research provides an opportunity to empower nurses and to tailor EBP to the practice context. Applying and implementing EBP is difficult for front-line nurses with limited EBP competencies. Relevance to clinical practice: Adaptation of the academic model of EBP to a more pragmatic approach seems necessary to introduce EBP into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice, it seems relevant to integrate scientific evidence with clinical expertise and patient values in nurses’ clinical decision making at the individual patient level.
Implementing new information systems and devices, in high-reliability organizations such as operating rooms (OR’s) in hospitals, is complex. To improve the success and efficiency of these implementations we constructed a protocol for implementation for digitization and devices in OR’s. This protocol consists of implementation factors, implementation activities, and implementation instructions. In this study, we evaluated this protocol. To gather data, we organized three focus group sessions with participants holding different job roles at different departments: a surgeon, a methodologist, anesthesiologists, a scrub nurse, a training officer, innovations officers, and OR-management. We gathered qualitative data regarding completeness, clearness, and the ability to execute. Sessions were video-recorded, transcribed, and coded in Nvivo for Windows according to Toulmins Argumentative Pattern. Based on this analysis, revisions to factors, activities, and instructions are presented for protocol enhancement; experts confirm that an implementation protocol is needed to increase implementation efficiency and adoption of new devices.
It has become a topic at Dutch educational institutes to feel not only responsible for improvement of theoretical and practical skills, but also of 'competences' in a broader sense. The curriculum of the Electrical and Electronic (E&E) Department has been changed enormously in the past decade. Fewer lessons and many more projects were introduced. We have choosen to let the students work on competences especially in the projects they are in. With the introduction of competences and the aid of a student portfolio we have given the tools to the students to improve their competences in a broader way. At the E &E department we introduced two different ways of working on competences. In the first years of their study students choose different roles in our projects every time. We have described all the roles and the related tasks for each specific role. While working on a role, the students indirectly work on different competences. This way of working inforces a broader educational level (a student shouldn t work on things he already knows or is able to handle) and the hitch hiking behaviour is banned out. Students now do take responsibility while contributing to the project teams. Inquiries amongst the students confirm these results. The second way is working on the specific competences in their traineeship and thesis work in the last part of their study. This will be introduced in autumn 2004 in the E&E department. In this paper we will show you how we are implementing the integration of competences, like the E&E department did, for IPD projects as well. This implementation is planned to start in autumn 2004.
Horse riding falls under the “Sport for Life” disciplines, where a long-term equestrian development can provide a clear pathway of developmental stages to help individuals, inclusive of those with a disability, to pursue their goals in sport and physical activity, providing long-term health benefits. However, the biomechanical interaction between horse and (disabled) rider is not wholly understood, leaving challenges and opportunities for the horse riding sport. Therefore, the purpose of this KIEM project is to start an interdisciplinary collaboration between parties interested in integrating existing knowledge on horse and (disabled) rider interaction with any novel insights to be gained from analysing recently collected sensor data using the EquiMoves™ system. EquiMoves is based on the state-of-the-art inertial- and orientational-sensor system ProMove-mini from Inertia Technology B.V., a partner in this proposal. On the basis of analysing previously collected data, machine learning algorithms will be selected for implementation in existing or modified EquiMoves sensor hardware and software solutions. Target applications and follow-ups include: - Improving horse and (disabled) rider interaction for riders of all skill levels; - Objective evidence-based classification system for competitive grading of disabled riders in Para Dressage events; - Identifying biomechanical irregularities for detecting and/or preventing injuries of horses. Topic-wise, the project is connected to “Smart Technologies and Materials”, “High Tech Systems & Materials” and “Digital key technologies”. The core consortium of Saxion University of Applied Sciences, Rosmark Consultancy and Inertia Technology will receive feedback to project progress and outcomes from a panel of international experts (Utrecht University, Sport Horse Health Plan, University of Central Lancashire, Swedish University of Agricultural Sciences), combining a strong mix of expertise on horse and rider biomechanics, veterinary medicine, sensor hardware, data analysis and AI/machine learning algorithm development and implementation, all together presenting a solid collaborative base for derived RAAK-mkb, -publiek and/or -PRO follow-up projects.
The developments of digitalization and automation in freight transport and logistics are expected to speed-up the realization of an adaptive, seamless, connected and sustainable logistics system. CATALYST determines the potential and impact of Connected Automated Transport (CAT) by testing and implementing solutions in a real-world environment. We experiment on smart yards and connected corridors, to answer research questions regarding supply chain integration, users, infrastructure, data and policy. Results are translated to overarching lessons on CAT implementations, and shared with potential users and related communities. This way, CATALYST helps logistic partners throughout the supply chain prepare for CAT and accelerates innovation.
The developments of digitalization and automation in freight transport and logistics are expected to speed-up the realization of an adaptive, seamless, connected and sustainable logistics system. CATALYST determines the potential and impact of Connected Automated Transport (CAT) by testing and implementing solutions in a real-world environment. We experiment on smart yards and connected corridors, to answer research questions regarding supply chain integration, users, infrastructure, data and policy. Results are translated to overarching lessons on CAT implementations, and shared with potential users and related communities. This way, CATALYST helps logistic partners throughout the supply chain prepare for CAT and accelerates innovation.
