Early mobilisation after abdominal surgery is necessary to avoid complications and increase recovery. However, due to a variety of factors, failure of early mobilisation is seen in clinical practice. The aim of this study is to investigate the perspectives of nurses and patients of the Haaglanden Medical Center (HMC) how to increase mobilisation frequency after colorectal surgery in the oncological surgery ward. This explorative study employed qualitative data collection and analysis by means of semi-structured interviews with patients and nurses. Patients were included when they had a colorectal resection, were older than 18 years and spoke Dutch. The interviews were audiotaped and verbatum transcribed. A thematic content analysis was performed. It was concluded that mobilisation can be increased when it is incorporated in daily care activities and family support during visiting hours. Appropriate information about mobilisation and physical activity is needed for nurses, patients and family and the hospital environment should stimulate mobilisation.
Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification (‘organization-related’, ‘prescriber-related’, ‘prescription-related’, ‘technologyrelated’ and ‘unclassified’) and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was ‘insufficient (drug) knowledge, prescribing skills and/or experience of prescribers’. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs.
MULTIFILE
Medical equipment is implemented in highly complex hospital environments, such as operating rooms, in hospitals around the world. In operating rooms (ORs), technological equipment is used for surgical activities and activities in support of surgeries. The implementation of government policies in hospitals has resulted in varying implementation activities for (medical) equipment. These result in varying lead times and success rates. An integral and holistic protocol for implementation does not yet exist. In this study, we introduce a protocol for the implementation of (medical) equipment in ORs that consists of implementation factors and implementation activities. Factors and activities are based on data from a systematic literature review and an explorative survey among surgical support staff on factors for the successful implementation of technological and (medical) equipment in ORs. The protocol consists of five factors and related implementation activities: the establishment of a project plan, organisational preparation, technological preparation, maintenance, and training.
LINK
Circular Economy is a novel disruptive paradigm redefining sustainability in the hospitality industry and addressing the environmental challenges set by this fast-growing impactful industry. To address these challenges, the creation of further knowledge on circular economy and its applications in the hospitality sector is fundamental, together with providing hoteliers and restaurateurs with proper skills and knowhow to tackle such challenges. Drawing on a on going pilot project on Circular Economy in Hotels in Amsterdam, the Friesland hospitality sector and the Professorship of Sustainability in Hospitality and Tourism at NHL Stenden University of Applied Sciences have set out to develop an innovative learning experimental environment in which Friesland hoteliers and restaurateurs can develop further knowledge and identify - together with students, researchers, and experts – possible key actions and strategies to implement regenerative circular processes of material up-cycling. To which extent this learning community of the Northern Netherlands contributes to develop wider knowledge on circular economy in hospitality and to identify, implement, and test innovative regenerative circular actions will be evaluated.
In het project CW4.0 onderzoeken MKB’ers uit de houtindustrie en Smart Industry samen met de Hogeschool van Amsterdam (HvA), kennispartners TNO, HMC en Bouwlab R&Do en partners in hospitality hoe zinvolle toepassingen te maken van resthout, met behulp van Industry 4.0-principes. Hoogwaardig hout blijft momenteel ongebruikt, omdat het te arbeids-intensief is grote hoeveelheden ongelijkmatige stukken hout van verschillende grootte en houtsoort te verwerken. Waardevol resthout wordt zo waardeloos afval, tegen de principes van de circulaire economie in. CW4.0 richt zich op de ontwikkeling van geautomatiseerde processen voor houtverwerking gebaseerd op Industry 4.0 technologieën - met behulp van digitale ontwerptools en industriële robots. Uit eerdere projecten van HvA en partners is gebleken dat deze processen het gebruik van resthout levensvatbaar kunnen maken, in het bijzonder voor toepassingen in de hospitality sector, bijvoorbeeld voor receptiebalies, hotelmeubilair en interieurdelen. CW4.0 wordt dan ook uitgevoerd in samenwerking met hospitality-ontwerpers en hotelketels. Het onderzoek concentreert zich op 1) het creëren van een digital twin (=digitale kopie van een beoogd object of proces, om dit te onderzoeken zonder het eerst te hoeven bouwen) van een ‘upcycle houtfabriek’; 2) het realiseren en beproeven van secties van de fabriek; 3) het ontwerpen en prototypen van hospitality toepassingen en 4) het evalueren van de business case van deze toepassingen en de fabriek in het algemeen. Na afloop is er kennis beschikbaar voor houtindustrie om afval te verminderen, voor Smart Industry om hun digitale technologieën toe te passen voor upcycling van materialen, en voor horecapartners om waardevolle toepassingen te creëren van resthout. Het project is een belangrijke stap in de opschaling van industriële robotproductie met circulaire materialen. Het legt een nieuwe, belangrijke verbinding tussen Smart Industry en de circulaire transitie, gericht op het aanpakken van urgente maatschappelijke uitdagingen verband houdend met materiële schaarste en de mondiale milieucrisis.
Single-Use Plastics (SUPs) are at the centre of European Union Agenda aiming at reducing the plastic soup with the EU Directive 2019/904. SUPs reduction is pivotal also in the Dutch Government Agenda for the transition to a Circular Economy by 2050. Worldwide the data on SUPs use and disposal are impressive: humans use around 1.2 million plastic bottles per minute; approximately 91% of plastic is not recycled (www.earthday.org/fact-sheet-single-use-plastics/). While centralised processes of waste collection, disposal, and recycling strive to cope with such intense use of SUPs, the opportunities and constraints of establishing a networked grid of facilities enacting processes of SUPs collection and recycling with the active involvement of local community has remained unexplored. The hospitality sector is characterised by a widespread capillary network of small hospitality firms nested in neighbourhoods and rural communities. Our research group works with small hospitality firms, different stakeholders, and other research groups to prompt the transition of the hospitality sector towards a Circular Economy embracing not only the environmental and economic dimensions but also the social dimension. Hence, this project explores the knowledge and network needed to build an innovative pilot allowing to close the plastic loop within a hospitality facility by combining a 3D printing process with social inclusiveness. This will mean generating key technical and legal knowledge as well as a network of strategic experts and stakeholders to be involved in an innovative pilot setting a 3D printing process in a hospitality facility and establishing an active involvement of the local community. Such active involvement of the local inhabitants will be explored as SUPs collectors and end-users of upcycled plastics items realised with the 3D printer, as well as through opportunities of vocational training and job opportunities for citizens distant from the job market.
