Background: The Nurses in the Lead (NitL) programme consists of a systematic approach and training to 1) empower community nurses in implementing evidence, targeted at encouraging functional activities of older adults, and 2) train community nurses in enabling team members to change their practice. This article aims to describe the process evaluation of NitL. Methods: A mixed-methods formative process evaluation with a predominantly qualitative approach was conducted. Qualitative data were collected by interviews with community nurses (n = 7), focus groups with team members (n = 31), and reviewing seven implementation plans and 28 patient records. Quantitative data were collected among community nurses and team members (N = 90) using a questionnaire to assess barriers in encouraging functional activities and attendance lists. Data analysis was carried out through descriptive statistics and content analysis. Results: NitL was largely executed according to plan. Points of attention were the use and value of the background theory within the training, completion of implementation plans, and reporting in patient records by community nurses. Inhibiting factors for showing leadership and encouraging functional activities were a lack of time and a high complexity of care; facilitating factors were structure and clear communication within teams. Nurses considered the systematic approach useful and the training educational for their role. Most team members considered NitL practical and were satisfied with the coaching provided by community nurses. To optimise NitL, community nurses recommended providing the training first and extending the training. The team members recommended continuing clinical lessons, which were an implementation strategy from the community nurses. Conclusions: NitL was largely executed as planned, and appears worthy of further application in community care practice. However, adaptations are recommended to make NitL more promising in practice in empowering community nurse leadership in implementing evidence.
Background: after hospitalisation for cardiac disease, older patients are at high risk of readmission and death. Objective: the cardiac care bridge (CCB) transitional care programme evaluated the impact of combining case management, disease management and home-based cardiac rehabilitation (CR) on hospital readmission and mortality. Design: single-blind, randomised clinical trial. Setting: the trial was conducted in six hospitals in the Netherlands between June 2017 and March 2020. Community-based nurses and physical therapists continued care post-discharge. Subjects: cardiac patients ≥ 70 years were eligible if they were at high risk of functional loss or if they had had an unplanned hospital admission in the previous 6 months. Methods: the intervention group received a comprehensive geriatric assessment-based integrated care plan, a face-to-face handover with the community nurse before discharge and follow-up home visits. The community nurse collaborated with a pharmacist and participants received home-based CR from a physical therapist. The primary composite outcome was first all-cause unplanned readmission or mortality at 6 months. Results: in total, 306 participants were included. Mean age was 82.4 (standard deviation 6.3), 58% had heart failure and 92% were acutely hospitalised. 67% of the intervention key-elements were delivered. The composite outcome incidence was 54.2% (83/153) in the intervention group and 47.7% (73/153) in the control group (risk differences 6.5% [95% confidence intervals, CI -4.7 to 18%], risk ratios 1.14 [95% CI 0.91-1.42], P = 0.253). The study was discontinued prematurely due to implementation activities in usual care. Conclusion: in high-risk older cardiac patients, the CCB programme did not reduce hospital readmission or mortality within 6 months.
BACKGROUND: To evaluate whether a training programme is a feasible approach to facilitate occupational health professionals' (OHPs) use of knowledge and skills provided by a guideline.METHODS: Feasibility was evaluated by researching three aspects: 'acceptability', 'implementation' and 'limited efficacy'. Statements on acceptability and implementation were rated by OHPs on 10-point visual analogue scales after following the training programme (T2). Answers were analysed using descriptive statistics. Barriers to and facilitators of implementation were explored through open-ended questions at T2, which were qualitatively analysed. Limited efficacy was evaluated by measuring the level of knowledge and skills at baseline (T0), after reading the guideline (T1) and directly after completing the training programme (T2). Increase in knowledge and skills was analysed using a non-paramatric Friedman test and post-hoc Wilcoxon signed rank tests (two-tailed).RESULTS: The 38 OHPs found the training programme acceptable, judging that it was relevant (M: 8, SD: 1), increased their capability (M: 7, SD: 1), adhered to their daily practice (M: 8, SD: 1) and enhanced their guidance and assessment of people with a chronic disease (M: 8, SD: 1). OHPs found that it was feasible to implement the programme on a larger scale (M: 7, SD: 1) but foresaw barriers such as 'time', 'money' and organizational constraints. The reported facilitators were primarily related to the added value of the knowledge and skills to the OHPs' guidance and assessment, and that the programme taught them to apply the evidence in practice. Regarding limited efficacy, a significant increase was seen in OHPs' knowledge and skills over time (X2 (2) = 53.656, p < 0.001), with the median score improving from 6.3 (T0), 8.3 (T1) and 12.3 (T2). Post-hoc tests indicated a significant improvement between T0 and T1 (p < 0.001) and between T1 and T2 (p < 0.001).CONCLUSIONS: The training programme was found to be a feasible approach to facilitate OHPs' use of knowledge and skills provided by the guideline, from the perspective of OHPs generally (acceptability and implementation) and with respect to their increase in knowledge and skills in particular (limited efficacy).
The postdoc candidate, Giuliana Scuderi, will strengthen the connection between the research group Biobased Buildings (BB), (collaboration between Avans University of Applied Sciences and HZ University of Applied Sciences (HZ), and the Civil Engineering bachelor programme (CE) of HZ. The proposed research aims at deepening the knowledge about the mechanical properties of biobased materials for the application in the structural and infrastructural sectors. The research is relevant for the professional field, which is looking for safe and sustainable alternatives to traditional building materials (such as lignin asphalt, biobased panels for bridge constructions, etc.). The study of the mechanical behaviour of traditional materials (such as concrete and steel) is already part of the CE curriculum, but the ambition of this postdoc is that also BB principles are applied and visible. Therefore, from the first year of the programme, the postdoc will develop a biobased material science line and will facilitate applied research experiences for students, in collaboration with engineering and architectural companies, material producers and governmental bodies. Consequently, a new generation of environmentally sensitive civil engineers could be trained, as the labour market requires. The subject is broad and relevant for the future of our built environment, with possible connections with other fields of study, such as Architecture, Engineering, Economics and Chemistry. The project is also relevant for the National Science Agenda (NWA), being a crossover between the routes “Materialen – Made in Holland” and “Circulaire economie en grondstoffenefficiëntie”. The final products will be ready-to-use guidelines for the applications of biobased materials, a portfolio of applications and examples, and a new continuous learning line about biobased material science within the CE curriculum. The postdoc will be mentored and supervised by the Lector of the research group and by the study programme coordinator. The personnel policy and job function series of HZ facilitates the development opportunity.
Nederland wil in 2050 circulair zijn. Dat vraagt een ongekende transitie in de wijze waarop onze samenleving onderneemt, samenwerkt, denkt en doet. Stedelijke regio’s zijn de geijkte plek om een transitie naar een circulaire economie in gang te zetten door hun dichte concentratie van kennis, kapitaal, data en resources op een relatief klein oppervlak. De baten die deze transitie oplevert zullen vooral in deze regio’s merkbaar zijn: minder verspilling, luchtvervuiling en CO2-uitstoot, meer economische waarde en sociale impact. CIRCOLLAB richt zich op het versterken van interdisciplinair praktijkgericht onderzoek voor de circulaire transitie in de metropoolregio Amsterdam (MRA). De SPRONG-groep bestaat uit lectoraten van de Centres of Expertise Urban Technology en Urban Governance & Social Innovation en de Faculteit Digitale Media en Creatieve Industrie van de Hogeschool van Amsterdam, Kenniscentrum Maatschappelijke Innovatie Flevoland van Hogeschool Windesheim en de Academie van Bouwkunst van de Amsterdamse Hogeschool voor de Kunsten. De SPRONG-groep combineert expertise vanuit het technologische, creatieve, economische en sociale domein en verricht praktijkgericht onderzoek naar ‘circulair denken en doen’, ‘circulair ondernemen’, ‘circulair menselijk kapitaal’ en ‘circulair samenwerken’ in relatie tot technische innovaties in twee waardeketens: de gebouwde omgeving en consumptiegoederen. De SPRONG-groep ontwikkelt, samen met actoren in de quadruple helix, een regionale infrastructuur voor inventariseren en prioriteren van onderzoeksbehoeften en het programmeren, opbouwen en uitwisselen van kennis. Hierbij worden kennis en ervaringen uit circulaire initiatieven, experimenten, onderzoek en onderwijs aan elkaar en aan fysieke experimenteerruimtes verbonden, om gezamenlijk van te leren, kennis te delen en op te schalen. Zo ontstaat een krachtige interdisciplinaire SPRONGgroep met de ambitie om het consortium uit te laten groeien tot dé regionale spil op het gebied van de circulaire transitie in grootstedelijke regio’s en een erkende (inter)nationale speler voor kennisuitwisseling en -opbouw op dit onderwerp.
Cross-Re-Tour supports European tourism SME while implementing digital and circular economy innovations. The three year project promotes uptake and replication by tourism SMEs of tools and solutions developed in other sectors, to mainstream green and circular tourism business operations.At the start of the project existing knowledge-gaps of tourism SMEs will be researched through online dialogues. This will be followed by a market scan, an overview of existing state of the art solutions to digital and green constraints in other economic sectors, which may be applied to tourism SME business operations: water, energy, food, plastic, transport and furniture /equipment. The scan identifies best practices from other sectors related to nudging of clients towards sustainable behaviour and nudging of staff on how to best engage with new tourism market segments.The next stage of the project relates to two design processes: an online diagnostic tool that allows for measuring and assessing (160) SME’s potential to adapt existing solutions in digital and green challenges, developed in other economic sectors. Next to this, a knowledge hub, addresses knowledge constraints and proposes solutions, business advisory services, training activities to SMEs participating. The hub acts as a matchmaker, bringing together 160 tourism SMEs searching for solutions, with suppliers of existing solutions developed in other sectors. The next key activity is a cross-domain open innovation programme, that will provide 80 tourism SMEs with financial support (up to EUR 30K). Examples of partnerships could be: a hotel and a supplier of refurbished matrasses for hospitals; a restaurant and a supplier of food rejected by supermarkets, a dance event organiser and a supplier of refurbished water bottles operating in the cruise industry, etc.The 80 cross-domain partnerships will be supported through the knowledge hub and their business innovation advisors. The goal is to develop a variety of innovative partnerships to assure that examples in all operational levels of tourism SMEs.The innovation projects shall be presented during a show-and-share event, combined with an investors’ pitch. The diagnostic tool, market scan, knowledge hub, as well as the show and share offer excellent opportunities to communicate results and possible impact of open innovation processes to a wider international audience of destination stakeholders and non-tourism partners. Societal issueSupporting the implementation of digital and circular economy solutions in tourism SMEs is key for its transition towards sustainable low-impact industry and society. Benefit for societySolutions are already developed in other sectors but the cross-over towards tourism is not happening. The project bridges this gap.
