Background and Objectives: The transition from home to a nursing home is a stressful event for both older persons and informal caregivers. Currently, this transition process is often fragmented, which can create a vicious cycle of health carerelated events. Knowledge of existing care interventions can prevent or break this cycle. This project aims to summarize existing interventions for improving transitional care, identifying their effectiveness and key components. Research Design and Methods: A scoping review was performed within the European TRANS-SENIOR consortium. The databases PubMed, EMBASE (Excerpta Medica Database), PsycINFO, Medline, and CINAHL (Cumulated Index to Nursing and Allied Health Literature) were searched. Studies were included if they described interventions designed to improve the transition from home to a nursing home. Results: 17 studies were identified, describing 13 interventions. The majority of these interventions focused on nursing home adjustment with 1 study including the entire transition pathway. The study identified 8 multicomponent and 5 single-component interventions. From the multicomponent interventions, 7 main components were identified: education, relationships/communication, improving emotional well-being, personalized care, continuity of care, support provision, and ad hoc counseling. The study outcomes were heterogeneous, making them difficult to compare. The study outcomes varied, with studies often reporting nonsignificant changes for the main outcome measures. Discussion and Implications: There is a mismatch between the theory on optimal transitional care and current transitional care interventions, as they often lack a comprehensive approach. This research is the first step toward a uniform definition of optimal transitional care and a tool to improve/develop (future) transitional care initiatives on the pathway from home to a nursing home.
The nursing home is often a final stage in the living career of older persons, but the question remains whether it is a true home or merely a place where care is provided for the residents. This study investigates the sense of home and its constituent factors among both permanent and temporary residents of nursing homes in The Netherlands. A qualitative research design was chosen for the study, which consisted of in-depth interviews using a topic list that was developed through literature review and a focus group session. Autonomy and safety and security are the basic aspects for a sense of home. These aspects refer to the relationships and actions of nursing home residents and the environment in which people live. The research findings show that developing a sense of home encompasses much more than just being surrounded by personal belongings and having a private room with certain facilities. Subjective components of relationships and (inter)actions are as important as the physical component of living and housing. Only when a right balance is achieved between all factors, a true sense of home, albeit away from the familiar home someone spent most of his/her life, can be developed. Understanding these perspectives and needs can contribute to a better design and retrofitting process of future nursing homes.
Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1) original and peer-reviewed research, (2) qualitative, quantitative, or mixed methods research, (3) research about nursing home residents (or similar type of housing), and (4) research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were included. The sense of home of nursing home residents is influenced by 15 factors, divided into three themes: (1) psychological factors (sense of acknowledgement, preservation of one's habits and values, autonomy and control, and coping); (2) social factors (interaction and relationship with staff, residents, family and friends, and pets) and activities; and (3) the built environment (private space and (quasi-)public space, personal belongings, technology, look and feel, and the outdoors and location). Conclusions. The sense of home is influenced by numerous factors related to the psychology of the residents and the social and built environmental contexts. Further research is needed to determine if and how the identified factors are interrelated, if perspectives of various stakeholders involved differ, and how the factors can be improved in practice.
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Aanleiding Mede door de vergrijzing groeit de zorgvraag in Nederland. Tegelijkertijd vallen veel verpleegkundigen uit door fysieke en mentale arbeidsbelasting. Dit begint al tijdens de opleiding/aan de start van de loopbaan. Dreigende arbeidstekorten en decentralisatie in de zorg vragen om verpleegkundigen die regie kunnen voeren over hun eigen werkgerelateerde gezondheid. Er is nog weinig wetenschappelijke kennis over het vroegtijdig signaleren en aanpakken van uitval onder verpleegkundigen. Bovendien hapert de invoer van effectieve interventies. Daarom willen zorginstellingen, verpleegkunde-opleidingen en wetenschappelijke organisaties onderzoek doen naar de oorzaken van uitval en een instrument ontwikkelen om problemen vroegtijdig te herkennen en te ondervangen. Doelstelling Het consortium wil een wetenschappelijk en praktisch onderbouwd instrumentarium ontwikkelen voor het signaleren van risicofactoren, gezondheidsproblemen, productiviteitsverlies en uitval bij stagiairs en beginnende verpleegkundigen, met daaraan gekoppeld effectieve preventieve interventies voor in de onderwijs- en stagepraktijk. Het programma kent twee fases. 1) literatuuronderzoek, kwalitatief onderzoek naar nog onbekende risicofactoren en longitudinaal cohortonderzoek vormen de basis voor een signaleringsinstrument/predictiemodel. In het cohortonderzoek worden van 750 (aankomend) verpleegkundigen 2,5 jaar de determinanten voor uitval gemonitord. In expertmeetings selecteert men vervolgens 6 evidencebased interventies. 2) het onderzoeksteam pre-test deze interventies op eerste haalbaarheid bij studenten verpleegkunde met risico. De 2 kansrijkste interventies, één voor mentale en één voor fysieke werkbelasting, worden in pilots op effectiviteit getoetst. In het onderzoek zet men de psychometrisch beproefde meetinstrumenten in van de European Nurses Early Exit Study (online enquêtes), aangevuld met inzichten uit interviews, fysieke metingen en praktijkobservaties. Beoogde resultaten De beoogde resultaten van het project zijn: " inzicht in de fysieke en mentale problemen van verpleegkundigen; " een gevalideerd predictiemodel voor geïndiceerde preventie in de zorg; " good practices en een kant-en-klare webapplicatie voor vroegsignalering met interventies in het stageonderwijs en het werkveld om uitval te voorkomen; " valorisatie van kennis in co-creatie met studenten, zorginstellingen en zorgprofessionals in de regio; " kennisinput voor de opleidingen Nurse practitioner, Verpleegkunde, Arbeid en Gezondheid, HRM. Een grote groep studenten is respondent in het onderzoek. In de uitvoering participeren ook studenten en daarnaast onder meer lectoren, onderzoekers en docenten van Hogeschool Rotterdam en twee promovendi. Voor de wetenschappelijke disseminatie worden refereerbijeenkomsten en presentaties gehouden op internationale congressen, en proefschriften en artikelen geschreven gepubliceerd. De verspreiding onder maatschappelijke partners gebeurt via vakpublicaties, expertmeetings en een slotsymposium. Met internationale partners uit het netwerk worden mogelijkheden verkend voor internationale parallelstudies.
To optimize patient care, it is vital to prevent infections in healthcare facilities. In this respect, the increasing prevalence of antibiotic-resistant bacterial strains threatens public healthcare. Current gold standard techniques are based on classical microbiological assays that are time consuming and need complex expensive lab environments. This limits their use for high throughput bacterial screening to perform optimal hygiene control. The infection prevention workers in hospitals and elderly nursing homes underline the urgency of a point-of-care tool that is able to detect bacterial loads on-site in a fast, precise and reliable manner while remaining with the available budgets. The aim of this proposal titled SURFSCAN is to develop a novel point-of-care tool for bacterial load screening on various surfaces throughout the daily routine of professionals in healthcare facilities. Given the expertise of the consortium partners, the point-of-care tool will be based on a biomimetic sensor combining surface imprinted polymers (SIPs), that act as synthetic bacterial receptors, with a thermal read-out strategy for detection. The functionality and performance of this biomimetic sensor has been shown in lab conditions and published in peer reviewed journals. Within this proposal, key elements will be optimized to translate the proof of principle concept into a complete clinical prototype for on-site application. These elements are essential for final implementation of the device as a screening and assessment tool for scanning bacterial loads on surfaces by hospital professionals. The research project offers a unique collaboration among different end-users (hospitals and SMEs), and knowledge institutions (Zuyd University of Applied Sciences, Fontys University of Applied Sciences and Maastricht Science Programme, IDEE-Maastricht University), which guarantees transfer of fundamental knowledge to the market and end-user needs.
