"The booklet presents curated real-world good practice examples that help translate our strategy into concrete actions, and in turn, into the design of education and training programmes that will contribute to skill, upskill, or reskill individuals into high demand professional software roles."
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Staffing practices in long-term care lack a clear evidence base and often seem to be guided by opinions instead of evidence. While stakeholders believe intuitively that there is a positive relationship between staffing levels and quality in nursing homes, the research literature is contradictory (1). In this editorial we consider the evidence found in a literature study that we conducted for the Dutch Ministry of Health, Welfare and Sports (VWS). The aim of this study was to summarize all available evidence on the relationship between staffing and quality in nursing homes. Specifically, we focused on the quantity and the educational background of staff and quality in nursing homes. The literature study has contributed to the recent Dutch quality framework for nursing homes (Kwaliteitskader verpleeghuiszorg in Dutch) of the National Health Care Institute. This quality framework was published in January 2017 and provides norms – among other quality aspects – for nursing home staffing. As well as a description of the main findings of the literature study, we present implications for different stakeholders charged with staffing issues in nursing homes.
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Background: Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods: We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n=4). Results: The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions: The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment.
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One of the key ways to tackle staff shortages is education, which requires collaboration between organisations. As internships are crucial in vocational training, educational and internship institutes need to agree on the terms of internships. The aim of this study is to answer the research question: What would be a successful way of arranging networks to create internships in the healthcare sector? Initial conditions, governance and reciprocal behaviour are key factors in the various stages of collaboration and are likely to leave their mark on the outcome. A comparison of networks in four regions in the Netherlands provides insight into how such networks are organised. We conducted structured interviews with key figures and analysed documents and open-source data. We conclude that regions differ in how they organise healthcare internships; some are very network-oriented, others to a lesser degree. Although all regions manage to arrange one internship per student, network-oriented regions seem to create better matches.
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The healthcare sector has been confronted with rapidly rising healthcare costs and a shortage of medical staff. At the same time, the field of Artificial Intelligence (AI) has emerged as a promising area of research, offering potential benefits for healthcare. Despite the potential of AI to support healthcare, its widespread implementation, especially in healthcare, remains limited. One possible factor contributing to that is the lack of trust in AI algorithms among healthcare professionals. Previous studies have indicated that explainability plays a crucial role in establishing trust in AI systems. This study aims to explore trust in AI and its connection to explainability in a medical setting. A rapid review was conducted to provide an overview of the existing knowledge and research on trust and explainability. Building upon these insights, a dashboard interface was developed to present the output of an AI-based decision-support tool along with explanatory information, with the aim of enhancing explainability of the AI for healthcare professionals. To investigate the impact of the dashboard and its explanations on healthcare professionals, an exploratory case study was conducted. The study encompassed an assessment of participants’ trust in the AI system, their perception of its explainability, as well as their evaluations of perceived ease of use and perceived usefulness. The initial findings from the case study indicate a positive correlation between perceived explainability and trust in the AI system. Our preliminary findings suggest that enhancing the explainability of AI systems could increase trust among healthcare professionals. This may contribute to an increased acceptance and adoption of AI in healthcare. However, a more elaborate experiment with the dashboard is essential.
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The shortage for ICT personal in the EU is large and expected to increase. The aim of this research is to contribute to a better understanding of the roles and competences needed, so that education curricula can be better aligned to evolving market demand by answering the research question: Which competence gaps do we need to bridge in order to meet the future need for sufficiently qualified personnel in the EU Software sector? In this research, a mixed method approach was executed in twelve European countries, to map the current and future needs for competences in the EU. The analyses shows changes in demand regarding technical skills, e.g. low-code and a stronger focus on soft skills like communication and critical thinking. Besides this, the research showed educational institutes would do well to develop their curricula in a practical way by integration of real live cases and work together with organizations.
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De alarmbellen luiden al een tijd voor de zorg. Het CBS telde onlangs 68 duizend vacatures. Ook vindt de helft van het zorgpersoneel de werkdruk te hoog. De piek van de vergrijzing moet dan nog komen, die wordt in 2040 verwacht.
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Standard SARS-CoV-2 testing protocols using nasopharyngeal/throat (NP/T) swabs are invasive and require trained medical staff for reliable sampling. In addition, it has been shown that PCR is more sensitive as compared to antigen-based tests. Here we describe the analytical and clinical evaluation of our in-house RNA extraction-free saliva-based molecular assay for the detection of SARS-CoV-2. Analytical sensitivity of the test was equal to the sensitivity obtained in other Dutch diagnostic laboratories that process NP/T swabs. In this study, 955 individuals participated and provided NP/T swabs for routine molecular analysis (with RNA extraction) and saliva for comparison. Our RT-qPCR resulted in a sensitivity of 82,86% and a specificity of 98,94% compared to the gold standard. A false-negative ratio of 1,9% was found. The SARS-CoV-2 detection workflow described here enables easy, economical, and reliable saliva processing, useful for repeated testing of individuals.
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Background The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses’ work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic. Methods A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding. Results We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses’ stress and improved work conditions. Conclusions This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.
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