Background: Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing. Methods: Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night). Results: All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members). Conclusion: We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.
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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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In dit artikel wordt het door Twigg et al. (2011) uitgevoerde onderzoek kritisch bekeken. In dit onderzoek is gekeken naar de relatie tussen de verpleegkundige bezetting en verbetering van verpleegkundig sensitieve uitkomsten. De onderzoekers constateren een positieve causale relatie maar onderbouwen dat niet door de gepresenteerde resultaten. Daarnaast wordt er geen aandacht geschonken aan andere contextuele factoren (zoals multidisciplinaire samenwerking) die van invloed zijn op de uitkomsten. Geconcludeerd kan worden dat de relatie tussen de verpleegkundige bezetting minder duidelijk is dan de onderzoekers concluderen.
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BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities. METHODS: We conducted a cross-sectional study among 282 wards and 6,145 residents from 95 Dutch long-term care facilities. The relationship between the presence of BRNs in wards and quality of care was assessed, controlling for background characteristics, i.e. ward size, and residents' age, gender, length of stay, comorbidities, and care dependency status. Multilevel logistic regression analyses, using a generalized estimating equation approach, were performed. RESULTS: 57% of the wards employed BRNs. In these wards, the BRNs delivered on average 4.8 min of care per resident per day. Among residents living in somatic wards that employed BRNs, the probability of experiencing a fall (odds ratio 1.44; 95% CI 1.06-1.96) and receiving antipsychotic drugs (odds ratio 2.15; 95% CI 1.66-2.78) was higher, whereas the probability of having an indwelling urinary catheter was lower (odds ratio 0.70; 95% CI 0.53-0.91). Among residents living in psychogeriatric wards that employed BRNs, the probability of experiencing a medication incident was lower (odds ratio 0.68; 95% CI 0.49-0.95). For residents from both ward types, the probability of suffering from nosocomial pressure ulcers did not significantly differ for residents in wards employing BRNs. CONCLUSIONS: In wards that employed BRNs, their mean amount of time spent per resident was low, while quality of care on most wards was acceptable. No consistent evidence was found for a relationship between the presence of BRNs in wards and quality of care outcomes, controlling for background characteristics. Future studies should consider the mediating and moderating role of staffing-related work processes and ward environment characteristics on quality of care.
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Objective: To obtain insight into (a) the prevalence of nursing staff–experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff–perceived promotion of functional activity. Method: Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. Results: Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. Discussion: Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff–perceived promotion of functional activity.
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Purpose: The increasing number of cancer survivors has heightened demands on hospital-based follow-up care resources. To address this, involving general practitioners (GPs) in oncological follow-up is proposed. This study explores secondary care providers’ views on integrating GPs into follow-up care for curatively treated breast and colorectal cancer survivors. Methods: A qualitative exploratory study was conducted using semi-structured interviews with Dutch medical specialists and nurse practitioners. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis by two independent researchers. Results: Fifteen medical specialists and nine nurse practitioners participated. They identified barriers such as re-referral delays, inexperience to perform structured follow-up, and worries about the lack of oncological knowledge among GPs. Benefits included the GPs’ accessibility and their contextual knowledge. For future organization, they emphasized the need for hospital logistics changes, formal GP training, sufficient case-load, proper staffing, remuneration, and time allocation. They suggested that formal GP involvement should initially be implemented for frail older patients and for prevalent cancer types. Conclusions: The interviewed Dutch secondary care providers generally supported formal involvement of primary care in cancer follow-up. A well-organized shared-care model with defined roles and clear coordination, supported by individual patients, was considered essential. This approach requires logistics adaptation, resources, and training for GPs. Implications for cancer survivors: Integrating oncological follow-up into routine primary care through a shared-care model may lead to personalized, effective, and efficient care for survivors because of their long-term relationships with GPs.
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The equine industry faces increasing scrutiny regarding its social license to operate (SLO), with appropriate care for horses at its center. Grooms play a vital role in professional horse care and management, yet their own working conditions often remain poor, resulting in an increasing number leaving the industry. Building on previous research, this study explored grooms’ perspectives on the changes needed to improve their profession’s long-term viability, and the types of future initiatives they believe would effectively address these issues. An online survey targeting professional grooms received 1,318 valid responses. Thematic analysis was used to analyze qualitative responses to two questions focusing on aspects related to Sustainable Workforce and Future Initiatives. For Sustainable Workforce, 15 unique lower-order themes were grouped into four higher-order themes: Working Conditions, Recognition and Respect, Future Prospects and Personal Development, and Acceptance and Status Quo. For Future Initiatives, 19 lower-order themes were organized into three higher-order themes: Working Conditions, External Recognition, and Change in General. Participants considered improved working conditions—particularly better pay, reasonable working hours, and legal protections—vital to ensuring the sustainability of the grooming profession. Respondents emphasized the importance of initiatives that address such tangible improvements, in addition to aspects such as unionization and health support, rather than symbolic recognition alone. Addressing these issues is critical for improving job satisfaction, retaining grooms, and ensuring horse welfare, ultimately contributing to the industry's SLO and long-term viability.
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1e alinea column: Natuurlijk proberen we allemaal lessen te trekken uit wat er nu met de integratie van sociale media in de bedrijfsvoering gebeurt en waarom dit tot nieuwe business modellen en andere bedrijfsstructuren leidt. Eerder heb ik hier al toegelicht dat bedrijven projecten worden, crowd working, maar zover is het nog niet al gaat het wel snel..
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From the article: "AbstractFeedback plays a central role in learning. Crucial to this is the nature and timing ofthe feedback. This experimental study explores the efficacy of immediate computer-mediated feedback within a virtual reality environment designed to facilitate thedevelopment of pre-university students' presentation skills. Two conditions wereestablished to assess the efficacy: immediate computer-mediated feedback; a controlcondition of delayed expert-mediated feedback. Results showed improvement butno statistically relevant difference in performance gains between the two conditions,suggesting both can facilitate learning. Furthermore, students perceived the environ-ment to be an effective and motivating platform in which to practise presentationskills. For educators seeking viable alternatives to face-to-face presentation practiceand feedback, the finding that immediate computer-mediated feedback is potentiallyas effective in aiding presentation performance is crucial for two reasons: first, itexpands practice opportunities for students; second, it could result in less pressureon resources, including time and staffing."
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Bundeling van vijf essays, geschreven door hbo-studenten Social Work. Zij volgden in studiejaar 2023/2024 een half jaar de minor Inclusiviteit in de stad aan de Haagse Hogeschool. In die minor zoomen we in op hedendaagse uitsluitingsmechanismen die bepaalde groepen in onze samenleving extra hard treffen. Het centrale thema van de essays is inclusiviteit. In elk essay is te zien hoe belangrijk dit onderwerp is voor de nieuwe generatie. De auteurs gaan in op de verschillende dimensies van inclusiviteit, variërend van uitsluiting door armoede, door culturele verschillen maar ook door het kiezen van het beroep sekswerk. Uitsluiting heeft een diep effect op het welzijn van mensen, op toegankelijkheid tot instituties en op sociale rechtvaardigheid.
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