New Virtual Care Centers (VCCs) within hospitals utilize information technology to remotely monitor and support patients with chronic diseases living at home. Nurses play a crucial role by providing remote coaching and guidance to help patients manage their conditions. Currently, there is a growing understanding regarding the evolving roles and responsibilities of nurses in VCCs, however studies have yet to establish connections with educational frameworks, which poses a challenge for nursing education programs to prepare students for this emerging professional role effectively. Our study aimed to provide insights into the evolving roles, tasks, and responsibilities of nurses providing remote care as per the CanMEDS framework. We conducted a qualitative content analysis of 15 interviews. Nursing work within VCCs is represented by the seven CanMEDS roles. Most tasks align with the roles of Leader and Collaborator, while Quality Promotor has the fewest. Our study maps the responsibilities and tasks of VCCs' care delivery to the core roles of nurses.
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Virtual care centres (VCCs) are novel wards of hospitals and facilitate the provision of remote monitoring and home-based patient care by virtual care nurses. Whereas since the COVID-19 pandemic VCCs have rapidly emerged, there is a lack of insight in virtual care nurses’ work and the associated work load. Therefore, the aim of this study was to identify the nursing activities performed in Virtual Care Centers (VCCs) and assess nurses’ perceived workload associated with these activities. A multicentre descriptive, observational cross-sectional study was performed.
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Seven college lecturers and two senior support staff were interviewed during 2021 about their experiences teaching in hybrid virtual classrooms (HVC). These technology-rich learning environments allow teachers to simultaneously teach students who are in class (on campus) and students who are joining remotely (online). There were two reasons for this choice: first, ongoing experimentation from innovative teaching staff who were already using this format before the COVID-19 pandemic; secondly, as a possible solution to restrictions on classroom size imposed by the pandemic. Challenges lecturers faced include adjusting teaching practice and lesson delivery to serve students in the class and those online equally; engaging and linking the different student groups in structured and natural interactions; overcoming technical challenges regarding audio and visual equipment; suitably configuring teaching spaces and having sufficient pedagogical and technical support to manage this complex process. A set of practical suggestions is provided. Lecturers should make reasoned choices when teaching in this format since it requires continued experimentation and practice to enhance the teaching and learning opportunities. When external factors such as classroom size restrictions are the driving force, the specific type of synchronous learning activities should be carefully considered. The structure and approach to lessons needs to be rethought to optimise the affordances of the hybrid virtual and connected classroom. The complexity of using these formats, and the additional time needed to do it properly, should not be underestimated. These findings are consistent with previous literature on this subject. An ongoing dialogue with faculty, support staff and especially students should be an integral part of any further implementation in this format.
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1 Maternity services across Europe during the pandemic has undergone changes to limit virus transmission; however, many changes are not evidence-based. 2 Although these changes were introduced to keep women, babies and healthcare staff safe, the exclusion of companions and the separation of mothers and babies is particularly antithetical to a human rights-based approach to quality care. 3 A poll of COST Action 18211 network members showed that inconsistency in the application of restrictions was high, and there were significant deviations from the recommendations of authoritative bodies. 4 Concerns have emerged that restrictions in practice may have longer term negative impacts on mothers and their families and, in particular, may impact on the long-term health of babies. 5 When practice changes deviate from evidence-based frameworks that underpin quality care, they must be monitored, appraised and evaluated to minimise unintended iatrogenic effects.
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Collaborative Online International Learning (COIL) is often framed as an example of a broader practice known as Virtual Exchange (VE). The term Virtual Exchange has increasingly been used as an attempt to unify a fragmented field of Higher Education practice and is often used interchangeably with the term COIL. However, the design of COIL, with its strong focus on collaborative and intercultural learning, is often very different to other VE initiatives. Labelling all VE initiatives, including COIL, generally as VE, can lead to both educators and researchers having difficulty identifying and distinguishing COIL. Therefore, the purpose of this paper is to provide a critical review of VE and define COIL and its key characteristics. This article also describes how theory can inform practice and explains why continued interchangeable use of the term COIL with the umbrella term Virtual Exchange is unhelpful for future research and practice.
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In the Netherlands, client and family participation in care for people with intellectual disabilities has been in vogue for a long time, and increasingly receives attention (KPMG and Vilans 2017). However, the perspective and experiential knowledge of service users and relatives is often still insuBiciently used for the co-creation of care. The professional perspective is often still dominant. In addition, professionals mainly focus on clients and less on relatives, even though relatives often play an important role in the client’s (quality of) life (Wiersma 2017). The project ‘Inclusive Collaboration in Disability Care’[1] (ICDC) focusses on enhancing equal communication between people with intellectual disabilities, their relatives, and professional caregivers, and hence contributes to redressing power imbalances in longterm care. It investigates the question: “How can the triangle of client, relative and professional caregiver together co-create better care and support?”.
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Our study shows a steady increase in dementia- and DHT-related publications, particularly in areas such as mobile health, virtual reality, artificial intelligence, and sensor-based technologies interventions. This increase underscores the importance of systematic approaches and interdisciplinary collaborations, while identifying knowledge gaps, especially in lower-income regions. It is crucial that researchers worldwide adhere to evidence-based medicine principles to avoid duplication of efforts. This analysis offers a valuable foundation for policy makers and academics, emphasizing the need for an international collaborative task force to address knowledge gaps and advance dementia care globally.
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In November 2019, scholars and practitioners from ten higher education institutions celebrated the launch of the iKudu project. This project, co-funded by Erasmus [1], focuses on capacity development for curriculum transformation through internationalisation and development of Collaborative Online International Learning (COIL) virtual exchange. Detailed plans for 2020 were discussed including a series of site visits and face-to-face training. However, the realities of the COVID-19 pandemic disrupted the plans in ways that could not have been foreseen and new ways of thinking and doing came to the fore. Writing from an insider perspective as project partners, in this paper we draw from appreciative inquiry, using a metaphor of a mosaic as our identity, to first provide the background on the iKudu project before sharing the impact of the pandemic on the project’s adapted approach. We then discuss how alongside the focus of iKudu in the delivery of an internationalised and transformed curriculum using COIL, we have, by our very approach as project partners, adopted the principles of COIL exchange. A positive impact of the pandemic was that COIL offered a consciousness raising activity, which we suggest could be used more broadly in order to help academics think about international research practice partnerships, and, as in our situation, how internationalised and decolonised curriculum practices might be approached. 1. KA2 Erasmus+ Cooperation for innovation and the exchange of good practices (capacity building in the field of Higher Education)
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Background: Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To date, a framework of nurses' competences on knowledge, skills, and attitudes as to interprofessional pharmaceutical care tasks is missing. Objectives: To reach agreement with experts about nurses' competences for tasks in interprofessional pharmaceutical care. Methods: A two-phase study starting with a scoping review followed by five Delphi rounds was performed. Competences extracted from the literature were assessed by an expert panel on relevance by using the RAND/UCLA method. The experts (n = 22) involved were healthcare professionals, nurse researchers, and educators from 14 European countries with a specific interest in nurses' roles in interprofessional pharmaceutical care. Descriptive statistics supported the data analysis. Results: The expert panel reached consensus on the relevance of 60 competences for 22 nursing tasks. Forty-one competences were related to 15 generic nursing tasks and 33 competences were related to seven specific nursing tasks. Conclusions: This study resulted in a competence framework for competency-based nurse education. Future research should focus on imbedding these competences in nurse education. A structured instrument should be developed to assess students' readiness to achieve competence in interprofessional pharmaceutical care in clinical practice.
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Background: The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective: In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods: Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results: A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions: Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.
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