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Browsing by Author "Koopmans, R.T.C.M."
Now showing items 1-13 of 13
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Effects on staff outcomes and process evaluation of the educating nursing staff effectively (TENSE) program for managing challenging behavior in nursing home residents with dementia: A cluster-randomized controlled trial Bielderman, A. ; Nieuwenhuis, A.F.M. ; Hazelhof, TJGM ; Gaal, B.G.I. van ; Schoonhoven, Lisette ; Akkermans, R. ; Spijker, A ; Koopmans, R.T.C.M. ; Gerritsen, D.L.2021, Article / Letter to editor (International Journal of Nursing Studies, vol. 120, (2021))Background: Challenging behavior is prevalent in people with dementia residing in nursing homes and places a high burden on the nursing staff of dementia special care units. This study evaluates an educational program for nursing staff for managing challenging behavior: The Educating Nursing Staff Effectively (TENSE) program. This program can be tailored to care organizations' wishes and needs and combines various learning styles. Objective: The aim of this cluster-randomized controlled trial was to examine the short-term (3 months) and long-term (9 months) effects of the TENSE training program on experienced stress, work contentment, and stress reactions at work in nursing staff working in dementia special care units. Design: Cluster-randomized controlled trial. Methods: Nursing staff members of 18 dementia special care units within nine nursing homes from different Netherlands regions were randomized into an intervention (n = 168) or control (n = 129) group. The TENSE program consisted of a three-day training course and two follow-up sessions after three and six months, respectively. The primary outcome was stress experienced by nursing staff measured with the Utrecht Burnout Scale - C. Secondary outcomes were work contentment and stress reactions at work. Furthermore, process evaluation data on the reach of and compliance with the program and the program's feasibility and relevance were collected. Data were collected between November 2012 and November 2014. Results: In general, the participants appreciated the quality and relevance of the TENSE training and evaluated the content of the training as beneficial. The TENSE training had no effect on the components of experienced stress, i.e., emotional exhaustion (p = 0.751), depersonalization (p = 0.701), and personal accomplishment (p = 0.182). Furthermore, no statistically significant effects of the intervention on work contentment and stress reactions at work were found. Conclusions: The TENSE training program did not have an effect on experienced stress, work contentment, nor stress reactions at work of nursing staff working in dementia special care units. In future studies, more focus on practicing new skills seems needed. (C) 2021 The Authors. Published by Elsevier Ltd. -
Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study Lovink, M.H. ; Vught, A.J.A.H. van ; Persoon, A. ; Koopmans, R.T.C.M. ; Laurant, M.G.H. ; Schoonhoven, Lisette2019, Article / Letter to editor (Nursing & Health Sciences, vol. 2019, iss. september, (2019), pp. 282-290)
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Physician Assistants (PA) en Verpleegkundig Specialisten (VS) in verpleeghuizen 2019, Article / Letter to editor (Tijdschrift voor Ouderengeneeskunde, vol. 2019, iss. 3, (2019))
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Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: a realist evaluation case study Lovink, M.H. ; Laurant, M.G.H. ; Vught, A.J.A.H. van ; Maassen, I.T.H.M ; Schoonhoven, Lisette ; Persoon, A. ; Koopmans, R.T.C.M.2019, Article / Letter to editor (BMJ Open, vol. 9, iss. 5, (2019)) -
Skill mix change between general practitioners, nurse practitioners, physician assistants and nurses in primary healthcare for older people: a qualitative study Lovink, M.H. ; Vucht, A.J.A.H. van ; Persoon, A. ; Schoonhoven, Lisette ; Koopmans, R.T.C.M. ; Laurant, M.G.H.2018, Article / Letter to editor (BMC Family Practice, vol. 19, iss. 1, (2018))
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The association between implementation and outcome of a complex care program for frail elderly people Ruikes, F.G.H. ; Gaal, B.G.I. van ; Oudshoorn, L. ; Zuidema, S.U. ; Akkermans, R.P. ; Assendelft, W.J.J. ; Koopmans, R.T.C.M.2018, Article / Letter to editor (Family Practice, vol. 35, iss. 1, (2018), pp. 6)
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Effects of substituting nurse practitioners, physician assistants or nurses for physicians concerning healthcare for the ageing population: a systematic literature review Lovink, M.H. ; Persoon, A. ; Koopmans, R.T.C.M. ; Vught, A.J.A.H. van ; Schoonhoven, Lisette ; Laurant, M.G.H.2017, Article / Letter to editor (Journal of Advanced Nursing, (2017))
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Nursing staff stress from challenging behaviour of residents with dementia: a concept analysis 2016, Article / Letter to editor (International Nursing Review - Sci, vol. 63, iss. 3, (2016), pp. 507-516)Aim: Provide insight into the concept of stress in the context of challenging behaviour of nursing home residents with dementia and its causes and consequences. Background: Challenging behaviour is frequent in residents with dementia, but consequences for nursing staff are unclear. Introduction: Challenging behaviour of residents can be enervating for nurses and may lead to stress. Although stress in general is associated with negative outcomes, an overview of stress in this context would be a welcome addition to the field. Method: Concept analysis according to Walker and Avant. Results: Identified antecedents of stress: physical and verbal aggression, conflicts, excessive demands and being unresponsive (residents), age, experience, tenure, nursing level and training (nursing staff). Defining attributes: disturbed homoeostasis and the personal appraisal of the situation. Identified consequences regard health, psychological aspects and behaviour. Discussion: Intervening in the identified factors may contribute to prevention of stress in nursing staff. Limitations: Given a lack of strong empirical studies, our analysis is not based on a high level of evidence and needs to be tested. Papers from before 1990 might have been missed. Conclusion: The concept analysis revealed that nursing staff stress in the context of challenging behaviour may result from resident and nursing staff factors. Besides health and psychological consequences, behavioural consequences can enormously impact the well-being of residents. Implications: Application in daily care to support teams in influencing resident and nursing staff factors could prevent stress, for instance using behavioural management training or recruiting higher educated nursing staff. Given the increasing complexity of care, creating specialized units with specifically trained staff for different groups of people with dementia may be desirable.
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Physician substitution by NPs, PAs and/or nurses in healthcare for older people Lovink, M.H. ; Persoon, A. ; Koopmans, R.T.C.M. ; Schoonhoven, Lisette ; Vught, A.J.A.H. van ; Laurant, M.G.H.2016, Article / Letter to editor (Journal of Advanced Nursing, vol. 72, (2016), pp. 96)
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Physician substitution by mid-level providers in primary healthcare for older people and long-term care facilities: protocol for a systematic literature review Lovink, M.H. ; Persoon, A. ; Vught, A.J.A.H. van ; Koopmans, R.T.C.M. ; Schoonhoven, Lisette ; Laurant, M.G.H.2015, Article / Letter to editor (Journal of Advanced Nursing, vol. 71, iss. 12, (2015), pp. 2998-3005)Aim. This protocol describes a systematic review that evaluates the effects of physician substitution by mid-level providers (nurse practitioners, physician assistants or nurses) in primary healthcare for older people and long-term care facilities. The secondary aim is to describe facilitators and barriers to the implementation of physician substitution in these settings. Background. Healthcare for older people is undergoing major changes, due to population ageing and reforms that shift care to the community. Besides, relatively few medical students are pursuing careers in healthcare for older people. Innovative solutions are needed to guarantee the quality of healthcare and to contain costs. A solution might be shifting care from physicians to mid-level providers. To date, no systematic review on this topic exits to guide policymaking. Design. A quantitative systematic literature review using Cochrane methods. Methods. The following databases will be searched for original research studies that quantitatively compare care provided by a physician to the same care provided by a mid-level provider: PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL and Web of Science. Study selection, data extraction and quality appraisal will be conducted independently by two reviewers. Data synthesis will consist of a qualitative analysis of the data. Funding of the review was confirmed in August 2013 by the Ministry of Health, Welfare and Sport of the Netherlands. Discussion. This review will contribute to the knowledge on effects of physician substitution in healthcare for older people and factors that influence the outcomes. This knowledge will guide professionals and policy administrators in their decisions to optimize healthcare for older people.
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Concurrent Incidence of Adverse Events in Hospitals and Nursing Homes Gaal, B.G.I. van ; Schoonhoven, Lisette ; Mintjes-de Groot, JAJ ; Defloor, T. ; Habets, H ; Voss, Andreas ; Achterberg, Theo van ; Koopmans, R.T.C.M.2014, Article / Letter to editor (Journal of Nursing Scholarship, vol. 46, iss. 3, (2014), pp. 187-198)Purpose To describe the concurrent incidence of pressure ulcers, urinary tract infections, and falls in hospitals and nursing homes, and the preventive care given. Additionally, the correlation between the occurrence of these adverse events and preventive care was explored. Design and Settings A prospective, 3-month, cohort study at 10 hospitals and 10 nursing homes in the Netherlands. Participants 687 hospital patients and 241 nursing home patients. Main Outcome Measures The incidence of three adverse events and preventive care given to patients at risk. During weekly visits, the patients and their files were assessed. Additionally, observations were performed. Results Seventy-seven hospital patients (11%) and 111 nursing home patients (46%) developed one or more adverse events. The incidence rate for both types of patients, and for the three adverse events combined, was 9% adverse events per patient week. In hospitals, 34% of the patients received adequate pressure ulcer preventive care, while 47% of the patients received adequate urinary tract infection preventive care, and none of the patients received adequate falls preventive care. In nursing homes, 18% of the patients received adequate pressure ulcer preventive care, 42% of the patients received adequate urinary tract infection preventive care, and less than 1% of the patients received adequate falls prevention care. Negative or no correlations were found between the incidence rates for the three adverse events. In nursing homes the incidence of pressure ulcers and preventive care were positively correlated. Conclusions There is a high incidence of adverse events in hospitals and nursing homes. Many patients at risk do not receive adequate preventive care.
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The CareWell-primary care program: design of a cluster controlled trial and process evaluation of a complex intervention targeting community-dwelling frail elderly Ruikes, F.G.H. ; Meys, ARM ; Wetering, G. van de ; Akkermans, R.P. ; Gaal, B.G.I. van ; Zuidema, S.U. ; Schers, H.J. ; Achterberg, Theo van ; Koopmans, R.T.C.M.2012, Article / Letter to editor (BMC Family Practice, vol. 13, (2012))Background: With increasing age and longevity, the rising number of frail elders with complex and numerous health-related needs demands a coordinated health care delivery system integrating cure, care and welfare. Studies on the effectiveness of such comprehensive chronic care models targeting frail elders show inconclusive results. The CareWell-primary care program is a complex intervention targeting community-dwelling frail elderly people, that aims to prevent functional decline, improve quality of life, and reduce or postpone hospital and nursing home admissions of community dwelling frail elderly. Methods/design: The CareWell-primary care study includes a (cost-) effectiveness study and a comprehensive process evaluation. In a one-year pragmatic, cluster controlled trial, six general practices are non-randomly recruited to adopt the CareWell-primary care program and six control practices will deliver 'care as usual'. Each practice includes a random sample of fifty frail elders aged 70 years or above in the cost-effectiveness study. A sample of patients and informal caregivers and all health care professionals participating in the CareWell-primary care program are included in the process evaluation. In the cost-effectiveness study, the primary outcome is the level of functional abilities as measured with the Katz-15 index. Hierarchical mixed-effects regression models / multilevel modeling approach will be used, since the study participants are nested within the general practices. Furthermore, incremental cost-effectiveness ratios will be calculated as costs per QALY gained and as costs weighed against functional abilities. In the process evaluation, mixed methods will be used to provide insight in the implementation degree of the program, patients' and professionals' approval of the program, and the barriers and facilitators to implementation. Discussion: The CareWell-primary care study will provide new insights into the (cost-) effectiveness, feasibility, and barriers and facilitators for implementation of this complex intervention in primary care.
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The effect of the SAFE or SORRY? programme on patient safety knowledge of nurses in hospitals and nursing homes: A cluster randomised trial Gaal, B.G.I. van ; Schoonhoven, Lisette ; Vloet, L.C.M. ; Mintjes, Joke ; Borm, George ; Koopmans, R.T.C.M. ; Achterberg, Theo van2010, Article / Letter to editor (International Journal of Nursing Studies, vol. 47, iss. 9, (2010), pp. 1117-1125)Background: Patients in hospitals and nursing homes are at risk for the development of often preventable adverse events. Guidelines for the prevention of many types of adverse events are available, however compliance with these guidelines appears to be lacking. As a result many patients do not receive appropriate care. We developed a patient safety program that allows organisations to implement multiple guidelines simultaneously and therefore facilitates guideline use to improve patient safety. This program was developed for three frequently occurring nursing care related adverse events: pressure ulcers, urinary tract infections and falls. For the implementation of this program we developed educational activities for nurses as a main implementation strategy. Objectives: The aim of this study is to describe the effect of interactive and tailored education on the knowledge levels of nurses. Design: A cluster randomised trial was conducted between September 2006 and July 2008. Settings: Ten hospital wards and ten nursing home wards participated in this study. Prior to baseline, randomisation of the wards to an intervention or control group was stratified for centre and type of ward. Participants: All nurses from participating wards. Methods: A knowledge test measured nurses' knowledge on the prevention of pressure ulcers, urinary tract infections and falls, during baseline en follow-up. The results were analysed for hospitals and nursing homes separately. Results: After correction for baseline, the mean difference between the intervention and the control group on hospital nurses' knowledge on the prevention of the three adverse events was 0.19 points on a zero to ten scale (95% Cl: -0.03 to 0.42), in favour of the intervention group. There was a statistically significant effect on knowledge of pressure ulcers, with an improved mean mark of 0.45 points (95% Cl: 0.10-0.81). For the other two topics there was no statistically significant effect. Nursing home nurses' knowledge did neither improve (0 points, Cl: -0.35 to 0.35) overall, nor for the separate subjects. Conclusion: The educational intervention improved hospital nurses' knowledge on the prevention of pressure ulcers only. More research on long term improvement of knowledge is needed.
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