1,721,057 research outputs found
Defining a set of potentially preventable complications relevant to nursing: A Delphi Study among head nurses
No full textAim To establish a list of potentially preventable complications as a tool for nursing management. Background Different outcome parameters have been used in patient safety research. However, they have mainly been used for medical and administrative goals. The role of nurses in achieving patient safety outcomes has been given little attention. Method A three-round Web-based modified Delphi study was conducted in four hospitals, using the list of potentially preventable complications (PPCs) as a starting point. Consensus on a shortlist of nursing relevant complications was the endpoint. Results This study revealed a shortlist 12 PPCs relevant to the nursing profession, based on the expert opinion of more than sixty head nurses from different wards and hospitals. An overall consensus of 77.58% was reached. In surgical, medical and geriatric wards, a consensus of 95.7% was achieved. Conclusion This is the first study that points out which PPCs are related to nursing. The shortlist contains some of the most studied complications and can serve a wide variety of hospital wards. Implications for Nursing Management Prevention of complications reduces harm to patients and avoids the nursing work and costs to treat them. This list provides nursing managers with a powerful tool to raise awareness for risk assessment and preventive measures among nurses. It offers an instrument to facilitate the documentation and handover of patient safety outcomes in nursing. This shortlist can also serve as an assessment tool for patient safety interventions.An unrestricted university grant was provid
ACKNOWLEDGEMENTS
This article could only be realized thanks to the willing cooperation
of the participating hospitals and head nurses.ed for the first authorGrosemans, J (corresponding author), Hasselt Univ, Fac Med & Life Sci, Martelarenlaan 42, B-3500 Hasselt, Belgium.
[email protected]
Screening for Atrial Fibrillation in Belgium: a multicentre trial
No full textScreening for Atrial Fibrillation (AF) in Belgium: a multicentre trial
Claes Neree, Goethals Marnix, Goethals Peter, Mairesse Georges, Schwagten Bruno,
Nuyens Dieter, Schrooten Ward, Vijgen Johan
Introduction
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The estimated prevalence is 0.4-1% in the general population, increasing with age to 8% in those older than 80y - . Epidemiological data of this arrhythmia in Belgium are scarce. It is important to screen for AF because patients with AF have a 5 times more risk for an ischemic stroke . The CHA2DS2-VASscore calculates the risk for stroke in those patients, a score ≥2 necessitate a therapy with anticoagulants .
Methods
Patients above 40 years were invited through different channels (TV, radio, journals, website, posters, leaflets) for a free screening in 69 hospitals allocated over Belgium during one week. After filling in a question on their personal history of AF, they had to fill in a questionnaire about their CHAD2-score. Afterwards a one channel ECG was taken using a versatile Heart Scan Device (Omron HCG-801-E©) by a trained nurse or a physician. If the ECG was positive for AF the patient was referred to their physician for follow-up. An Access database was constructed to collect the data and statistics were done in SPSS.
Results
11.550 patients were screened. 38% are male and 62% are female with a mean age of 59y (+/-SD 11). 860 patients declared a history of AF (7.4%), 10.188 had no history of AF and in 502 the history was missing. 229 (1.9%) of the total population had AF on the one lead ECG where 148 were newly detected. According the CHADS2 68 patients had a score of 0, 70 of 1 and 91 of ≥2. For the CHA2DS2-VASscore the distribution was as follows: 14 patients with 0, 46 with 1 and 169 with ≥2.
Conclusion
Screening campaigns are feasible and able to detect 2% of patients with AF. A significant proportion of these patients are at risk for trombo-embolic event.
Go AS, Hylek EM, Philips KA et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhytm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-5.
Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994; 7:236-41.
Wolf PA, Abbott RD, Kannel WB. Atrial Fibrillation as an independent risk factor for stroke: teh Framingham Study. Stroke 1991;22:983-8.
Lip G, Pisters R, Crijns H. Refining clinical risk stratification using a novel risk factor based approach: The Euro Heart Survey on Atrial Fibrillation. Chest 2010;137:263-72.Sanofi Aventi
Screening for Atrial Fibrillation in Belgium: a multicentre trial
No full textScreening for Atrial Fibrillation (AF) in Belgium: a multicentre trial
Claes Neree, Goethals Marnix, Goethals Peter, Mairesse Georges, Schwagten Bruno,
Nuyens Dieter, Schrooten Ward, Vijgen Johan
Introduction
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The estimated prevalence is 0.4-1% in the general population, increasing with age to 8% in those older than 80y - . Epidemiological data of this arrhythmia in Belgium are scarce. It is important to screen for AF because patients with AF have a 5 times more risk for an ischemic stroke . The CHA2DS2-VASscore calculates the risk for stroke in those patients, a score ≥2 necessitate a therapy with anticoagulants .
Methods
Patients above 40 years were invited through different channels (TV, radio, journals, website, posters, leaflets) for a free screening in 69 hospitals allocated over Belgium during one week. After filling in a question on their personal history of AF, they had to fill in a questionnaire about their CHAD2-score. Afterwards a one channel ECG was taken using a versatile Heart Scan Device (Omron HCG-801-E©) by a trained nurse or a physician. If the ECG was positive for AF the patient was referred to their physician for follow-up. An Access database was constructed to collect the data and statistics were done in SPSS.
Results
11.550 patients were screened. 38% are male and 62% are female with a mean age of 59y (+/-SD 11). 860 patients declared a history of AF (7.4%), 10.188 had no history of AF and in 502 the history was missing. 229 (1.9%) of the total population had AF on the one lead ECG where 148 were newly detected. According the CHADS2 68 patients had a score of 0, 70 of 1 and 91 of ≥2. For the CHA2DS2-VASscore the distribution was as follows: 14 patients with 0, 46 with 1 and 169 with ≥2.
Conclusion
Screening campaigns are feasible and able to detect 2% of patients with AF. A significant proportion of these patients are at risk for trombo-embolic event.
Go AS, Hylek EM, Philips KA et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhytm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-5.
Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994; 7:236-41.
Wolf PA, Abbott RD, Kannel WB. Atrial Fibrillation as an independent risk factor for stroke: teh Framingham Study. Stroke 1991;22:983-8.
Lip G, Pisters R, Crijns H. Refining clinical risk stratification using a novel risk factor based approach: The Euro Heart Survey on Atrial Fibrillation. Chest 2010;137:263-72.Sanofi Aventi
Cardiovascular is a major cause of mortality and morbidity and its prevalence is set to increase
No full textCardiovascular is a major cause of mortality and morbidity and its prevalence is set to increase. While the benefits of medical and lifestyle interventions is established, the effectiveness of interventions which seek to improve the way preventive care is delivered in primary care is less so. The purpose was to study the effectiveness of 2 intervention programs in reducing cardiovascular risk factors within primary care.
Methods: A randomized controlled trial conducted in Belgium 2007-2010 with 295 participants allocated to a medical (=MP) and a medical + behavioral (=MBP) program. The MP consisted of medical assessments (screening and follow-up) by a general practitioner. The BP was a tailored behavior change program (web-based and individual coaching). The dose of the coaching was chosen by the participants. Primary outcome measures were total cholesterol, blood pressure, and body mass index (BMI). The secondary outcomes were smoking status, fitness-score, total cardiovascular risk and events.
Results: The median age was 40 years (IQR 32– 49), 75 participants were female, 6 had a personal cardiovascular event and 3 had diabetes. The median total cholesterol was 181,5 mg/dl (IQR 165 – 207), median systolic pressure 130 mmHg (IQR 120 – 140), median diastolic blood pressure 83 mmHg (IQR 75 - 90) and median BMI was 25 kg/ m² (IQR 22 - 27). Being a smoker was reported by 48 of the participants. There were no significant differences in baseline characteristics between MP and MBP. Our drop-out after three years of intervention was 13%. there was a significant decrease in total cholesterol (median difference: -4,5 mg/dl; p<0,001), systolic blood pressure (-1 mmHg; p=0,016), and diastolic blood pressure (-16,5 mmHg; p<0,001). There was a significant increase in BMI (+0,3 kg/m²; p<0,001). There were no significant differences found between MP and MBP in primary outcomes. At baseline, 48 participants were smoker compared to 29 at the study endpoint. Overall there was a significant decrease in fitness-score (median difference: -2; p=0,035). Calculation of the total cardiovascular risk for participants gave a median score of 0,35 (IQR 0,11 – 1,19) at baseline and 0,34 (IQR 0,091 – 1,11) at end-point (p<0,001). During the study period one participant in the MBP had a cardiovascular event.
Conclusion: Both intervention programs are effective in reducing cardiovascular risk factors. In our population the combined medical and behavioural program was not superior to the medical program
Evaluating the Effects of the COVID-19 Pandemic on HIV Testing, Enrollment, ART Use and Mortality in Suriname Using Interrupted Time Series Analysis
No full textOur study evaluates the changes in HIV testing, new enrollments in the HIV surveillance system, treatment, and mortality of people with HIV during and after the SARS-CoV-2 (COVID-19) pandemic in Suriname. A retrospective population-based study was conducted, using interrupted time series analyses with data from the HIV surveillance system from January 2013 until December 2023. The commencement of the COVID-19 pandemic lead to a decline in HIV testing, enrollment, treatment initiation, and the annual number of individuals receiving treatment, respectively, by 16%, 32%, 40%, and 2% in 2020 compared to 2019. The mortality rate among people with HIV went from 7.8 in 2019 to 26 per 100,000 in 2022. The regression model showed an immediate significant effect at the start of the COVID pandemic for the HIV enrollments and the yearly number of people on treatment. For HIV mortality there is significant sustained effect. An overall decline in HIV services resulted in an increased mortality in 2021 and 2022. Innovative strategies and additional human and financial investments are needed to regain and improve access to health services and reverse the current epidemical trend.We extend our appreciation to the different pharmacies, testing sites, laboratories and clinics who regularly report data on provided HIV services. Without their invaluable support we could not have developed the HIV patient master index which serves as the basis for many of our analysis
Cardiovascular is a major cause of mortality and morbidity and its prevalence is set to increase
No full textCardiovascular is a major cause of mortality and morbidity and its prevalence is set to increase. While the benefits of medical and lifestyle interventions is established, the effectiveness of interventions which seek to improve the way preventive care is delivered in primary care is less so. The purpose was to study the effectiveness of 2 intervention programs in reducing cardiovascular risk factors within primary care.
Methods: A randomized controlled trial conducted in Belgium 2007-2010 with 295 participants allocated to a medical (=MP) and a medical + behavioral (=MBP) program. The MP consisted of medical assessments (screening and follow-up) by a general practitioner. The BP was a tailored behavior change program (web-based and individual coaching). The dose of the coaching was chosen by the participants. Primary outcome measures were total cholesterol, blood pressure, and body mass index (BMI). The secondary outcomes were smoking status, fitness-score, total cardiovascular risk and events.
Results: The median age was 40 years (IQR 32– 49), 75 participants were female, 6 had a personal cardiovascular event and 3 had diabetes. The median total cholesterol was 181,5 mg/dl (IQR 165 – 207), median systolic pressure 130 mmHg (IQR 120 – 140), median diastolic blood pressure 83 mmHg (IQR 75 - 90) and median BMI was 25 kg/ m² (IQR 22 - 27). Being a smoker was reported by 48 of the participants. There were no significant differences in baseline characteristics between MP and MBP. Our drop-out after three years of intervention was 13%. there was a significant decrease in total cholesterol (median difference: -4,5 mg/dl; p<0,001), systolic blood pressure (-1 mmHg; p=0,016), and diastolic blood pressure (-16,5 mmHg; p<0,001). There was a significant increase in BMI (+0,3 kg/m²; p<0,001). There were no significant differences found between MP and MBP in primary outcomes. At baseline, 48 participants were smoker compared to 29 at the study endpoint. Overall there was a significant decrease in fitness-score (median difference: -2; p=0,035). Calculation of the total cardiovascular risk for participants gave a median score of 0,35 (IQR 0,11 – 1,19) at baseline and 0,34 (IQR 0,091 – 1,11) at end-point (p<0,001). During the study period one participant in the MBP had a cardiovascular event.
Conclusion: Both intervention programs are effective in reducing cardiovascular risk factors. In our population the combined medical and behavioural program was not superior to the medical program
CLINICAL PLACEMENT EXPERIENCE OF NURSING STUDENTS DURING THE COVID-19 PANDEMIC: A CROSS-SECTIONAL STUDY
No full textBackground The impact of the COVID-19 pandemic on our society is profound, not least for the healthcare sector. On the one hand, this exceptional situation created unprecedented learning opportunities for nursing students. Yet, on the other hand, this situation can jeopardise nursing students learning trajectory. Objectives To study nursing students‘ experiences during clinical placement during the COVID-19 pandemic. Design Cross-sectional survey design Settings Clinical placements during COVID-19 pandemic Participants Nursing students from nine Belgian nursing schools Methods All students enrolled in nursing education are eligible to participate. The survey consists of five dimensions: demographics, risk perception, self-efficacy, support and communication, and resilience. Results The gaps that were identified by students focused on the need for more psychosocial support, establishing (regular) contact with their clinical placement supervisor, recognition of the difficult work situation, and the need for more space to unwind. Conclusions Nursing students expressed a strong need to be heard, prepared, and supported. Most students felt supported by their nursing schools. Because of COVID-19, the role of the preceptor became more important; however, due to several reasons did not always meet the student‘s expectations. Preparing students for specific skills is needed. Finally, it is of the utmost importance that nursing schools coordinate with clinical sites on matters such as the responsibility for testing nursing students, the provisions of uniforms and personal protective equipment, and structurally sharing guidelines with students to provide safe patient careFunding:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors
Acknowledgments:
The authors would like to thank the all participating students, educators, and nurses involved
COST-EFFECTIVENESS OF CHILDHOOD TONSILLECTOMY COMPARED TO WATCHFUL WAITING: IMPACT OF ECONOMIC PRODUCTIVITY LOSS CAUSED BY PARENTS’ WORK ABSENTEEISM
No full textIntroduction and aim: Tonsillectomy is one of the most commonly performed surgical procedures in children. The main reason for performing this surgery is recurrent episodes of acute tonsillitis. Economic loss of productivity caused by parents’ work absenteeism is an underestimated factor in the total cost linked to children’s illness. The aim of this study was to investigate the cost-effectiveness of tonsillectomy compared to watchful waiting in children with recurrent episodes of acute tonsillitis and the role of economic productivity loss in this calculation.
Materials and Methods: 275 parents of children undergoing tonsillectomy in Ziekenhuis Oost Limburg provided information about their work absenteeism caused by their children’s surgery. Information about the work absence for an episode of acute tonsillitis was provided retrospectively. Information was assessed by a self-administered questionnaire. Socio-economic costs caused by the parents’ productivity loss were assessed based on the total labor cost calculated by the NIS in 2000 and converted to the year 2008. Costs of surgical procedure and hospital stay were calculated on resource use and personnel input in the participating Hospital. Hospitalization risk after tonsillectomy was considered to be comparable to hospitalization rate for acute tonsillitis.
Results: An episode of acute tonsillitis in the child results in a longer period of parents’ work absenteeism (mean:3.79 days, 95% CI:3.27-4.31) compared to tonsillectomy (mean:2.97 days, 95%, CI:2.61-3.31) leading to a higher cost of economic productivity loss caused by tonsillitis (746.06€) compared to tonsillectomy (584.65€). The general costs linked to surgical procedure correspond to 605.45€ per child. The general costs linked to an acute tonsillitis are estimated at 186.46€.
Conclusions: In children suffering from recurrent episodes of acute tonsillitis, watchful waiting results in a higher economic loss of productivity compared to tonsillectomy. At the level of cost-effectiveness, 1.2 episodes of acute tonsillitis per year justify a tonsillectomy.
(totale kost TE = 1190.102€, totale kost angina = 967.959€
Patient Views Towards Surgical Safety and Checklists Measure
No full textThe Patient Views Towards Surgical Safety and Checklists Measure (Bergs et al., 2018) was developed for the purposes of a study investigating the views patients have towards surgical safety and checklists. Eleven items were constructed, designed to measure perception of patient safety (2 items), attitudes towards the WHO surgical safety checklist (5 items) and attitudes regarding how the checklist is used in practice (4 items). Each item, except for the questions regarding the respondents’ perception of patient safety, was phrased as a statement. The measure was administered to a sample of Dutch patients (18-91 years). No reliability or validity data was provided for the measure. (PsycTESTS Database Record (c) 2018 APA, all rights reserved
Evolution of patient safety culture in Belgian hospitals after implementing a national patient safety plan
No full textIntroduction: Within a 5-year federal program on quality and safety (2007–2012), the Belgian government provided a framework for implementing quality and safety strategies in the acute, psychiatric and long-term care hospitals with attention to three pillars: structure, processes and outcome measurement. One of the main objectives in the federal program was the development of a safety culture.
This research sought to examine to what extent the hospitals' safety culture evolved after participating in the federal program and to what extent safety culture could be explained by predictor variables.
Methods: In order to measure safety culture within the Belgian hospitals, the Hospital Survey on Patient Safety Culture (HSPSC) was selected since it covers a broad range of patient safety aspects and previous research demonstrated good psychometric properties of the Dutch and French versions. The HSPSC includes 42 items that assess safety culture on 12 dimensions.
Between 2007 and 2009, 88% of all Belgian hospitals (180 out of 205) entered the federal program and conducted a baseline organization-wide safety culture measurement. In 2011, 91% of the hospitals (179 out of 197) conducted a second safety culture measurement. In order to track changes in safety culture after a period of three years, hospitals were invited to participate in a follow-up comparative research, organized by a neutral academic institution. Generalized Estimating Equations models were fitted to examine any existing relationships between safety culture predictor variables and each of the 12 safety culture dimensions.
Results: The Belgian safety culture benchmark database includes 115 827 records drawn from 176 hospitals. Of those, 147 hospitals conducted a first measurement (53.6% response rate) and 140 hospitals repeated the measurement after three years (50.6% response rate). A comparative report was provided to each hospital, including its position on each dimension, to facilitate internal assessment and learning in the patient safety improvement process
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