152 research outputs found
Mortality From Falls in Dutch Adults 80 Years and Older, 2000-2016
No full textFalls are a leading cause of health care consumption, morbidity, and mortality among older adults.1,2 Falls mortality in persons 80 years and older in the Netherlands decreased from 1969 through 1999, and then slightly increased from 2000 through 2008.3 We assessed trends in falls mortality in persons 80 years and older from 2000 through 2016.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Applied Ergonomics and Desig
Gevolgen van ernstige en zeer ernstige letsels
No full textThe effects of severe injuries can be charted using the International Classification of Functioning, Disability and Health (ICF) model and the burden of disease model, in which the burden of disease is expressed in 'disabilityadjusted life years' (DALYs). Severe accidents cause 10 DALYs per 1000 people, which is comparable with the burden of disease of mood disorders and lung cancer. In the Netherlands, severe injury victims are often males aged < 40 years, who are often injured in road traffic accidents. The average hospital stay after a severe injury is one month, after which almost 75% of the patients are discharged home, while one quarter subsequently stay in rehabilitation facilities for 36 months. More than half return to their original employment. Patients with thoracic and abdominal injuries recover relatively well, whereas injuries of the lower extremities, brain and spinal cord give a relatively poor prognosis. Comorbidity increases the chance of a less good recovery. Older people who survive an accident recover relatively well
Stijging lichte letsels bij de huisarts valt samen met daling op de SEH
No full textOBJECTIVE: In the past 10 years, there has been a decrease in the number of patients who report to the Emergency Department (ED) every year for injuries from accidents or violence, especially in the subgroup of patients who did not require hospital admission. We investigated how the number of injury-related emergency department visits and GP contacts evolved over the period 2013-2017. DESIGN: Retrospective observational trend study. METHOD: To calculate the trend in emergency department visits in the Netherlands, we used data from the injury information system (LIS) for the period 2013-2017. To calculate the trend in GP contacts (GP practices as well as GP centres), we used data from the NivelZorgregistraties (Nivel medical records). In order to compare the trends, we distinguished between minor and major injuries. The numbers from the records were extrapolated to numbers for the whole of the Netherlands. RESULTS: In the period studied, the number of patients with minor injuries who visited the ED dropped by 38.5%, while the number of patients with major injuries (fractures and brain injuries) increased by 4.1%. In the same period, the number of GP contacts for minor injuries at GP practices increased by 25% and at GP centres by 43%; the number of primary care contacts for major injuries increased by 5.1% (GP practices) and 31% (GP centres) respectively. CONCLUSION: The role of general practitioners in the treatment of patients with minor injuries is increasing. The trend in major injuries is a better indicator for monitoring accidents and violence in the Netherlands. Conflict of interest and financial support: none declared
How adequate are emergency department home and leisure injury surveillance systems for cross-country comparisons in Europe?
No full textThe objective of this study was to assess whether the emergency department (ED) injury surveillance systems in Europe are suitable for cross-country comparisons. For this, the ED injury surveillance systems in Austria, Denmark, Greece, Ireland, the Netherlands, Norway and the UK (England, Wales) were considered. Standardised injury incidence and healthcare utilisation indices were calculated and the influence of measurement bias due to data collection and sampling differences, as well as trauma policy and health systems characteristics were assessed. The results showed that there was an over 3-fold variation of the grossly estimated incidence for home and leisure injuries (HLIs), with the highest values observed in England and Greece (111 and 104 per 1000 person years), and the lowest in Ireland and the Netherlands (27 and 48 per 1000 person years). The ranking of countries changed, however, when only injuries with an inherent need for ED treatment were considered (selected radiological verifiable fractures) with Austria topping the table followed by Greece and England. Thus, it is concluded that the naive use of ED injury surveillance systems for cross-country comparisons should be discouraged, as this is subject to measurement bias. Nevertheless, the observed variation in the healthcare utilisation and injury incidence, particularly among children and older people, indicates the potential to reduce the burden of HLI in Europe
Assessing the optimal location for alcohol-based hand rub dispensers in a patient room in an intensive care unit
No full textBackground The introduction of alcohol-based hand rub dispensers has had a positive influence on compliance of healthcare workers with the recommended guidelines for hand hygiene. However, establishing the best location for alcohol-based hand rub dispensers remains a problem, and no method is currently available to optimize the location of these devices. In this paper we describe a method to determine the optimal location for alcohol-based hand rub dispensers in patient rooms. Methods We composed a method that consists of a combination of qualitative and quantitative research methods. Firstly, different arrangements of dispensers were determined based on the results of two types of assessment: workflow observations and interviews with nurses and physicians. Each arrangement was then evaluated using two types of assessment: interviews with nurses and physicians and electronic measurements of the user frequency of the dispensers. This procedure was applied in a single-bed patient room on a thoracic surgery intensive care unit. Results The workflow observations revealed that the activities of patient care were most often at the entrance and near the computer at the right side of the test room. Healthcare workers stated that the location of the dispenser should meet several requirements. Measurements of the frequency of use showed that the dispenser located near the computer, at the back of the room, was used less frequently than the dispenser located near the sink and the dispenser located at the entrance to the room. Conclusion The applied method has potential for determining the optimal location for alcohol-based hand rub dispensers in a patient room. Workflow observations and the expressed preferences of healthcare workers guide the choice for the location of alcohol-based hand rub dispensers. These choices may be optimized based on measurement of the frequency of use of the dispensers.Industrial DesignIndustrial Design Engineerin
Health-related quality of life after TBI: a systematic review of study design, instruments, measurement properties, and outcome
No full textMeasurement of health-related quality of life (HRQL) is essential to quantify the subjective burden of traumatic brain injury (TBI) in survivors. We performed a systematic review of HRQL studies in TBI to evaluate study design, instruments used, methodological quality, and outcome. Fifty-eight studies were included, showing large variation in HRQL instruments and assessment time points used. The Short Form-36 (SF-36) was most frequently used. A high prevalence of health problems during and after the first year of TBI was a common finding of the studies included. In the long term, patients with a TBI still showed large deficits from full recovery compared to population norms. Positive results for internal consistency and interpretability of the SF-36 were reported in validity studies. The Quality of Life after Brain Injury instrument (QOLIBRI), European Brain Injury Questionnaire (EBIQ), Child Health Questionnaire (CHQ), and the World Health Organization Quality of Life short version (WHOQOL-BREF) showed positive results, but evidence was limited. Meta-analysis of SF-36 showed that TBI outcome is heterogeneous, encompassing a broad spectrum of HRQL, with most problems reported in the physical, emotional, and social functioning domain. The use of SF-36 in combination with a TBI-specific instrument, i.e., QOLIBRI, seems promising. Consensus on preferred methodologies of HRQL measurement in TBI would facilitate comparability across studies, resulting in improved insights in recovery patterns and better estimates of the burden of TBI
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