Introduction: Modern safety approaches in healthcare differentiate between daily practice (work-as-done) and the written rules and guidelines (work-as-imagined) as a means to further develop... Show moreIntroduction: Modern safety approaches in healthcare differentiate between daily practice (work-as-done) and the written rules and guidelines (work-as-imagined) as a means to further develop patient safety. Research in this area has shown case study examples, but to date lacks hooking points as to how results can be embedded within the studied context. This study uses Functional Analysis Resonance Method (FRAM) for aligning work-as-imagined with the work-as-done. The aim of this study is to show how FRAM can effectively be applied to identify the gap between work prescriptions and practice, while subsequently showing how such findings can be transferred back to, and embedded in, the daily ward care process of nurses. Methods: This study was part of an action research performed among ward nurses on a 38 bed neurological and neurosurgical ward within a tertiary referral centre. Data was collected through document analysis, in-field observations, interviews and group discussions. FRAM was used as an analysis tool to model the prescribed working methods, actual practice and the gap between those two in the use of physical restraints on the ward. Results This study was conducted in four parts. In the exploration phase, work-as-imagined and work-as-done were mapped. Next, a gap between the concerns named in the protocol and the actual employed methods of dealing with physical restraint on the ward was identified. Subsequently, alignment efforts led to the co-construction of a new working method with the ward nurses, which was later embedded in quality efforts by a restraint working group on the ward. Conclusion The use of FRAM proved to be very effective in comparing work-as-done with work-as-imagined, contributing to a better understanding, evaluation and support of everyday performance in a ward care setting. Show less
Bahlman-van Ooijen, W.; Belle, E. van; Bank, A.; Man-Van Ginkel, J. de; Huisman-de Waal, G.; Heinen, M. 2022
Aims: To explore and describe hospital nurses' perceptions of leadership behaviours in facilitating patient participation in fundamental care. Design: An ethnographic interview study. Methods:... Show moreAims: To explore and describe hospital nurses' perceptions of leadership behaviours in facilitating patient participation in fundamental care. Design: An ethnographic interview study. Methods: Individual semi-structured interviews with 12 nurses with a bachelor's or master's degree working at a university medical centre were conducted between February and April 2021. The interview data were analysed using thematic analysis. Results: Six themes were derived from the data: (1) nursing leadership; (2) patient participation; (3) using patients' preferences; (4) building relationships; (5) task-focused nursing; (6) need for role modelling. Conclusion: Nurses indicated leadership behaviour to facilitate patient participation in fundamental care as inviting patients to participate and eliciting and supporting patients' preferences. Although nurses also regarded leadership as motivating colleagues to act and enhancing evidence-based practice, they appeared not to practise this themselves about patient participation. Role modelling was indicated as a need for improvement. Impact: The findings established that not all leadership behaviours mentioned were used in practice about patient participation in fundamental care. Role modelling and the use of evidence-based practice are needed to increase patient participation. Further research will be necessary to develop and test leadership interventions to improve patient participation in fundamental care. Show less
Smits, R.M.; Veldhuijzen, D.S.; Middendorp, H. van; Heijden, M.J.E. van der; Dijk, M. van; Evers, A.W.M. 2022
Objectives: Placebo effects, beneficial treatment outcomes due to non-active treatment components, play an important role in the overall treatment response. To facilitate these beneficial effects... Show moreObjectives: Placebo effects, beneficial treatment outcomes due to non-active treatment components, play an important role in the overall treatment response. To facilitate these beneficial effects it is important to explore the perspectives of health care professionals (HCPs) on the integration of placebo effects in clinical care. Three themes were investigated: knowledge about placebo effects and factors that contribute to these, frequency of placebo use, and attitudes toward acceptability and transparency of placebo use in treatment.Methods: A cross-sectional survey, according to the Checklist for Reporting Results of Internet E-Surveys guidelines and STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE), was conducted in the Netherlands in 2020. The survey was conducted in two samples: a (nested) short survey in 78 nurses during working shifts (sample 1) and an extended online survey in 47 general HCPs e.g., medical psychologists, oncologists, surgeons (sample 2).Results: Respondents from both samples reported to be somewhat or quite familiar with placebo effects (24.0 and 47.2%, respectively). From the six placebo mechanisms that were presented, mind-body interaction, positive expectations, and brain activity involved in placebo effects were rated as the most influential factors in placebo effects [F-(5,F-119) = 20.921, p < 0.001]. The use of placebo effects was reported in 53.8% (n = 42) of the nurses (e.g., by inducing positive expectations), and 17.4% of the HCPs (n = 8 reported to make use of pure placebos and 30.4% of impure placebos (n = 14). Attitudes toward placebo use in treatment were acceptant, and transparency was highly valued (both up to 51%).Conclusions: The findings from this study address knowledge gaps in placebo effects in practice and provide insights in attitudes toward the integration of placebo effects from HCPs. Altogether, integrating these findings may potentially optimize treatment outcomes. Show less
Wijn, A.N. de; Fokkema, M.; Doef, M. P. van der 2021
Aims: This study aims to assess the prevalence of stress-related outcomes (burnout, sleep problems and post-traumatic stress) and occupational well-being (work engagement, job satisfaction and... Show moreAims: This study aims to assess the prevalence of stress-related outcomes (burnout, sleep problems and post-traumatic stress) and occupational well-being (work engagement, job satisfaction and turnover intention) of Dutch emergency room nurses and to identify job factors related to key outcomes. Background: While emergency nurses are prone to stress-related outcomes, no large-scale studies have been conducted in the Netherlands. Furthermore, few studies considered combined effects of job factors on emergency nurses’ well-being. Methods: In 2017, an occupation-specific survey was filled out by 701 (response: 74%) emergency nurses from 19 Dutch hospitals. Decision tree methods were used to identify the most important (combination of) job factors related to key outcomes. Results: High prevalence of stress-related outcomes and turnover intention were found, while the majority experienced work engagement and were satisfied with their job. Emotional exhaustion was mainly associated with worktime demands and aggression/conflict situations. Work engagement was mainly associated with developmental opportunities. Conclusions: Dutch emergency room nurses are at risk of stress-related outcomes and have high turnover intention, while feeling engaged and satisfied with their job. Implications for Nursing Management: To retain and attract emergency room nurses, it is recommended to focus efforts on increasing developmental opportunities, while reducing worktime demands and aggression incidents. Show less
Pisanti, R.; Van der Doef, M.; Maes, S.; Lombardo, C.; Lazzari, D.; Violani, C. 2015
