Research

Abstract

Our current healthcare system faces difficulties in meeting the growing need for recruiting and retaining healthcare professionals. By 2030, there is a projected shortage of 18 million healthcare workers, the majority of whom are nurses. In addition to the upcoming wave of retirements, the increasing shortage is aggravated by a significant number of nurses opting to leave the profession. A noteworthy finding is that nurses are particularly vulnerable to drop-out during the early stages of their careers, as they transition from undergraduate nursing students to novice professionals. This transition-to-practice is a precarious moment in the developmental trajectory of nurses. When aiming to impact nurse retention, professional identity development proves to be of fundamental importance. However, studies investigating the concept of professional identity – and its associated concepts – in the context of transition-to-practice are sparse. Moreover, strategies that positively influence early-career retention are lacking. Therefore, the present study delves into professional identity development in nursing students and novice nurses during their transition to practice. Focused on professional identity, self-leadership, resilience, and emotional intelligence, it aims to create a targeted transition-to-practice intervention, essential for improving retention in the nursing profession.

Researcher(s)

• Promoter: Franck Erik
• Co-promoter: Goossens Eva
• Fellow: Vanuytrecht Janne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Healthcare organizations worldwide are under increasing pressure to deliver safe, high-quality care while navigating budgetary constraints, underscoring the imperative for quality enhancements. Nurses, as frontline providers, play a central role in improving care delivery and outcomes. However, the effectiveness of quality improvement initiatives (QI) remains highly variable, with contextual factors playing a crucial role. This research project aims to investigate the impact of contextual factors and competencies on the presence of a culture of continuous QI within nursing teams at the microsystem level in acute care settings. Drawing from existing literature and a qualitative study, a conceptual framework outlining contextual factors and competencies was developed. Subsequently, a measurement tool was constructed and validated to assess the QI culture within nursing teams. A multicentre cross-sectional study will be conducted in to investigate the presence of contextual factors and competencies within nursing teams and their impact on the efficacy of QI efforts and perceived quality of care. Findings from this study will inform the development of a toolkit in collaboration with subject matter experts, aimed at fostering a culture of continuous QI within nursing teams. The research outcomes have the potential to advance scientific understanding and guide healthcare organizations in cultivating a QI culture, ultimately enhancing the quality and safety of care delivery.

Researcher(s)

• Promoter: Franck Erik
• Co-promoter: Van Bogaert Peter
• Fellow: Slootmans Stijn

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

The SIMNPACT project aims to empower healthcare education in Europe by advancing interprofessional simulation education (ISE) for nursing and medicine undergraduates. Healthcare educators and practitioners will be equipped with a research-informed SIMNPACT-toolbox and associated training opportunities to successfully implement interprofessional simulation education. The goal is to promote collaboration, innovation and inclusive educational environments that improve healthcare quality across Europe

Researcher(s)

• Promoter: Haegdorens Filip

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project
• Education Project

Abstract

To set up a scientific program as guidance for the Wit-Gele Kruis van Antwerpen quality and patient safety policy and strategy additional to a first 3 year period during second 2 year period with the focus on the ANCC Pathway of Excellence program® as well as to identify and implement quality and patient safety indicators in daily practice. To implement the SaaS Balance Nursing Teams for home care organizations as well as to support a study trip in Canada and US visiting exemplary home care organizations and academic partners.

Researcher(s)

• Promoter: Van Bogaert Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

The care and welfare sector in the Flemish-Dutch border region has been facing significant challenges for several years. With the growing demand for care and an aging population, the shortage of qualified workers is expected to increase exponentially in the future. According to the Care and Welfare (NL) forecast model, the province of North Brabant is projected to experience a shortage of nearly 17,000 care workers by 2030. Additionally, the province of Antwerp is already facing a 15% shortage in filling open care vacancies, as reported by VDAB (Flemish Employment Service). Furthermore, Verso, an employers' federation, has calculated that the social profit sector in Flanders will require 46,000 new employees annually until 2026. Apart from the quantitative challenges, there are also qualitative issues where the skills provided by care professionals do not adequately align with the changing competency requirements in the field. This issue was highlighted in the Interreg VL-NL project ZORO, which emphasized the need for technological agility in care innovations, digitalization, and intra- and interprofessional collaboration. Research indicates that the work environment of healthcare providers significantly affects job satisfaction, with care environments that prioritize interprofessional collaboration experiencing fewer professionals considering leaving the profession. Additionally, there is a demand for support in developing the competencies required for digitalized care. By equipping (future) caregivers with tools to enhance their technological agility, we can empower them in their practice, foster a positive attitude toward the care profession, improve their well-being, and indirectly impact workforce retention and recruitment. To address these challenges, a key element is to provide (future) care providers with opportunities to learn and develop within robust learning environments that strongly emphasize the connection between education and the labor market, interprofessional collaboration, and technological agility. In response to these challenges and opportunities, our project aims to facilitate strong cross-border cooperation between educational institutions. The goal is to strengthen the connection between education and the needs of the care labor market by establishing hybrid learning environments. Based on the identified opportunities, we envision a significant impact by offering enhanced support to (future) care providers through powerful simulation environments and training programs that prioritize the connection between education and the labor market, interprofessional collaboration, and the evolving nature of (highly) technological care settings.

Researcher(s)

• Promoter: Haegdorens Filip

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

There is a growing staff shortage in healthcare. Many healthcare professionals want to leave healthcare or are doing so. Together we care focuses on retaining healthcare professionals and strengthening their adaptive & innovative capacity. This cross-border Interreg project is a follow-up to the previous projects Stay @ work and Care2Adapt. Specifically, this project offers several free pathways for healthcare and welfare organisations: Pathway Team Champions: for team members working bottom-up to increase resilience. Pathway Leadership to captivate and engage: for managers working on developing a positive leadership style. Pathway Simuleerkracht: for nurses starting a training programme to increase resilience Pathway Care2Adapt: for employees who will fulfil a bridging function between innovation and the workplace. We are also developing an instrument to measure, among other things, resilience of individuals and teams, allowing more data-driven (to reality) action to be taken. In addition to contextual data and data from self-reports, this application will also integrate data from activity trackers, providing additional information on physiological parameters around stress and resilience of healthcare staff and teams.

Researcher(s)

• Promoter: Franck Erik
• Co-promoter: Haegdorens Filip
• Co-promoter: Van Bogaert Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project website

Project type(s)

• Research Project

Abstract

Healthcare is under increasing pressure. In this age, the health workforce shortage is rising, where nurses represent the largest professional group. Attracting and retaining healthcare workers is, therefore, of fundamental importance to ensure a viable workforce and deliver excellent quality of patient care. Research demonstrated that, especially during the early career stage, nurses proved particularly vulnerable to drop-out. This transition-to-practice is a precarious moment in the developmental trajectory of professional role identity, self-leadership behavior, and individual professional resilience. However, studies investigating the transition from nursing education to practice and factors related to early career retention are sparse. The present project aims to provide empirical research into the transition-to-practice, thereby focusing on the theoretical concepts of professional role identity, self-leadership, and professional resilience. Research on the factors that influence these important constructs is fundamental to developing a transition-to-practice program contributing to the retention of professional novice nurses.

Researcher(s)

• Promoter: Franck Erik
• Co-promoter: Goossens Eva
• Fellow: Vanuytrecht Janne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Healthcare services such as acute care hospitals are confronted with challenges to attract and retain nurses in order provide high quality of care and a safe environment for patients. Currently, the nursing profession is considered as a bottleneck profession. Balance Nursing Teams or BNuT is a software-as-a-service (SAAS) which allows informed strategic, tactical, and operational decision-making by using relevant and available data on nursing teams and their patients. The aim of BNuT is to align team composition (numbers, skill mix, qualifications, and competencies) with components of team capacity, reliability, and efficiency to guarantee desirable team and patient outcomes. This PhD-project will examine how nursing team should be composed and has three research objectives: the relationships between team composition on the one hand and the other key capacity and efficient and reliable performance factors and how do they jointly impact nursing care team outcomes; identify the key parameters within the BNuT database to explain differences in team and patient outcomes and how to utilize knowledge on key concepts and parameters to improve nursing teams over time. The study sample contains 12 acute care hospitals that are using the BNuT system. For each hospital 8 nursing units have been selected such as medical or surgical nursing units, combined medical and surgical nursing units and geriatric nursing units. BNuT implementation started in four hospitals in February 2021. This means the PhD applicant will use the existing dataset together collected data up to October 30th, 2024 to achieve a dataset with a duration of at least two years. To our knowledge, the proposed project's aim is new, innovative and neither studied nor implemented in practice nationally or internationally. Our findings will provide a better insight for decision makers in healthcare organizations as well as policy makers to understand how to put in place resources to achieve desirable outcomes in healthcare. By examining a wide variety of compositional characteristics as well as key team-level context factors using data mining and scenario analyses, we can create a better theoretical understanding of what constitutes an optimal nursing team composition.

Researcher(s)

• Promoter: Van Bogaert Peter
• Co-promoter: De Meulenaere Kim
• Co-promoter: Willem Lander
• Fellow: Vleminckx Senne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Within Western countries, the number of pregnancies and deliveries in women afflicted with acquired, congenital or inherited cardiovascular disease is significantly growing. Unfortunately, maternal heart disease is currently the leading cause of non-obstetric mortality in women during pregnancy, accounting for 33% of pregnancy-related deaths globally. To increase chances of a successful pregnancy with safeguarding maternal and fetal health on the long term, the provision of care by a multidisciplinary pregnancy heart team is recommended by several scientific and professional bodies. These European and American guidelines endorse the establishment of a joint cardio-obstetric outpatient clinic aiming to reduce the risk for adverse pregnancy outcomes. Such a Pregnancy Heart Clinic should integrate several components, including pre-conceptual counselling, perinatal risk assessment, antenatal care and post-partum follow-up. Hence, as the cohort of women of childbearing age with underlying CVD is ever growing, the evaluation of the effectiveness of a cardio-obstetric model of care is urgently needed. Although several guidelines recommend the creation of a Pregnancy Heart Clinic, these recommendations are currently largely eminence-based, urging the provision of empirical evidence as underpinning. To date, little empirical evidence is available on the patient-reported needs, organizational challenges and effectiveness of this care model in terms of feto-maternal outcomes. As maternal cardiovascular mortality and morbidity are to be considered a public health emergency, studies are needed to gain insight into successful strategies on how to create a dedicated clinic that incorporates multiple guideline-recommended components. Hence, this research project primarily aims to develop, implement and evaluate a multidisciplinary integrated care pathway for women with cardiovascular disease before, during and after pregnancy involving relevant stakeholders. To achieve this primary aim, several research objectives will be addressed in a consecutive project pathway. Three main research objectives are proposed. Firstly, we aim to gain insights into the needs, challenges and experiences of women with CVD before and after pregnancy using a qualitative study using semi-structured interviews. Secondly, we will establish a multicentric prospective registry of physiological and psychological outcomes in pregnant women with CVD during the post-partum period (i.e., fourth trimester). As part of this study, we will use a validated, standard set of parameters combining clinical outcomes, patient-reported outcomes and patient-reported experience measurements developed by ICHOM. Thirdly, we will develop an Integrated Care Pathway for women with CVD before, during and after pregnancy using the new European Pathway Association Framework. Furthermore, several scientific bodies propose to set-up a multidisciplinary cardio-obstetrics programs as a strategy to mitigate pregnancy-associated risks, limited data are currently available demonstrating the clinical and patient-reported effectiveness. Therefore, we will investigate the impact of the implementation of an integrated care pathway for women with CVD in terms of maternal, obstetric, fetal and patient-reported outcomes in the short -term post-partum period (i.e., fourth trimester).

Researcher(s)

• Promoter: Goossens Eva
• Co-promoter: Van Berendoncks An
• Fellow: Vanharen Yaël

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

This project coaches women with Type 2 Diabetes towards a healthier lifestyle and increases their physical activity. In the city of Oujda in Morocco, a safe women-only lifestyle centre opens under supervision of trained female nurses from the adjacent local health centre and a female project coordinator from the local university. The centre becomes a hub bridging practice, education and research. Patients become agents of change in inspiring and instructing other patients towards prevention and treatment of Type 2 Diabetes. Nurses become more apt in their task of diabetes management. Female PhD researchers study the benefits and pitfalls of a gender-sensitive approach. Hence, incentivising education of female nurses and female leadership in health and research, the medical and social outcome, in female T2D patients improves.

Researcher(s)

• Promoter: Van Rompaey Bart

Research team(s)

• Primary and interdisciplinary care Antwerp (ELIZA)
• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project
• Education Project

Abstract

The survival rates of children with chronic conditions have increased markedly over the past decades. Hence, many of them have a fair chance of reaching adulthood thanks to advanced treatment options. However, these patients are in need of life-long specialized care addressing their specific healthcare needs at each respective stage of their life. During adolescence, these patients are expected to transfer their care from the pediatric environment towards an adult-focused setting. To prevent an abrupt and unprepared transfer of care, it is recommended to provide these patients education, counselling and guidance through a transition program. The goal of a transition program is to prepare adolescents for the challenges faced in adulthood and adult healthcare. Although preliminary data suggest that structured transition programs are associated with increased patient satisfaction, self-care, self-advocacy, and psycho-social functioning, high quality studies on the impact of such programs are scarce. The first aim of this study is to develop a prototype of a multidisciplinary transition program for young patients with diabetes type I, asthma or obesity, using an experience-based co-design methodology. Next, the project will evaluate the impact of this program prototype in terms of clinical effectiveness, cost effectiveness and user experiences in adolescents and their families.

Researcher(s)

• Promoter: Goossens Eva
• Co-promoter: Van Hoorenbeeck Kim

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

In hospital, healthcare providers usually manage medication for patients although patients are expected to self-manage their medication after discharge. A lack of self-management competencies is found to be associated with low adherence levels and medication errors harming patients' health. Approximately 50% of patients afflicted by chronic conditions do not adhere to prescribed medication regimens. When self-management is allowed during hospitalization, it rarely is provided using a structured, evidence based format. Medication self-management is considered to be a promising strategy to optimize adherence rates. To date, however, empirical data demonstrating the effect of medication self-management on patient adherence is lacking. The proposed PhD project will: 1) develop and evaluate an evidence-based guideline for healthcare providers supporting patients with medication self-management problems; 2) explore medication-related shared decision making as a supportive measure in medication self-management; 3) assess the feasibility and applicability of a combined set of tools measuring medication adherence to polypharmacy from a longitudinal perspective; 4) evaluate the effect of structured medication self-management (i.e., SelfMED) on medication adherence after discharge. Using a stepped wedge trial design, the effect of the SelfMED-intervention will be compared to usual care in hospitalized patients with polypharmacy.

Researcher(s)

• Promoter: Goossens Eva
• Co-promoter: Dilles Tinne
• Fellow: Mortelmans Laura

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

This project led by the University of Antwerp in collaboration with Netwerk Verpleegkunde, VVVS (Vlaamse Vereniging van Verpleegkundigen Spoedgevallenzorg), and AFIU (Association Francophone des Infirmiers d'Urgence), is dedicated to developing a National dataset for process and outcome data of emergency services in Belgium. This initiative aims to significantly enhance the operational efficiency and effectiveness of emergency services. By creating a validated Dutch codebook for a comprehensive database, the project will enable more streamlined and accurate data collection and analysis, ultimately leading to improved emergency care and patient outcomes in Belgium.

Researcher(s)

• Promoter: Haegdorens Filip

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

The nursing shortage is an international phenomenon with wide-reaching implications for healthcare. The WHO estimated a 7.6 million shortfall in nurses by 2030. Attracting and, most importantly, retaining nurses is a global challenge. In Belgium, there is a chronic shortage in nurses and allied staff throughout all healthcare sectors. Moreover, because patient care is becoming more complex, there is an increasing need for sufficient, qualified and well-trained staff that can be assigned in changing environments as critical experienced since March 2020 because of the COVID-2 pandemic. The Chief Nursing Officers workgroup of Zorgnet-Icuro and previous research insights identified a strong need for the development of a standardised method to objectively allocate nurses and other care professionals to care teams considering the assigned governmental budget (Flemish and/or Federal). The computerised decision support instrument Balance Nursing Teams or BNUT support informed decisions concerning the allocation, monitoring and benchmarking of nursing care composition including numbers, qualification and competencies (skill mix) as well as additional roles related to care demands and other factors. In a conceptual phase, BNUT was developed to Technology Readiness Level 4 (June 2020) and was financed externally. In a next phase, financed by IOF-POC, a software as a service solution (SaaS) was developed with data of five hospitals to Technology Readiness Level 5 and prepared for the market with a sales and market plan (commercial readiness plan of CRL6) (December 2021). Now, we will have to develop and implement our SaaS solution in collaboration with 3 acute care hospitals and further develop a first commercial version (TRL8) with first representative sales (CRL7) in general and university acute care hospitals in Flanders in 2022.

Researcher(s)

• Promoter: Van Bogaert Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

To set up a scientific program as guidance for the Wit-Gele Kruis van Antwerpen quality policy and strategy during a period of 3 years with the focus on the ANCC Pathway of Excellence program® as well as to identify and implement quality and patient safety indicators in daily practice. To develop and implement the SaaS Balance Nursing Teams for home care organizations as well as in year 3 to organize a study trip in Canada and US visiting exemplary home care organizations and academic partners.

Researcher(s)

• Promoter: Van Bogaert Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

The "Arega Chair" focuses on the following: The quality of care and quality of life of patients with polypharmacy and complex pharmacotherapy, with patient involvement and support as primary concerns. The prevalence of polypharmacy is very high, especially in the elderly and in patients with chronic diseases. Taking medication can be very important to maintain or improve health as much as possible, and thus increase the quality of life. On the other hand, taking these drugs can also be quite challenging for the patient, interfere with daily life, cause side effects and have a negative impact on quality of life. From research into the way polypharmacy and complex pharmacotherapy interfere with the quality of life, the aim is to develop opportunities to improve care delivery for this population. The social context of the patients will be taken into account. Potential opportunities for improvement will be tailored to the needs, and can be diverse, from strengthening patient participation to technological innovations. We use Hepler and Strand's definition of pharmaceutical care, in which interprofessional, and in consultation with the patient, the aim is, through the provision of pharmacotherapy in a responsible manner, to achieve results that improve the patient's quality of life.

Researcher(s)

• Promoter: Dilles Tinne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

The nursing shortage is an international phenomenon with wide-reaching implications for healthcare. The WHO estimated a 7.6 million shortfall in nurses by 2030. Attracting and, most importantly, retaining nurses is a global challenge. In Belgium, there is a chronic shortage in nurses and allied staff throughout all healthcare sectors. Moreover, because patient care is becoming more complex, there is an increasing need for sufficient, qualified and well-trained staff that can be assigned in changing environments. Policy makers are addressing the need for qualified staff by increasing the numbers of nurses entering the workplace. However, increasing the supply of nurses is insufficient to address the current staffing problems in healthcare. Organisations should also focus on methods to retain experienced personnel. However, organisations are not always well equipped to estimate if care teams are working optimally. To estimate the ideal composition of care teams, organisations apply patient assessment systems estimating acuity and care needs. However, these systems lack contextual information and need adjustment by management to be used for staff deployment. Because of the pressing shortage in nurses, organisations search for an optimal allocation of nurses across care teams. It is known that nurses sometimes are undertaking work that could be done by other caretakers. However, an optimal proportion of highly educated nurses is essential to provide high-quality care. It seems very difficult to acquire an optimally composed care team aiming for retention of staff and ensuring the quality of care. A report by the department of health by the Irish government recommended the development of software package using an evidence-based approach to assist in decisions on nurse staffing and skill-mix. The Chief Nursing Officers workgroup of Zorgnet-Icuro, a Flemish member organisation including 94 hospitals and 332 nursing homes, identified a strong need for the development of a standardised method to objectively allocate nurses and other care professionals to care teams taking into account the assigned governmental budget (Flemish and/or Federal). The project aim is to develop and study a computerised decision support instrument (CDSI), Balance Nursing Teams or BNUT, as a proof of concept, to support decisions concerning the allocation, monitoring and benchmarking of nursing care composition including numbers, qualification and competencies (skill mix) as well as additional roles related to care demands. The project is focussed on nursing care teams in acute care and psychiatric hospital as well as long-term facilities and primary care. BNUT discriminates and predicts the balance of care teams, in a continuum from negative imbalance, balance to positive imbalance, between supply and organisation of human resources including their capacity, efficiency and reliability and patient care needs and demands. During a conceptual phase of 10 months, the CDSI BNUT will be developed to Technology Readiness Level 4 (June 2020) and was financed externally. In the next phase, which will last 18 months (proof of concept A), BNUT will be developed further to implement in practice aiming for Technology Readiness Level 7 and operating at a pre-commercial scale guided by an internal and external technological and scientific validation process. In addition, the CDSI will be integrated as a Software as a Service (SaaS) product in order to assure the provision and dissemination in Belgian healthcare services. Lastly, BNUT will be prepared for full commercial international application reaching Technological Readiness Level 9.

Researcher(s)

• Promoter: Van Bogaert Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Generally, nursing home (NH) residents use many medications. Medications are beneficial and needed to treat symptoms and diseases, but some medications have questionable benefits at the end of life. These medications with questionable benefits are suitable for deprescribing. Deprescribing means stopping or tapering a medication. Up to now, we do not know the effects of changes in medication use (e.g. deprescribing medications with questionable benefits and initiating beneficial medications) at the end of life. In this study, we will evaluate these effects on the quality of life of NH residents with limited life-expectancy, as well as on their susceptibility to disease and risk of dying, using innovative data techniques. We will use data on quality of life and physical and psychosocial health of NH residents with limited life-expectancy collected in an ongoing data implementation project (BelRAI 2.0). These data are linked to administrative databases ("Big Data") including reimbursed treatment and medication data of the whole Belgian population. Using these data we can approximate an RCT and measure effects of changes in medication use on quality of life, susceptibility to disease and mortality by comparing people for whom use of a specific medication has changed (exposure group) to people for whom use of this medication has not changed (control group), without putting them at actual risks of e.g. dying sooner by actually stopping a medication in real-life.

Researcher(s)

• Promoter: Dilles Tinne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Identify and develop competencies in primary healthcare for practice and education programs in Flanders and the Netherlands about (1) entrepeneurship, (2) inteprofessional collaboration (3) applying technology and (4) ethical decision making in care processes for (licensed practice, diplome and bachelor) nurses as well as other qualifications in care providers such as nurse aids.

Researcher(s)

• Promoter: Van Bogaert Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project website

Project type(s)

• Research Project

Abstract

The project aim is to develop and study a computerized decision support instrument (CDSI), Balance Nursing Teams or BNUT, as a proof of concept, to support decisions about the allocation, monitoring and benchmarking of nursing care composition concerning numbers, qualification and competencies (skills mix) as well as additional roles related to patient care demands. The project focus is on nursing care teams in acute care and psychiatric hospital as well as long-term facilities and home care. BNUT discriminates and predicts the balance of care teams, in a continuum from negative imbalance, balance to positive imbalance, between supply and organization of human resources including their capacity, efficiency and reliability and patient care needs and demands. During a conceptual phase of 10 months, the CDSI BNUT wil be developed to Technology Readiness Level 4 (June 2020).

Researcher(s)

• Promoter: Van Bogaert Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project website

Project type(s)

• Research Project

Abstract

Nursing homes residents often take many medications. Some medications can be potentially inappropriate, leading to side-effects such and increased risks for falls, hospitalisations or mortality. To reduce the number of potentially inappropriate medications, we present the OptiMEDs tool: a combined intervention of an electronic decision support tool for the identification of potentially inappropriate medications, anticholinergic medications, or medications that can be deprescribed, with focussed nurse-observations supporting a multidisciplinary medication review. The Ageing of the population will lead to more older adults. For Belgium; around 18% of the population is 65 years or older, but this number is to rise significantly to 23% by 2030 (equalling more than 100.000 extra adults of 65 years and older). These older adults will develop an increasing number of diseases (multimorbidity), affecting their social life, activities of daily living, and quality of life. As a result, they will be prescribed more medications, but this again can induce problems. Older adults are more sensitive to the effects and side-effects of medications than younger adults. DRPs potentially affect quality of life and are also an important risk factor for hospital admissions or increased risks for mortality. All prescribers face a more complex medication choice process in poly-medicated patients with a higher level of multimorbidity. All face the problem of lack of specific evidence in this particular age group so support complex drug choice processes with regard to efficacy and safety of medications. Medications can affect the quality of life of patients, could induce severe medication side-effects, and could increase the costs for the Belgian government. For Belgium, the findings of the PHEBE project indicate that nursing home residents have a high chronic intake of medications (mean of 7.1 chronic medications), costing up to 140€ each month. An analysis of the quality of prescribing showed that 82% of the nursing home residents had potentially inappropriate medications, showing the potential for optimising the pharmacotherapy. Currently, medication reviews are seldom performed, or are not structured. Nurses reported different barriers (a lack of pharmacotherapeutic knowledge, a lack of communication possibilities), believing that observation of Drug Related Problems (DRPs) is not part of their job. Pharmacists mostly restrict their role in nursing homes to the delivery of medications. With our intervention, we propose a method that could investigate the medication use on a deeper level, in order to support the decision of GPs regarding the pharmacotherapy of older adults. We want to aid and involve different actors (nurses and clinical pharmacists) in the medication review by offering them tools to strengthen their role (enhanced knowledge, focussed observation). The study objectives are to examine whetherThe OptiMEDs intervention, the combination of an electronic decision support tool (for the appraisal of potentially inappropriate medication use, anticholinergic use, or medications that can be deprescribed in the medication chart of nursing home residents) with focussed nurse observations (derived from the Pharmanurse component in the OptiMEDs software, where potential medication symptoms are listed based on the medication chart of nursing home residents), that will serve as the basis during a medication review between GPs and nurses (where additional feedback from clinical pharmacists is provided) can lead to a more appropriate, safer, and more cost-effective pharmacotherapy in nursing home residents (e.g. less medication-related symptoms, less inappropriate prescribing, a better quality of life, less hospitalisations, health care usage, or mortality).

Researcher(s)

• Promoter: Dilles Tinne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

This research aims to objectively map the time spent by nurses in five different settings (home care, residential care centres and in hospitals on geriatric, surgical and internist services), supplemented by a self-reporting questionnaire on the perceived workload and workload. This set-up makes it possible to map the link between the time spent and the experienced workload and workload. During this research, the following research questions will be answered: - How does the time spent by nurses influence their experienced workload and workload in home care? - How does the time spent by nurses influence their experienced workload and workload in residential care centres? - How does the time spent by nurses influence their experienced workload and workload on geriatric services in hospitals? - How does the time spent by nurses influence their experienced workload and workload on surgical services in hospitals? - How does the time spent by nurses influence their experienced workload and workload on internist services in hospitals? This study also provides insight into the following questions: - How much time do nurses spend on their professional duties and how is their working time filled in? - How is this time divided over the day and week cycle? - How does the context play a role (degree of social interaction, locations, ...)? - Are there differences in terms of gender, employment status, organisation, experience, etc.?

Researcher(s)

• Promoter: Van Rompaey Bart

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project website

Project type(s)

• Research Project

Abstract

Introduction: Improving the speed and quality of empirical evidence's implementation into real world settings is a top priority for health care systems. Indeed, suboptimal implementation not only adds increases research waste, it both keeps cutting-edge treatments and interventions from the patients who need them and, in the worst cases, leaves those patients exposed to ineffective or even harmful ones. To date, the most effective bridge between lab results and clinical outcomes is implementation science. Defined as "the scientific study of methods to promote the integration of research findings and evidence-based interventions into healthcare policy and practice", implementation science "seeks to understand the behaviour of healthcare professionals and support staff, healthcare organizations, healthcare consumers, and policymakers in context as key variables in the sustainable uptake, adoption, and implementation of evidence-based interventions". Accordingly, over the past decade, implementation science's success at translating researchers' results into meaningful actions across the full range of health care stakeholders has made it a leading methodology for proposals submitted to the EU's Horizon 2020 programme. Goal of the course: This course's overall goal is to advance course participants' knowledge and skills in view of implementation science, with a particular focus on implementation research designs, implementation science outcomes, contextual analyses, implementation strategies, patient and public involvement in research, and reporting of implementation science results. Target group: This implementation science course is relevant to all health care disciplines. It applies to a variety of health care settings for a broad set of interventions. Course participants will need a solid basis in clinical research methods (e.g., conceptual thinking, quantitative and qualitative methodology, statistical analysis).

Researcher(s)

• Promoter: Dilles Tinne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Summary Background Nurses' role in interdisciplinary pharmaceutical care is not transparent and varies between European countries. Similarly, in nurse education, a clear description of specific learning outcomes on pharmaceutical care is lacking and curricula in pharmaceutical care vary a lot. Furthermore, the match with the needs of the labour market and society is insufficient. The lack of transparency and recognition, together with the variation between countries, in nursing practice and nurse education, has a major impact. It hinders collaboration on different levels: interdisciplinary collaboration in clinical practice; transnational collaboration in research, education and innovation in Europe; labour mobility of nurses. As a result patient safety is threatened, development and innovation are slowed down, and healthcare budgets are not used in the most efficient way. Preliminary analysis of EUPRON data of 3300 European nurses, doctors and pharmacists, in preparation of DeMoPhaC, shows nearly all participants are convinced of the positive impact on quality of care of increased nurse involvement in pharmaceutical care. Interprofessional communication in pharmaceutical care scored 5,2/10, an alarming score given the link between patient safety and interprofessional communication. DeMoPhaC objectives and related outputs: 1. to develop a model for nurses' role in interprofessional pharmaceutical care, a framework for collaboration in pharmaceutical care on the different levels aforementioned, based on the needs and context of the labour market and society, in a qualitative interview study → A scientific report on the results of the EUPRON study → A scientific report on the qualitative study results → A validated model for nurses' role in interprofessional pharmaceutical care in Europe 2. to specify and validate learning outcomes for nurse education in pharmaceutical care, which meet the learning needs of students, matched to the labour market and societal needs, in a Delphi study → Validated learning outcomes for nurse education in Europe on pharmaceutical care, framed in the European Qualification Framework 3. to develop an assessment to evaluate competences in pharmaceutical care, as a guidance to evaluate nurse education, as a tool for nurse educators, for benchmarking, and nurse labour mobility → An assessment to evaluate nurse competences in pharmaceutical care 4. to strengthen an international network for pharmaceutical care in nursing, to collaborate on nurse education, research, practice and policy → A sustainable European network on nurse and pharmaceutical care, NuPhaC 5. A strong involvement of students in the projects, connecting research, education and policy in Europe → About 80 European nurse students trained in and contribute to nurse research, education and policy in Europe 6. to describe nurses' role, nurse education and student nurses' competences in interdisciplinary pharmaceutical care in the European partner countries, necessary to reach objectives 1-3, and allowing benchmarking, a clarification of differences and similarities, essential for international collaboration, in 3 large-scale international cross-sectional studies → 3 scientific reports + benchmarking in Europe on: 1) nurses' role in in interprofessional pharmaceutical care; 2) nurse educational programs in pharmaceutical care; 3) nurse students' competences in pharmaceutical care. ​ https://ec.europa.eu/programmes/erasmus-plus/projects/eplus-project-details/#project/2018-1-BE02-KA203-046861

Researcher(s)

• Promoter: Dilles Tinne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project website

Project type(s)

• Education Project
• Research Project

Abstract

The aim is to decrease the prevalence of pregnancy and birth-related complications (pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), caesarean section (CS), and large-for-gestational-age babies (LGA)). These complications occur in 26% of pregnancies with normal start BMI and adequate weight gain, in 34% in normal start BMI but excessive gestational weight gain and in up to 66% in obese class III (BMI≥40kg/m²) combined with excessive gestational weight gain (table 1, B1). Moreover, as the prevalence of maternal obesity continues to rise, increasing numbers of children are exposed to an 'obesogenic intrauterine environment'. Obesity in pregnancy has therefore the potential to result in an 'intergenerational cycle' of obesity through in utero programming. We focus on women with excessive weight gain during their 1st pregnancy as currently, half of them do not return to their pre-pregnancy weight before the next pregnancy. This results in a complication rate as high as 42% (PIH, GDM, CS, LGA). We target a healthy BMI at start of pregnancy by intervening during the pre-conception period- and an adequate weight gain during pregnancy by intervening during pregnancy in these women. The intervention will be evaluated in a randomized controlled trial including 1,100 women. Our proposed intervention combines face-to-face coaching with the use of a mobile App connected to medical devices (scale and pedometer). The app monitors women's weight, eating behaviour, physical activity, mental wellbeing, and provides continuously coaching through positive behavioral change techniques. The 'inter-Act' App (during pre-conception, will be developed in the course of this project) covers breast-feeding support, while 'ZWApp' (during pregnancy, prototype available) includes the gestational weight gain guidelines of the Institute of Medicine (IOM). Drop out of less motivated women is avoided as the time points of the six pre-conception coaching sessions coincide with the existing postnatal follow-up visits for neonates (Governmental vaccination scheme through the organisation " Kind & Gezin"), and the three pregnancy coaching sessions coincide with the three routine ultrasound scans during normal pregnancy (KCE Guidelines). Each year, there are 8,900 singleton pregnancies in whom the mother had excessive gestational weight gain in the prior pregnancy. The current rate of at least one of the four major pregnancy and birth-related complications (PIH, GDM, CS, LGA) in the 8,900 pregnancies is 42%. If we can reduce this with 1/4, we prevent complications in more than 900 pregnancies, and reduce the costs of related caesarean sections, gestational diabetes, obesity in mother & child. Utilisation of study results into Flanders is facilitated as the advisory committee covers all important Flemish health care organisations: RIZIV, Kind & Gezin (huizen van het kind), Academic Centre for General Practice, organizations of midwives, dieticians, 'Wit-Gele Kruis', knowledge center Eetexpert.

Researcher(s)

• Promoter: Bogaerts Annick

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Stress and burnout are becoming serious problems in Belgium. This causes a wide array of negative consequences for the individual, the team, the quality of work and the organization. During the past years an e-learning program to prevent stress and burn-out within the nursing population was developed by the Centre of Expertise on Psychological Wellbeing in Patient Care. This program distinguishes itself from existing products by the fact that it is personalized, aimed specifically at nurses and based on scientific research. However, stress and burnout are not only pressing issues in nursing, but within other sectors as well. Therefore, we want to investigate whether the concept of an individual and job specific elearning program – which has been validated within the nursing population – can be transferred to other sectors. We aim to do so by first transferring this concept to another social profession and population at risk where the need for preventive measures is tangible – more specifically to lecturers within higher education. As such, the study at hand serves as a proof of concept to demonstrate that the program is also more widely applicable. This will facilitate the valorization of the program. Therefore, we will 1) investigate on which topics the content of the prevention program for nurses differs from that for lecturers and which content can be transferred without adjustments, 2) subsequently, insert this content in the existing framework or structure; 3) study the effect of this prevention program; 4) and finally, select the most appropriate model for commercialization. After finalizing the study at hand, we will take further steps to adjust this concept to other professions and commercialize these as well.

Researcher(s)

• Promoter: Franck Erik
• Co-promoter: Van Petegem Peter

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

This project represents a formal service agreement between UA and on the other hand EORTC. UA provides EORTC research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Elseviers Monique
• Promoter: Van Rompaey Bart

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

This project represents a formal research agreement between UA and on the other hand ZNA. UA provides ZNA research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

• Promoter: Elseviers Monique

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Elseviers Monique
• Fellow: Dilles Tinne

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Elseviers Monique

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project

Abstract

Researcher(s)

• Promoter: Couttenye Marie

Research team(s)

• Centre for Research and Innovation in Care (CRIC)

Project type(s)

• Research Project