Suchergebnisse

This article presents a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutional, long-term care settings delegate care. Findings from this study include both the strategies and processes these nurses used for delegating care and also their perceptions of barriers to effective delegation and potential benefits of delegation. Nurses reported two key approaches to delegation, including the "follow the job description" approach, which emphasized adherence to facility-level roles and job descriptions, and the "consider the scope of practice" approach, which emphasized consideration of multiple aspects of scope of practice and licensure along with the context of care. While the former approach resulted in more clarity and certainty for the RN, the latter facilitated a focus on quality of resident-care outcomes as linked to the delegation process. Perceived barriers to effective delegation were comparable among RNs using either approach to delegation, and almost all RNs could describe benefits of delegation for long-term care. Future directions regarding delegation in long-term care settings are disclosed.

Abstract
Clinical care interactions influence important health outcomes in older adults such as nosocomial infections, falls, and care satisfaction. However, traditional measurements of interactions are often time-consuming, costly, biased, or they interfere with normal clinical care. Wearable sensors measure interpersonal contact with a high degree of spatial and temporal detail and accuracy when applied to examining the spread of infection. This study aims to test the feasibility of implementing two types of commercially available wearable sensors to collect spatial and temporal data for measuring care interactions in health care settings. EMBC02 (Bluetooth) and OpenBeacon (RFID) sensors were tested in a simulation laboratory. Five nursing students wore the sensors along with name tags and enacted a scenario of a fallen nursing home resident. Sensor data were plotted in Python and compared with video recordings of the simulated care interaction to determine sensor usability, accuracy, and precision. EMBC02 and OpenBeacon detected multiple wearers and provided spatial and temporal data. OpenBeacon showed better usability and validity than EMBC02 for using proximity data collected by sensors to infer care interactions. Both OpenBeacon and EMCB02 showed some limitations in accuracy and precision, such as increased data missingness due to idling function and high data noise. Bluetooth and RFID sensors measure different aspects of proximity. OpenBeacon outperformed EMBC02 for measuring care interactions. Combining Bluetooth with RFID may provide richer information for measuring and understanding care interactions. Simulation laboratories can be leveraged to test health technology before use in clinical research.

Background: Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. Method: In order to develop and test the roadmap, a COST Action project was initiated: COST CARES, with 28 participating countries. This paper provides an overview of evidence about the effects of each of the identified enablers. Intersections between the drivers and the enablers are identified as critical for the success of future cost containment, in tandem with maintained or improved quality in healthcare. This will require further exploration through testing. Conclusion: Cost containment of future healthcare, with maintained or improved quality, needs to be addressed through a concerted approach of testing key factors. We propose a framework for test lab design based on these drivers and enablers in different European countries. ; peer-reviewed

Background Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. Method In order to develop and test the roadmap, a COST Action project was initiated: COST−CARES, with 28 participating countries. This paper provides an overview of evidence about the effects of each of the identified enablers. Intersections between the drivers and the enablers are identified as critical for the success of future cost containment, in tandem with maintained or improved quality in healthcare. This will require further exploration through testing. Conclusion Cost containment of future healthcare, with maintained or improved quality, needs to be addressed through a concerted approach of testing key factors. We propose a framework for test lab design based on these drivers and enablers in different European countries.

Background Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. Method In order to develop and test the roadmap, a COST Action project was initiated: COST−CARES, with 28 participating countries. This paper provides an overview of evidence about the effects of each of the identified enablers. Intersections between the drivers and the enablers are identified as critical for the success of future cost containment, in tandem with maintained or improved quality in healthcare. This will require further exploration through testing. Conclusion Cost containment of future healthcare, with maintained or improved quality, needs to be addressed through a concerted approach of testing key factors. We propose a framework for test lab design based on these drivers and enablers in different European countries.

Background Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. Method In order to develop and test the roadmap, a COST Action project was initiated: COST−CARES, with 28 participating countries. This paper provides an overview of evidence about the effects of each of the identified enablers. Intersections between the drivers and the enablers are identified as critical for the success of future cost containment, in tandem with maintained or improved quality in healthcare. This will require further exploration through testing. Conclusion Cost containment of future healthcare, with maintained or improved quality, needs to be addressed through a concerted approach of testing key factors. We propose a framework for test lab design based on these drivers and enablers in different European countries.

Background Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. Method In order to develop and test the roadmap, a COST Action project was initiated: COST−CARES, with 28 participating countries. This paper provides an overview of evidence about the effects of each of the identified enablers. Intersections between the drivers and the enablers are identified as critical for the success of future cost containment, in tandem with maintained or improved quality in healthcare. This will require further exploration through testing. Conclusion Cost containment of future healthcare, with maintained or improved quality, needs to be addressed through a concerted approach of testing key factors. We propose a framework for test lab design based on these drivers and enablers in different European countries.

Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies.