ObjectivesNursing homes are hit relatively hard by the COVID-19 pandemic. Dutch long-term care (LTC) organisations installed outbreak teams (OTs) to coordinate COVID-19 infection prevention and control. LTC organisations and relevant national policy organisations expressed the need to share experiences from these OTs that can be applied directly in COVID-19 policy. The aim of the ‘COVID-19 management in nursing homes by outbreak teams’ (MINUTES) study is to describe the challenges, responses and the impact of the COVID-19 pandemic in Dutch nursing homes. In this first article, we describe the MINUTES Study and present data characteristics.DesignThis large-scale multicentre study has a qualitative design using manifest content analysis. The participating organisations shared their OT minutes and other meeting documents on a weekly basis. Data from week 16 (April) to week 53 (December) 2020 included the first two waves of COVID-19.SettingNational study with 41 large Dutch LTC organisations.ParticipantsThe LTC organisations represented 563 nursing home locations and almost 43 000 residents.ResultsAt least 36 of the 41 organisations had one or more SARS-CoV-2 infections among their residents. Most OTs were composed of management, medical staff, support services staff, policy advisors and communication specialists. Topics that emerged from the documents were: crisis management, isolation of residents, personal protective equipment and hygiene, staff, residents’ well-being, visitor policies, testing and vaccination.ConclusionsOT meeting minutes are a valuable data source to monitor the impact of and responses to COVID-19 in nursing homes. Depending on the course of the COVID-19 pandemic, data collection and analysis will continue until November 2021. The results are used directly in national and organisational COVID-19 policy.
Objectives: To examine facilitators of and barriers to interprofessional collaboration (IPC) in institutional long-term care (LTC) and geriatric rehabilitation (GR), and to provide an overview of instruments used to assess IPC in LTC and GR. Design: Systematic integrative review. Setting and Participants: Institutional long-term care and geriatric rehabilitation. Methods: We systematically searched relevant databases for articles using the terms interprofessional collaboration, interdisciplinary, long-term care, geriatric rehabilitation, elderly, facilitators, and barriers. We conducted a systematic integrative review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis method. Papers containing empirical data about barriers to and facilitators of IPC in LTC and GR were included. The Mixed Method Appraisal Tool was used for quality assessment. Data were analyzed using qualitative thematical analysis. Results: Three interdependent themes regarding facilitators of and barriers to IPC emerged: Team performance, Organizational conditions, and Sharing information. Eight instruments were used to assess IPC in LTC and none for GR. Limited descriptions and insufficient psychometric qualities of the instruments were reported. Conclusions and Implications: To enhance IPC, it is necessary to stimulate facilitators and limit barriers on all 3 themes. Furthermore, a reliable, validated instrument to assess IPC in LTC and GR, based on a clear definition of IPC is needed. Successful IPC when caring for patients with multimorbidity in LTC and GR requires integration, understanding, and recognition of the interdependency from all persons involved, including patients and family caregivers.
The ACRE (ACtive REhabilitation) robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursing home rehabilitation. The study was designed as randomized controlled trial, one group receiving therapy as usual and the other receiving additional ACRE training. Changes in motor abilities, stroke impact, quality of life and emotional well-being were assessed. In total, 24 patients were included. In this small number no significant effects of the ACRE training were found. A large number of 136 patients were excluded. Main reasons for exclusion were lack of physiological or cognitive abilities. Further improvement of the ACRE can best be focused on making the system suitable for self-training and development of training software for activities of daily living.
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