Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.
Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.
The inherent complexity of planning at sea, called maritime spatial planning (MSP), requires a planning approach where science (data and evidence) and stakeholders (their engagement and involvement) are integrated throughout the planning process. An increasing number of innovative planning support systems (PSS) in terrestrial planning incorporate scientific models and data into multi-player digital game platforms with an element of role-play. However, maritime PSS are still early in their innovation curve, and the use and usefulness of existing tools still needs to be demonstrated. Therefore, the authors investigate the serious game, MSP Challenge 2050, for its potential use as an innovative maritime PSS and present the results of three case studies on participant learning in sessions of game events held in Newfoundland, Venice, and Copenhagen. This paper focusses on the added values of MSP Challenge 2050, specifically at the individual, group, and outcome levels, through the promotion of the knowledge co-creation cycle. During the three game events, data was collected through participant surveys. Additionally, participants of the Newfoundland event were audiovisually recorded to perform an interaction analysis. Results from survey answers and the interaction analysis provide evidence that MSP Challenge 2050 succeeds at the promotion of group and individual learning by translating complex information to players and creating a forum wherein participants can share their thoughts and perspectives all the while (co-) creating new types of knowledge. Overall, MSP Challenge and serious games in general represent promising tools that can be used to facilitate the MSP process.
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