Wat is een expertverpleegkundige, ook wel (advanced) nurse practitioner genoemd? De functie van deze nieuwe beroepsgroep is nog (bijna) nergens volledig uitgekristalliseerd. Op heldere en goed beargumenteerde wijze wordt daarom in dit boek uiteengezet wat deze verpleegkundige van andere verpleegkundigen onderscheidt. Wetenschappelijke en filosofische inzichten verschaffen een breed spectrum aan perspectieven waaruit wordt geput om deze in Nederland nog nieuwe rol transparant te omschrijven.
Aim: To develop an understanding of how nurses obtain and take account of patient preferences in shared decision-making processes in evidence-based practice to provide personalized nursing care. Design: Qualitative grounded theory. Methods: This research was part of a PhD study successfully completed in December 2015. Semi-structured interviews were conducted with 27 nurses in four medium-sized hospitals in the Netherlands. Additionally, seven nurses were observed during their shift on the ward. Constant comparative analysis underpinned by Strauss and Corbin’s framework was used. Results: Three communication tools of nurses were identified to discern and attend to patient preferences to provide individual tailored nursing care: 1) A click-making tool that enables to build rapport instantly; 2) The use of antennae to carefully monitor the individual patient’s needs; 3) Asking empathic questions so that the care is fine-tuned to the individual patient’s preferences. This way, the nurses attempt to provide optimal nursing care to enhance the patient's perceived quality of life. Conclusion: The excellent nurses have a set of three implicit and intuitive tools to continuously attune their professional care to individual patient preferences in the evidence-based practice to provide personalized care. The nurses consciously spend time to discover patient preferences. The use of the implicit communication tools appears to be part of the nurses’ professional knowledge, and deserves further research as a follow up to this study. Considering the importance of taking account of patient preferences in the evidence-based practice, these findings have international relevance to nursing professionals across the world. Dit artikel is later verschenen in de Journal of Advanced Nursing onder de titel 'The role of patient preferences in nursing decision‐making in evidence based practice: excellent nurses’ communication tools' (2019).
Nursing Leadership is an important competence to develop in order to provide quality of care and prevent attrition of nurses. This research program looked into the perceptions and experiences of nurses on practising leadership. Next to that supporting the development of nursing leadership was addressed. The program has a mixed-method, action research design in which 75 in-depth interviews and 24 focus group interviews and quantitative data of 435 nurses form the backbone. According to hospital nurses, nursing leadership is related to proactiveness and voicing expertise in order to deliver good nursing care. Nevertheless, they do not feel fully competent and knowledge deficits were detected on aspects of the bachelor nursing profile, such as evidence based practice. Working-culture factors can either inhibit or encourage nursing leadership. The further awareness of unconsciously using expertise and knowledge deficits as well as team development towards a continuous safe learning environment are necessary steps for the enhancement of nursing leadership. A Nursing Leadership model was developed in which generic personal leadership competencies combined with expertise of the nurses' level of education and degrees form the essence of shared leadership in teams focussed on the realisation of good nursing care.
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De samenwerking tussen de onderzoeksgroep FRIA van de Vrije Universiteit Brussel, afdeling oudergeneeskunde van het UMCG Groningen en de onderzoeksgroep (lectoraat) Healthy Ageing, Allied health Care and Nursing van de Hanzehogeschool Groningen is gericht op onderzoek naar bewegingsstoornissen bij veroudering. In het bijzonder wordt gekeken naar paratonic, een bewegingsstoornis bij dementie.The International Joint Research group ‘Move in Age’ concluded in a systematic review that paratonia still is a barely understood and devastating phenomenon in dementia and revealed the urgency of gaining more insight in the pathophysiology. Paratonia, a distinctive change in muscle tone, starts in early stages of dementia and develops further with progress of the disease. Resulting in severe discomfort for patients, but also affecting caregivers since daily care becomes increasingly difficult. It is hypothesized that changes in motor control due to dementia influences peripheral neurological control and biomechanical muscle structures (by crosslinking and inflammation caused by advanced glycation end-products (AGEs).This IJRG started in 2018 and aims to develop a long-term comprehensive research program on movement-related impairments at higher age. The three partners have a strong track record on research in the area of movement-related impairments in older persons; however, each focusing on a specific aspect. In fact, the Frailty in Ageing research group (FRIA) of the Vrije Universiteit Brussel (VUB) is running focused research program on the triad sarcopenia-dynapenia-inflammation with mainly a bio-gerontological and bio-psycho-medical approach; the department of General Practice and Elderly Care Medicine of the University Medical Center Groningen (UMCG) has anongoing research line on the medical aspects of mobility impairments in frail elderly persons and in elderly dementia patients; and finally Research Group Healthy Ageing, Allied Health Care and Nursing of the Hanze University of Applied Sciences Groningen (HUAS) developed a research program on physical, psycho-cognitive and social dimensions of frailty including the functional impact of mobility impairments. In the first 3-5 years, the focus will be on the movement-related impairments that occur in patients with dementia and in specific on paranoia. The programme will be extended towards movement-related impairments in the context of other geriatric syndromes.
