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Nienke E Dijkstra,1,2 Marcia Vervloet,3 Carolien G M Sino,1 Eibert R Heerdink,2,4 Marjorie Nelissen-Vrancken,5 Nienke Bleijenberg,1,6 Marijn de Bruin,7 Lisette Schoonhoven6,8 1Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, the Netherlands; 2Research Group Innovation in Pharmaceutical Care, University of Applied Sciences Utrecht, Utrecht, the Netherlands; 3Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 4Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; 5Dutch Institute for Rational Use of Medicine, Utrecht, the Netherlands; 6Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; 7IQ Healthcare, Radboud University Medical Centre, Nijmegen, the Netherlands; 8School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southhampton, UKCorrespondence: Nienke E DijkstraResearch Group Proactive Care for Elderly People Living at Home, University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, the NetherlandsTel +31 641620681Email nienke.dijkstra@hu.nlPurpose: To describe nurses’ support interventions for medication adherence, and patients’ experiences and desired improvements with this care.Patients and Methods: A two-phase study was performed, including an analysis of questionnaire data and conducted interviews with members of the care panel of the Netherlands Patients Federation. The questionnaire assessed 14 types of interventions, satisfaction (score 0– 10) with received interventions, needs, experiences, and desired improvements in nurses’ support. Interviews further explored experiences and improvements. Data were analyzed using descriptive statistics and a thematic analysis approach.Results: Fifty-nine participants completed the questionnaire, and 14 of the 59 participants were interviewed. The satisfaction score for interventions was 7.9 (IQR 7– 9). The most common interventions were: “noticing when I don’t take medication as prescribed” (n = 35), “helping me to find solutions to overcome problems with using medications” (n = 32), “helping me with taking medication” (n = 32), and “explaining the importance of taking medication at the right moment” (n = 32). Fifteen participants missed ≥ 1 of the 14 interventions. Most mentioned the following: “regularly asking about potential problems with medication use” (33%), “regularly discussing whether using medication is going well” (29%), and “explaining the importance of taking medication at the right moment” (27%). Twenty-two participants experienced the following as positive: improved self-management of adequate medication taking, a professional patient–nurse relationship to discuss adherence problems, and nurses’ proactive attitude to arrange practical support for medication use. Thirteen patients experienced the following as negative: insufficient timing of home visits, rushed appearance of nurses, and insufficient expertise about side effects and taking medication. Suggested improvements included performing home visits on time, more time for providing support in medication use, and more expertise about side effects and administering medication.Conclusion: Overall, participants were satisfied, and few participants wanted more interventions. Nurses’ support improved participants’ self-management of medication taking and enabled patients to discuss their adherence problems. Adequately timed home visits, more time for support, and accurate medication-related knowledge are desired.Keywords: medication adherence, patient preference, home care, home care nurses, patient satisfaction, patient adherence

Paul Clarkson,1,2 Peter R Worsley,1 Lisette Schoonhoven,1,3 Dan L Bader11School of Health Sciences, University of Southampton, Southampton, UK; 2Southern Health NHS Foundation Trust, Calmore, UK; 3Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, NetherlandsBackground: Pressure ulcers (PUs) are a major burden to individuals, impacting their physical, mental and social wellbeing. While PU prevention is traditionally regarded as a nursing issue, an interprofessional approach has been promoted as best practice. However, little is known about current practice or the knowledge and attitudes of the wider interprofessional team (IPT).Purpose: Pre-designed questionnaires were used to explore knowledge and attitudes with healthcare staff in the community.Methods: Questionnaires were disseminated to all healthcare staff within a community healthcare Trust predominantly via an online tool. Data were analyzed using descriptive and inferential statistics.Results: The median values of all professional groups demonstrated satisfactory attitudes (>75%) and levels of knowledge (>60%) to PU prevention. However, there were differences within and between groups. Management staff demonstrated the most positive attitude to PU prevention (89%), followed by occupational therapists (OTs) and healthcare assistants (HCAs) (87%, IQR: 75%→89%). OTs demonstrated the highest scores for knowledge (69%, IQR: 62%→73%), while healthcare and rehabilitation assistants scored the lowest (58%, IQR: 58%-64%).Conclusion: This study has demonstrated that the majority of healthcare staff in a UK community setting have satisfactory levels of knowledge and attitudes in relation to PU prevention overall. Nevertheless, there were some differences between groups, albeit non-significant. There were also differences between sub-themes of the questionnaires, indicating a greater focus of pressure ulcer treatment over prevention. While PU prevention is widely regarded to be a nursing issue, these findings provide some indication of the potential for an interprofessional approach.Keywords: pressure ulcer, interprofessional, knowledge, attitudes, community, questionnaire

Purpose Recalibration and determining discriminative power, internationally, of the existing delirium prediction model (PRE-DELIRIC) for intensive care patients. Methods A prospective multicenter cohort study was performed in eight intensive care units (ICUs) in six countries. The ten predictors (age, APACHE-II, urgent and admission category, infection, coma, sedation, morphine use, urea level, metabolic acidosis) were collected within 24 h after ICU admission. The confusion assessment method for the intensive care unit (CAM-ICU) was used to identify ICU delirium. CAM-ICU screening compliance and inter-rater reliability measurements were used to secure the quality of the data. Results A total of 2,852 adult ICU patients were screened of which 1,824 (64 %) were eligible for the study. Main reasons for exclusion were length of stay Conclusions In this multinational study, we recalibrated the PRE-DELIRIC model. Despite differences in the incidence of predictors between the centers in the different countries, the performance of the PRE-DELIRIC-model remained good. Following validation of the PRE-DELIRIC model, it may facilitate implementation of strategies to prevent delirium and aid improvements in delirium management of ICU patients., Author(s): M. van den Boogaard [sup.1], L. Schoonhoven [sup.2] [sup.3], E. Maseda [sup.4], C. Plowright [sup.5], C. Jones [sup.6], A. Luetz [sup.7], P. V. Sackey [sup.8], P. G. Jorens [sup.9], [...]