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1. Contact investigations for antibiotic-resistant bacteria: a mixed-methods study of patients’ comprehension of and compliance with self-sampling requests post-discharge

Author

van Veen, Anneloes, Lescure, Dominique L. A., Verhaegh, Suzanne J. C., de Goeij, Inge, Erasmus, Vicki, van Beeck, Ed F., Tjon-a-Tsien, Aimée, Splinter, José, Christiaanse, Jan C., Damen, Marjolein, Huijskens, Elisabeth G. W., Paltansing, Sunita, van Rijn, Michiel, Veenemans, Jacobien, Vos, Margreet C., and Severin, Juliëtte A.

Published
2023
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10. Effects of a management team training intervention on the compliance with a surgical site infection bundle: a before–after study in operating theatres in the Netherlands

Author

van Dijk, Manon D, primary, van Beeck, Ed F, additional, Huis, Anita, additional, van der Gun, Bernardina TF, additional, Polinder, Suzanne, additional, van Eijsden, Rianne AM, additional, Burdorf, Alex, additional, Vos, Margreet C, additional, and Erasmus, Vicki, additional

Published
2023
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11. Contact investigations for antibiotic-resistant bacteria:a mixed-methods study of patients' comprehension of and compliance with self-sampling requests post-discharge

Author

van Veen, Anneloes, Lescure, Dominique L.A., Verhaegh, Suzanne J.C., de Goeij, Inge, Erasmus, Vicki, van Beeck, Ed F., Tjon-A-Tsien, Aimée, Splinter, José, Christiaanse, Jan C., Damen, Marjolein, Huijskens, Elisabeth G.W., Paltansing, Sunita, van Rijn, Michiel, Veenemans, Jacobien, Severin, Juliëtte A., Vos, Margreet C., van Veen, Anneloes, Lescure, Dominique L.A., Verhaegh, Suzanne J.C., de Goeij, Inge, Erasmus, Vicki, van Beeck, Ed F., Tjon-A-Tsien, Aimée, Splinter, José, Christiaanse, Jan C., Damen, Marjolein, Huijskens, Elisabeth G.W., Paltansing, Sunita, van Rijn, Michiel, Veenemans, Jacobien, Severin, Juliëtte A., and Vos, Margreet C.

Abstract

BACKGROUND: Contact investigation is an important tool to identify unrecognized patients who are colonized with antibiotic-resistant bacteria. Many Dutch hospitals include already discharged contact patients by sending them a self-sampling request at home, incl. an information letter and sampling materials. Each hospital composes these information letters on their own initiative, however, whether discharged patients comprehend and comply with these requests remains unclear. Therefore, the aim was to provide insight into patients' comprehension of and self-reported compliance with self-sampling requests post-discharge. METHODS: This mixed-methods study was performed in eight Dutch hospitals. First, the Common European Framework of Reference (CEFR) language level of self-sampling request letters was established. Second, a questionnaire about patients' comprehension of the letter, self-reported compliance, and reasons for compliance or non-compliance were sent to patients that received such a request in 2018/2019. Finally, a random selection of questionnaire respondents was interviewed between January and March 2020 to gain additional insights. RESULTS: CEFR levels of 15 letters were established. Four letters were assigned level B1, four letters B1-B2, and seven letters B2. The majority of patients reported good comprehension of the letter they had received. Conversely, some respondents indicated that information about the bacterium (18.4%), the way in which results would be communicated (18.1%), and the self-sampling instructions (9.7%) were (partially) unclear. Furthermore, self-reported compliance was high (88.8%). Reasons to comply were personal health (84.3%), the health of others (71.9%), and general patient safety (96.1%). Compliant patients appeared to have a need for confirmation, wanted to protect family and/or friends, and felt they were providing the hospital the ability to control the transmission of antibiotic-resistant bacteria. Although a limited num

Published
2023

12. Effects of a management team training intervention on the compliance with a surgical site infection bundle:A before-after study in operating theatres in the Netherlands

Author

Van Dijk, Manon D., Van Beeck, Ed F., Huis, Anita, Van Der Gun, Bernardina T.F., Polinder, Suzanne, Van Eijsden, Rianne A.M., Burdorf, Alex, Vos, Margreet C., Erasmus, Vicki, Van Dijk, Manon D., Van Beeck, Ed F., Huis, Anita, Van Der Gun, Bernardina T.F., Polinder, Suzanne, Van Eijsden, Rianne A.M., Burdorf, Alex, Vos, Margreet C., and Erasmus, Vicki

Abstract

Objectives: To assess the effects of a quality improvement (QI) team training intervention, by measuring the intervention fidelity and the compliance with a surgical site infection (SSI) bundle in the operating theatre (OT). Design: Multicentre before-after study. Setting: This study was performed in four Dutch hospitals. Intervention: The QI team training intervention consisted of four sessions per hospital and stimulated participants to set culture norms and targets, identify barriers, and formulate management activities to improve compliance with four standard operating procedures (SOPs) of a SSI bundle in the OT. Participants were executive board members, top-level managers, leading clinicians and support staff. The four SOPs were: (1) reducing door movements; (2) preoperative antibiotic prophylaxis prescribing; (3) preoperative shaving; and (4) postoperative normothermia. Poisson and logistic regression analyses were performed to analyse the effect of the intervention on compliance with the individual SOPs (primary outcome measure) and on the influence of medical specialty, time of day the procedure took place and time in the OT (secondary outcome measures). Results: Not all management layers were successfully involved during all sessions in the hospitals. Top-level managers were best represented in all hospitals, leading clinicians the least. The number of implemented improvement activities was low, ranging between 2 and 14. The team training intervention we developed was not associated with improvements in the compliance with the four SOP of the SSI bundle. Medical specialty, time of day, and time in OT were associated with median number of door movements, and preoperative antibiotic prophylaxis administration. Conclusion: This study showed that after the QI team training intervention the overall compliance with the four SOPs did not improve. Minimal involvement of leading clinicians and a low number o

Published
2023

27. Compliance to a novel hand hygiene protocol tailored to non-sterile healthcare workers in the operating theatre.

Author

van Dijk, M.D., Waltmans-den Breejen, C.M., Vermeeren, J.M.J.J., van den Berg, S., van Beeck, E.F., Vos, M.C., van Dijk, Manon D, Waltmans-den Breejen, Mieke C M, Vermeeren, Joke M J J, van den Berg, Sonja, van Beeck, Ed F, Vos, Margreet C, and Cooperating Rijnmond Hospitals (SRZ)

Abstract

Background: Observing hand hygiene compliance (HHC) among non-sterile healthcare workers (HCW) in the operating theatre (OT) is challenging, since there are no tailored protocols or observation tools.Aim: To develop and test a hand hygiene protocol tailored to non-sterile HCW in the OT.Methods: In this prospective observational study, nine hospitals in the Rotterdam-Rijnmond region provided input on a draft protocol on hand hygiene in the OT, resulting in a new consensus protocol for the region. An observation tool based on the protocol was developed and tested. HHC rates with 95%-confidence intervals (CI) were calculated by type of hospital and type of HCW.Findings: The protocol contains three sections: 1. written general hand hygiene rules, 2. written hand hygiene rules specific for anaesthesia and surgery, and 3. visual representation of the OT, divided into four hand hygiene areas. Hand hygiene should be applied when changing from area. An average HHC of 48.0% (95%-CI:45.2%-61.2%) was observed in OTs across all hospitals. The two specialized hospitals (64.0%, 95%-CI: 30.6%-89.8% and 76.7%, 95%-CI:62.8%-84.5%) scored the highest HHC, while the academic teaching hospital scored the lowest (23.1%, 95%-CI: 0.0%-45.8%). The average HHC of anaesthesiologists was the lowest (31.6%, 95%-CI: 19.2%-62.4%), the OT-assistants scored the highest (57.4%, 95%-CI: 50.1%-78.2%).Conclusion: This uniform way of observing HHC in the OT, enables evaluation of the effectiveness of interventions in the OT and facilitates friendly competition. In the Rotterdam-Rijnmond region, HHC in the OT was below 50% and needs to be addressed in teaching hospitals and among physicians. [ABSTRACT FROM AUTHOR]

Published
2023
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30. The Effect of Written and Video Discharge Instructions After Mild Traumatic Brain Injury on Healthcare Costs and Productivity Costs

Author

Hoek, Amber E., primary, Geraerds, A. J. L. M., additional, Rood, Pleunie P. M., additional, Joosten, Marieke, additional, Dippel, Diederik W. J., additional, van Beeck, Ed F., additional, van den Hengel, Leandra, additional, Dijkstra, Björn, additional, Papathanasiou, Dafni, additional, van Rijssel, Daphne, additional, van den Hamer, Maaike, additional, Schuit, Stephanie C. E., additional, Burdorf, Alex, additional, Haagsma, Juanita A., additional, and Polinder, Suzanne, additional

Published
2021
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34. Stijging lichte letsels bij de huisarts valt samen met daling op de SEH

Author

Panneman, Martien J. M., Blatter, Birgitte M., Gaakeer, Menno I., Jansen, Tessa, van Beeck, Ed F., Graduate School, Public and occupational health, APH - Global Health, APH - Health Behaviors & Chronic Diseases, APH - Methodology, and APH - Quality of Care

Abstract

OBJECTIVE: In the past 10 years, there has been a decrease in the number of patients who report to the Emergency Department (ED) every year for injuries from accidents or violence, especially in the subgroup of patients who did not require hospital admission. We investigated how the number of injury-related emergency department visits and GP contacts evolved over the period 2013-2017. DESIGN: Retrospective observational trend study. METHOD: To calculate the trend in emergency department visits in the Netherlands, we used data from the injury information system (LIS) for the period 2013-2017. To calculate the trend in GP contacts (GP practices as well as GP centres), we used data from the NivelZorgregistraties (Nivel medical records). In order to compare the trends, we distinguished between minor and major injuries. The numbers from the records were extrapolated to numbers for the whole of the Netherlands. RESULTS: In the period studied, the number of patients with minor injuries who visited the ED dropped by 38.5%, while the number of patients with major injuries (fractures and brain injuries) increased by 4.1%. In the same period, the number of GP contacts for minor injuries at GP practices increased by 25% and at GP centres by 43%; the number of primary care contacts for major injuries increased by 5.1% (GP practices) and 31% (GP centres) respectively. CONCLUSION: The role of general practitioners in the treatment of patients with minor injuries is increasing. The trend in major injuries is a better indicator for monitoring accidents and violence in the Netherlands. Conflict of interest and financial support: none declared.

Published
2020

44. Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017

Author

Haagsma, Juanita A, primary, Olij, Branko F, additional, Majdan, Marek, additional, van Beeck, Ed F, additional, Vos, Theo, additional, Castle, Chris D, additional, Dingels, Zachary V, additional, Fox, Jack T, additional, Hamilton, Erin B, additional, Liu, Zichen, additional, Roberts, Nicholas L S, additional, Sylte, Dillon O, additional, Aremu, Olatunde, additional, Bärnighausen, Till Winfried, additional, Borzì, Antonio M, additional, Briggs, Andrew M, additional, Carrero, Juan J, additional, Cooper, Cyrus, additional, El-Khatib, Ziad, additional, Ellingsen, Christian Lycke, additional, Fereshtehnejad, Seyed-Mohammad, additional, Filip, Irina, additional, Fischer, Florian, additional, Haro, Josep Maria, additional, Jonas, Jost B, additional, Kiadaliri, Aliasghar A, additional, Koyanagi, Ai, additional, Lunevicius, Raimundas, additional, Meretoja, Tuomo J, additional, Mohammed, Shafiu, additional, Pathak, Ashish, additional, Radfar, Amir, additional, Rawaf, Salman, additional, Rawaf, David Laith, additional, Riera, Lidia Sanchez, additional, Shiue, Ivy, additional, Vasankari, Tommi Juhani, additional, James, Spencer L, additional, and Polinder, Suzanne, additional

Published
2020
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49. Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma: a prospective cohort study

Author

Haagsma Juanita A, Ringburg Akkie N, van Lieshout Esther MM, van Beeck Ed F, Patka Peter, Schipper Inger B, and Polinder Suzanne

Subjects
Major trauma, Posttraumatic stress disorder, Follow-up study, Psychiatry, RC435-571
Abstract

Abstract Background Among trauma patients relatively high prevalence rates of posttraumatic stress disorder (PTSD) have been found. To identify opportunities for prevention and early treatment, predictors and course of PTSD need to be investigated. Long-term follow-up studies of injury patients may help gain more insight into the course of PTSD and subgroups at risk for PTSD. The aim of our long-term prospective cohort study was to assess the prevalence rate and predictors, including pre-hospital trauma care (assistance of physician staffed Emergency Medical Services (EMS) at the scene of the accident), of probable PTSD in a sample of major trauma patients at one and two years after injury. The second aim was to assess the long-term course of probable PTSD following injury. Methods A prospective cohort study was conducted of 332 major trauma patients with an Injury Severity Score (ISS) of 16 or higher. We used data from the hospital trauma registry and self-assessment surveys that included the Impact of Event Scale (IES) to measure probable PTSD symptoms. An IES-score of 35 or higher was used as indication for the presence of probable PTSD. Results One year after injury measurements of 226 major trauma patients were obtained (response rate 68%). Of these patients 23% had an IES-score of 35 or higher, indicating probable PTSD. At two years after trauma the prevalence rate of probable PTSD was 20%. Female gender and co-morbid disease were strong predictors of probable PTSD one year following injury, whereas minor to moderate head injury and injury of the extremities (AIS less than 3) were strong predictors of this disorder at two year follow-up. Of the patients with probable PTSD at one year follow-up 79% had persistent PTSD symptoms a year later. Conclusions Up to two years after injury probable PTSD is highly prevalent in a population of patients with major trauma. The majority of patients suffered from prolonged effects of PTSD, underlining the importance of prevention, early detection, and treatment of injury-related PTSD.

Published
2012
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50. Posttraumatic stress symptoms and health-related quality of life: a two year follow up study of injury treated at the emergency department

Author

Haagsma Juanita A, Polinder Suzanne, Olff Miranda, Toet Hidde, Bonsel Gouke J, and van Beeck Ed F

Subjects
posttraumatic stress disorder, injury, functional outcome, quality of life, Psychiatry, RC435-571
Abstract

Abstract Background Among injury victims relatively high prevalence rates of posttraumatic stress disorder (PTSD) have been found. PTSD is associated with functional impairments and decreased health-related quality of life (HRQoL). Previous studies that addressed the latter were restricted to injuries at the higher end of the severity spectrum. This study examined the association between PTSD symptoms and health-related quality of life (HRQoL) in a comprehensive population of injury patients of all severity levels and external causes. Methods We conducted a self-assessment survey which included items regarding demographics of the patient, accident type, sustained injuries, EuroQol health classification system (EQ-5D) and Health Utilities Index (HUI) to measure functional outcome and HRQoL, and the Impact of Event Scale (IES) to measure PTSD symptoms. An IES-score of 35 or higher was used as indication for the presence of PTSD. The survey was completed by 1,781 injury patients two years after they were treated at the Emergency Department (ED), followed by either hospital admission or direct discharge to the home environment. Results Symptoms indicative of PTSD were associated with more problems on all EQ-5D and HUI3 domains of functional outcome and a considerable utility loss in both hospitalized (0.23-0.24) and non-hospitalized (0.32-0.33) patients. Differences in reported problems between patients with IES scores higher or lower than 35 were largest for EQ-5D health domains pain/discomfort (82% versus 28%) and anxiety/depression (53% versus 11%) and HUI domains emotion (92% versus 33%) and pain (84% versus 38%). After adjusting for potential confounders, PTSD remained strongly associated with adverse HRQoL. Conclusions Among patients treated at an ED posttraumatic stress symptoms indicative of PTSD were associated with a considerable decrease in HRQoL in both hospitalized and non-hospitalized patients. PTSD symptoms may therefore raise a major barrier for full recovery of injury patients of even minor levels of severity.

Published
2012
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