Getty Huisman-de Waal

• PhD, RN
• Radboud University Medical Centre, Netherlands

Aims To explore how coaching can facilitate the development of an Evidence‐Based Quality Improvement (EBQI) learning culture within nursing teams in hospital and community care settings. This study also explores the specific contextual factors that influence effective outcomes. Design Action research. Method Nine teams, including 254 nurses were...

Introduction The World Health Organization defines quality of care as providing effective, evidence‐based care, and avoiding harm. Low‐value care provides little or no benefit to the patient, causes harm, and wastes limited resources. In 2017, shortly after the start of the International Choosing Wisely campaign, the first Dutch nursing “Do‐not‐do”...

Aim To facilitate the delivery of appropriate care, the aim was to test if a tailored, multifaceted de‐implementation strategy (RENEW) (1) would lead to less low‐value nursing care and (2) was acceptable, implementable, cost effective and scalable in the home‐based nursing care context. Design A mixed‐methods design. Methods The RENEW strategy wi...

Objective Insights about what actions contributed to the development of an interprofessional learning and working culture were lacking for nursing homes. This study aimed to provide insight into the context and actions that trigger mechanisms for the development of an interprofessional learning and working culture in nursing homes. Study design Re...

Aim To explore barriers and facilitators for reducing low‐value home‐based nursing care. Design Qualitative exploratory study. Method Seven focus group interviews and two individual interviews were conducted with homecare professionals, managers and quality improvement staff members within seven homecare organizations. Data were deductively analy...

Background: Transformation of healthcare is necessary to ensure patients receive high-quality care. Working with the evidence-based practice (EBP) principles enables nurses to make this shift. Although working according to these principles is becoming more common, nurses base their actions too much on traditions and intuition. Therefore, to promot...

Background Patient participation is fundamental in nursing care and has yielded benefits for patient outcomes. However, despite their compassionate care approach, nurses do not always incorporate patients' needs and wish into evidence‐based practice, quality improvement or learning activities. Therefore, a shift to continuous quality improvement ba...

Continuous monitoring of vital signs using a wireless wearable device was implemented in 2018 at a surgical care unit of an academic hospital. This study aimed at gaining insight into nurses’ and patients’ perspectives regarding the use and innovation of a continuous vital signs monitoring system, three years after its introduction. This qualitativ...

For frail older people it is evident to maintain their functional abilities and independence. Nursing staff are in a key position to encourage older people’s independence and stimulate their engagement in functional activity. However, nurses tend to take over tasks frequently thereby depriving older people’s remaining abilities. Clearly nurses need...

The concept of aging-in-place has become increasingly popular worldwide, including the Netherlands. However, as individuals age, their ability to perform activities of daily living often declines leading towards a need for homecare. Unfortunately, staff often unnecessarily take over care tasks and thereby potentially accelerate older adults’ functi...

Aims To explore potential areas of low‐value home‐based nursing care practices, their prevalence and related influencing factors of nurses and nursing assistants working in home‐based nursing care. Design A quantitative, cross‐sectional design. Methods An online survey with questions containing scaled frequencies on five‐point Likert scales and o...

Introduction In the perioperative period of hospitalization, barriers to food intake are common due to special nutritional needs, compromised nutritional status, and metabolic stress. Good nutritional care call for an interdisciplinary approach. And patients themselves may also play an essential role in managing nutritional care. Objective This st...

Background Choosing Wisely is an international movement that stimulates conversations about unnecessary care. The campaign created five recommendations including a statement that less wound care is sometimes better. Aims The study aims to evaluate nurses' and physicians' adherence to the Choosing Wisely recommendations for acute wound care in the...

Aim To systematically provide an overview of the qualitative evidence available on the motivations for nurses to leave the nursing profession. Design A qualitative systematic review using the meta‐aggregation design of the Joanna Briggs Institute. Data Sources Qualitative studies in English, dating from 2010 until January 2023, were obtained from...

Background: A changing nursing workforce and an increase in demands for care together with more complex care, raise arguments that leading and guiding nursing practice is more challenging than ever. Therefore, nurses need to have a shared agenda and a common language to show the importance of nursing care and the consequences of not addressing thi...

Objectives: Translating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter-rater reliability among community nurses. Methods: The original version of the OHAT was translated following the five stages of the 'Guidelines for the Process of Cross-Cultural Adaptation'. After a forward and backward translation, consensus on the...

Objectives: To describe an insight into nursing nutritional care delivery in the hospital from the perspectives of observed nursing care and an exploration of multidisciplinary attitudes and experiences with patient participation in nutritional care. Background: The prevalence of malnutrition in hospitalised patients continues to be high. Nurses...

This study evaluated the applicability and efficacy of patient education regarding fasting recommendations to shorten fasting times in patients undergoing esophagogastroduodenoscopy (EGD). A prospective nonrandomized controlled pilot study was performed. The intervention group (IG) was educated by nurses to eat until 6 hours and drink until 2 hours...

Aims To explore and describe hospital nurses' perceptions of leadership behaviours in facilitating patient participation in fundamental care. Design An ethnographic interview study. Methods Individual semi‐structured interviews with 12 nurses with a bachelor's or master's degree working at a university medical centre were conducted between Februa...

Background Nurses are in a key position to stimulate older people to maximize their functional activity and independence. However, nurses still often work in a task-oriented manner and tend to take over tasks unnecessarily. It is evident to support nurses to focus on the capabilities of older people and provide care assistance only when required. F...

Objective: Identifying the scope of pain interventions executed by nurses for adult patients in hospital and community care settings. This endeavour should help to formulate evidence-based recommendations for this nursing-sensitive outcome. Background: In health care settings, patients are prone to experience pain. Nurses play a vital role in pain...

Background: Nursing homes face challenges caused by increasing numbers of older adults with multimorbidity and the demand for quality of care. Developing an evidence-based nursing (EBN) culture is a promising strategy to face these challenges. Therefore, the aim of this study was to develop an EBN culture in nursing homes and gain insight into the...

Function Focused Care (FFC) interventions support nurses to adapt their level of care to the capabilities of older people and to optimize their self-reliance. Recently, three FFC-interventions were implemented in various Dutch care settings. Lessons learned and implications were synthesized and an advanced FFC-program ‘SELF’ was developed for wide...

Background : Home-based nursing care continues to expand, delivering care to increasingly older clients with multiple, chronic and complex conditions that require the use of additional and more numerous invasive medical devices. Therefore, the prevention of infections poses a challenge for nurses, professional caregivers and clients. Objective : T...

Background and Objective: Function-Focused Care (FFC) aims to optimize daily functioning of older people by changing clinical nursing practice of care professionals. Recently, three multicomponent FFC-programs were implemented in the Dutch home, nursing home, and hospital care setting. Process evaluations were conducted including eight focus groups...

Aims and objectives To gain insight into the experiences and perceptions of hospital and home care nurses regarding nutritional care for older adults to prevent and treat malnutrition. Background In‐depth knowledge about hospital and home care nurses’ experiences and perceptions can contribute to optimise nutritional care for older adults across t...

Background Since 1999, international guidelines recommend fasting from solid foods up to 6 hours and clear liquids up to 2 hours before surgery. Early recovery after surgery programs recommend restoration of oral intake as soon as possible. This study determines adherence to these guidelines up to 20 years after its introduction. Methods A 2-cente...

Rationale Home parenteral nutrition (HPN) is the ultimate treatment for patients who suffering from chronic intestinal failure (CIF). We tested the feasibility and effects of Mindfulness Based Cognitive Therapy (MBCT) in patients on HPN. Because of the high dropout rate, however, we were next urged to develop and test a web-based coaching program (...

Context Malnutrition in institutionalized patients is associated with adverse outcomes and increased costs. Nurses have a crucial role in the recognition and treatment of malnutrition and empowering patients in nutritional care. Objective This systematic review provides an overview of the effectiveness of nursing nutritional interventions to count...

In recent years, Function Focused Care (FFC) interventions have been developed and implemented in Dutch home care, nursing homes and acute care. These interventions aimed to train nursing staff to adapt their level of support to the capabilities of elderly and to maintain/optimize their self-reliance and physical functioning. After synthesizing kno...

Ondervoeding is in alle sectoren van de gezondheidszorg een veelvoorkomend probleem: gemiddeld is één op de vier à vijf patiënten in ziekenhuizen, zorginstellingen en de thuiszorg ondervoed. Hoewel voedingszorg onderdeel is van essentiële verpleegkundige zorg, bestaat het bachelor-verpleegkundecurriculum anno 2019 slechts voor 0,4 procent uit voedi...

Background: Patient participation is fundamental to nursing care and has beneficial effects on patient outcomes. However, it is not well embedded yet and little is known on how nurses could effectively stimulate patient participation in hospital care. The Tell-us Card is a communication tool for inviting patients to talk about their preferences an...

Background & aims Home total parenteral nutrition (HPN) is indicated in long-term intestinal failure (IF) to maintain or improve the nutritional status, guarantee patient survival and improve quality of life (QoL). The patients ”caregiver” is often an essential partner to help perform daily activities. The aim of this study was to compare QoL, expe...

BACKGROUND Society is facing a global shortage of 17 million healthcare workers, along with increasing healthcare demands from a growing number of older adults. Social robots are being considered as solutions to part of this problem. OBJECTIVE To evaluate the quality of care perceived by patients and caregivers for an integrated care pathway in an...

Background: Society is facing a global shortage of 17 million health care workers, along with increasing health care demands from a growing number of older adults. Social robots are being considered as solutions to part of this problem. Objective: Our objective is to evaluate the quality of care perceived by patients and caregivers for an integr...

Background: Undernutrition in surgical patients leads to a higher risk of postoperative complications like infections and delayed recovery of gastrointestinal functions, often resulting in a longer hospital stay and lower quality of life. Nurses at outpatient clinics can deliver nutritional care during outpatient preoperative evaluation of health...

Aims and objectives: To analyse oral care delivery in one hospital to through exploring experiences from both nurses' and patients' perspectives and examining patients' oral health. Background: Oral health problems are associated with undernutrition and other general health outcomes. Although oral care belongs to the essentials of nursing, it is...

Background & aims: To improve the nutritional status of surgical patients before hospital admission, an Outpatient Nursing Nutritional Intervention (ONNI) was developed. The ONNI comprehends five components: determining causes of undernutrition, performing a nutritional care plan including tailored and general advice, self-monitoring of nutritiona...

Objective The International Learning Collaborative (ILC) is an organisation dedicated to understanding why fundamental care, the care required by all patients regardless of clinical condition, fails to be provided in healthcare systems globally. At its 11th annual meeting in 2019, nursing leaders from 11 countries, together with patient representat...

Aims and objectives To identify interventions to prevent and treat malnutrition in older adults, which can be integrated in nursing care, and to evaluate the effects of these interventions on outcomes related to malnutrition. Background Older adults are at great risk for malnutrition, which can lead to a number of serious health problems. Nurses h...

Introduction: Malnutrition is an increasing problem among community-dwelling elderly (1) and reported prevalence data are up to 50% (2). Malnutrition is associated with depression, lower cognitive and functional status, infections, comorbidities, a higher use of home care facilities and mortality (3, 4). In older community-dwelling people malnutrit...

Objective: To explore how nurses in hospitals enact person-centred fundamental care delivery. Background: Effective person-centred care is at the heart of fundamental nursing care, but it is deemed to be challenging in acute health care as there is a strong biomedical focus and most nurses are not trained in person-centred fundamental care deliv...

Aims and objectives To evaluate the effects of preoperative nutritional support using a regular diet for undernourished surgical patients at the outpatient clinic. Background Undernutrition (or malnutrition) in surgical patients has severe consequences i.e. more complications, longer hospital stay, and decreased quality of life. While systematic r...

Background: Low-value care provides little or no benefit to the patient, causes harm and wastes limited resources. Reducing it is therefore important for safer and more sustainable care. Objectives: We systematically assessed nursing low-value care practices in Dutch clinical practice guidelines with the aim to facilitate and stimulate nurses to...

Background: Rapid response systems aim to improve early recognition and treatment of deteriorating general ward patients. Sole reliance on deviating vital signs to escalate care in rapid response systems disregards nurses' judgments about a patient's condition based on worry and other indicators of deterioration. To make worry explicit, the Dutch-...

De voedingstoestand van een patiënt is een belangrijke factor voor succesvol herstel na een chirurgische ingreep:1 ondervoeding beïnvloedt het herstel negatief.2 Verpleegkundigen spelen een grote rol in het verbeteren van de preoperatieve voedingszorg. Drie lopende voedingsstudies geven inzicht in taken en ervaringen.

Background: Delirium occurs frequently in intensive care unit (ICU) patients and is associated with numerous deleterious outcomes. There is a large variation in reported delirium occurrence rates, ranging from 4% to 89%. Apart from patient and treatment-related factors, organisational factors could influence delirium incidence, but this is current...

Aims: The aim of this paper is to describe and discuss the 'Basic Care Revisited' (BCR) research programme, a collaborative initiative that contributes to evidence-based basic nursing care and raises awareness about the importance of basic nursing care activities. Background: While basic nursing care serves nearly all people at some point in the...

Aims and objectives: The aim of the study is to explore the perspectives of nursing students on their education concerning basic nursing care, learned either during theoretical education or clinical placement, with a specific focus on nutrition and communication. Background: Basic care activities lie at the core of nursing, but are ill-informed...

Rationale: Undernutrition among patients planned for surgery influences outcomes, e.g. higher complication rates, longer length of hospital stay (LoS) and increased mortality. The aim of this study was to evaluate the feasibility and effectiveness of an early nursing nutrition intervention (NNI) in outpatients planned for surgery. Methods: The NNI...

Kwaliteit van verpleegkundige zorg brengen we in kaart met zorguitkomsten, de zogenaamde ‘nurse sensitive outcomes, om te evalueren welk effect de organisatie van verpleegkundige zorg heeft op bijvoorbeeld tevredenheid van patiënten, patiëntveiligheid, decubitus en pijn.

Recent kwam de Beter Laten-lijst uit met 66 handelingen die verpleegkundigen beter kunnen laten. Op deze lijst komen opvallend veel handelingen voor die onder de categorie basiszorg vallen, zoals eten en drinken. Eveneens bevat de lijst handelingen die palliatieve zorg betreffen. In dit artikel lichten we deze twee eruit. Ze kunnen als voorbeeld ku...

Aims and objectives: To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. Background: Even though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences int...

Ondervoeding in het ziekenhuis is een veelvoorkomend probleem; gemiddeld 1 op de 3 patiènten is ondervoed. Ondervoeding is geassocieerd met een toename van complicaties, langere opnameduur en hogere zorgkosten. Behandeling van ondervoeding is erop gericht de voedingsinname en voedingstoestand te verbeteren. Het is echter moeilijk om tijdens ziekenh...

Background: Currently available tools for the management of safety in health care are largely based on quantitative management information. Executive WalkRounds (WalkRounds [WR]) seems useful as a leadership tool to detect "soft signals"-alerts of unsafe situations or practices-and to enhance the mutual trust between frontline staff and the board...

Aims and objectives: To determine the predictive value of individual and combined dutch-early-nurse-worry-indicator-score indicators at various Early Warning Score levels, differentiating between Early Warning Scores reaching the trigger threshold to call a rapid response team and Early Warning Score levels not reaching this point. Background: D...

Oudere patiënten hebben, meer dan gemiddeld, baat bij vroege herkenning van een verslechtering van hun situatie. Dit omdat vooral zij risico lopen op complicaties tijdens ziekenhuisverblijf. Het ‘niet-pluisgevoel’ van verpleegkundigen blijkt een goede voorspeller van zo’n verslechtering te zijn.

Background: Nurses' 'worry' is used as a calling criterion in many Rapid Response Systems, however it is valued inconsistently. Furthermore, barriers to call the Rapid Response Team can cause delay in escalating care. The literature identifies nine indicators which trigger nurses to worry about a patient's condition. Objectives: The objective of...

Background: Undernutrition is a common complication of disease and a major determinant of hospital stay outcome. Dutch hospitals are required to screen for undernutrition on the first day of admission. Objective: We sought to determine the prevalence of the screening score "undernourished" with use of the Short Nutritional Assessment Questionnai...

Rationale: In The Netherlands, screening on malnutrition is common practice in hospitals, using the Short Nutritional Assessment Questionnaire (SNAQ) or the Malnutrition Universal Screening Tool (MUST). Using the screening data of 14 hospitals of 2007 2014 two questions were answered: 1. What is the percentage of patients with screening score “mal...

Nurses often recognize deterioration in patients through intuition rather than through routine vital signs measurement. Adding the 'worry/concern' sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be 'worried/concerned' might help to put intuition into words...