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To develop a reflection method for community nurses and certified nursing assistants to support the implementation of the Dutch Informal Care guideline in daily care.
Design-based research.
A design group and four test groups of community nurses and nursing assistants were formed to develop a reflection method that aligns with the needs and preferences of its end-users. The design and test group meetings were video recorded. The video data were iteratively discussed and analysed thematically to adapt and refine the method and to identify its key features.
A final reflection method was developed. Five main themes were identified from the analysis: the group, reflective triggers, knowledge about the guidelines, the coach and preconditions. The themes are linked to nine key features representing the building blocks of the reflection method. The key features are group size, participants with different (educational) backgrounds, pairs of participants, expressing thoughts, video feedback, reflection game, making the connection with the guideline, coaching as a process facilitator and meeting organizational and contextual conditions for implementation.
An evidence- and practice-based reflection method for community nurses and certified nursing assistants is developed to support the implementation. By involving community nurses and certified nursing assistants, the method closely matches their needs and preferences. Critical elements of the reflection method are a game element, video feedback and working in pairs in a group of participants from different (educational) backgrounds. Guidance is needed to make the transfer from theory to practice.
A reflection method for community nurses and certified nursing assistants was developed to enhance care work according to guideline recommendations, aiming to improve the care provided by informal caregivers.
The COREQ guideline was used.
This reflection method was developed in close collaboration with all stakeholders during the entire study.
The aims of the study were to gain insight in the transfer process from hospital to homecare or rehabilitation centre from a patient's perspectives and to describe the experienced involvement, information provision and information needs patients.
A multiple case study with a phenomenological approach.
Observations and interviews were employed, between May 2019 and August 2019, to capture the patient's perspectives and experiences on involvement, information provision and needs. Observations were executed during the discharge process from hospital to homecare (n = 6) or revalidation centre (n = 1) and during admission interviews with community nurses (n = 6). Interviews were conducted at the patient's home and the revalidation centre.
Eight themes were identified within three phases of the transfer process. The Sign-up phase contained two themes: ‘organizing follow-up care’ and ‘planning the moment of discharge from the hospital’. The two themes in the Transfer phase were, ‘verbal information provision’ and ‘written information provision’. Four themes were identified in the End phase: ‘nursing supplies’, ‘medication’, ‘the electronic patient portal’ and ‘continuation of (para)medical care’.
Patient participation in the transition process from the hospital to follow-up care can be improved. This study indicates that unsafe situations could be prevented by patient involvement and clear perceptions of the role and responsibilities of patients, family and healthcare professionals.
Patient and family involvement has the potential to improve transition of care and techniques for shared decision-making can be applied to a greater extent.
This paper highlights that patients and families should be acknowledged as key figures in the transfer process and gives direction to healthcare professionals on how to increase involvement in the transfer process by actively inviting patients to participate in the transfer process.
COREQ guidelines for qualitative reporting.
No patient or public contribution.
This paper gives insights in patients’ and families’ perspectives on transition of nursing care and their involvement during the whole transfer process. This paper gives direction how to improve patient participation during the discharge process from hospital to follow-up care.
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