Creating optimized and future-proof emergency care for patients with complex multimorbidity
Projectomschrijving
Preventie van onbedoelde schade door spoedzorg bij patiënten met complexe multimorbiditeit
Binnen de spoedzorg (ambulancezorg en spoedeisende hulp) zien we steeds meer patiënten met meerdere complexe aandoeningen. Deze patiënten hebben vaak heel specifieke en context gebonden zorgbehoeften.
Onbedoelde schade
De spoedzorg is primair ingericht op levensreddend handelen, maar dit kan, juist bij deze patiënten, leiden tot onbedoelde schade. Naást de focus op levensreddend handelen is namelijk meer nodig: spoedzorg die afgestemd is op de individuele context en behoeften.
Doel en werkwijze
In deze onderzoekslijn wordt de aard en impact van onbedoelde schade door spoedzorg onderzocht bij ‘kwetsbare ouderen’ en ‘psychisch ontregelde patiënten’. Het perspectief van patiënten (en hun naasten) speelt daarin een cruciale rol. Om de onderzoeksresultaten te kunnen vertalen naar praktijk en onderwijs, wordt een wetenschappelijk netwerk opgebouwd waarin zowel praktijk, onderwijs en onderzoek vertegenwoordigd zijn.
Nieuwsberichten en artikelen
Kennisagenda
Daarnaast wordt binnen deze onderzoekslijn een wetenschappelijke kennisagenda opgesteld om de kwaliteit van zorg voor psychisch ontregelde patiënten binnen de acute zorg context (ambulancezorg en spoedeisende hulp) te verbeteren. De kennisagenda is multidisciplinair van aard en heeft een sterke samenhang met de eerste en tweede lijn, waardoor ketenzorg en samenwerking kunnen worden geoptimaliseerd.
Toolbox ConnectEM
Lees hoe de toolbox ConnectEM, die is ontwikkeld met artsen, ambulancepersoneel, SEH-verpleegkundigen, psychiatrisch verpleegkundigen en patiënten, ondersteuning biedt bij acute zorg voor psychisch ontregelde patiënten.
Producten
Auteur: Geurt Van de Glind 1, Niek Galenkamp 2, Nienke Bleijenberg 2, Lisette Schoonhoven 3 4, Floortje E Scheepers 5, Julia Crilly 6 7, Mark van Veen 2, Wietske H W Ham 2
Magazine: BMJ open
Link: https://pubmed.ncbi.nlm.nih.gov/37918925/
Auteur: Dorien Venema, Sigrid C J M Vervoort, Janneke M de Man-van Ginkel, Nienke Bleijenberg, Lisette Schoonhoven, Wietske H W Ham
Magazine: International Emergency Nursing
Link: https://www.sciencedirect.com/science/article/pii/S1755599X23000022?via%3Dihub
Verslagen
Samenvatting van de aanvraag
From a patient perspective, “doing the right thing” may not only incorporate survival, but requires tailored emergency care, in which the individual needs and experiences are weighed to “what should be done”. Worldwide, the number of people living with complex multimorbidity has increased and will continue to increase the following decades. Patients with complex multimorbidity have two or more co-occurring or interacting chronic and acute conditions, which has major impact on daily functioning, quality of life and increases mortality risk, health care costs and utilization. “Complex” delineates the non-linear, unpredictable, dynamic and contextual health condition of these patients. Therefore these patients have unique needs, disabilities, or functional limitations in oftentimes complex social and economic circumstances, which requires the attention of multiple healthcare providers or facilities. Complex multimorbidity is associated with increased vulnerability for acute events and increased emergency department visits. The primary focus of emergency care is to “treat first what kills first”, which saves lives, but does not discriminate between individual needs or circumstances of patients with complex multimorbidity. The focus on survival, combined with the high paced and complex emergency environment, increases the risk for undesirable harmful effects from emergency treatment, also defined as unintentional side effects from emergency care. The risk for unintentional side effect in patients with complex multimorbidity of emergency care is still largely overlooked and awareness and structural research within this area is extremely scarce. How can we shift from “treat first what kills first” towards “doing the right thing” in which the individual needs and experiences are weighed to “what should be done”? The overall aim of my research line is to tailor the emergency care for patients (and their relatives) with complex multimorbidity to their needs and experiences in order to minimize or prevent unintentional side effects of emergency care, without compromising the principles of survival. For this proposal, two aims were described; the first aim is to explore the nature and impact of unintentional side effects of emergency care from the perspective of patients and their relatives and the perceived challenges and barriers of their healthcare professionals. This will give insight into the care trajectory through the emergency care system and lead to a thorough inventory of the problems, context and needs of patients (and their relatives) as well as their healthcare professionals. Not only will the study results from this phase form the building blocks for future interventions, they will constitute an important foundation for the further development of the research line itself. The second aim is to build and strengthen a sustainable scientific and knowledge infrastructure around emergency care for patients with complex multimorbidity where practice, education and science will collaborate close to gain maximum impact on this topic. Patients, their relatives and healthcare providers will be actively involved in all planned studies and into the scientific and knowledge infrastructure. This grant enables me to build my research line, and to expand and substantiate my network both national as internationally. It enables me to further develop my research skills and to disseminate new knowledge through the network into research, education and practice. The involved consortium partners are selected on expertise and their relevant contribution in education, research and healthcare practice. All partners share the ambition to better align emergency care for frail older people or mentally ill patients with the needs and specific care characteristics of the patient, while optimizing collaboration between professionals and patients.The involved healthcare institutes that represent practice are the University Medical Center Utrecht, st. Antonius hospital, Meander Medical Center, Diakonessen hospital, the Regional Ambulance Services Utrecht, and The Trauma Care Network Utrecht Region. “Patients experts” will be recruited from members of involved interest groups (Network Utrecht Care Elderly, and the UMCU patient/family panel for mental illness) and representatives of MIND Foundation, 113 Suicide Prevention Foundation. Educational institutions are the Institute of Nursing Studies of the University of Applied Sciences Utrecht; the Master of Clinical Health Sciences/Nursing Science of the University Utrecht, and the UMC Utrecht Academy and St Antonius Academy and Secondary vocational education in Nursing (ROC midden Nederland). Nursing science (Utrecht University) is represented by prof. Lisette Schoonhoven, who chairs Nursing Science and dr. Nienke Bleijenberg, lecturing professor of the Research Group Proactive Care for Older People from the University of Applied Science Utrecht.