http://repub.eur.nl/res/pub/19509/100422_Swarte%2C%20Renate%20Maria%20Cornelia.pdf
Monday, April 30, 2012
The Clinical Value of Intensive Monitoring in Term Asphyxiated Newborns Swarte, R.M.C. 2010-04-22 Doctoral Thesis Pediatrics
http://repub.eur.nl/res/pub/19509/100422_Swarte%2C%20Renate%20Maria%20Cornelia.pdf
Compliance to Hand Hygiene Guidelines in Hospital Care: A stepwise behavioural approach Erasmus, V. 2012-04-25 Doctoral Thesis
Healthcare associated infections (HAI) are a threat to the health of people requiring acute
or chronic care. Since HAI can often be avoided by taking preventative measures, including
proper application of hand hygiene principles, the prevention of these infections has
received growing attention over the past decades. However, the application of preventive
measures in clinical practice remains problematic and the observed compliance with
such measures is often poor. Hand hygiene is one such area where compliance needs to
be improved. To be able to develop successful interventions for the improvement of hand
hygiene, it is essential to identify the factors influencing hand hygiene behaviour, and to
investigate which interventions best target these factors.
This thesis reports on a number of studies on the identification of behavioural and environmental
correlates of hand hygiene behaviour among healthcare workers, and the translation
of these determinants into an intervention. This chapter describes the background,
aims and theoretical framework used, and presents an introduction to the individual
studies that are part of this thesis.
Understanding Outstanding: quality assurance in colonoscopy Jonge, V. de Nicolaas, J.S. 2012-04-20 Doctoral Thesis
Since a couple of years, quality assurance (QA) stands at the core of the attention in the
healthcare sector. Especially after the publication in 2000 of the Institute of Medicine’s report
‘To err is human’ the interest in QA has taken a quantum leap and many quality initiatives have
been developed. This report revealed that every year in the United States approximately
98,000 patients died because of medical errors. Following this report, within the healthcare
sector the awareness arose that the quality of the service had to improve, with special attention
to safety and patient experiences. Since then the healthcare sector has learned some
important lessons in QA from other industries such as the airline industry and energy sector,
which are generally classified as ultra-safe organizations.
Gastrointestinal endoscopy has been one of the medicine specialties which enrolled
important quality initiatives. Especially since the introduction of colorectal cancer (CRC)
screening programs, many efforts have been undertaken to better understand the concept
of high quality endoscopy. CRC screening has been proven to decrease the incidence of CRC,
and CRC related mortality. Therefore many institutions and societies recommend to screen
asymptomatic individuals by fecal occult blood tests, flexible sigmoidoscopy, or colonoscopy.
As these screening programs involve healthy individuals, the cost-effectiveness of such
programmatic screening approaches is highly dependent on the quality of the procedure,
but also on pre- and post-procedure quality aspects to improve screenee experiences and
thereby the uptake of and adherence to screening modalities.
In the Netherlands, CRC screening is about to start in 2013 by means of biennial fecal immunochemical
testing. To attain the highest effect a comprehensive QA program should be
enrolled with major focus on endoscopy as secondary screening method, as is recommended
now by the European Union. The other diagnostic and therapeutic services provided by the
endoscopy units will benefit simultaneously from such an initiative.
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