J. Wielenga - Academia.edu (original) (raw)
Papers by J. Wielenga
Nursing in Critical Care, 2015
Nederlands Tijdschrift voor Evidence Based Practice, 2012
Family-centered care has become the new trend in the health care field that involves honoring the... more Family-centered care has become the new trend in the health care field that involves honoring the patient and families' perspectives and choices and supporting them in participating in care and decision making at whatever level they choose. Family presence on rounds is one of the guidelines instituted for evidence-based best practices for support of family in the delivery of patient-centered care in the intensive care unit (ICU) but identified as the least studied among all the other aspects of family-centered care in the ICU. From 1988 to 2010, only 1 research study on family presence was conducted in an adult ICU. The purpose of this article was to review research studies related to family presence on medical rounds; reviews that focus on both adults and pediatric patients in the critical and noncritical care settings are also included.
Nederlands Tijdschrift voor Evidence Based Practice, 2007
Pediatric Critical Care Medicine, 2014
Advances in Neonatal Care, 2008
To study the effect of introduction of the Newborn Individualized Developmental Care and Assessme... more To study the effect of introduction of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on nursing staff job satisfaction. Registered nurses, with specialist neonatal qualifications or in training, in a level III neonatal intensive care unit (NICU) in the Netherlands. A survey was performed before 2001 and 6 months after (2003) the introduction of NIDCAP as the new model of care. Job satisfaction was measured by means of the Index of Work Satisfaction (IWS) instrument. From the 74 and 70 nurses on the payroll, who participated in the survey before and after the introduction of NIDCAP, respectively 67.6% and 80% responded. No differences were seen in background variables between both groups. Individual components of the IWS on importance and satisfaction were ranked in the same order before and after the NIDCAP introduction. The results on the IWS demonstrated no change in the overall satisfaction rate, respectively 14.4 and 14.5. Only in 1 component, organizational policies, the mean score increased significantly (3.68 and 4.13, respectively, P = .008). The other component scores did not increase significantly. Major changes in nursing care practice by means of NIDCAP, on our NICU did not affect overall satisfaction. Scores suggested that nursing staff were persistently satisfied with their job.
Acta Paediatrica, 2007
To compare the short-term clinical outcomes of Newborn Individualized Developmental Care and Asse... more To compare the short-term clinical outcomes of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) and conventional care. A prospective phase-lag cohort study was performed in a Dutch tertiary level neonatal intensive care unit (NICU). Infants born before 30 weeks of gestational age (GA) were included, 26 in the conventional and 25 in the NIDCAP group. Outcomes were respiratory status, cerebral ultrasound findings, growth and length of NICU stay. At study entry, NIDCAP infants had a lower birth weight (mean [SD]: 1043 [191] vs. 1154 [174] g, p = 0.044), were more often small for GA (8 vs. 2, p = 0.038), had smaller head circumferences (mean [SD]: 25.1 [1.3] vs. 26.1 [1.8] cm, p = 0.041) and were less often multiples (6 vs. 14, p = 0.029) than conventional care infants. During NICU stay, more infants in the NIDCAP group developed pneumonia (9 vs. 3, p = 0.040) due to nosocomial infections. After adjustment for these differences, a decreased risk for more severe cerebral damage in favour of NIDCAP was seen (Odds ratio: 0.12, 95% CI: 0.03-0.46, p = 0.002). No differences were observed for the other outcomes. We conclude with precaution that in this phase-lag cohort study NIDCAP may have resulted in less severe cerebral damage, but was not associated with other clinical outcomes. In light of these findings, NIDCAP deserves further exploration.
Journal of Nursing Care Quality, 2006
International Journal of Nursing Studies
Archives of Disease in Childhood
Children Clinic/Academic Medical Center in Amsterdam the Netherlands was a complicated process. M... more Children Clinic/Academic Medical Center in Amsterdam the Netherlands was a complicated process. Methods A multidisciplinary workgroup, 5 nurses, 5 neonatologists and a pharmacist composed a phased implementation procedure which consisted of the following activities: A multidisciplinary meeting before and 10 months after implementation; Existing protocols were made evidence based; Working visits were made; A centre of expertise was established; A group of experienced nurses and doctors were steered as leaders in the care; Clinics and workshops for leading nurses; Clinics for all professionals concerned; Sessions for nurses to reflect and learn from each other; Evaluation of the implementation; and an Inventory to readjust existing guideline. Results Due to media attention, an early start was forced. Protocols were not ready, material and equipment not available. The number of infants was higher than expected. The decision to perform the care for these infants by leading nurses resulted in agitation amongst other nurses. Their opinion was that complex nursing care should be performed by all experienced nurses. New rules resulted in a lack of clarity. Conclusions Well-considered choices were made, however it appeared that nurses were in need of training on the job instead of planned theoretical training in advance.
Archives of Disease in Childhood, 2012
Tijdschrift voor kindergeneeskunde, 2002
Summary Design. Sample of an open population. Setting. Neonatology department (Neonatal Intensi... more Summary Design. Sample of an open population. Setting. Neonatology department (Neonatal Intensive Care Unit), Academic Medical Centre/Emma Children's Hospital, Amsterdam. Method. One clinical expert and nine observers observed ventilated premature born babies simultaneously. Criterion validity was assessed by correlating the comfort scale with the clinical judgement regarding the amount of stress. Inter observer reliability was assessed on the clinical judgement
Archives of Disease in Childhood, 2012
Archives of Disease in Childhood, 2014
Parent participation in the nursing process significantly contributes to the overall wellbeing of... more Parent participation in the nursing process significantly contributes to the overall wellbeing of a newborn and the whole family. It is important to ensure that nurses, who take care of newborns and collaborate with their family members, are well-acquainted with the influence that an infant's illness and critical condition as well as the stress have on the functioning of a family unit The Aim To compare parents' and nurses' perceptions of parents needs in Neonatal Intensive Care Unit. The study was conducted in Kaunas University Hospital NICU. The sample consisted of 181 parents and 37 nurses. The NICU Family Needs Inventory was used for data collection. The instrument included five following subscales of needs: proximity, information, assurance, support and comfort. Reliability of the scale was identified as 0.94 using Cronbach's a. The parents' needs perceived by both groups were compared within the subscales. Using Mann'o-Whitney rank test the significant differences between the parents' and nurses' assessments of individual statements were identified. The majority of statistically significant differences between parents and nurses have been found in case of assessment of proximity (75.0%) and informational (72.7%) needs related to the possibility for parents to be close to their newborn and to receive timely and adequate information about their newborn's health condition. Parents, if compared to nurses, assessed these needs as more important. The assessment of support needs showed the lowest number of differences (38.9%). There was a statistically significant difference in case of the decision making needs related to the newborn care that parents identified as being more important. Nurses perceived as being more important the needs related to parent-toparent support and possibility to share feelings. The comparison of parents and nurses perceptions of parents needs in NICU showed that there are statistically significant differences of individual statements assessment within the all five subscales.
Archives of Disease in Childhood, 2014
ABSTRACT
Archives of Disease in Childhood, 2014
Method A neonatal research nurse was recruited in 2012. Measures were implemented to increase the... more Method A neonatal research nurse was recruited in 2012. Measures were implemented to increase the number and complexity of studies, and to be proactive in effective screening mechanisms, resulting in early identification of patients. Research was actively promoted, and teaching provided on a rolling programme. A close link was established with the Paediatric Research Nursing Team, to provide administrative support and cover in times of absence. Links were made with research colleagues both regionally and nationally, and attendance at study days and conferences were identified as effective networking strategies. Parental participation in research was encouraged, with the research nurse providing a link for the parents. Results The number of studies has increased from an average of 1 ongoing study to 7 current studies. These studies include a meningitis study, a vaccine study, a platelet transfusion study and a large cohort observational study. A Patient Participation Involvement study is planned for the near future, and a service evaluation of the research team is awaiting approval. Conclusions Effective neonatal research is dependent on a motivated and adequately resourced research team, including dedicated nursing research time. This has ensured that our LNNU will continue to provide excellent neonatal care, underpinned by research.
Archives of Disease in Childhood, 2014
Neonatal Network: The Journal of Neonatal Nursing, 2004
Objective: Assessment of clinimetric properties and diagnostic quality of a stress measurement sc... more Objective: Assessment of clinimetric properties and diagnostic quality of a stress measurement scale (COMFORT scale).Design: Sample of an open population.Setting: Neonatology department (Neonatal Intensive Care Unit), Academic Medical Centre/Emma Children’s Hospital, Amsterdam, the Netherlands.Method: One clinical expert and 9 observers observed ventilated premature born babies simultaneously. Criterion validity was assessed by correlating the COMFORT scale with the clinical judgment regarding the amount of stress. Interobserver reliability was assessed on the clinical judgment as well as on the COMFORT scale. Diagnostic qualities were evaluated with a ROC curve.Results: On 19 ventilated prematurely born babies (mean gestational age 30 weeks, mean birth weight 1385 gm), one clinical expert and 9 observers made 30 paired observations. The criterion validity of the COMFORT scale was good (Pearson’s r of 0.84). The interobserver reliability of the clinical judgment was very good (weigh...
Nursing in Critical Care, 2015
Nederlands Tijdschrift voor Evidence Based Practice, 2012
Family-centered care has become the new trend in the health care field that involves honoring the... more Family-centered care has become the new trend in the health care field that involves honoring the patient and families' perspectives and choices and supporting them in participating in care and decision making at whatever level they choose. Family presence on rounds is one of the guidelines instituted for evidence-based best practices for support of family in the delivery of patient-centered care in the intensive care unit (ICU) but identified as the least studied among all the other aspects of family-centered care in the ICU. From 1988 to 2010, only 1 research study on family presence was conducted in an adult ICU. The purpose of this article was to review research studies related to family presence on medical rounds; reviews that focus on both adults and pediatric patients in the critical and noncritical care settings are also included.
Nederlands Tijdschrift voor Evidence Based Practice, 2007
Pediatric Critical Care Medicine, 2014
Advances in Neonatal Care, 2008
To study the effect of introduction of the Newborn Individualized Developmental Care and Assessme... more To study the effect of introduction of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on nursing staff job satisfaction. Registered nurses, with specialist neonatal qualifications or in training, in a level III neonatal intensive care unit (NICU) in the Netherlands. A survey was performed before 2001 and 6 months after (2003) the introduction of NIDCAP as the new model of care. Job satisfaction was measured by means of the Index of Work Satisfaction (IWS) instrument. From the 74 and 70 nurses on the payroll, who participated in the survey before and after the introduction of NIDCAP, respectively 67.6% and 80% responded. No differences were seen in background variables between both groups. Individual components of the IWS on importance and satisfaction were ranked in the same order before and after the NIDCAP introduction. The results on the IWS demonstrated no change in the overall satisfaction rate, respectively 14.4 and 14.5. Only in 1 component, organizational policies, the mean score increased significantly (3.68 and 4.13, respectively, P = .008). The other component scores did not increase significantly. Major changes in nursing care practice by means of NIDCAP, on our NICU did not affect overall satisfaction. Scores suggested that nursing staff were persistently satisfied with their job.
Acta Paediatrica, 2007
To compare the short-term clinical outcomes of Newborn Individualized Developmental Care and Asse... more To compare the short-term clinical outcomes of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) and conventional care. A prospective phase-lag cohort study was performed in a Dutch tertiary level neonatal intensive care unit (NICU). Infants born before 30 weeks of gestational age (GA) were included, 26 in the conventional and 25 in the NIDCAP group. Outcomes were respiratory status, cerebral ultrasound findings, growth and length of NICU stay. At study entry, NIDCAP infants had a lower birth weight (mean [SD]: 1043 [191] vs. 1154 [174] g, p = 0.044), were more often small for GA (8 vs. 2, p = 0.038), had smaller head circumferences (mean [SD]: 25.1 [1.3] vs. 26.1 [1.8] cm, p = 0.041) and were less often multiples (6 vs. 14, p = 0.029) than conventional care infants. During NICU stay, more infants in the NIDCAP group developed pneumonia (9 vs. 3, p = 0.040) due to nosocomial infections. After adjustment for these differences, a decreased risk for more severe cerebral damage in favour of NIDCAP was seen (Odds ratio: 0.12, 95% CI: 0.03-0.46, p = 0.002). No differences were observed for the other outcomes. We conclude with precaution that in this phase-lag cohort study NIDCAP may have resulted in less severe cerebral damage, but was not associated with other clinical outcomes. In light of these findings, NIDCAP deserves further exploration.
Journal of Nursing Care Quality, 2006
International Journal of Nursing Studies
Archives of Disease in Childhood
Children Clinic/Academic Medical Center in Amsterdam the Netherlands was a complicated process. M... more Children Clinic/Academic Medical Center in Amsterdam the Netherlands was a complicated process. Methods A multidisciplinary workgroup, 5 nurses, 5 neonatologists and a pharmacist composed a phased implementation procedure which consisted of the following activities: A multidisciplinary meeting before and 10 months after implementation; Existing protocols were made evidence based; Working visits were made; A centre of expertise was established; A group of experienced nurses and doctors were steered as leaders in the care; Clinics and workshops for leading nurses; Clinics for all professionals concerned; Sessions for nurses to reflect and learn from each other; Evaluation of the implementation; and an Inventory to readjust existing guideline. Results Due to media attention, an early start was forced. Protocols were not ready, material and equipment not available. The number of infants was higher than expected. The decision to perform the care for these infants by leading nurses resulted in agitation amongst other nurses. Their opinion was that complex nursing care should be performed by all experienced nurses. New rules resulted in a lack of clarity. Conclusions Well-considered choices were made, however it appeared that nurses were in need of training on the job instead of planned theoretical training in advance.
Archives of Disease in Childhood, 2012
Tijdschrift voor kindergeneeskunde, 2002
Summary Design. Sample of an open population. Setting. Neonatology department (Neonatal Intensi... more Summary Design. Sample of an open population. Setting. Neonatology department (Neonatal Intensive Care Unit), Academic Medical Centre/Emma Children's Hospital, Amsterdam. Method. One clinical expert and nine observers observed ventilated premature born babies simultaneously. Criterion validity was assessed by correlating the comfort scale with the clinical judgement regarding the amount of stress. Inter observer reliability was assessed on the clinical judgement
Archives of Disease in Childhood, 2012
Archives of Disease in Childhood, 2014
Parent participation in the nursing process significantly contributes to the overall wellbeing of... more Parent participation in the nursing process significantly contributes to the overall wellbeing of a newborn and the whole family. It is important to ensure that nurses, who take care of newborns and collaborate with their family members, are well-acquainted with the influence that an infant's illness and critical condition as well as the stress have on the functioning of a family unit The Aim To compare parents' and nurses' perceptions of parents needs in Neonatal Intensive Care Unit. The study was conducted in Kaunas University Hospital NICU. The sample consisted of 181 parents and 37 nurses. The NICU Family Needs Inventory was used for data collection. The instrument included five following subscales of needs: proximity, information, assurance, support and comfort. Reliability of the scale was identified as 0.94 using Cronbach's a. The parents' needs perceived by both groups were compared within the subscales. Using Mann'o-Whitney rank test the significant differences between the parents' and nurses' assessments of individual statements were identified. The majority of statistically significant differences between parents and nurses have been found in case of assessment of proximity (75.0%) and informational (72.7%) needs related to the possibility for parents to be close to their newborn and to receive timely and adequate information about their newborn's health condition. Parents, if compared to nurses, assessed these needs as more important. The assessment of support needs showed the lowest number of differences (38.9%). There was a statistically significant difference in case of the decision making needs related to the newborn care that parents identified as being more important. Nurses perceived as being more important the needs related to parent-toparent support and possibility to share feelings. The comparison of parents and nurses perceptions of parents needs in NICU showed that there are statistically significant differences of individual statements assessment within the all five subscales.
Archives of Disease in Childhood, 2014
ABSTRACT
Archives of Disease in Childhood, 2014
Method A neonatal research nurse was recruited in 2012. Measures were implemented to increase the... more Method A neonatal research nurse was recruited in 2012. Measures were implemented to increase the number and complexity of studies, and to be proactive in effective screening mechanisms, resulting in early identification of patients. Research was actively promoted, and teaching provided on a rolling programme. A close link was established with the Paediatric Research Nursing Team, to provide administrative support and cover in times of absence. Links were made with research colleagues both regionally and nationally, and attendance at study days and conferences were identified as effective networking strategies. Parental participation in research was encouraged, with the research nurse providing a link for the parents. Results The number of studies has increased from an average of 1 ongoing study to 7 current studies. These studies include a meningitis study, a vaccine study, a platelet transfusion study and a large cohort observational study. A Patient Participation Involvement study is planned for the near future, and a service evaluation of the research team is awaiting approval. Conclusions Effective neonatal research is dependent on a motivated and adequately resourced research team, including dedicated nursing research time. This has ensured that our LNNU will continue to provide excellent neonatal care, underpinned by research.
Archives of Disease in Childhood, 2014
Neonatal Network: The Journal of Neonatal Nursing, 2004
Objective: Assessment of clinimetric properties and diagnostic quality of a stress measurement sc... more Objective: Assessment of clinimetric properties and diagnostic quality of a stress measurement scale (COMFORT scale).Design: Sample of an open population.Setting: Neonatology department (Neonatal Intensive Care Unit), Academic Medical Centre/Emma Children’s Hospital, Amsterdam, the Netherlands.Method: One clinical expert and 9 observers observed ventilated premature born babies simultaneously. Criterion validity was assessed by correlating the COMFORT scale with the clinical judgment regarding the amount of stress. Interobserver reliability was assessed on the clinical judgment as well as on the COMFORT scale. Diagnostic qualities were evaluated with a ROC curve.Results: On 19 ventilated prematurely born babies (mean gestational age 30 weeks, mean birth weight 1385 gm), one clinical expert and 9 observers made 30 paired observations. The criterion validity of the COMFORT scale was good (Pearson’s r of 0.84). The interobserver reliability of the clinical judgment was very good (weigh...