[The development and validation of a standardised transfer sheet for care transitions between residential and acute care settings in Leuven, Belgium]. / De ontwikkeling en validering van een transferdocument voor de zorgoverdracht tussen de residentiële en de acute zorgsector: een voorbeeld uit de regio Leuven, Vlaams Brabant.

BACKGROUND: When elderly patients are transferred from a residential to an acute care setting, important information regarding their health care can be lost. Over the past years, the concept of advance care planning has also been given a more prominent place in the care for the elderly. However it remains a challenge to communicate the results achieved by this process when patients are referred to another health care setting. Developing a sound method for transferring information is a key element in the transitional care for the elderly patient. OBJECTIVES: In collaboration with the residential and acute care settings in Leuven, Flemish Brabant, Belgium this study aimed to develop a validated, standardized transfer-sheet. METHODS: After a literature search a topic list was generated to be used as the basis for a Delphi-procedure in which 16 experts from both the acute and the residential care settings participated. The transfer-sheet was then evaluated for content validity by an expert-panel (n = 9) from the acute and residential care settings. Face validity was assessed by two nurses and two doctors, randomly selected from the above settings. RESULTS: All 44 subthemes in the transfer-sheet showed excellent content validity. The scale content validity universal agreement (S CVIUA) for the entire transfer-sheet was 0.68. The average scale content validity (S CVIAve) was 0.96. After a second and final Delphi-round a final transfer-sheet was constructed consisting of 8 themes and 50 sub-themes. CONCLUSIONS: Based on these results standardized transfer-sheet was developed and validated.

Acquiring a dataset of labeled video images showing discomfort in demented elderly.

One of the effects of late-stage dementia is the loss of the ability to communicate verbally. Patients become unable to call for help if they feel uncomfortable. The first objective of this article was to record facial expressions of bedridden demented elderly. For this purpose, we developed a video acquisition system (ViAS) that records synchronized video coming from two cameras. Each camera delivers uncompressed color images of 1,024 x 768 pixels, up to 30 frames per second. It is the first time that such a system has been placed in a patient's room. The second objective was to simultaneously label these video recordings with respect to discomfort expressions of the patients. Therefore, we developed a Digital Discomfort Labeling Tool (DDLT). This tool provides an easy-to-use software representation on a tablet PC of validated "paper" discomfort scales. With ViAS and DDLT, 80 different datasets were obtained of about 15 minutes of recordings. Approximately 80% of the recorded datasets delivered the labeled video recordings. The remainder were not usable due to under- or overexposed images and due to the patients being out of view as the system was not properly replaced after care. In one of 6 observed patients, nurses recognized a higher discomfort level that would not have been observed without the DDLT.