• Kwaliteitsindicatoren voor de eerstelijnsverloskunde

      Kooistra M; Waelput AJM; Boer J de; Driel W van; Offerhaus P; Blaauw J; Ketel-Hamaker ND; Amelink-Verburg MP; Ouden AL den; Kolk M van der; Graafmans WC; PZO (IGZ, 2009-08-06)
      In order to monitor the quality of home care deliveries in the Netherlands, a set of 23 quality indicators has been defined. The quality indicators include percentages for deliveries without the presence of a midwife, referrals to an obstetrician and deliveries without the presence of a maternity assistant. This research was commissioned by the Netherlands Health Care Inspectorate (IGZ), which, after consultation and agreement with professional groups, will adopt some indicators for their surveillance purposes. The indicators were defined by a steering committee comprising members of the Royal Dutch Organization of Midwives (KNOV), the Association of Obstetric Active General Practitioners (VVAH), a practising midwife, the IGZ, and researchers from the National Institute for Public Health and the Environment (RIVM). Several years ago, the KNOV introduced methods to improve the quality of midwifery care; these included the quality register and practice accreditation. In line with this, the next step will be to use indicators to monitor the quality of midwifery care. Compared to existing quality instruments, indicators are useful for gaining detailed insight into certain aspects of midwifery care. Indicators are measures that reflect, or indicate, the state of health care. The steering committee first identified thirteen quality domains. Subsequently, based on the literature and existing guidelines, a list of possible indicators was generated. This list was then judged by experts from the field. The indicators were judged on their relevance to clinical practice. In addition, their feasibility for the health care professional for deriving information from routinely collected data was judged.
    • Risks associated with the lay use of 'over-the-counter' medical devices. Study on infrared thermometers and wound care products

      Hollestelle ML; Hilbers ESM; van Drongelen AW; BMT (Rijksinstituut voor Volksgezondheid en Milieu RIVMIGZ, 2007-10-30)
      An assessment of the files on two types of 'over-the-counter' medical devices (infrared thermometers and wound care products) revealed major shortcomings in the risk analyses, available user information and post-market surveillance procedures. These three components are important for guarding the safe use of a medical device, especially in terms of reducing risks as far as possible in the design stage of the device, informing the user of residual risks and undertaking post-market surveillance activities. Particularly for over-the-counter medical devices, a rapidly growing market segment, information for the (lay) user is important. Application by lay users and potential errors when using the products were often not addressed in the risk analyses and were insufficiently covered in the user information. Moreover, the coherence between items addressed in the risk analyses and those stated in the user information was poor. The user information addressed more residual risks associated with the use of the product than the risk analyses. The comprehensibility of the user information was often compromised by poor readability and difficult phrasing. Appropriate user information is crucial for the safe application of self-care medical devices, even more so if the devices to be used are complex and/or relatively new to the consumer market. Files on 16 products eight infrared thermometers and eight wound care products were requested. These files contained the risk analysis, user information, post-market surveillance procedure and, if available, results of studies carried out with lay users. Files on all 16 products were received, but the documentation was often incomplete, notably for the thermometers. The absence of risk analyses and post-market surveillance procedures was remarkable as this information is an important requirement of the Medical Device Directive.
    • Vaccinatietoestand Nederland per 1 januari 2004

      Abbink F; Oomen PJ; Zwakhals SLN; de Melker HE; Ambler-Huiskes A; CIE (Rijksinstituut voor Volksgezondheid en Milieu RIVMLandelijke Vereniging van EntadministratiesIGZ, 2005-06-07)
      This report describes the progress of the National Immunization Programme (NIP) in the Netherlands. Immunization coverage figures as at 1 january 2004 are presented for all vaccines used in the NIP for agecohorts born in 1993, 1998 and 2001.For years national immunization coverage in the Netherlands has been excellent. For 2004 national coverage levels for all vaccines used increased and exceeded 95% for the first time. The slow but steady decrease in coverage for infants reported since 1996 has been restored to a level of coverage exceeding 97%.Although high national immunization coverage can mask variations within country, regional and municipal immunization coverage also improved over the past year. All provinces reported over 90% immunization coverage for all vaccines used and municipal immunization coverage levels below 60%, previously observed each year, were not reported.Areas with low immunization coverage are - once again - concentrated in the so called 'Bible-belt' where groups of orthodox reformed people live who refuse vaccination for religious reasons.In spite of the progress made for the past year under review, joint efforts are still needed to obtain and sustain high immunization coverage. Particularly because it is already known that immunization coverage for the birthcohorts following 2001 was negatively affected by the massive attention paid to the introduction of the new DTaP-IPV-Hib vaccine by the media. Continuous attention and joined efforts of all parties engaged in the NIP will be needed to ensure that the population of the Netherlands is well educated and motivated to have their children immunized.