Care Staff Research Articles

Interventions to improve continence for children and young people with neurodisability: a national survey of practitioner and family perspectives and experiences

ObjectiveDescribe families’ experiences of interventions to improve continence in children and young people with neurodisability, and health professionals’ and school and social care staff’s perspectives regarding factors affecting intervention use.DesignFour...

Nursing Home Staffing: Share Of Immigrant Certified Nursing Assistants Grew As US-Born Staff Numbers Fell, 2010-21.

Nursing homes have long faced a shortage of direct care workers, a problem that was magnified during the COVID-19 pandemic. Using nationally representative data from three sources, we found that much of the certified nursing assistant (CNA) workforce in US nursing homes is filled by immigrant labor. The number of native-born CNAs has been declining rapidly since the mid-2010s, whereas the number of foreign-born CNAs has remained relatively constant. During the first two years of the COVID-19 pandemic, the share of immigrant CNAs employed by nursing homes surged, which can be explained by a simultaneous drop in the share of native-born staff. Staffing shortages observed during the pandemic would have been worse if not for foreign-born CNAs remaining in the workforce. However, the share of foreign-born CNAs varied considerably across states, from less than 1percent in West Virginia to more than 70percent in Hawaii. In an analysis of prepandemic data, we found that nursing homes in regions with a higher share of immigrant CNAs were associated with more direct care staff hours per resident day and better nursing home quality performance. With the growing demand for long-term care, creating pathways for job-seeking immigrants to fill the gaps in direct care will be crucial to meeting future staffing needs.

Integrating extended reality in industrial maintenance: a game-based framework for compressed air system training

In industrial environments, maintenance technologies developed under Industry 5.0 are important to ensure trouble-free production and reduce downtime. Compressed Air Systems (CASs) are an integral part of industrial production processes and require competent and correct maintenance. Maintenance personnel should be equipped with continuous and up-to-date training and their knowledge should be tested. There is a significant gap in the field of interactive educational games to improve the technical skills of the care staff, especially in the field of CAS. This research proposes a theoretical framework for a game based on Extended Reality (XR) technologies adapted for CAS maintenance training. The game leverages the trio of Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR) to provide immersive and interactive learning encounters aimed at improving technical proficiency, problem-solving skills, and safety awareness among maintenance workers. The aim is to take advantage of the rewards of game-oriented learning, such as enhanced user engagement and knowledge absorption, to increase the effectiveness of training. In this context, the CAS game framework was created with three frameworks: education, game, and CAS. The study concludes by highlighting the potential benefits, research areas, and technologies that underpin the proposed structure.

Skin Tear Management: A Multidisciplinary Education Project.

To identify the number of skin tears present at the authors' facility and evaluate a multidisciplinary educational intervention to support treatment of skin tears. The authors determined the prevalence of skin tears from an analysis of a wound audit dataset at Baycrest Health Sciences and compared it with the literature to inform the aims of the educational intervention. They developed an educational module and presented it to physicians and students at separate in-person sessions and to clinical care staff at a virtual session. Participants completed an evaluation survey after the education sessions to assess their knowledge and confidence with skin tear management and obtain their feedback about the session. The prevalence of skin tears at Baycrest hospital was 5.6%, which was low compared with the values reported in the literature. For the 10 studies reviewed, the median prevalence was 8.8% (range, 3.0%-22.1%). A total of 7 physicians, 12 students, and 7 clinical care staff completed the evaluation survey. All of the physicians (100%), 43% of students, and 57% of clinical care staff could classify an image of a skin tear; 86% of physicians, 33% of students, and 43% of clinical care staff identified the correct skin tear complications; and 71% of physicians, 0% of the students, and 29% of clinical care staff selected the appropriate dressing. Participants reported moderate to considerable increases in knowledge and confidence in skin tear management. This method of multidisciplinary teaching on skin tears was well received and useful in enhancing knowledge and confidence in identifying and treating skin tears.

Emergency Department and Dental Clinic Perceptions of Appropriate, and Preventable, Use of the ED for Non-Traumatic Dental Conditions in Hot-Spot Counties: A Mixed Methods Study.

Frequency of emergency department (ED) use for nontraumatic dental conditions (NTDC) is a well-researched community health concern. However, research predominately relies on ambulatory ED discharge records. This explanatory sequential mixed methods study reviewed NTDC ED use in hot-spot counties and assessed perceptions around preventable and appropriate use among EDs and dental clinics. Tooth pain data (2015-2021) were drawn from State Medicaid, and the Early Notification of Community-Based Epidemics (ESSENCE). NTDC data were compiled using International Classification of Disease, Ninth and Tenth Revisions. Employing extreme case sampling, providers in counties with the highest per-capita NTDC ED use were interviewed. North Dakota experienced a decline in NTDC ED visits between 2017 and 2020, though the rate is now increasing. The greatest proportion of NTDC ED visits were among persons ages 20 to 34 and 35 to 44. ED and dental care staff have misconceptions around each other's roles in reducing NTDC ED visits, but unanimously suggest community-level prevention as a solution. NTDC ED use was perceived as "appropriate" care. However, there is consensus that improved access to, and utilization of, affordable and quality preventative dental care would reduce NTDC ED visits and improve overall community health, especially among populations experiencing greater inequities.

Primary care system-level training and support programme for the secondary prevention of domestic violence and abuse: a cost-effectiveness feasibility model

ObjectivesThis study aimed to evaluate the prospective cost-effectiveness of the Identification and Referral to Improve Safety plus (IRIS+) intervention compared with usual care using feasibility data derived from seven UK...

Extended Sanitation Intervals for Cage Components and Automated Watering Valves: Validation and Cost Analysis.

Although the Guide suggests changing rodent cage components every 2 wk, it states that "decreased sanitation frequency may be justified if the microenvironment in the cages, under the condition of use ..., is not compromised." The purpose of this study was to evaluate extended sanitation intervals of cage components (automated watering valve, wire bar lid, and filter top) of mouse individually ventilated caging (IVCs) at our institution. We hypothesized that there would be no significant difference in relative light units measured by ATP luminometry of these cage components at the control time point of 14 d as compared with each extended time interval: 28, 56, and 84 d. In addition, for automated watering valves, the study was extended to 168 d. We also hypothesized that time-and-motion studies performed by moving to a sanitation interval of 84 d for all components would result in substantial time and cost savings. The components of a total of 24 cages containing 4 or 5 mice each were swabbed, and an ATP luminometer was used to detect organic matter. We found no significant differences in organic matter load between 14 d and all other time points for all cage components. Our time- and cost-savings analysis found that extending the sanitation interval of cage components from every 2 wk (14 d) to every 3 mo (84 d) for every 10,000 cages would save about 3,000 technician hours annually, for a total annual labor cost savings of about $100,000. This study is the first to validate the extended sanitation interval of automated watering valves and confirms the findings of previous studies that validated the extended sanitation frequency of wire bar lids and filter tops of rodent IVCs. Overall, extending the sanitation frequency of cage components reduces workload of animal care staff without compromising the cage microenvironment.

Artificial intelligence-supported diabetic retinopathy screening in Tanzania: rationale and design of a randomised controlled trial

IntroductionGlobally, diabetic retinopathy (DR) is a major cause of blindness. Sub-Saharan Africa is projected to see the largest proportionate increase in the number of people living with diabetes over the...

Exploring Effective Alternatives to Beta-Lactam Antibiotics for Surgical Prophylaxis: A Comprehensive Investigation

Introduction: The significance of administering preventive antibiotics before a surgical procedure is firmly established,moreover the aim of antibiotic prophylaxis is to limit surgical site infections in surgical patients, based essentially on the use of betalactamines, Individuals with a beta-lactam allergy may experience adverse reactions to antibiotics within this class, such as penicillins and cephalosporins, it leeds to life-threatening symptoms that require immediate medical attention, the aim of our study is to evaluate the surgical antibiotic prophylaxis practices by our staff Material and methods: we carried out a survey using a questionnaire aimed at anesthesia-intensive care staff working in different operating rooms of different types of surgeries. to assess antibiotic prophylaxis practices in the case of allergy to betalactam antibiotics (essentially the alternative antibiotic molecules used). The study lasted 3 months and involved 40 anesthesia-intensive care staff. Once the data had been collected from the questionnaires, they were processed using Excel, then presented in the form of tables and figures, reflecting the results obtained in relation to the aim of the study. Results: the results of antibiotic prophylaxis showed that the use of betalactam antibiotics represented 96% of practices and that the antibiotic molecule chosen as an alternative in case of betalactam allergy was compliant in 84.44% of practices in relation to SFAR 2018 recommendations. Conclusion: Antibiotic prophylaxis practices for patients allergic to betalactamines require major caution in order to limit surgical site infections and reduce hospitalization costs.

Implementation of a One-Day Living Kidney Donor Assessment Clinic to Improve the Efficiency of the Living Kidney Donor Evaluation: Program Report.

A key barrier to becoming a living kidney donor is an inefficient evaluation process, requiring more than 30 tests (eg, laboratory and diagnostic tests), questionnaires, and specialist consultations. Donor candidates make several trips to hospitals and clinics, and often spend months waiting for appointments and test results. The median evaluation time for a donor candidate in Ontario, Canada, is nearly 1 year. Longer wait times are associated with poorer outcomes for the kidney transplant recipient and higher health care costs. A shorter, more efficient donor evaluation process may help more patients with kidney failure receive a transplant, including a pre-emptive kidney transplant (ie, avoiding the need for dialysis). In this report, we describe the development of a quality improvement intervention to improve the efficiency, effectiveness, and patient-centeredness of the donor candidate evaluation process. We developed a One-Day Living Kidney Donor Assessment Clinic, a condensed clinic where interested donor candidates complete all testing and consultations within 1 day. The One-Day Living Kidney Donor Assessment Clinic was developed after performing a comprehensive review of the literature, receiving feedback from patients who have successfully donated, and meetings with transplant program leadership from St. Joseph's Healthcare Hamilton. A multistakeholder team was formed that included health care staff from nephrology, transplant surgery, radiology, cardiology, social work, nuclear medicine, and patients with the prior lived experience of kidney donation. In the planning stages, the team met regularly to determine the objectives of the clinic, criteria for participation, clinic schedule, patient flow, and clinic metrics. Donor candidates entered the One-Day Clinic if they completed initial laboratory testing and agreed to an expedited process. If additional testing was required, it was completed on a different day. Donor candidates were reviewed by the nephrologist, transplant surgeon, and donor coordinator approximately 2 weeks after the clinic for final approval. The team continues to meet regularly to review donor feedback, discuss challenges, and brainstorm solutions. The One-Day Clinic was implemented in March 2019, and has now been running for 4 years, making iterative improvements through continuous patient and provider feedback. To date, we have evaluated more than 150 donor candidates in this clinic. Feedback from donors has been uniformly positive (98% of donors stated they were very satisfied with the clinic), with most noting that the clinic was efficient and minimally impacted work and family obligations. Hospital leadership, including the health care professionals from each participating department, continue to show support and collaborate to create a seamless experience for donor candidates attending the One-Day Clinic. Clinic spots are limited, meaning some interested donor candidates may not be able to enter a One-Day Clinic the same month they come forward. This patient-centered quality improvement intervention is designed to improve the efficiency and experience of the living kidney donor evaluation, result in better outcomes for kidney transplant recipients, and potentially increase living donation. Our next step is to conduct a formal evaluation of the clinic, measuring qualitative feedback from health care professionals working in the clinic and donor candidates attending the clinic, and measuring key process and outcome measures in donor candidates who completed the one-day assessment compared with those who underwent the usual care assessment. This program evaluation will provide reliable, regionally relevant evidence that will inform transplant centers across the country as they consider incorporating a similar one-day assessment model.

Composition of staff teams in early childhood education and care centres in nine countries

This study draws on data from TALIS Starting Strong 2018, an international survey of early childhood education and care (ECEC) staff and leaders, to examine the staff roles (leader, teacher, assistant, specialised staff, intern, other) that are included in ECEC centres in nine countries: Chile, Denmark, Germany, Iceland, Israel, Japan, Korea, Norway and Türkiye. The staffing profiles in ECEC centres are compared across countries as well as within countries, according to whether the centre was co-located with a primary school, its size in terms of the number of children enrolled, and the concentration of children with special needs and those from socio-economically disadvantaged homes. In addition, associations between the share of teachers and assistants in ECEC centres and staff reports of their time working on tasks without children, their collaboration with colleagues, their work-related stress and job satisfaction were examined. Results are discussed in terms of the different policy contexts in the participating countries and implications for building an ECEC workforce to address demands for both increased access to and better ECEC quality for children.

응급구조(학)과 학생들의 신경학적 검진 역량 교육요구도 조사

Objectives This study aims to identify educational needs for neurological examination capabilities for department of paramedicine students, and to provide basic data on the development and application of educational programs to improve neurological capabilities, as well as implications for finding strategies to efficiently cope with neurological emergencies in practice.
 Methods To develop an education program to strengthen neurological examination capabilities, the survey on educational needs for strengthening neurological examination capabilities among paramedicine students was designed as a cross-sectional descriptive research survey using importance and performance analysis, and was designed to determine the importance of neurological examination and Paired t-test was used to determine differences in performance, and Importance-Performance Analysis (IPA) was used to select priorities for training needs.
 Results First, the neurological screening capability measurement tool developed in this study can also be seen as a meaningful attempt to improve the neurological capabilities of department of paramedicine students. Second, the exercise function item was the highest in the neurological examination competency item that the department of paramedicine students considered important. Third, as a result of analyzing the educational needs for enhancing neurological screening capabilities recognized by department of paramedicine students using IPA techniques, the items recognized by this study subjects as priorities were pathological reflexes, cerebral function, and brain neurological examination, and the items that should be maintained and managed continuously were motor function, symptoms and signs, overall neurological evaluation, records and reports.
 Conclusions It is also very important to provide education to new medical staff or health care personnel in the medical field for neurological emergencies, but before that, it is necessary to develop subjects and conduct regular education by organizing various contents, including coping protocols for neurological emergencies and overall understanding of neurological emergencies, to meet students'needs.

'We see they are abandoned': Social support between people discharged from long-term psychiatric hospitalizations and their neighbors in Argentina.

Neighbors are an important component of personal social network (PSN) and despite their peripheral role and being considered as familiar strangers, they typically provide instrumental support. For people who is discharged after long-term psychiatric hospitalizations, neighbors would offer other types of social support and play a different role fostering the process of becoming full member of a given community. To analyze the effects of neighboring on both, those who have had long-term psychiatric hospitalizations and their neighbors. Data was collected between 2020 and 2021, including interviews with formal care staff of three housing support experiences in Argentina, and short testimonies from formerly discharged mental health service users living in the community and their neighbors. We analyzed the data using the Framework Method with a focus on the different aspects of social support and equity and reciprocity theories. Results suggest that emotional support was a frequent function displayed by neighbors toward people with a history of long-term psychiatric hospitalizations, which differs from typical neighboring relationships. Despite reciprocity was observed, users and neighbors displayed an unbalanced helping relationship.

JOB SATISFACTION AND TURNOVER INTENTION OF BLUD WORKERS AT TROSOBO PUBLIC PRIMARY HEALTH CARE

Job satisfaction is defined as a person's attitude or emotional response toward their job duties. Poor job satisfaction leads to turnover. Trosobo public primary health care staffing data showed a high turnover intention of BLUD workers. This study aims to determine the job satisfaction and turnover intention of BLUD worker at the Trosobo public primary health care. This study was quantitative study with a cross-sectional design. The research was conducted in November 2023 at Trosobo public primary care. Eleven BLUD workers were obtained using total sampling calculations. Data analyzed descriptively. The instruments used in this study were MSQ and TIS-6. The lowest average satisfaction score was recognition (43.64) and the highest were authority and achievement (80,00). Job satisfaction of BLUD workers was in the moderate category (score 26-74) and the turnover intention was in the high category (score >15). Trosobo public primary health care BLUD workers had a moderate category of job satisfaction and high turnover intention. Providing services based on workload and length of service, as well as opportunities for career development to BLUD workers, can be carried out by the Trosobo public primary health care as an effort to reduce the turnover problem

Workforce resilience supporting staff in managing stress: A coherent breathing intervention for the long-term care workforce.

Staff in long-term care (LTC) homes have long-standing stressors, such as short staffing and high workloads. These stressors increased during the COVID-19 pandemic; better resources are needed to help staff manage stress and well-being. The purpose of this study was to evaluate the effect of a simple stress management strategy (coherent breathing). We conducted a pre-post intervention study to evaluate a self-managed coherent breathing intervention from February to September 2022. The intervention included basic (breathing only) and comprehensive (breathing plus a biofeedback device) groups. Six hundred eighty-six participants were initially recruited (359 and 327 in the comprehensive and basic groups respectively) from 31 LTC homes in Alberta, Canada. Two hundred fifty-four participants completed pre-and post-intervention questionnaires (142 [55.9%] in comprehensive and 112 [44.1%] in basic). Participants were asked to use coherent breathing based on a schedule increasing from 2 to 10 min daily, 5-7 times a week over 8 weeks. Participants completed self-administered online questionnaires pre- and post-intervention to assess outcomes-stress, psychological distress, anxiety, depression, resilience, insomnia, compassion satisfaction, compassion fatigue, and burnout. We used a mixed-effects regression model to test the main effect of time (pre- and post-intervention) and group while testing the interaction between time and group and controlling for covariates. We found statistically significant changes from pre- to post-intervention in stress (b = -2.5, p < 0.001, 95% CI = -3.1, -1.9), anxiety (b = -0.5, p < 0.001, 95% CI = -0.7, -0.3), depression (b = -0.4, p < 0.001, 95% CI = -0.6, -0.2), insomnia (b = -1.5, p < 0.001, 95% CI = -2.1, -0.9), and resilience (b = 0.2, p < 0.001, 95% CI = 0.1, 0.2). We observed no statistically significant differences between the two intervention groups on any outcome. Our findings suggest that coherent breathing is a promising strategy for improving stress-related outcomes and resilience. This intervention warrants further, more rigorous testing.

Emotional burden in social professions and its implications – presentation of own research results against a literature review

The article presents an overview of emotional burdens that are typical of social professions, along with their causes, protective factors, and health implications. Particular attention is given to the demands associated with social interactions occurring between those helping and those asking for help, which are expressed by interpersonal communication. The subject matter is discussed using examples from the work environment of health care workers and staff at emergency call centres. The results of own research are compared with the findings of other current studies. The introduction presents information on the sources of emotional burden experienced by health care employees, taking into account the changes caused by the COVID-19 pandemic. The requirements associated with interpersonal communication are discussed using the concept of emotional labour. In the following part, the adverse consequences of emotional labour ‒ such as occupational burnout syndrome and health problems ‒ are discussed. They are illustrated with the results of our own study. The problems identified fall within two main domains. First, relationships linking emotional labour to the levels of empathy, work engagement, and professional burnout are examined. The second issue encompasses the predictors of job burnout including the demands of the work environment, marital status, and childcare burden, as well as personal resources in the form of the levels of perceived stress, generalised self-efficacy, and active hobbies. Negative changes pertaining to the levels of helplessness, burnout, and overweight and obesity relating to work during the first wave of the COVID-19 pandemic are also presented. The final part includes a summary and conclusions.

Clinical Challenges of the COVID-19 Vaccines: Frequency of Serious Adverse Events After Immunization in Hospitalized Patients

Background and aims: Today, the role of coronavirus disease 19 (COVID-19) vaccines in preventing the disease and reducing the severity of the disease is undeniable; however, there is a possibility of serious adverse events following immunization (sAEFI) that might be life-threatening. The present study was designed to identify the frequency of the most common sAEFI in hospitalized people after receiving the COVID-19 vaccine in the south of Iran. Methods: This cross-sectional study was conducted in 2022. In total, since the start of the COVID-19 vaccination program in the city of Larestan, in the south of Iran, a total of 68 sick people have been hospitalized due to complications caused by the vaccine. The research tool of the present study was a standard checklist called the sAEFI of the COVID-19 vaccine. Results: A total of 68 hospital cases were reviewed. The mean age of the individuals with sAEFI was 59.78±12.70 years, and 21 (56.8%) of them were females. Acute respiratory distress syndrome (ARDS) was the most common 24 (64.9%) sAEFI. Based on the results, 2 (5.4%) had acute coronary syndrome (ACS), 2 (5.4%) had Guillain-Barré syndrome, and 2 (5.4%) had a stroke. Conclusion: It can be mentioned that there is always a possibility of sAEFI, but its frequency in the general population is extremely rare. However, the most common sAEFIs included adverse drug reactions, stroke, and Guillain-Barré syndrome. The readiness of health care staff for early detection of possible sAEFI can be effective in reducing the severity of the sAEFI.

Spiritual understandings of psychosis: the perspectives of spiritual care staff

ABSTRACT Pathologizing spiritual beliefs has been an ongoing challenge in mental health services. Spiritual care services have been working alongside clinicians in discerning psychosis-like experiences that present with a spiritual or religious content. This study aimed to explore how spiritual care staff make sense of experiences otherwise termed as “psychosis” by interviewing a multi-faith sample of six participants using Interpretative Phenomenological Analysis (IPA). Participants acknowledged “psychosis” as a label applied to certain experiences that are spiritual in nature, emphasizing holisticism. Mental health services were described as predominantly biomedical and that spiritual care integration requires conceptual, collaborative, and practical considerations.

The Role and Experiences of Frontline Social Care Staff within Integrated Care

Background: This study explores the role of those frontline individuals working in care and support roles in ensuring that people receive Integrated Care and how they interact, collaborate and work in partnership with external professionals. Such staff are often central to the people’s experience of person-centred, co-ordinated care due to their frequent contact with people, their families and a multitude of professionals. Despite the centrality of their role, there is a lack of research on these individuals with most research around Integrated Care focused on formal professions such as Nurses and Social Workers. &#x0D; Who is it for? This research study has been conducted for frontline social care staff within Integrated Care services and for all stakeholders involved in a person’s care ranging from Social Workers, CPNs, Housing support, health and local authorities. This will also be of interest to those responsible for managing future integrated services and to those implementing new Integrated Care programmes.&#x0D; Who did you involve and engage with? This research study was led by a PhD Research student around an Integrated Mental Health Recovery Service for Adults in the Midlands region of England which had been implementing integrated care over the past five years. The service supports people to leave /avoid hospital or prison etc to develop new skills, manage their risks and to support the Mental Health Recovery journey for individuals. The emerging insights from this study will be shared with a lived experience panel in order to gain their perspectives.&#x0D; What did you do? A scoping literature review was conducted which highlighted the limited number of research studies involving frontline social care and support staff. With the premise that all involved in Integrated Care are equal partners, a lack of literature on these individuals highlighted a gap in data. Qualitative semi-structured interviews are being conducted with social care staff and various professionals involved in the case study site, based on themes which emerged in the literature review.&#x0D; What results did you get? This research study is part of a PhD Thesis due for completion in September 2023 and data gathering will be complete and initial analysis will be presented at the conference.&#x0D; What is the learning for the international audience? The areas of learning will be around the key themes which emerge from the findings of the qualitative interviews on barriers and facilitators of Integrated Care based on the role and experiences of frontline social care staff, a group which has been under researched both within the UK and internationally.&#x0D; What are the next steps? The insights from this research study will help to inform the Integrated service and the local areas to improve the support to people in services, to help advance practice within Integrated Care and for the future development of Integrated Care services and programmes.

How to ensure the sustainability of good practices transfer to heterogeneous contexts? Sharing the results of the JADECARE Joint Action

Summary: This workshop presents the general results of the implementation process of JADECARE and explores the key elements to support the sustainability of good practice transfer beyond the Joint Action.&#x0D; It presents the JADECARE Sustainability strategy that sets three core elements: policy environment, ownership of sustainability and culture of collaboration and consensus seeking.&#x0D; Two Next Adopters (NAs) adopting and transferring good practices will present the results of the implementation of their local good practices and their work to build sustainability beyond JADECARE.&#x0D; Background: JADECARE (the Joint Action on digitally enabled integrated person-centred care) contributes to innovative, efficient and sustainable health systems, providing expertise and sharing good practices to assist the Member States in undertaking health system reforms. It enables the participating national authorities and those beyond the Consortium, to benefit from efficient solutions in digitally enabled integrated person-centred care via supporting best practice transfer to 21 other settings of Next Adopters.&#x0D; Aim: Share the results of the implementation process of JADECARE and explore the key elements to ensure the sustainability of local good practices beyond the Joint Action.&#x0D; Objectives:&#x0D; -Share the results of the JADECARE transfer and adoption process&#x0D; -Present the JADECARE Sustainability strategy&#x0D; -Promote the discussion among attendees to highlight the key elements to ensure sustainability and scale up of local good practices beyond the project&#x0D; Target audience: Policy makers, decision makers, health managers, health authorities, health and social care professionals, researchers, academia, health experts, and staff working on implementation of integrated care, digitalization and/or evaluation.&#x0D; Facilitators/speakers: Yhasmine Hamu and Ane Fullaondo (Institute for Health Services Research Kronikgune ) will introduce the workshop, present the general implementation results, moderate and facilitate the thematic discussion.&#x0D; Jelka Zaletel and Denis Opresnik (NIJZ) will present the JADECARE Sustainability strategy.&#x0D; Chiara Ferravante (ARS Tuscany) and Martina Zorko, Karmen Janša (ZZZS) with Jelka Lindič (Slovene Nephrology Society) representing two NAs will expound the results of their transfer and adoption process highlighting the holders of sustainability beyond JADECARE.&#x0D; Format: (90’)&#x0D; 5’-Introduction and workshop objectives – Ane Fullaondo&#x0D; 10’- JADECARE transfer and adoption general implementation results – Yhasmine Hamu&#x0D; 15’- JADECARE Sustainability strategy – Jelka Zaletel and Denis Opresnik &#x0D; 15’- Implementation of local good practices within JADECARE with a focus on sustainability – Results from two NAs- Chiara Ferravante, Martina Zorko, Karmen Janša and Jelka Lindič&#x0D; 40’- Thematic discussion. All participants will be divided into two stations where brainstorming about two topics related to “Key elements to ensure the sustainability and scale up of practices beyond a Joint Action” will be facilitated and harmonised by two moderators. After half of the time the groups will exchange the discussion topic.&#x0D; 5’- Sharing of main conclusions and Take home messages&#x0D; Key Learnings/Take away:&#x0D; ‒Learnings on the JADECARE transfer and adoption implementation results&#x0D; ‒Understanding about the actions undertaken by the NAs for building sustainable local good practices&#x0D; ‒Awareness about the challenges related to the sustainability of good practices transfer to heterogeneous contexts