Samenvatting

Background: During hospitalization patients frequently have a low level of physical activity, which
is an important risk factor for functional decline. Function Focused Care (FFC) is an evidencebased
intervention developed in the United States to prevent functional decline in older patients.
Within FFC, nurses help older patients optimally participate in functional and physical
activity during all care interactions. FFC was adapted to the Dutch Hospital setting, which led to
Function Focused Care in Hospital (FFCiH). FFCiH consists of four components: (1) ‘Environmental
and policy assessment’; (2) ‘Education’; (3) ‘Goal setting with the patient’ and (4)
‘Ongoing motivation and mentoring’. The feasibility of FFCiH in the Dutch hospital setting needs
to be assessed.
Objective: Introduce FFCiH into Dutch hospital wards, to assess the feasibility of FFCiH in terms of
description of the intervention, implementation, mechanisms of impact, and context.
Design: Mixed method design
Setting(s): A Neurological and a Geriatric ward in a Dutch Hospital.
Participants: 56 Nurses and nursing students working on these wards.
Methods: The implementation process was described and the delivery was studied in terms of
dose, fidelity, adaptions, and reach. The mechanisms of impact were studied by the perceived
facilitators and barriers to the intervention. Qualitative data were collected via focus group interviews,
observations, and field notes. Quantitative data were collected via evaluation forms and
attendance/participation lists.
Results: A detailed description of FFCiH in terms of what, how, when, and by whom was given. 54
Nurses (96.4%) on both wards attended at least 1 session of the education or participated in bedside teaching. The nurses assessed the content of the education sessions with a mean of 7.5
(SD 0.78) on a 0–10 scale. The patient files showed that different short and long-term goals were
set. Several facilitators and barriers were identified, which led to additions to the intervention. An
important facilitator was that nurses experienced FFCiH as an approach that fits with the principles
underpinning their current working philosophy. The experienced barriers mainly concern
the implementation elements of the FFCiH-components ‘Education’ and ‘Ongoing motivation and
mentoring’. Optimizing the team involvement, improving nursing leadership during the implementation,
and enhancing the involvement of patients and their family were activities added to
FFCiH to improve future implementation.
Conclusions: FFCiH is feasible for the Dutch hospital setting. Strong emphasis on team involvement,
nursing leadership, and the involvement of patients and their families is recommended to
optimize future implementation of FFCiH in Dutch hospitals.