Due to the imminent demographic surge of older people, many suffering from multiple chronic diseases and age-related health problems, the demand for professional nursing care will increase massively over the coming decades. However, the demand for qualified nursing personnel in long-term healthcare is already outpacing the supply. Without a change of course, this can only lead to a crisis of quality. Experiences, e.g. from the U.S., have shown that masters-prepared Advanced Practice Nurses (APN) facilitate quality improvement in the long-term care of elderly people. With their focus on interdisciplinary collaboration and clinical results, they support the development of the institutions they work with and of gerontological nursing in general. This article describes the development of Advanced Nursing Practice in three gerontological long-term care facilities in Switzerland's German speaking region on the basis of practice development projects advancing the assessment and management of pain. APNs' defined competencies serve as a framework to evaluate the implementation of their roles: working in clinical leadership projects, they support interdisciplinary collaboration, focusing on direct clinical practice, the development of evidence-based nursing care, and the expert guidance of nurses. The role of APN in stationary long-term care in Switzerland has considerable potential for development.
Background: People with an indwelling urinary catheter often suffer from complications and health care professionals are regularly confronted with questions about catheter management. Clinical guidelines are widely accepted to promote evidence-based practice. In the literature, the adaptation of a guideline is described as a valid alternative to the development of a new one. Aim: To translate a guideline for the care for adults with an indwelling urinary catheter in the acute and long term care setting as well as for home care. To adapt the guideline to the Swiss context. Method: In a systematic and pragmatic process, clinical questions were identified, guidelines were searched and evaluated regarding clinical relevance and quality. After each step, the next steps were defined. Results: An English guideline was translated, adapted to the local context and supplemented. The adapted guideline was reviewed by experts, adapted again and approved. After 34 months and an investment of a total of 145 man working days, a guideline for the care for people with an indwelling urinary catheter is available for both institutions. Conclusions: Translation and adaptation of a guideline was a valuable alternative to the development of a new one; nevertheless, the efforts necessary should not be underestimated. For such a project, sufficient professional and methodological resources should be made available to achieve efficient guideline work by a constant team.
Die sogenannte evidenzbasierte Pflege und Gesundheitsversorgung gibt immer wieder Anlass zu Diskussionen und stellt Praxis und Forschung vor große Probleme. Medizinische, therapeutische und pflegerische Leistungen sollen gleich zeitig wirksam, zweckmäßig und wirtschaftlich erbracht werden. Eine Herausforderung -ja -doch die Autorinnen zeigen, welche Chancen eine evidenzbasierte Praxis für eine fundierte und nachhaltige Praxisentwicklung birgt.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.