Entscheidungen treffen in Pandemiezeiten

Bieber, Anja; Dammermann, Anna; Dichter, Martin N.; Dinand, Claudia; Eich-Krohm, Astrid; Freytag, Stefanie; Mohler, R. Albert; Sander, Marco; Thalhammer, Regina; Fleischer, Steffen

doi:10.1007/s00391-022-02034-6

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…To be informed, they used external networks; which resulted in sometimes contradicting sources of expertise and information. Moreover, the lack of prioritization by authorities led to additional work and sometimes impaired the ability of staff and managers to make decisions [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges, strategies and consequences from the perspective of German nursing home managers during the first wave of the COVID-19 pandemic - a qualitative interview study

Sander

Dano²,

Bieber³

et al. 2023

BMC Geriatr

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Background The first wave of the COVID-19 pandemic reached Germany between March and May 2020. In order to contain the spread of the virus and particularly protect vulnerable people, the government imposed a lockdown in March 2020. In addition to infection control measures, such as hygiene and social distancing requirements, a general ban on access to nursing homes for relatives and external service providers was issued. Methods To investigate the challenges and consequences of the enacted infection prevention measures and specific strategies for nursing homes in Germany, a multicentre cross-sectional qualitative interview study with nursing home managers and ward managers was conducted. Recorded audio data were transcribed, analysed using thematic framework analysis and reflected in peer debriefings. Results Seventy-eight interviews with 40 nursing home managers and 38 ward managers from 43 German nursing homes were conducted. At organisational level, the following six themes were identified: Appointing a multi-professional crisis task force, reorganizing the use of building and spatial structures, continuous adaption and implementation of hygiene plans, adapting staff deployment to dynamically changing demands, managing additional communicative demands and relying on and resorting to informal networks. To deal with the pandemic challenges also six themes can be described for the direct care level: Changed routines, taking over non-nursing tasks, increased medical responsibility, increased documentation demands, promoting social participation and increased communication demands. Also various negative consequences were identified (four themes): Psychological stress, negative emotional consequences, permanent feeling of responsibility and increased potential for conflicts. Positive emotional consequences were also reported (two themes): resources for the challenges and positive emotional consequences for home managers and staff. Conclusions The results of the described challenges, strategies and consequences allow recommendations as basis for possible approaches and successful adaptation processes in nursing home care in the future. In particular, there is a need for local networks to act in a coordinated way and a need for quantitative and qualitative support for nurses, such as staff support as well as advanced nursing practice, to cope with the challenges of the pandemic.

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Section: Discussionmentioning

confidence: 99%

Challenges, strategies and consequences from the perspective of German nursing home managers during the first wave of the COVID-19 pandemic - a qualitative interview study

Sander

Dano²,

Bieber³

et al. 2023

BMC Geriatr

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“…Grundsätzlich sind Kontaktbeschränkungen und Hygienemaßnahmen bei Menschen mit stärkeren intellektuellen/sozioemotionalen Einschränkungen schwieriger umzusetzen, da sie die Maßnahmen meist nicht konsequent einhalten können. Aber auch Menschen mit einer leichteren geistigen Behinderung benötigen Zeit, um alles zu verstehen und einzuüben [ 33 , 34 ]. Soweit möglich, sollten auch in Phasen mit hoher Infektionsgefahr therapeutische Angebote stattfinden, die dann ggf.…”

Section: Problembereiche Als Ansatzpunkte Für Public-health-maßnahmenunclassified

“…die Mitaufnahme einer Begleitperson bzw. regelmäßige Besuche ermöglicht werden können [ 33 , 34 ]. Zur Koordination der coronabedingten Maßnahmen ist eine verstärkte Kommunikation zwischen verschiedenen Einrichtungsebenen, den involvierten Einrichtungen (Wohnen/Arbeit/Klinik) sowie den Angehörigen der betroffenen MmgB nötig.…”

Section: Problembereiche Als Ansatzpunkte Für Public-health-maßnahmenunclassified

Die Situation von Menschen mit geistiger Behinderung in der COVID-19-Pandemie – Risikofaktoren, Problembereiche, Maßnahmen

Habermann-Horstmeier

2023

Bundesgesundheitsbl

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Viele Menschen mit geistiger Behinderung (MmgB) waren wesentlich stärker von COVID-19 betroffen als der Bevölkerungsdurchschnitt. Aufgrund ihrer Wohn- und Betreuungsformen sowie behinderungsassoziierter Gesundheitsfaktoren (wie etwa beim Down-Syndrom) war die Morbidität in dieser Bevölkerungsgruppe deutlich erhöht. Dies führte u. a. zu einer höheren Inzidenz in stationären Einrichtungen, einer höheren Sterblichkeit bei hospitalisierten Erkrankten und einer höheren Fallsterblichkeit bei bestimmten Subgruppen. Risikofaktoren waren Co-Erkrankungen wie Dysphagie, Epilepsie oder psychische Störungen. Hinzu kamen gesundheitliche Folgen durch einschränkende Maßnahmen der Expositionsprophylaxe zu Beginn der COVID-19-Pandemie. Dieser Übersichtsartikel beschreibt die wesentlichen Entwicklungen in der Versorgung von MmgB seit Pandemiebeginn. Neue bzw. eine Verstärkung bereits vorhandener psychischer Probleme traten häufiger bei ambulant oder von Angehörigen betreuten MmgB auf. MmgB in stationären Wohneinrichtungen waren seltener betroffen. Gründe für psychische Probleme waren v. a. fehlende soziale Kontakte, weggefallene Arbeits- und Beschäftigungsmöglichkeiten, die Angst machende Pandemiesituation sowie die großen strukturellen und personellen Veränderungen in den Einrichtungen zu Beginn der Pandemie. Während der Pandemie gab es zudem Probleme bei der Umsetzung therapeutischer und präventiver Maßnahmen. Dagegen wirkte sich vor allem im stationären Bereich die mit den Einschränkungen verbundene „Entschleunigung des Lebens“ zu Pandemiebeginn bei einem Teil der MmgB auch stressreduzierend aus und wurde von ihnen als etwas Positives empfunden. Betreuungskräfte hatten mehr Zeit für die eigentliche (= pädagogische) Arbeit. Insgesamt zeigte sich, dass gesundheitsfördernde Maßnahmen auch während der Pandemie die große Heterogenität der MmgB und ihrer Lebensbedingungen berücksichtigen müssen.

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Attitudes of Nursing Home Managers Regarding Cognitively Stimulating Activities in People With Dementia: A Multicentre Cross‐Sectional Study

Guicheteau,

Köpke,

Seven

et al. 2024

Int J Older People Nursing

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IntroductionGroup‐based cognitive stimulation has shown short‐term benefits for the cognitive outcomes of people with dementia living in nursing homes (NH). However, group participation can be a barrier for people with advanced dementia, bedridden people or isolated people. The CogStim24 project seeks to develop and implement a new psychosocial intervention based on cognitively stimulating (CS) activities integrated into daily nursing care. As part of the intervention development process, this study aimed to survey NH managers' attitudes and describe currently used approaches to CS activities in German NH.MethodsWe performed a multicentre cross‐sectional study between September and December 2021 in randomly recruited NH in the German federal state of North Rhine‐Westphalia. NH representatives were asked to fill in a self‐developed online questionnaire. We analysed data descriptively, presenting means and standard deviations. For case scenario questions, we used a summative content analysis.ResultsWe contacted 354 NH and 106 agreed to participate. Representatives of 64 facilities completed the survey. Almost all stated to have implemented CS activities. Cognitive exercises (98%), physical and relaxation exercises (98%) and reminiscence therapy (95%) were most often used. The majority (96%) thought that CS activities could support people with dementia in maintaining their cognitive functions and that nurses should have a key role in the implementation of CS activities. More than half believed that regular CS activities were easy to implement alongside routine nursing care.ConclusionsResults indicate that CS activities are frequently applied in German NH. The positive attitude of NH managers regarding the implementation and effects of CS activities is an important implementation resource.Implications for PracticeNursing staff should be more involved in providing CS activities for people with dementia. Training, information, and implementation material must be made available for nursing staff who wish to have an active role in providing CS activities.

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Entscheidungen treffen in Pandemiezeiten

Cited by 4 publications

References 18 publications

Challenges, strategies and consequences from the perspective of German nursing home managers during the first wave of the COVID-19 pandemic - a qualitative interview study

Challenges, strategies and consequences from the perspective of German nursing home managers during the first wave of the COVID-19 pandemic - a qualitative interview study

Die Situation von Menschen mit geistiger Behinderung in der COVID-19-Pandemie – Risikofaktoren, Problembereiche, Maßnahmen

Attitudes of Nursing Home Managers Regarding Cognitively Stimulating Activities in People With Dementia: A Multicentre Cross‐Sectional Study

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