Hochschulisch qualifizierte Pflegende in der Langzeitversorgung?!

Ewers, Michael; Lehmann, Yvonne

doi:10.1007/978-3-662-58935-9_13

Cited by 6 publications

(7 citation statements)

References 35 publications

(8 reference statements)

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“…Previous work shows that higher qualification of nursing professionals is associated with improved patient outcomes [ 38 , 39 ]. Regression analysis did not show a significant correlation between nurses' additional qualification in gerontopsychiatry and a higher risk for the prescription of PIM/antipsychotics to participating patients .…”

Section: Discussionmentioning

confidence: 99%

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

Stolz,

Krause,

Junius-Walker

et al. 2023

Aging Clin Exp Res

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Background Nursing home residents (NHR) show high rates of polypharmacy. The HIOPP-3-iTBX study is the first cRCT on medication optimization in nursing homes (NH) in Germany. The intervention did not result in a reduction of PIM and/or antipsychotics. This analysis looks at structure quality in the HIOPP-3-iTBX study participants. Aims Evaluation of structure quality as part of a cluster-randomized controlled intervention study. Methods Structure quality in multiprofessional teams from n = 44 NH (n = 44 NH directors, n = 91 family doctors (FD), and n = 52 pharmacies with n = 62 pharmacists) was assessed using self-designed questionnaires at baseline. Main aspects of the questionnaires related to the qualification of participants, quality management, the medication process and size of the facilities. All completed questionnaires were included. number of PIM/antipsychotics was drawn from the baseline medication analysis in 692 NHR. Data were analyzed by descriptive statistics and mixed model logistic regression. Results The presence of a nurse with one of the additional qualifications pain nurse or Zertifiziertes Curriculum (Zercur) Geriatrie in the participating NH was associated with a lower risk for the prescription of PIM/antipsychotics. No association between any characteristic in the other participants at baseline was observed. Conclusions and discussion The results support the known role of nursing qualification in the quality and safety of care. Further studies need to look more closely at how use is made of the additional qualifications within the multiprofessional teams. Perspectively, the results can contribute to the development of quality standards in NH in Germany.

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Section: Discussionmentioning

confidence: 99%

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

Stolz,

Krause,

Junius-Walker

et al. 2023

Aging Clin Exp Res

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“…4 For these residents, skills of academically qualified nurses could create a meaningful benefit. 5 Academic training enables nurses to combine their clinical expertise with scientific evidence to provide care according to patient's or resident's preferences (evidence-based nursing). 6 Care that is guided by individuals' values and preferences is referred to as person-centred care and can improve patient experiences and outcomes, and enhance the efficiency of healthcare delivery.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Ninety per cent of these hospital transfers are unplanned, and between 4% and 55% are considered avoidable 4. For these residents, skills of academically qualified nurses could create a meaningful benefit 5. Academic training enables nurses to combine their clinical expertise with scientific evidence to provide care according to patient’s or resident’s preferences (evidence-based nursing) 6.…”

Section: Introductionmentioning

confidence: 99%

Expanded nursing competencies to improve person-centred care for nursing home residents with complex health needs (Expand-Care): study protocol for an exploratory cluster-randomised trial

et al. 2023

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IntroductionOlder age is associated with multimorbidity, chronic diseases and acute deteriorations and leads to complex care needs. Nursing home residents are more often unnecessarily transferred to emergency departments or hospitals than community dwellers—largely due to a lack of qualified staff and diffusion of responsibility in the institutions. In Germany, only few academically trained nurses work in nursing homes, and their potential roles are unclear. Therefore, we aim to explore feasibility and potential effects of a newly defined role profile for nurses with bachelors’ degree or equivalent qualification in nursing homes.Methods and analysisA pilot study (Expand-Care) with a cluster-randomised controlled design will be conducted in 11 nursing homes (cluster) in Germany, with an allocation ratio of 5:6 to the intervention or control group, aiming to include 15 residents per cluster (165 participants in total). Nurses in the intervention group will receive training to perform role-related tasks such as case reviews and complex geriatric assessments. We will collect data at three time points (t0 baseline, t1 3 months and t2 6 months after randomisation). We will measure on residents’ level: hospital admissions, further health services use and quality of life; clinical outcomes (eg, symptom burden), physical functioning and delivery of care; mortality, adverse clinical incidents and changes in care level. On nurses’ level, we will measure perception of the new role profile, competencies and implementation of role-related tasks as part of the process evaluation (mixed methods). An economic evaluation will explore resource use on residents’ (healthcare utilisation) and on nurses’ level (costs and time expenditure).Ethics and disseminationThe ethics committees of the University of Lübeck (Nr. 22-162) and the University Clinic Hamburg-Eppendorf (Nr. 2022-200452-BO-bet) approved the Expand-Care study. Informed consent is a prerequisite for participation. Study results will be published in open-access, peer-reviewed journals and reported at conferences and in local healthcare providers’ networks.Trial registration numberDRKS00028708.

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“…TVPOI represent a very heterogeneous group, especially with regard to their age, ventilator-causing diseases and comorbidities, course of disease and care needs, therapy goals, as well as living and care situations 1–3. In Germany, different care settings for TVPOI exist: inpatient facilities and outpatient care supported by nursing care service providers (eg, in the patient’s own home or in a shared apartment).…”

Section: Introductionmentioning

confidence: 99%

“…Detailed information on intensive care in Germany can be found in box 1 4. However, high costs of medical, rehabilitative-therapeutic and nursing care services,1 5 and an intransparent provider market,3 with increasing evidence of quality deficiencies4 6 7 have been criticised. Studies found indications of medical-therapeutic overuse, underuse and misuse, especially with regard to unused weaning potential,5 8 9 overload of general practitioners,10 lack of therapeutic rehabilitation services11 and qualified specialist nurses,6 7 with regionally varying availability 12.…”

Section: Introductionmentioning

confidence: 99%

ATME—Needs, requirements and cross-sectoral patient journeys of patients with out-of-hospital mechanical ventilation and intensive care in outpatient settings: study protocol for an observational study

Knizia,

Hirschler,

Stegbauer

et al. 2024

BMJ Open

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IntroductionAn increasing number of tracheotomised and/or ventilated patients with high-cost out-of-hospital intensive care needs and, at the same time, a decreasing number of healthcare professionals inevitably lead to challenges in the care of this patient population. In addition, little is known about this population, their health restrictions, needs, patient journeys, care structures and processes. The project ‘Needs, requirements and cross-sectoral care pathways of out-of-hospital ventilated intensive care patients’ (ATME) aims to analyse these aspects and explore current care structures to inform further development of care in line with patients’ needs and requirements.Methods and analysisQualitative and quantitative methods will be used. In preparation of a semistandardised survey, exploratory interviews will be conducted with tracheotomised and/or ventilated patients with out-of-hospital intensive care needs (TVPOI) (n=15), nursing care providers (n=30), outpatient medical centres, as well as outpatient medical, medical technology and therapeutic care providers (n=35). Three semistandardised survey questionnaires for TVPOI (n=2,000) will be developed and conducted with nursing care facilities (n=250) and outpatient medical centres for mechanical ventilation (n=25). Content analyses will be conducted for qualitative data; survey data will be analysed descriptively. In addition, healthcare claims data will be analysed descriptively to provide information on patient journeys. Three result workshops and one consensus conference will be carried out with representatives of the relevant target groups to analyse the suitability of care structures and to develop recommendations for action to improve TVPOI.Ethics and disseminationThe ATME study received a positive vote from the Ethics Committee of the Osnabrück University of Applied Sciences and is registered in ‘Deutsches Register Klinischer Studien (DRKS)’ (registration number: DRKS00030891). The study results will be presented at national conferences and in relevant peer-reviewed journals. Additionally, study results will be published by the funding institution (the Innovation Committee of the Federal Joint Committee) on their website.

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Hochschulisch qualifizierte Pflegende in der Langzeitversorgung?!

Abstract: Wandel der (pflegerischen) Langzeitversorgung -168 13.2 Situation in Deutschland -169 13.3 Situation im Ausland -171 13.4 Effekte hochschulisch qualifizierter Pflege (in der Langzeitversorgung) -173 13.5 Schlussfolgerungen -174 Literatur -175

Cited by 6 publications

References 35 publications

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

Expanded nursing competencies to improve person-centred care for nursing home residents with complex health needs (Expand-Care): study protocol for an exploratory cluster-randomised trial

ATME—Needs, requirements and cross-sectoral patient journeys of patients with out-of-hospital mechanical ventilation and intensive care in outpatient settings: study protocol for an observational study

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