[Structuring emergency management in nursing homes: Results of interprofessional focus group interviews]. / Strukturierung des Notfallmanagements in Pflegeheimen: Ergebnisse interprofessioneller Fokusgruppeninterviews.

ABSTRACT

BACKGROUND: Emergencies in nursing homes lead to frequent utilization of emergency medical services and emergency department visits, which are frequently assessed as avoidable and do not comply with the patients' wishes. Emergency management is complicated by structural conditions, uncertainty and difficulties in communication between the treating healthcare professionals. OBJECTIVE: In the framework of the NOVELLE research project a model for a recommendation for action was developed in an interprofessional process to structure the emergency management in nursing homes. MATERIAL AND METHODS: The research process was organized according to the grounded theory as a constant interplay of data collection, analysis and concept development. From January to April 2021 a total of 6 focus group interviews were conducted with 24 nurses, physicians and experts from medical ethics and 1 guideline interview with an expert from the field of medical law. All interviews were performed as video conferences. They were digitally recorded, transcribed verbatim and coded with MAXQDA software. RESULTS: Recommendations for organizing and improving the emergency management are structured into three components 1) initial assessment, 2) structured assessment including nursing evaluation and integration of patient treatment preferences and 3) organization of further treatment. Components include actions, results and consequences and can be arranged in the form of an algorithm. DISCUSSION: Recommendations for improvement of emergency management should enhance the competences of nursing staff, respect patient treatment preferences, consider situational conditions and support communication with external medical and care providers.