[Clinical leadership competencies in advanced nursing practice : Scoping review]. / Clinical-Leadership-Kompetenzen auf der Grundlage einer erweiterten und vertieften Pflegepraxis (Advanced Nursing Practice) : Ein Scoping-Review.

BACKGROUND: The competencies of advanced practice nurses (APN) include clinical activity in a special field, coaching and consulting, collaboration, leadership, ethical decision-making, and research competence. Clinical leaders initiate and implement changes in the healthcare system and respond to the needs of patients and healthcare institutions. Clinical leadership based on advanced nursing practice can challenge existing management and care structures. OBJECTIVES: The aim of the review is to provide an overview of clinical leadership competencies based on advanced nursing practice. The investigated question deals with which roles and competencies of APN are associated with clinical leadership from a national and international perspective. METHODS: A systematic search in MEDLINE®(US National Center for Biotechnology Information (NCBI))/PubMed, CINAHL and the Cochrane Library as well as a hand search in library catalogs and journals (April 2019 to January 2020) produced a total of 235 hits. Eight studies were included in the review and analyzed. RESULTS: Clinical leadership competencies are increasingly a topic of international studies and can be described and recognized in clinical practice on the basis of leadership models, and the role and leadership domains of APNs. Clinical leadership in nursing practice is recognized when APNs independently control treatment processes in complex nursing situations, exert influence, develop and implement change strategies, consult, coach, train, collaborate, and establish a connection to other health professionals and management. In order for clinical leadership competencies to be effective in nursing care processes, broad support in the multiprofessional team, structural support of the organization and legal legitimation are required. CONCLUSIONS: There are hardly any studies in the German-language literature on the relevance, interpretation, and legitimacy of APN clinical leadership. Further research is needed on the interpretation of the roles of APNs, especially clinical leadership competencies, their influence on nursing care processes, leadership structures, and their interaction within the organizational culture.

Wahrnehmungen von Pflegenden im Bereich der Intensivpflege während der COVID-19-Pandemie.

Perceptions of intensive care nurses during the COVID-19 pandemic - A qualitative survey Abstract. Background: While at the beginning of the COVID-19 pandemic the need for intensive care is increasing, the specific care needs of patients are still largely unknown. This is a challenge for the work of intensive care staff. AIM: The aim of the study is to understand how intensive care nurses perceive their working conditions and the consequences for patient care. METHODS: The study is a qualitative survey. Using a web-based questionnaire, narratives of n = 902 nurses were collected. This article reports the perceptions of n = 397 intensive care nurses. The evaluation is based on the qualitative content analysis according to 18-2Mayring (2015). RESULTS: The analysis of the data shows the following six categories: "The lack of staff is extremely noticeable" to "Waiting for something", "struggle for PPE (personal protective equipment)", "time to learn", "considerable discrepancy" in patient care, "attempts to compensate" and "constantly a bad feeling". The tension between the lack of knowledge and information on the one hand and the professional demand to do justice to the seriously ill and their relatives on the other hand, brings nurses to their professional limits. CONCLUSION: Conditions for ethical decision making have to be developed and concepts for a clear attribution of autonomy and responsibility for intensive care nurses must be introduced.

Beliefs of students about growing older and perceptions of working in gerontology.

An ageing population that is increasing does not necessarily mean an increase in people who require health and social care. However, it is predicted that a wide range of such services is likely to be needed. This demand is set against a shortage of skilled healthcare professionals and a lack of interest in working with older people. There is a particular shortage of skilled gerontological workers in the developed world, made worse by a perceived lack of professional esteem, economic reward and poor working environments in the specialism. Most studies recommend education to enable individuals to develop accurate knowledge about the ageing process and interest in working with older people. There is a discrepancy in the literature as to whether health and social care workers hold positive or negative attitudes towards older people. As attitudes are strongly linked with perceptions of working with older people, this article presents a review of the literature and discussion on attitudes of health and social care students to ageing and perceptions of working with older people.

[Optimising rehabilitative care for people with major amputation - a qualitative study]. / Optimierung der rehabilitativen Versorgungvon Menschen mit Majoramputation - eine qualitative Studie.

This project explored the experiences of people before, during and after lower limb amputation within the health care process by means of a qualitative study. Structured interviews were analysed by way of content analysis to describe the needs of amputees in professionally empowering their self care competences and their health care situation. According to the statements of amputees, they need a continuous and steady health care process to live mobile and independent lives. To realise this need, a permanent health care manager and enduring skills training to cope with the activities of daily living is necessary. Amputees often feel lonely. This study's results form the basis of a new multidisciplinary, client oriented rehabilitation concept.

[Quality needs competence and responsibility - challenges and perspectives of Advanced Nursing Practice for the health care system from a nursing science perspective]. / Qualität braucht Kompetenz und Verantwortung - Herausforderungen und Perspektiven einer Advanced Nursing Practice für die Gesundheitsversorgung aus pflegewissenschaftlicher Sicht.

Advanced Nursing Practice seems to be an answer to the complex challenges of the health system. However, the quality of Advanced Nursing Practice is researched by comparison to medical care. These attempts to legitimise Advanced Nursing Practice decrease the potentials of nursing care. In contrast to this, a prospect for Advanced Nursing Practice should be derived from the core of nursing, namely the relation to the life-world of the clients, the closeness to the clients and their families, and the opportunity for consistency in health care. This vision has to be realised by means of autonomy and responsibility in nursing care. The competence to autonomous and responsible decision-making is based on an educational process, where the ability to perceive the situation of client as changeable is developed.

[The importance of an assessment of dysphagia for patients with a stroke]. / Bedeutung des pflegerischen Assessments von neurogener Dysphagie bei Patienten mit akutem Schlaganfall.

This paper describes a study which was carried out within a project regarding the assessment of dysphagia for patients who had suffered a stroke. The aim of this investigation was to evaluate formatively the implementation of an assessment instrument for the care of patients with dysphagia. By means of a qualitative study semi-structured interviews with six nurses of a stroke unit were carried out. The interviews were analysed using content-analysis described by Mayring. The analysis illustrated that the interviewed nurses perceived the therapeutical value of nursing for patients with dysphagia. Furthermore the participants determined that a training course on the subject of caring for patients with dysphagia was important for the development of systematic knowledge which again added to the nurses' confidence of care for patients affected by dysphagia. However the utilisation of the assessment instrument developed by means of the project was problematic as described by the nurses participating in this study.

[A discussion of Gadamer's philosophical hermeneutics in international nursing research]. / Gadamers philosophische Hermeneutik in der Pflegeforschung--eine Diskussion.

This paper discusses various phenomenological and hermeneutical approaches within international nursing research. The first part contains an extensive literature review which shows that the Anglo-American debate into qualitative research is based on translated material of German philosophers, which is then interpreted not only according to language but also to culture. Philosophical terms are therefore differently interpreted and used. German nursing research is beginning to influence this international debate. The second part contains a methodological discussion of original philosophical texts and international nursing research and provides the foundation for a research method based on Gadamer's philosophical Hermeneutics. It is concluded that qualitative nursing research can only be justified by reference to a philosophical foundation.

Hermeneutic research in nursing: developing a Gadamerian-based research method.

This paper takes the stance that although there are many different approaches to phenomenological and hermeneutic research, some of these have become blurred due to multiple interpretations of translated materials. Working from original texts by the German philosophers, this paper reconsiders the relevance of phenomenology and hermeneutics to nursing research. We trace the development of Gadamer's philosophy in order to propose a research method based in this tradition. Five steps have been identified as a guide for nurse researchers. These are deciding upon a question, identification of preunderstandings, gaining understanding through dialogue with participants, gaining understanding through dialogue with text and establishing trustworthiness.