Leadership in Zeiten von Corona: Die Perspektive von Pflegenden und Hebammen in einem Universitätsspital.

Leadership in the time of Corona: The perspective of nurses and midwives at a University Hospital - A quality assessment Abstract. Background: The high number of predicted patients arising from the COVID-19 pandemic presents several challenges to hospitals. Data is available on psychological stress in caregivers during pandemics. To date, there are no known studies regarding the impact of leadership on nursing and midwifery practice. Aim: Evaluation of leadership during the COVID-19 pandemic at a Swiss University Hospital. Methods: The approach to this study was based on action research. The authors defined quality indicators and "values of excellence" on the impact of leadership. In May 2020 140 nurses and midwives of different departments were interviewed using one-time questionnaires. The quantitative data was analyzed descriptively and the open questions evaluated by thematic analysis. Results: The results showed that through the combination of different interventions, a mostly positive working situation could be created for the interviewees. Uncertainty existed about the safety measures. The interviewees were highly stressed by their own private situations, the frequent changes in guidelines and the flood of information. However, the staff felt well supported by the leadership teams. Improvements were described in teamwork and decision-making. Conclusions: The results indicate an impact on leadership and demonstrate as well the need for adequate support. The framework of transformational leadership methods, practice development and Lean management empowers the organization to work in a focused manner, effectively and safely during challenging situations.

Zwischen Traum und Trauma - Aufbau und Betrieb einer Kohortenstation für Patient_innen mit COVID-19 in einem Akutspital - Eine Fallstudie.

Between dream and distress - Setting up and running a cohort ward for COVID-19 Patients at an acute hospital - A case study Abstract. Background: In the context of the pandemic, hospitals must be able to care for COVID-19 patients within a very short timeframe. OBJECTIVE: Description of the setting up of a cohort ward for patients with COVID-19 on a surgical ward including the development of the nursing team. METHODS: The intrinsic retrospective case study describes the situation, identifies special phenomena in a reflective manner and links them to existing knowledge. Data were anecdotal, routine data were collected in the context of nursing practice development. RESULTS: Setting up the cohort ward in a Swiss hospital consisted of structural and technical planning, infection control measures, the establishment of interprofessional structures, and internal communication. During the four-week operation, 71 patients were treated. The use of practice development methodology initiated a cultural change. The reflection describes a field of tension between "dream and distress": As a dream, the lived experience of optimal care, with well-functioning processes, sufficient material, sufficient personnel and a very good interprofessional cooperation was evaluated. Distress in the form of high infection rates as well as psychological and physical stress did not occur. After the cohort ward was closed, there was a risk working back in normal operations based on existing economical and organizational conditions, with the knowledge that a different cooperation and organization is possible. CONCLUSIONS: Positive experiences from the "crisis mode" should be used to further develop essential operations during normal times.

Women's experiences of nurse case management on a gynaecological oncology unit in a Swiss tertiary hospital. A thematic analysis.

RATIONALE: Women with gynaecological cancer face various physical, social and emotional challenges concerning their health. Existing research shows that case management can improve patient satisfaction and reduce readmission rates. Although nurse case management was introduced on a gynaecological oncology unit in a Swiss university hospital in 2013, little is known about the experiences of female patients on a unit that uses this model of care. AIMS: The aims were to explore women's experiences and to gain deeper understanding about hospital-based nurse case management on a gynaecological oncology unit and to qualitatively evaluate the concept of nurse case management. METHODS: Sound research knowledge suggests that experiences are best explored with a qualitative research design. Ten participant interviews were conducted and inductively analysed between September 2014 and May 2015 as described by the thematic analysis method. Ethical approval was obtained, and the women signed a consent form. RESULTS: The first theme was named continuous relationship, with the nurse case manager as contact person and trusted partner. Study participants explained that friendliness and being present were essential qualities of nurse case management. Secondly, an essential support for women dealing with the situation of gynaecological cancer was described in the theme sharing information. The organisation of rehabilitation and other services by the nurse case management defined the third theme coordinating care. CONCLUSIONS AND LIMITATIONS: Trust was seen as the basis of the continuous relationship, marked by friendliness and presence of the nurse case manager. The helpful approach of persons practicing nurse case management made dealing with the situation of illness easier for women with gynaecological cancer. Coordination of information between the nurse case management and other healthcare services could be improved. Further evaluation is suggested to explore effects of the concept on family members.

[Disease management for chronic heart failure patient]. / Vernetzte Betreuung von Patientinnen und Patienten mit Herzinsuffizienz.

Patients with chronic heart failure (HF) are limited in their quality of life, have a poor prognosis and face frequent hospitalisations. Patient self-management was shown to improve quality of life, reduce rehospitalisations and costs in patients with chronic HF. Comprehensive disease management programmes are critical to foster patient self-management. The chronic care model developed by the WHO serves as the basis of such programmes. In order to develop self-management skills a needs orientated training concept is mandatory, as patients need both knowledge of the illness and the ability to use the information to make appropriate decisions according to their individual situation. Switzerland has no established system for the care of patients with chronic diseases in particular those with HF. For this reason a group of Swiss experts for HF designed a model for disease management for HF patients in Switzerland. Since 2009 the Swiss Heart Foundation offers an education programme based on this model. The aim of this programme is to offer education and support for practitioners, patients and families. An initial pilot evaluation of the program showed mixed acceptance by practitioners, whereas patient assessed the program as supportive and in line with their requirements.

[Development and implementation of a multidisciplinary nurse-led educational programme for inpatients with heart failure: the Basel-HF-Programme]. / Entwicklung und Implementierung eines multidisziplinären pflegegeleiteten Programms zur stationären Betreuung von Patientinnen und Patienten mit Herzinsuffizienz: Das Basler HI-Programm.

Individuals with chronic heart failure are a vulnerable group of patients, with a poor prognosis and frequent hospitalisations. Research shows that multidisciplinary education outpatient programmes for heart failure (HF) increases the quality of life of these patients and decreases mortality and rehospitalisation respectively. As a result of this research, the University Hospital Basel has developed and implemented a multidisciplinary, nurse-led inpatient programme. The article describes the development and difficulties of the programme from its beginning until the verification of its effectiveness. Based on a systematic review of the literature and principles of action research the programme was developed by a group of nurses specialised in HF and two physicians under the guidance of an Advanced Practice Nurse student. The group developed a patient pathway and guidelines describing education, skills training sessions for patients, as well as descriptions of responsibilities and tasks of the different members of the multidisciplinary team. To date, an individualised programme with information material and specific documentation is offered to patients who receive personalised recommendations before their discharge. For the nurses the implementation of the programme was a new challenge of structured counselling in their normal "busy" routine because of this challenge the nurses needed continuing coaching.

[A nurse-led multidisciplinary malnutrition program to assess and treat patients with malnutrition or those at risk of malnutrition]. / Multidisziplinäres Malnutritionsprogramm zur Erfassung und Behandlung von Patienten mit dem Risiko oder bestehender Mangelernährung in pflegerischer Verantwortung.

Malnutrition is a world-wide problem that does not only affect developing countries. People in industrialised countries, in particular the elderly, the poor and the sick, are at risk. In Switzerland, it is estimated that between 15 and 20% of patients (depending on patient population) show signs of malnutrition upon hospital admission. In response and based on a systematic review of the literature, a working group of the internal medicine department at the University Hospital Basel has developed a malnutrition programme comprising a screening instrument, a multidisciplinary care guideline, an information brochure, and a training programme for nursing staff. It is the aim of this article to report how the programme to recognise and treat malnutrition was developed, implemented, and evaluated.

Optimizing treatment initiation: Effects of a patient education program about fingolimod treatment on knowledge, self-efficacy and patient satisfaction.

BACKGROUND: Satisfaction with information on medication is linked to adherence, but patients are often dissatisfied with information about medication. Information about treatment with fingolimod is important for MS patients since an active role in managing treatment is required from them. To facilitate optimal treatment initiation, a nurse-led patient education program on fingolimod was implemented in a Swiss MS center. OBJECTIVE: To evaluate the impact of the evidence-based comprehensive patient education program on knowledge, self-efficacy and patient satisfaction. METHODS: Knowledge gain, subjective perception of being informed about the new treatment, self-efficacy in handling it and satisfaction with the program were evaluated in a pretest-posttest design. Patient reported outcomes were collected before and after an educational session on the first-dose day at the MS Center in a consecutive sample of 98 people with MS. Data was analyzed descriptively, score comparisons were done by Wilcoxon tests, and associations were estimated with Spearman's correlation coefficient. RESULTS: Knowledge increased significantly from pre- to posttest. Similarly, perception of being informed and self-efficacy increased significantly. Satisfaction with the program was high. Pretest-differences in knowledge concerning gender and marital status were balanced after the educational session. Results did not differ between patients with fingolimod as first treatment and those switching from other MS treatments. At posttest perception of being informed and self-efficacy were significantly related to satisfaction. CONCLUSIONS: An evidence-based comprehensive treatment education program is suitable to satisfy MS patients' information needs at treatment initiation. It enhances short-term treatment knowledge and self-efficacy in handling a new treatment in daily life. MS Nurses can thus contribute to effective treatment education and potentially to medication safety and adherence.