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.

[The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study]. / Die Praxis der psychiatrischen Intensivbetreuung bei Erwachsenen in der Deutschschweiz ­ eine deskriptive Querschnittstudie.

The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study Abstract. INTRODUCTION: Psychiatric Special Observation (PSO) is an intervention often used by nurses to prevent service users of harming themselves or to protect others. The intervention ranges between control and therapy and is resource intensive. Despite the widespread use of PSO, there is still no data on the practice of the intervention in Switzerland. AIM: What is the current practice of PSO in adults in psychiatric hospitals in the German-speaking part of Switzerland? METHOD: Descriptive cross-sectional study. Nurses from inpatient psychiatric services in the German-speaking part of Switzerland completed a questionnaire based on a concept analysis of PSO. RESULTS: 538 questionnaires were analysed. PSO was more often conducted intermittent than as constant observation. In more than one out of four cases, suicidality reasoned as a cause for prescription. Nurses generally used standardized instruments to assess the risk of harming oneself or others. The duration of PSO lasted eight hours or more in three out of four cases. In every fifth case, there was no validation of the need of the intervention taking place during one shift. Nurses have a neutral attitude towards the intervention and are experiencing no or weak negative feelings during performance of PSO. CONCLUSIONS: The results suggest that there is an inconsistent performance of PSO in Switzerland as well as in other countries. The validation of the need of the intervention is insufficient. To facilitate PSO as a justified performance, the preparation of an interprofessional guideline is recommended.

Compression therapy in patients with venous leg ulcers.

Wund-D.A.CH. is the umbrella organization of the various wound care societies in German-speaking countries. The present consensus paper on practical aspects pertinent to compression therapy in patients with venous leg ulcers was developed by experts from Germany, Austria, and Switzerland. In Europe, venous leg ulcers rank among the most common causes of chronic wounds. Apart from conservative and interventional wound and vein treatment, compression therapy represents the basis of all other therapeutic strategies. To that end, there are currently a wide variety of materials and systems available. While especially short-stretch bandages or multicomponent systems should be used in the initial decongestion phase, ulcer stocking systems are recommended for the subsequent maintenance phase. Another - to date, far less common - alternative are adaptive Velcro bandage systems. Medical compression stockings have proven particularly beneficial in the prevention of ulcer recurrence. The large number of treatment options currently available enables therapists to develop therapeutic concepts geared towards their patients' individual needs and abilities, thus resulting in good acceptance and adherence. Compression therapy plays a crucial role in the treatment of patients with venous leg ulcers. In recent years, a number of different treatment options have become available, their use and application differing among German-speaking countries. The present expert consensus is therefore meant to outline concrete recommendations for routine implementation of compression therapy in patients with venous leg ulcers.

Kompressionstherapie bei Patienten mit Ulcus cruris venosum.

Wund-D.A.CH. ist der Dachverband deutschsprachiger Fachgesellschaften, die sich mit den Thematiken der Wundbehandlung beschäftigen. Experten verschiedener Fachgesellschaften aus Deutschland, Österreich und der Schweiz haben nun einen aktuellen Konsens der Kompressionstherapie für Patienten mit Ulcus cruris venosum erstellt. In Europa ist das Ulcus cruris venosum eine der häufigsten Ursachen für chronische Wunden. Neben der konservativen und interventionellen Wund- und Venentherapie, ist die Kompressionstherapie die Basis der Behandlungsstrategien. Die Kompressionstherapie kann heute mit sehr unterschiedlichen Materialien und Systemen durchgeführt werden. Während in der Entstauungsphase insbesondere Verbände mit Kurzzugbinden oder Mehrkomponentensysteme zur Anwendung kommen, sind es anschließend überwiegend Ulkus-Strumpfsysteme. Eine weitere, bislang wenig verbreitete Alternative sind adaptive Kompressionsbandagen. Insbesondere für die Rezidivprophylaxe werden medizinische Kompressionsstrümpfe empfohlen. Durch die Vielzahl der heute zur Verfügung stehenden Behandlungsoptionen, kann für nahezu alle Patienten ein Konzept entwickelt werden, dass sich an den individuellen Bedürfnissen und Fähigkeiten orientiert und daher auch akzeptiert und durchgeführt wird. Die Kompressionstherapie ist für die Behandlung von Patienten mit Ulcus cruris venosum essentiell. In den letzten Jahren sind viele verschiedene Therapieoptionen verfügbar, die in den deutschsprachigen Ländern unterschiedlich angewendet oder durchgeführt werden. Daher soll dieser Expertenkonsens dazu beitragen, konkrete Empfehlungen für die praktische Durchführung der Kompressionstherapie von Patienten mit Ulcus cruris venosum darzustellen.

[Conflict of interest with industry--a survey of nurses in the field of wound care in Germany, Australia and Switzerland]. / Interessenkonflikte mit der Industrie--eine Befragung von Pflegenden im Bereich der Wundversorgung in Deutschland, Österreich und der Schweiz.

BACKGROUND: Nurses in the field of wound care are increasingly being courted by the wound industry. OBJECTIVES: A survey regarding nurses' perceptions and participation in pharmaceutical marketing was conducted. METHODS: Based on existing instruments, a standardized questionnaire (39 items, 5-point Likert scale) was developed. It was sent electronically and by mail to all nursing members of the Austrian Society for Vascular Care (ÖGvP), the German Wound Healing Society (DGfW e. V.) and the Swiss Association for Wound Care (SAfW). RESULTS: 178 nurses participated in the survey (75 % women; aged 27 - 70 years [median 45], 0 - 40 years [median 9] practice in the area of the wound care). Only about one fourth of the respondents (23,0 %) did not participate in pharmaceutical marketing last year. Generally small gifts were more frequently received than expensive gifts. Most of the nurses valued inexpensive gifts, educational gifts and gifts with patient benefit as appropriate. The majority of respondents consider themselves as less influenceable in decision making, compared to physicians. CONCLUSIONS: The behavior and attitude of nurses are ambivalent. The occurrence of conflict of interest is partly justified by perceived patient benefit. Lack of knowledge about the topic and social desirability could be the cause of an uncritical attitude. For a more critical approach education and ethical standards are necessary.

[M.O.I.S.T. concept for the local therapy of chronic wounds]. / Lokaltherapie chronischer Wunden: Das M.O.I.S.T. Konzept.

The treatment of patients with chronic wounds is still an interdisciplinary and interprofessional challenge. The basis of successful therapy for these patients is based on causal treatment of the underlying, pathophysiologically relevant diseases. In addition, however, local wound therapy should always be provided to support wound healing and avoid complications. In order to better structure the multitude of wound products, the M.O.I.S.T. concept was developed by a multidisciplinary expert group of WundDACH, the umbrella organization of German-speaking professional societies. M describes, O oxygenation, I infection control, S support of the healing process and T tissue management.The M.O.I.S.T. concept is intended to provide healthcare professionals a guidance for systematic planning and also for education with regard to the local therapy of patients with chronic wounds. The 2022 update of this concept is now presented here for the first time.

[Hepatitis C! Experience in diagnosis and medical treatment. A literature review]. / Hepatitis C! Erleben der Diagnose und der medikamentösen Therapie. Eine Literaturübersicht.

Chronic hepatitis C can have physical, psychological or emotional effects on a person. The chronic infection can result in an advanced liver disease and/or influence daily life and self-perception. Today, the possibility to eliminate the virus exists but the therapy is difficult, a decrease in quality of life is known. Anyway, the sustained viral response isn't achievable for everyone. Care in Switzerland usually takes place in the outpatient clinics. Nurse participation to improve self-management is in discussion. For this specific work knowledge of patient's perception is crucial. A literature review was done to answer two questions: "What is the experience of the illness 'chronic hepatitis C'?" and additionally "What has to be managed when undergoing treatment?". A literature search was conducted in the databases of Pubmed and CINAHL. Seven qualitative studies were included. Diagnosis, contagion, illness, stigmatisation and fatigue are central themes and can influence each other. Discussion about treatment and the decision for it seems to be ambiguous. Patients feel reduced to their disease and demand for individual interventions especially for their experience with their illness. A targeted assessment seems important to appreciate their needs in each situation.

[Impact of a pre-operative mobilisation program using the Viv-Arte training model based on kinesthetic mobilisation on mobility, pain, and post-operation length of stay of patients receiving an elective medial laparotomy: a prospective, randomised, controlled pilot study]. / Auswirkungen eines präoperativen Bewegungsschulungsprogramms nach dem für kinästhetische Mobilisation aufgebauten Viv-Arte-Lernmodell auf Mobilität, Schmerzen und postoperative Verweildauer bei Patienten mit elektiver medianer Laparotomie.

A medial incision is a common surgical technique to obtain access to the abdomen. Thereby, the muscles involved in movement are manipulated, leading to post-operative restrictions in mobility and pain determined by movement. The aim of this pilot study was to assess the impact of a pre-operative training session using the Viv-Arte model, which is based on kinesthetic mobilisation principles. The parameters to be measured were mobility, pain, and length of hospital stay for patients, who were undergoing elective medial laparotomy. In addition, the study tested the research design and to identify possible effect sizes. The method chosen was a prospective, randomised, controlled, and unblinded design. Twenty-seven patients were involved (median=63 years, 19 of the patients were male) who were to have a medial incision for cystectomy. The intervention involved pre-operative training of post-operative mobility techniques. Mobility was tested using the "Mobilitätstest für Patienten im Akutkrankenhaus (MOTPA) (Mobility test for patients in hospital)"; pain intensity was assessed using the visual analogue scale. The intervention and control groups were comparable for all variables. There were no significant differences in the two groups related to the objectives. It is possible that the study groups or the operationalisation were not appropriate for testing the effects of the intervention. It seems important to continue to develop instruments that are appropriate for measuring the effect of mobility-related interventions.

[Collaboration between science and practice: experiences of conducting a nursing intervention study]. / Zusammenarbeit von Forschung und Praxis: Erfahrungen bei der Durchführung einer pflegerischen Interventionsstudie.

In a five-year intervention study about the impact of pre-operative mobilisation training session of patients receiving an elective medial laparotomy experiences about the collaboration between practice (University Hospital Ulm) and science (Hessian Institute of Nursing Research) were made. During the project possibilities and borders of clinical nursing research became clear. A research question based on practice experiences of nurses helps to develop and maintain motivation to conduct a study at a nursing unit. There was a lack of nursing knowledge to develop the best possible design, e.g. outcome criteria for mobilisation and standardized assessment instruments. The cooperation with other health care professionals (human movement science, statistics) was important and without difficulties. In Germany, without doctors' agreement and common application it is impossible to conduct nursing intervention studies in hospitals. It is necessary to train nursing specialists with both scientific and clinical competence to explore systematically clinical research questions.

Diabetes foot self-care practices in the German population.

AIM: The object of this study was to find out which self-care activities patients with diabetes perform to prevent diabetic foot syndrome (DFS) and to look for differences between patient groups (diabetes education and foot at risk). BACKGROUND: Besides the importance of screening patients at risk to develop a DFS and the clinical interventions, it is also necessary to involve the patient with diabetes in the self-care of their feet. There is no information in Germany concerning self-care activities carried out by patients for the prevention of DFS. DESIGN: A cross-sectional study. METHOD: A secondary analysis of the data used in the study for the development of the 'Frankfurter Catalogue of Foot Self-Care - Prevention of Diabetic Foot Syndrome'. Two hundred and sixty-nine patients with type 1 and type 2 diabetes were included. The study population was divided into different training experience groups and foot at risk groups based on self-reported data. RESULTS: Patients who had participated in more than three education programmes performed significantly better self-care than patients who had no or only one training programme. Patients with a foot at risk for the development of diabetic foot ulcer perform more adequate self-care regarding professional assistance in foot care, but are not more active in the self-control of the feet, shoes and socks. CONCLUSIONS: There are self-care deficits regarding self-control of feet, shoes and socks. Based on the data it seems to be that more than three education programmes are needed to lead to performance of adequate self-care. Especially patients with a foot at risk need more professional support for their daily self-care activities to prevent DFS or further foot complications. RELEVANCE TO CLINICAL PRACTICE: The first findings support that it might be helpful to identify patients with self-care deficits and therefore to improve patients daily foot self-care.

[Assessment instruments for the measurement of the health-related self-care of patients with heart failure]. / Instrumente zur Messung der Selbstpflege bei Patienten mit Herzinsuffizienz. Ergebnisse einer Literaturanalyse.

UNLABELLED: Heart Failure is a frequent disease that is accompanied by much suffering for the patients and high costs for the health care system. An improvement of the health-related self-care is supposed to improve the outcomes of patients with heart failure. In order to evaluate the efficiency of interventions valid and reliable instruments measuring the health-related self-care are needed in practice and research. The aim of the systematic literature review is to create a synopsis of the present nursing assessment instruments for the measurement of the health-related self-care of patients with heart failure and to evaluate these instruments' reliability and validity. With a systematic literature search in three electronic databases and hand-search studies using instruments that measure the health-related self-care of patients with heart failure have been identified. The instruments are described and their reliability and validity are discussed. RESULTS: Five Instruments were identified: European Heart Failure Self-care Behaviour Scale (EHFScBS); Revised Heart Failure Self-care Behaviour Scale (rHFScBS); Heart Failure Self-Care Inventory (HFS-CI), Self-Management of Heart Failure Scale (SMHF); Self-Care of Heart Failure Index (SCHFI). As far as the psychometric properties are concerned, each of these scales has its strengths and weaknesses. The EHFScBS, the HFS-CI, and the SCHFI can be recommended with restriction for use in practice and research. However, further testing in order to evaluate reliability and validity is necessary for all instruments.

[Living with a chronic abdominal wound--the patients' perspective]. / Leben mit einer chronischen Bauchwunde--Die Erfahrung Betroffener und ihre Erwartungen an die betreuenden Fachpersonen.

Chronic abdominal wounds lead to prolonged hospital stays. However, no data exist that describe the experience of persons living with a chronic abdominal wound. The aim of this qualitative study was to explore the experience of persons living with chronic abdominal wounds and elicit their expectations in health professionals. Narrative interviews were conducted with five women and four men. Using content analysis techniques, five categories with one to four subcategories emerged from the data. "Returning to everyday life without a wound" represents the main goal of the participants and is driven by their hope to achieve this outcome. "Everyday life with the wound" illustrates the reality of participants' lives, which is affected by suffering. "The patients' work" demonstrates the component that patients contribute to managing their wound. "The work of primary support persons" shows the importance of the work of people close to the patient. "The work of professionals" includes the expectations that patients have in their caregivers. Teamwork between professionals, patients and primary support persons seems to be an essential condition for the successful healing of an abdominal wound.

[Valid and reliable methods for describing pressure sores and leg ulcer--a systematic literature review]. / Valide und reliable Methoden zur Wundbeschreibung von Dekubitus und Ulcus cruris--Eine systematische Literaturübersicht.

In the wound documentation of pressure sore and leg ulcer the most important tasks and objectives are the presentation of the outcomes of the diagnostic inspection, planning of therapy and evaluation of wound healing. The aim of the systematic literature review covering the period of time between 2001 and 2006 was to look for valid, reliable and feasible methods to the size, appearance, edge, grade, and healing of wounds. Due to their heterogeneity the studies that were found can hardly be compared; some of them show methodological weaknesses. Measurements of an elliptical area based on the perpendicular method using a ruler are the most reliable within the linear methods; however, they only allow an estimation of the size. Together with mechanical or digital planimetry tracings can measure the wound's size reliably. Photographs do not assess large or circular wounds reliably, nor do they adequately document the wound's colour. There are no valid and reliable standardized procedures for the documentation of the wound's colour, exudate, odour; margins and maceration. To describe the pressure sore's degree of severity there are twenty different systems of classification. The data, however, confirm the difficulty to classify pressure ulcers reliably. Wound healing can also be assessed by a number of standardized tools: PSST, PUSH, SWHT, SS, PUHP, CODED and DESIGN (pressure sore) and LUMT (leg ulcer). These tools have not been translated into German and have not been adequately researched. No data exists to allow generalization concerning the practicability of these methods. For all methods of measurement, it can be concluded that training and experience in the use of the method is required and that the validity and reliability are higher when measurements are conducted by an experienced person.

[Cooperation between practice and academia: the self-concept of nursing and scientific experts]. / Kooperation von Praxis und Hochschule. Zum Selbstverständnis von pflegerischen und wissenschaftlichen Experten.

The term best-practice stems from industry and administration vocabulary, meaning improvement of processes regarding quality, efficiency and output. Nursing output of healthcare institutions are nursing outcomes gained for patients. Research results are their basis. In research literature exemplary best-practice projects can be found, which describe conceptual models for the transfer from research to practice as well as specific projects in which these theories were used. These projects identified different obstacles and solutions for research transfer, each for scientists, nursing staff, institutions and the nursing profession on the whole. The question remains why in Germany specific support programmes for colloboration between theory and practice are necessary, although nursing science is considered as a practical discipline. For further developments in nursing practice experts are required who show both nursing and scientific expertise and who are working directly with patients.