Reducing Avoidable Hospital Transfers From Nursing Homes in Austria: Project Outline and Baseline Results.

Hospital transfers from nursing homes (NHs) are frequent, burdensome for residents, and often avoidable. The evidence regarding the effectiveness of interventions to reduce avoidable transfers is limited, and most projects focus on nurses' knowledge and skills. In the present project, interventions focusing on nurses and physicians are integrated, elaborated, and implemented in 17 NHs. Results of the 6 months preintervention period are reported. Hospital transfer rates (N = 1,520) and basic data on all residents (N = 1,238) were collected prospectively. Nurses' preintervention knowledge and self-efficacy were assessed using standardized questionnaires (N = 330). Many hospital transfers were initiated by nurses without physician involvement, polypharmacy was common, and a high potential for reducing transfers by increasing physician presence was observed. Nurses showed rather low knowledge but high self-efficacy. The results are discussed against the background of the interventions including enhancement of physician presence and geriatric quality circles.

[From the nursing home to hospital and back again A mixed methods study on hospital transfers from nursing homes]. / Vom pflegeheim ins krankenhaus und wieder zurück Eine multimethodale analyse von krankenhaustransporten aus alten- und pflegeheimen.

Hospital transfers from nursing homes are frequent, costly, often preventable, and can have negative effects on the residents' health. The present study investigated the current situation in Carinthia (Austria) regarding the characteristics of relocated nursing home residents, the proportion of avoidable transfers, the consequences of relocation from the physicians' and nurses' perspectives and ways for improving nursing home care. Retrospectively, the documentations of a regional hospital (N=4149), a rescue service (N=10754), and a social insurance agency (N=7051) were analysed; qualitative interviews with physicians (N=25) and nursing administrators (N=16) were conducted. A considerable proportion of these transports seemed to be avoidable: for example, about 40% of the ambulatory treatments in the emergency department of the investigated hospital were inappropriate. Options for improving the current situation will be discussed.

[Cancer pain from the nurses' perspective--findings from Austria]. / Tumorschmerz aus Sicht der Pflege--Befunde aus Osterreich.

The present study addresses the issue of cancer pain from the perspective of Austrian nurses. By the means of a standardised questionnaire 332 nurses (79 percent female, 63 percent with age < 40) were asked about causes and triggers of cancer pain, patients' burden of pain, used analgesics and their side effects, and the authority by whom they want to be informed about an own malignant disease. The respondents mentioned a wide range of causes, triggers and multipliers of cancer pain. According to the respondents, most cancer patients experience pain that exceeds the degree of pain a person can bear. Many side effects of use of analgesics are observed. In case of an own malignant disease the majority of the interviewees would like to be informed by a physician. The results point out that nursing personnel is aware of the patients' burden of pain, but at the same time they show the need for improvement at clinical pain management and in the area of vocational training and advanced nursing education.