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.

Optimization of competency in obstetrical emergencies: a role for simulation training.

PURPOSE: In obstetrical emergency situations, optimal management requires the immediate coordinated actions of a multi-disciplinary and multi-professional team. This study investigated the influence of simulation training on four specific skills: self-confidence, handling of emergency situation, knowledge of algorithms and team communication. METHODS: Clinical algorithms were first presented to the participants. Training for six emergency situations (shoulder dystocia, postpartum haemorrhage, pre-eclampsia, maternal basic life support, neonatal resuscitation and operative vaginal birth) was performed using high- and low-fidelity simulation mannequins. General impression of the simulation training and the four above-mentioned skills were evaluated anonymously through a self-assessment questionnaire with a five-point Likert scale immediately after the training and 3 months later. RESULTS: From November 2010 to March 2012, 168 participants, distributed over six one-day courses, took part in the training. 156 participants returned the questionnaire directly after the course (92.9 %). The questionnaire return rate after 3 months was 36.3 %. The participants gave higher Likert scale answers for the questions on the four specific skills after 3 months compared to immediately after the course. The improvement was statistically significant (p ≤ 0.05) except for the question regarding team communication. CONCLUSION: Implementation of simulation training strengthens the professional competency.

Health Care Professionals' Interest in Vaccination Training in Switzerland: A Quantitative Survey.

Objectives: Health care professionals (HCPs) play an important role for patients' vaccination decisions. To counsel patients/clients appropriately, HCPs need current factual knowledge about vaccines and strong communication skills. Methods: We conducted an online survey with physicians, pharmacists, nurses, and midwives in Switzerland (01.11.2020-31.03.2021). We evaluated: 1) interest in vaccination knowledge and counseling training; 2) vaccination recommendation practices; 3) experience with vaccination counseling/administration; 4) comfort level in addressing vaccine hesitancy (VH); 5) perspectives on patient/client VH, delays, and refusals. Results: In total, 1,933 practicing HCPs responded (496 physicians, 226 pharmacists, 607 nurses, 604 midwives). 43% physicians, 31% pharmacists, 15% nurses, and 23% midwives felt comfortable counseling VH patients/clients. 96% physicians, 98% pharmacists, 85% nurses, and 91% midwives were interested in additional vaccination-related training. All professionals mentioned safety, efficacy, and side effects as topics of most interest for additional training. Conclusion: Results demonstrate a high interest among HCPs for additional vaccination-related training. In addition to factual information about vaccination, such training will likely benefit from a communication component, given the low rates of comfort reported by HCPs when counseling VH patients/clients.

Safety and acceptance of "Vibwife", a new moving mattress to support mobilization during labor: Result of a clinical study.

OBJECTIVE: To examine the safety and acceptance "Vibwife", a new moving mattress to support mobilization of pregnant women during labor. DESIGN: The study was a prospective medical device clinical study without a control group. The study was designed in intervention phases, with safety evaluation by a safety review board after each intervention phase. SETTING: The study took place at the University Hospital of Basel, Switzerland. PARTICIPANTS: 50 women were included with a low risk singleton pregnancy > 37th weeks during the first stage of labor. INTERVENTION: Evaluation of the safety and acceptance of women, midwives and physicians during the first stage of labor. The intervention was carried out in 3 phases. In the first phase five women in labor used the device for 10 minutes, the next 10 women for 20 minutes, and finally the next 35 women for 30 minutes. MEASUREMENTS: Measurement included capturing Adverse Events (AEs) (including Adverse Device Effects (ADEs)), Serious Adverse Events (SAEs) and recording vital parameters before, during, and after intervention, as well as CTG before and after intervention. Acceptance by women, midwives and physicians was measured by questionnaires with a 4-point Likert scale and pain intensity by a discrete Visual Analogue Scale (VAS) from 0-10. FINDINGS: No SAE occurred during the trial. A total of 32 AEs occurred in 25 women during the intervention or in the 30 minutes follow-up. The most frequently observed AEs were modification of blood pressure and CTG abnormalities. None of the 32 AEs led to sequels of any kind. The relationship between AEs occurrence and the use of the medical device was viewed as certain in 2 cases (6.2%), possible or likely in 8 cases (25%), and unlikely or unrelated in 22 cases (68, 7%). Overall, women, midwives and physicians reported high satisfaction with their use of the device. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The medical device "Vibwife" was judged as safe for women. Acceptance among women and health personnel was good. Considering the potential benefits of mobilization during labor, this new medical device could be a very interesting adjunct to other obstetrical tools. Particularly, women whose mobility is restrained by epidural anesthesia while giving birth could be very suitable candidates. To answer the question of efficacy, a randomized-controlled trial is required.