Development and pilot-testing of an evidence-based quality indicator set for home mechanical ventilation care: the OVER-BEAS project.

BACKGROUND: The number of patients depending on home mechanical ventilation (HMV) has increased substantially in Germany in recent years. These patients receive long-term care in different nursing facilities (nursing home, shared living community, private home). However, there are limited data available on the quality of care of HMV patients. The aim of the OVER-BEAS project was to identify quality indicators (QIs) of HMV care using an evidence-based approach. METHODS: A multidisciplinary board consisting of professionals and experts of HMV provision compiled a set of QIs between March and September 2019. In a structured, transparent process a set of QIs covering structures, processes and outcome of HMV patient's care were proposed and evaluated based on the best available evidence. QIs were defined as relevant, reliable and valid measurements of the quality of HMV care and furthermore to be comprehensive and applicable in practice. RESULTS: The experts proposed 40 QIs and consented a final set of 26 QIs. Based on the final set, questionnaires to document the QIs were developed: (1) to assess the quality and describe the structure of the nursing facility; and (2) to gather information on patient-related processes and outcomes. The feasibility of the questionnaires was tested in 5 nursing facilities treating HMV patients. The remarks from the nursing specialists were categorised in three groups: (1) term missing accuracy, (2) problem of understanding, and (3) not documented or documented elsewhere. Mean documentation time by the nursing specialists for one patient was 15 min. Based on this feedback, the questionnaires were finalised. CONCLUSIONS: We proposed a set of QIs relating to long-term HMV care and developed two questionnaires to collect this information. In a pilot study, we found the set of questionnaires to be feasible in assessing the quality of HMV care according to current evidence. The development of standardised evidence-based QIs to evaluate HMV care is a step towards implementing a standardised quality assurance program to document the quality of care of HMV patients.

Concept of the term long lie: a scoping review.

BACKGROUND & AIMS: The term "long lie" is often used when individuals who have fallen are unable to stand up on their own, so they have to lie unintentionally for a longer period of time until they are noticed and can be helped. Although long lie can lead to both short- and long-term physical and psychological effects, little is known about what describes the term. The aim of this review is to identify what characterizes the term. METHODS: Using the Arksey and O'Malley's framework for scoping reviews in accordance with the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, a systematic search was conducted for papers and gray literature that define, explain, or describe a long lie. The literature research was conducted via seven databases and Google Scholar. FINDINGS: The search yielded 921 hits, of which 22 research papers are included; most studies were published after 2010. Emergency medicine and public health in particular have studied long lies and have found that it does not only affect the older adults who have fallen and cannot stand up on their own because of their frailty but also individuals with restricted mobility, which can be related to several reasons. CONCLUSIONS: The results show that a standard concept of a long lie is lacking. The duration of lying and the location alone are not relevant criteria. Further factors (helplessness, psychological and physical consequences, etc.) should also be taken into account.

[Advanced Nursing Practice as a concept of care for people with outpatient ventilation in Germany: Results of a demand- and curriculum analysis]. / Advanced Nursing Practice als Konzept für die Versorgung von Menschen mit außerklinischer Beatmung in Deutschland: Ergebnisse einer Bedarfs- und Curriculumanalyse.

INTRODUCTION: Outpatient intensive care for people on home mechanical ventilation (HMV) is a complex area of care with high demands on the nurses specialised in this field. Internationally, academic qualification as an Advanced Practice Nurse (APN) has become established in these fields of specialised care. Despite the large number of further training opportunities, there is no university qualification for home mechanical ventilation in Germany. Based on a demand- and curriculum analysis, this study therefore defines the role of an APN for home mechanical ventilation (APN-HMV). METHODS: The study structure is based on the PEPPA framework (Participatory, Evidence-based and Patient-focused Process for the Development, Implementation and Evaluation of Advanced Practice Nursing). The need for a new model of care was determined with a qualitative secondary analysis based on interviews with health care professionals (n = 87) and a curriculum analysis (n = 5). Analyses were conducted using the Hamric model with a deductive-inductive approach. Subsequently, the main problems and objectives to improve the model of care were agreed upon in the research group, and the APN-HMV role was defined. RESULTS: The qualitative secondary data analysis illustrates the need for APN core competencies, especially in the psychosocial area and in family-centred care. The curriculum analysis resulted in a total of 1,375 coded segments. The focus of the curricula was on the central competency "direct clinical practice" (1,116 coded segments) and thus on ventilatory and critical care measures. Based on the results, the profile of APN-HMV could be defined. CONCLUSIONS: The introduction of an APN-HMV can usefully complement the skill and grade mix in outpatient intensive care and counteract care problems in this highly specialised area. The study provides a basis for the development of appropriate academic programmes or advanced training courses at universities.

[Students' perspective on generalized nursing education in Germany: Results of a nationwide online survey]. / Die generalistische Pflegeausbildung in Deutschland aus Sicht Auszubildender.

Students' perspective on generalized nursing education in Germany: Results of a nationwide online survey Abstract. Background: Generalized nursing education in Germany was introduced in 2020 as a reaction to changed care conditions. The reform's implementation is accompanied by a nationwide longitudinal survey with three surveys among students in generalized nursing education. Aims: We present results of the first survey round. The explorative approach provides data that allows insights into students' experiences and thus indicates adjustment opportunities. Method: The online survey used standardized questionnaires and was directed at students that had begun generalized nursing education in 2020. 1,267 students from 316 nursing schools in 15 German federal states participated in the first survey round. The survey recorded students' career choice motivations, learning experiences in nursing schools and practical placements, as well as contextual factors. Results: The students' career choice is mainly interest-driven (77.8%). The program is rated good to satisfactory (overall grade 2.45). Frequent and well-designed practical guidance and a transfer of information between nursing school and clinical placement appear important but insufficiently implemented. Data shows an increased need for support services. Conclusions: In addition to positive findings, the practical learning design and the dialogue between theory and practice appear challenging, while support services should be expanded.

Activities of Daily Living Are Improved by Inpatient Multimodal Complex Treatment for PD-a Real-World Cohort Study.

Background: The multimodal complex treatment for Parkinson's disease (MCT) provides inpatient care by a multi-disciplinary team for people with Parkinson's disease (PwP) in Germany. Objectives: We conducted a 5-year real-world mono-center cohort study to describe the effectiveness of MCT in the full cohort and various subgroups and outcome predictors. Methods: We collected an anonymized dataset between Jan 2015 and Dec 2019, involving N = 1773. The self-reported MDS-UPDRS part II was used as primary outcome, and clinical routine data for explanatory variables. PwP were categorized as responders or non-responders according to a response of at least 3 points 4 weeks after discharge. Results: N = 591 complete data records were available for statistical analyses. The full group improved by -2.4 points on the MDS-UPDRS II (P = <0.0001). 47.7% (n = 282) and 52.3% (n = 309) were coded as responders and non-responders, respectively. A clinically meaningful response was positively associated to age (χ2 = 11.07, P = 0.018), as well as baseline-severity of the MDS-UPDRS II (χ2 = 6.05, P = 0.048) and negatively associated to the presence of psychiatric disorder (χ2 = 3.9, P = 0.048) and cognitive dysfunction (χ2 = 7.29, P = 0.007). Logistic regression showed that baseline severity of the MDS-UPDRS II predicted therapy success. PwP with moderate baseline-severity had an about 2fold chance (OR 2.08; 95% CI 1.20-3.61; P = 0.009) and with severe an about 6fold chance (OR 5.92; 95% CI 2.76-12.68; P < 0.0001) to benefit clinically meaningful. Discussion: In a naturalistic setting of a specialized Parkinson's center, MCT improved ADL disability of PwP at least 4 weeks after discharge. Moderately and severely impaired patients were more likely to achieve clinically meaningful responses.

[Analysis of the weaning process in intensive care patients with regard to documentation and transfer to further treatment units]. / Analyse des Weaningprozesses bei Intensivpatienten im Hinblick auf Dokumentation und Verlegung in weiterbehandelnde Einheiten.

BACKGROUND AND OBJECTIVES: Weaning from ventilators is not always finished in the primary intensive care unit (ICU) setting. Transfer to other treatment facilities is a sensitive stage in the treatment and rehabilitation of the weaning patient. The aim of the present study was to investigate transition management and interhospital transfer of weaning patients, with special emphasis on documentation quality. METHODS: A retrospective data analysis of one year (2018) in two ICUs of a university hospital was performed. All ventilated patients with the following tracer diagnoses were included: chronic obstructive pulmonary disease (COPD), asthma, patients with multiple injuries, pneumonia, sepsis, acute respiratory distress syndrome (ARDS), and cardiac arrest (ventilation > 24 h). RESULTS: A total of 750 patients were included in the study (median age 64 [IQR 52.8-76]; 32% female). In all, 48 (6.4%) patients were not weaned at the time of transfer (especially sepsis and ARDS). Routine documentation was sufficient for the sections "spontaneous breathing trial", "assessment of readiness to wean" and "presumed weanability" to adequately assess the parameters of the German S2k guideline "prolonged weaning". Predominantly, these patients were transferred with tracheostoma (76%) to rehabilitation units (44%) by specialized physician-assisted patient transport ambulances (75%). DISCUSSION: The transfer of ventilated patients after initial ICU stay is a relevant issue for interhospital transfer. Routine documentation of a structured weaning process is sufficient in core elements to describe the weaning process. This is of great importance for continuity in the further treatment of these patients.

[German nursing study programs from the students' perspective: First results of a nationwide longitudinal study]. / Primärqualifizierende Pflegestudiengänge aus Sicht Studierender.

German nursing study programs from the students' perspective: First results of a nationwide longitudinal study Abstract. Background: The Nursing Professions Act establishes a concrete framework for academic nursing education in Germany for the first time. The primary qualifying nursing courses started in 2020 and will be accompanied by a systematic reporting of students' experiences over a period of three years. Aims: The article presents the results of the initial survey period (2021) on the students' point of view. Challenges and the need for further regulation of the primary qualifying nursing studies are analyzed and approaches to solutions are developed. Methods: The online survey is designed as a longitudinal cohort study with three measurement periods (2021, 2022, 2023). A descriptive analysis considers data of N = 57 students in the initial survey period. Results: The primary qualifying nursing study program is rated good overall (overall grade 2.32). However, one third (35.85%) are more critical in their assessments. Every second student perceives a need for adjustment in the financing of students. Learning in clinical placement settings often does not meet students' expectations. 86% of respondents report that nursing practice sites are insufficiently informed about students' qualification. Conclusions: Students' financing, and in particular the payment of assignments in the nursing practice, represents a regulatory gap with need for short-term solutions. For learning in nursing practice, there is a need for an enhanced practical placement guidance that is better geared to academic nursing education. This is accompanied by the need for a more specific definition of later professional fields and job profiles.

[Recommendations for a Core Curriculum for Master's Degree Programs in Health Services Research]. / Empfehlungen für ein Kerncurriculum für Masterstudiengänge der Versorgungsforschung.

The aim of the present study was to develop recommendations for a core curriculum for master's degree programs in health services research. For this purpose, a standardized online survey of university lecturers was conducted in the first step. In the second step, the curricula of the existing study programs were analyzed. In the third step, a literature search was conducted. In the last step, the resulting recommendations were discussed in a panel of experts. The final recommendations comprise 13 topics on five guiding questions with 26 subtopics. The main topics come from the areas of basic sciences in the context of health services research, the health care system and health policy, the (empirical) health services research process, and knowledge transfer. The present recommendations will serve as a basis for discussion and as a starting point. The development of recommendations should be seen as an ongoing process, as the core competencies of health services researchers will have to be continuously adapted to new research topics, new research methods and regulations.

[Complexity of outpatient intensive care for ventilated people: Cross-mapping into the standardised NNN-taxonomy]. / Komplexität außerstationärer Intensivpflege beatmeter Menschen.

Complexity of outpatient intensive care for ventilated people: Cross-mapping into the standardised NNN-taxonomy Abstract. Background: In Germany, free text is the preferred method for recording the nursing process in outpatient intensive care, although classification systems could enable a more precise description. Research question: How is nursing care for people with outpatient ventilation represented by the NNN-taxonomy and what are the recommendations for nursing practice? Methods: A qualitative "multiple case" design was applied. Using deductive content analysis (data sources: nursing documentation and secondary analysis of interviews with affected persons), several cases, both individually and across all cases were linked to the NNN-taxonomy (cross-mapping). Results: In total, the nursing documentation of 16 invasively ventilated persons with a mean age of 58.4 years (SD = 16.3) was analysed. Seven persons additionally contributed interview data. Documentation was mainly based on the "Strukturmodell" (14/16) with a moderate to high accuracy (D-Catch Score: 16.6; SD = 4.1). Cross-mapping resulted in 4016 codes: 618 nursing diagnoses, 1956 interventions and 1442 outcomes. Documentation was strongly measure-oriented, not very person-centred and with a lack of differentiation between diagnosis and intervention. Conclusions: To improve nursing practice, a person-centred attitude and the ability to differentiate between nursing diagnoses, interventions and outcomes should be promoted.

Comparing the quality of care for long-term ventilated individuals at home versus in shared living communities: a convergent parallel mixed-methods study.

BACKGROUND: People on home mechanical ventilation (HMV) belong to a heterogeneous population with complex care needs. In Germany, outpatient intensive care is provided in people's private home (PH) or in shared living communities (SLC). Increasing patient numbers have led to criticism of the quality of care in recent years. Since quality deficits from the perspective of those affected are largely unclear, the following research question emerged: How do interviews with ventilated individuals and family caregivers explain any differences or similarities in the quality of care between PH and SLC? METHODS: This study used a mixed-methods convergent parallel design, where quantitative and qualitative components were separately collected and analysed. The quantitative component (structured interviews and online survey) included ventilation characteristics, health-related resource use, health-related quality of life (HRQL) measured with the Severe Respiratory Insufficiency Questionnaire (SRI; range 0-100; higher scores indicated higher HRQL) and the Burden Scale of the Family Caregivers short version (BSFC-s; range 0-30; higher scores indicated higher burden). The qualitative component (semi-structured interviews) focused on people's experience of person-centred care. Data were merged using a weaving method and the Picker framework of Person-Centred Care. RESULTS: The quantitative component revealed that ventilated individuals living in PHs were on average 20 years younger than participants living in SLCs (n = 46; PH: 46.86 ±15.40 years vs. SLC: 65.07 ±11.78 years; p = .001). HRQL (n = 27; PH: 56.62 ±16.40 vs. SLC: 55.35 ±12.72; p > .999) and the burden of family caregivers (n = 16; PH: 13.20 ±10.18 vs. SLC: 12.64 ±8.55; p > .999) were not significantly different between living situation. The qualitative component revealed that person-centred care is possible in both care settings (ventilated individuals: n = 13; family caregivers: n = 18). CONCLUSION: This study describes a care situation that is as heterogeneous as the population of people with HMV. HRQL and the burden of family caregivers are highly individual and, like person-centred care, independent of the living situation. Policy decisions that facilitate person-centred care need to recognise that quality of care is highly individual and starts with the free choice of the care setting.

Therapy options for those affected by a long lie after a fall: a scoping review.

BACKGROUND: After a fall, more than half of older people living alone are unable to get up or get help independently. Fall-related recumbency makes affected individuals aware of functional status limitations and increased vulnerability. Patient-centered therapy is needed to manage physical, psychological, and social needs. This review summarizes the current evidence on care options for the special patient population. METHODS: The scoping review used the six-step framework proposed by Arksey and O´Malley and was conducted in accordance with the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework for scoping reviews. The literature searches were conducted in five databases and ten online archives. Articles were screened, assessed and selected using defined inclusion and exclusion criteria. Articles were included if they were published in either German or English and related to the care of long lies. Thematic synthesis was based on the literature review. RESULTS: The search yielded 1047 hits, of which 19 research papers were included. Two themes were identified: (1) acute therapy, focused on prolonged recumbency and pronounced physical effects; and (2) preventive therapy, which examined standing up training, technical aids, and social control systems in the context of fall management. CONCLUSIONS: There are a limited number of interventions that relate to the patient population. The interventions are predominantly presented independently, so there is a lack of structuring of the interventions in the form of a treatment pathway. In addition to pooling professional expertise and an interprofessional approach, it is important to continue inpatient treatment in the home setting, even though the effectiveness of interventions in a home setting has hardly been verified thus far. The solution for a missing treatment process is first of all a planned, interprofessional and intersectoral approach in therapy.

[Educational Programmes in Health Services Research in Germany: Current State and Future Perspectives]. / Studiengänge zur Versorgungsforschung in Deutschland: aktueller Stand und zukünftige Perspektiven.

OBJECTIVE: The aim of this study was to analyse accredited study programmes of health services research in Germany at Master's degree level regarding their structural data and content. METHODS: Using a descriptive qualitative design, all included plans of study courses, module handbooks and descriptions of the Master's degree programmes were analysed. RESULTS: The Master's degree programmes were similar in their structural elements as well as in their content of education. They aim at enhancing competences related to the areas of health services research to identify health care needs and to develop, initiate, evaluate and critically assess innovative care strategies across disciplines. DISCUSSION: Although the content is similar, the study programmes focus on specific aspects that allow students to choose a certain programme depending on their preferences. A next step can be the development of a core curriculum that takes into consideration further findings and the discourse of different stakeholders.

How to improve the quality of care for people on home mechanical ventilation from the perspective of healthcare professionals: a qualitative study.

BACKGROUND: The rapid increase in the use of home mechanical ventilation (HMV) for people with chronic respiratory failure poses extreme challenges for the healthcare system. People on HMV have complex care needs and require support from an interprofessional team. In Germany, HMV is criticised for inadequate quality standards, particularly in outpatient intensive care practice. The objective of this study was to describe the quality of care for people on outpatient HMV in Germany, Bavaria and provide recommendations for improvement from the perspective of healthcare professionals (HCPs). METHODS: Semi-structured qualitative telephone interviews with HCPs (i.e., nurses, equipment providers, therapists, and physicians) were analysed using the framework method. The quality framework of Health Improvement Scotland (HIS), which aims to improve the quality of person-centred care, was used to build a deductive analysis matrix. The framework includes the three key areas: (1) Outcomes and impact, (2) Service delivery, and (3) Vision and leadership. The domains (meta-codes) and quality indicators (sub-codes) of the quality framework were used for deductive coding. RESULTS: Overall, 87 HCPs (51 female, mean age of 44.3 years, mean professional experience in HMV of 9.4 years) were interviewed (mean duration of 31 min). There was a complex interaction between the existing health care system (Outcomes and impact, 955 meaning units), the delivery of outpatient intensive care (Service delivery, 939 meaning units), and improvement-focused leadership (Vision and leadership, 70 meaning units) that influenced the quality of care for people on HMV. The main barriers were an acceleration in transition management, a neglect of weaning potential, a shortage of qualified professionals and missing quality criteria. The central recommendations for promoting person-centred care were training and supervision of staff and an inspiring leadership. An integrated care structure supporting medical home visits and outpatient rehabilitation should be developed. CONCLUSION: This study describes a heterogeneous and partly deficient care situation for people on HMV, but demonstrates that high quality care is possible if person-centred care is successfully implemented in all areas of service provision. The recommendations of this study could inform the development of a person-centred integrated care structure for people on HMV.

[Attitudes to publication of quality testing reports in nursing homes]. / Einstellungen zur Veröffentlichung von Qualitätsberichten in Pflegeeinrichtungen.

BACKGROUND: The Nursing and Living Quality Act (PfleWoqG) regulates the implementation of legally regulated quality inspections and publication of statutory quality inspection reports for residential nursing homes in Bavaria. In the currently valid version, the quality records have to be published but a decision of the higher administrative court (VGH) repealed this rule and it is no longer in force. OBJECTIVE AND METHODS: Within the framework of a project for the Bavarian State Ministry for Health and Nursing concerning the revision of the publication of legally regulated quality testing reports, appraisals by the institutional management in nursing homes were collated. The E­survey reached 24% (n = 529) of all residential care homes for elderly people and residential care homes for handicapped people in Bavaria. RESULTS AND CONCLUSION: Approximately two thirds of the persons questioned attested that the inspections and the resulting reports reflected an appropriate picture of the quality of nursing carried out in the institutions. Nevertheless, the vast majority did not approve of the obligatory publication of the quality testing records. While the inspections were seen as a valuable basis to reflect on the quality of care in the institutions, it was simultaneously argued that the inspections are only snapshots, which could be misinterpreted by the public. It was criticized that the quality testing records were not comprehensible for users. Furthermore, it was commented that the ratings of the responsible authorities were influenced by the competence of the inspectors and their subjective point of view and there was therefore a risk that invalid results would be made public.

Arbeitsengagement und Belastungserleben von Health Professionals in Zeiten der Corona-Pandemie - Eine Querschnittstudie.

Work engagement and stress experience of health professionals in times of the corona pandemic Abstract. Background: The corona pandemic, caused by the novel viral disease COVID-19, has led to excessive strain in health professionals whose general occupational situation in itself is associated with high levels of stress. So far, there is no quantitative data on the stress experience caused by the COVID-19 pandemic in German health professionals and on the consequences of this experience for their commitment to work. METHOD: With a cross-sectional design, German health professionals were asked about their stress experience, health concerns and work commitment. The snapshot survey used self-developed questions plus items of a validated scale measuring work engagement. A convenience sample of health professionals was recruited through social media. The E-Survey reached 1168 valid cases, the majority of which were nurses (80.4 %, n = 855). RESULTS: The evaluation shows that health professionals in direct contact with COVID-19 patients show higher stress levels than participants with no contact and that their main concern is about the health of relatives, friends and family. In addition, it was found that the participants' work commitment decreased parallel to the increase in pandemic-related stress. DISCUSSION: The study shows significant correlations between work demands, stress experience and work engagement. In contrast to earlier studies, the results for work engagement in the sample are relatively low. There is a growing number of international recommendations for reducing work-related stress factors in a pandemic which should now be implemented in Germany on a large scale. These include, amongst others, pandemic specific catalogues of prevention measures and the creation of a blame-free work environment.

[Quality of Care for People with Home Mechanical Ventilation in Germany: A Scoping Review]. / Qualität der Versorgung beatmeter Menschen in der außerstationären Intensivpflege in Deutschland: Ein Scoping Review.

BACKGROUND: Outpatient intensive care for people with long-term mechanical ventilation is a rapidly growing area with a wide range of care demands. The aim of this Scoping Review is to present the current state of research on the quality of care for people with home mechanical ventilation in Germany and to identify research gaps. METHODS: Based on predefined inclusion criteria, 4 databases were searched for publications dealing with the care of people with home ventilation in Germany. The method of "data driven thematic analysis" led the data extraction and analysis. Distinction was made between research and expert opinion. RESULTS: The search resulted in 493 matches of which 68 publications were included in the this study: two guidelines (3%), 45 (66%) research papers and 21 (31%) expert opinions. The following topics were identified: Organization and control of ventilation (n=43; 63%), nursing (n=23; 34%), medical (n=39; 57%), therapeutic (n=7; 10%) and assistive technologies care (n=24; 35%), as well as the perspective of people with home mechanical ventilation and their relatives (n=33; 49%) and other topics (n=13; 19%). CONCLUSION: Although the debate on the quality of care for people living with home mechanical ventilation is conducted broadly, studies focusing on individual care demands, autonomy and participation depending on the living situation or on the role of specific health professionals within the interprofessional team are missing.

[Quality criteria for university-based practical learning in nursing: Results of a Delphi method]. / Qualitätskriterien für hochschulisches Praxislernen in der Pflege - Ergebnisse eines Delphi-Verfahrens.

INTRODUCTION: A Bachelor of Nursing qualification has been facilitated by the new Care Professions Reform Act since January 1, 2020 as a standard in Germany. Due to the Reform Act students must have completed 2,300hours of practical training in a healthcare institution. Recent projects have revealed that the practical part of current study programs is inadequate with regard to content, organization and didactics. Therefore, specific quality criteria need to be developed for institutions providing academic training of nursing professionals that are in line with the requirements of medical teaching hospitals. METHODS: These quality criteria have been developed from March 2019 to February 2020 in a three-phase process using the Delphi technique. Phases I and II were conducted as online surveys among various stakeholders (n = 396; n = 555) to identify quality criteria and to assess both their relevance and feasibility. Phase III consisted of an expert conference to finally select the quality criteria. RESULTS: The result was a set of requirements for practical and academic education with a total of 55 criteria subdivided into five dimensions (organizational, personal, infrastructural, formal and didactic). DISCUSSION: Against the background of the diversity of settings and institutions providing practice learning opportunities for nursing students and their specific frameworks, the practicability of individual criteria needs to be discussed. Also, the level of commitment and the related approval process have to be questioned. CONCLUSION: The criteria developed should be a tool to leverage quality, that is to improve the practical learning part of the nursing study programs. The addressees include representatives of universities and healthcare institutions taking part in the fundamental academic qualification in nursing care. The results provide guidance for the selection and the design of strategic and operational cooperation. Furthermore, the criteria can be used as a basis for the certification of academic teaching institutions.