[Nursing experts in primary care of chronically ill persons: Insights into an ongoing project]. / Pflegeexpert_innen in der Primärversorgung von chronisch kranken Menschen.

Nursing experts in primary care of chronically ill persons: Insights into an ongoing project Abstract. Background: The project HandinHand develops and tries out a new interprofessional form of care for chronically ill persons. On referral by the attending doctors, nursing experts visit chronically ill persons older than 60 years on a regular basis. In this framework a clinical supervision takes place and is complemented by a promotion of health and self-management competencies of the patients. According to advanced nursing practice, nursing experts function as consultants and instructors for the target group and their relatives. Methods: This paper describes the field of action and the vocational role of nursing experts. Following the delegation agreement and the development of the project, opportunities and boundaries of this new form of care are discussed. Results: The project HandinHand introduces a new role for nursing experts in the German health care system. Conclusion: This form of cooperation between doctors and nursing experts is a model of good practice. It can be seen as a starting point for the development of new fields of action and roles of advanced nursing practice for academically educated nurses.

Indicating Care Process Quality: A Multidimensional Scaling Analysis.

Background and Purpose: Resident assessments are analyzed by multidimensional scaling. Methods: We analyzed observer-based real care and support time in four facilities with 209 residents during two working days; resident, organizational data and pairs of residents were assessed by registered and assistant nurses regarding the dissimilarity of resident pairs. Registered- and assistant nurses dissimilarity assessments are compared to criteria-based nursing management assessment. Results: The fits of management criteria matrices as external restrictions are higher in registered nurses' than in assistant nurses' assessments. These differences disappear with low staffing. Conclusion: The influence of qualification levels on assessment is affected by staffing. Low complexity of Assistant Nurses assessments is connected to higher nursing care and support time in groups of demanding residents.