Nursing Care Sector Research Articles

Two-year audit of compliance in the preparation and administration of medications by nursing staff in a mother-and-child university hospital center

ObjectiveAudits are essential for reviewing and improving the medication-use process. Identifying areas for improvement can limit the risk of errors when preparing and administering drugs. Pediatric centers face specific challenges in ensuring the safety of the medication-use process. The objective of this study was to observe and compare compliance with criteria for the preparation and administration of medications by nurses in a mother-and-child university hospital center over two consecutive years. MethodsThis observational cross-sectional study was conducted in a Canadian mother-and-child university hospital center. Audits were conducted over a 1-month period in 16 and 18 nursing care sectors in 2021 and 2022, respectively. The standardized audit evaluated compliance with prespecified criteria related to the preparation and administration of medication by nursing staff (77 criteria for 2021 and 82 criteria for 2022). The auditors comprised nurses and a pharmacist trained by the research team. Compliance was compared between years and assessed through a chi-square test. ResultsThe audit consisted of 522 observations in 2021 and 448 observations in 2022. Overall compliance was 76% in 2021 and 66% in 2022. The compliance rate by criterion ranged from 16% to 100%. In 2021 and 2022, 51 (84%) and 52 (87%) of the criteria, respectively, had compliance rates of more than 75%, and 12 (20%) and eight (13%), respectively, had 100% compliance. There were statistically significant decreases in compliance for nine of the 39 criteria for preparation of medications, notably prior hand hygiene (91%% vs. 84%, p = 0.002), and for six of the 17 criteria for administration of medications, including mentioning possible adverse effects to the patient (41% vs- 30%, p = 0.008). ConclusionIn this study, compliance was over 75% for most of the criteria. However, for a few criteria, we observed a decrease in compliance from 2021 to 2022. Various hypotheses are proposed to explain these decreases, such as the COVID-19 pandemic.

Experiences Shared by the (Future) Public Health Workforce during the COVD-19 Pandemic in Germany: Results of a Survey on Workload, Work Content, and Related Challenges among Students and Young Professionals.

Although previous studies have focused on the adverse effects of the COVID-19 pandemic on various professional groups (particularly in the health and nursing care sector), this study aims to close a research gap by assessing perspectives of students and young professionals in epidemiology and public health in Germany in terms of shifts in workload, work content, and related challenges caused by the pandemic. We conducted a cross-sectional survey between mid-February and mid-March 2022. Quantitative data were analyzed via standardized mean differences. Qualitative data based on answers to open-ended questions were analyzed via a qualitative content analysis. Overall, 172 individuals participated in this survey. Results indicate that students felt burdened the most by lack of exchange with other students and lecturers. Study participants employed in public health experienced changes in their employment because they had changes in their work content- and administration, which was accompanied by a high burden due to the workload. Multiple demands that can have an impact on both acquired skills and mental health during the professional qualification phase were mentioned by the participants. Therefore, more in-depth analyses are needed to investigate the impact the pandemic will have on the (future) public health workforce in the long run.

Examining the sustainability and effectiveness of co-created physical activity interventions in vocational education and training: a multimethod evaluation

BackgroundCo-creation approaches are increasingly used in physical activity promotion to develop interventions tailored to the target group and setting. The resulting complexity of such interventions raises challenges in evaluation. Accordingly, little is known about the effectiveness of co-created interventions and the underlying processes that impact their sustainable implementation. In this study, we attempt to fill this gap by evaluating co-created multi-component physical activity interventions in vocational education and training in nursing care and automotive mechatronics regarding (1) their sustainable implementation at the institutional level and (2) the effectiveness of single intervention components at the individual level.MethodsFollowing a multimethod design, we conducted a questionnaire survey (n = 7) and semi-structured interviews (n = 4) to evaluate the sustainability of the interventions. Quantitative data were analyzed descriptively, and qualitative data were analyzed using qualitative content analysis. To examine the interventions’ effectiveness, we conducted two non-randomized controlled trials (n = 111). Analysis of variance was used to examine differences between groups.ResultsAt the institutional level, long-term implementation of single intervention components in nursing care was observed; in contrast, long-term implementation in automotive mechatronics was not observed. In this context, various factors at the outer contextual (e.g., COVID-19 pandemic), inner contextual (e.g., health-promoting leadership), intervention (e.g., acceptance), and personal levels (e.g., champion) influenced sustainability. At the individual level, no significant intervention effects were found for changes in physical activity behavior and physical activity-related health competence.ConclusionThe role of co-creation on the effectiveness and sustainability of physical activity promotion in vocational education and training cannot be answered conclusively. Only in the nursing care sector, a co-creation approach appeared promising for long-term intervention implementation. Sustainable implementation depends on various influencing factors that should be considered from the outset. Demonstrating effectiveness at the individual level was challenging. To conclusively clarify both the role and impact of co-creation, methodologically complex and elaborate evaluation designs will be required in future research projects.Trial registrationThis study was retrospectively registered at clinicaltrials.gov on 24/08/2021 (NCT05018559).

Ein Jahr Coronapandemiemanagement an einem 300-Betten-Krankenhaus

HintergrundAus dem Blickwinkel der Pandemiebeauftragten eines Schwerpunktkrankenhauses mit 300 Betten wurde das erste Jahr der SARS-CoV‑2(„Severe Acute Respiratory Syndrome Coronavirus Type 2“)-Pandemie mit allen Herausforderungen für den klinischen Alltag anhand der erhobenen Datenlage mit dem Ziel aufgearbeitet, das zukünftige Pandemiemanagement besser planbar zu machen.MethodikDas Caritas-Krankenhaus St. Josef in Regensburg beschäftigt rund 1330 Mitarbeitende (MA) und versorgt jährlich fast 20.000 stationäre Patienten. Sämtliche Aufzeichnungen des Pandemiebeauftragten zwischen dem 01.03.2020 und 28.02.2021 wurden in die vorliegende deskriptive Studie eingeschlossen.ErgebnisseIm Beobachtungszeitraum wurden 280 SARS-CoV-2-positiv getestete Patienten (durchschnittliches Alter 68 ± 19 Jahre) behandelt. Zwischen 11/2020 und 02/2021 wurden 81 % (n = 227) dieser Patienten im Haus behandelt. Neben der Analyse dieser Patienten erfolgte eine Analyse des Testkonzepts sowohl der Patienten (53 % der Tests i. R. der sog. 2. Welle) als auch der MA; hier erfolgten 1633 PCR-Tests, wobei sich 5,6 % aller MA im Verlauf der Pandemie mit SARS-CoV‑2 infizierten. Zudem wurden auch weitere Maßnahmen wie die Reduktion des OP-Programms und andere Allgemeinmaßnahmen im Haus evaluiert.ZusammenfassungViele etablierte Prozesse mussten im Krankenhaus während der Pandemie verändert werden. Sowohl der Ausfall der positiv getesteten MA wie auch die Quarantänezeiten von Kontaktpersonen führten zu einer weiteren Anspannung der insbesondere im Pflegesektor ohnehin engen Personaldecke und erschwerte die Patientenversorgung. Das Testkonzept im Krankenhaus war sehr komplex und gerade asymptomatische Tests wiesen eine geringe Trefferquote bei gleichzeitig hohem Personalaufwand auf.

Berufs- und branchenbezogene Analyse des COVID-19-Risikos in Deutschland

Analysis of the COVID-19 risk by occupational groups and industry in Germany Background: Cases of COVID-19 in healthcare professionals and employees in the nursing service who, as a result of their professional activities, are exposed to a significantly increased risk of infection compared to the general population can be recognised as an occupational disease (BK 3101). However, the question arises whether there is an increased risk of infection in occupational groups other than those mentioned in BK 3101. Methods: Based on the routine data of the BARMER health insurance fund for all employed regular insured persons in the age range from 15 to under 65 years, age- and gender-specific incidence rates for COVID-19 were calculated. On this basis, standardised incidence ratios (SIR) were analysed according to industry and occupational groups as well as according to the risk groups proposed by the Collegium Ramazzini. Results: A total of 15,167 cases of COVID-19 were identified for the more than 4.1 million regular insured persons, of which 2,890 were admitted to hospital (19.1%). For employees in the health and nursing care sector, a significantly increased risk was confirmed with SIR = 1.80 (95%CI: 1.62–1.99). But even for risk group 2 (very high risk) a significantly increased risk was detected: SIR = 1.34 (95%CI: 1.15–1.55). The highest risk was observed among contract workers in the industrial sector and in the postal and logistics sector. Conclusion: The analysis suggests that the risk of COVID-19 is highest among healthcare professionals, employees in the nursing service and in workplaces where inadequate occupational health and safety measures may have been implemented. In order to reduce the risk of COVID-19 in the future, the new SARS-CoV-2 occupational safety regulations must be implemented and strict monitoring of compliance with the internal policies based on these regulations must be ensured. Keywords: COVID-19 risk – occupational disease (BK 3101) – risk groups – occupational health and safety measures

OP509 Do They Care? Debates About Nursing And Health Technology Assessment In The German Bundestag

IntroductionOpposition parties in Germany are allowed to send formal requests to the government to control actions and pass important political debates to the parliament. These formal requests include a comprehensive analysis report issued by the scientific service of the German parliament. A systematic overview of these reports would support a deeper understanding about healthcare topics and assessments discussed by parties in the highest German decision body, particularly in the field of nursing.MethodsWe conducted a review using the German parliament “Bundestag” database for all formal requests since 1949. To systemize the formal requests we performed a quantitative category analysis using descriptive statistics.ResultsWe identified 26,197 formal requests with 146 reports related to nursing issued between 1978 and 2019. The 146 reports related to nursing accounted for 0.54 percent of all requests. Almost 30 percent of these requests were related to recruitment and qualification. The second major topic, with 15 percent, was financing of the nursing sector. Of all 146 formal requests in the history of the Bundestag, 55 percent (n = 81) were issued in the last 10 years.ConclusionsNursing is an emerging topic in the German parliament, highlighting the demographic shift in Germany and the growing pressure in the nursing care sector. Health Technology Assessment bodies should be informed and work together with the scientific services of parliamentary bodies. This would support a more transparent and evidence based healthcare system, aside from lobbyism.

The importance of the assurance that “humans are still in the decision loop” for public trust in artificial intelligence: Evidence from an online experiment

This study investigates the public's initial trust in an artificial intelligence (AI) decision aid utilized in the delivery of public services. Amidst societal anxiety surrounding AI, the study posited that the information communicated to the public about the use of AI matters to the public's initial trust in AI. More specifically, the study hypothesized that an assurance that “humans are still in the decision loop” (HDL) makes a difference in the public's initial trust (H1), which might also depend on the stated purposes for using AI (H2). This article reports on the results from an online experiment testing these hypotheses in the context of Japan's long-term nursing care sector, based on the responses of care users and their families (N = 1542). The study did not find strong evidence to support H2. However, it found some support for H1: the proportion of those who trusted a care plan prepared with AI assistance more than a care plan not involving AI was higher by 8.95 percentage points with the HDL assurance than without. This highlights the importance of the HDL assurance and reveals respondents' reservations about a complete AI takeover in care planning.

Psychosocial burden and strains in geriatric nursing: comparison of nursing personnel with and without migration background

Because of demographic changes the nursing care sector is faced with alack of qualified employees in the medium and long term. The shortage in the work force is caused by high workloads and unfavorable working conditions. In response to this shortage, there have been attempts to recruit qualified nursing staff from abroad and also to improve the integration of people with amigration background living in Germany into the job market. Based on aquantitative cross-sectional study of 366 nurses, the psychosocial burden and strains among employees with amigration background (n = 112) and without amigration background (n = 254) were examined. For this purpose, 13scales of the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for the assessment of psychosocial factors at work. The results were compared with professional group-specific reference values (geriatric care) from the COPSOQ database. The comparison of nursing staff with and without amigration background revealed that the emotional demands, work-privacy conflict and role conflicts factors received asignificantly better rating among nursing staff with amigration background, while development opportunities were rated worse by this population group. The surveyed nursing staff exhibited higher stress values compared to the COPSOQ reference group in almost all scales. Nursing staff with amigration background need to be supported with respect to development opportunities. Suitable education and training measures may offer adequate career perspectives and may encourage employees to stay in their jobs.

Moving towards a competence centre for geriatric medicine and care: Quality management and human resource management as major support factors.

Changed employment models, an ageing workforce and demands of new generations are challenging healthcare facilities to go down new paths. Never before have well-qualified staff been as highly sought after within the medical and nursing care sector as they are today. For many years, the Geriatric Health Care Centres of the city of Graz (GGZ)-a large regional health care provider with more than 650 staff across five locations-has focused a lot on the topic of competence management, facilitation of specialist and management careers in nursing and medicine as well as the optimal mix of skills and grades in staffing. In addition to competence management, quality management is another prerequisite for systematic staff development. The consistent path of quality management at GGZ has demonstrated for more than 15 years that the regular consideration of quality management systems supports the constant development of human resource management; additionally, it has also demonstrated that it leads to important certifications and prestigious prices: these include the KTQ award for Cooperation for Transparency and Quality in Health Care (Kooperation für Transparenz und Qualität im Gesundheitswesen) in 2010 and 2013, the Austrian Quality Award (Staatspreis Unternehmensqualität) in 2014, the European Quality Award from EFQM (European Foundation for Quality Management) in 2015 and runner-up for the Austrian award for the most family-friendly company (Staatspreis Familienfreundlichster Betrieb Österreichs) in 2014. Furthermore, the competitive edge is sustainably ensured. However, to remain competitive in the labour market and to satisfy the aforementioned requirements, skill-based teamwork and consideration of life-phase-orientation are keys to increase the job and life satisfaction of staff, especially for the mentally and physically draining work with elderly, chronically ill and dying patients. The facilitation of specialist and management careers and age-appropriate workplaces are in turn part of workplace health management of the company. Incorporating workplace health management into the corporate strategy allows health-related management decisions to be made. The integration of health-relevant agendas as strategic management instruments (e.g. the so-called balanced scorecard) is supported by the processes of quality management systems (e.g. EFQM). The strategic corporate objective of GGZ is to increase the health literacy of the population-and by doing so, also increases the health literacy of patients and residents. This kind of patient empowerment can be substantially supported by specially qualified, empathic staff with good social skills and a genuine interest in the elderly; this reinforces the high significance of professional human resource management.

Recruiting migrant nurses to fill the gaps: the contribution of migrant women in the nursing care sector in Greece

The study examines the complex and stratified nature of the health care profession in Greece, which is increasingly staffed and thus shaped by female migrants. The research explores how immigrant labour is drawn on to fill the most urgent needs in the lower end of the nursing care sector, how immigrant labour gains access to these jobs, the implications of the recruitment process and the effect of these factors on the local labour market structure. It is shown that a predominantly female migrant cohort provides a ready source of nursing care, both complementing and further stratifying the local labour market while also contributing to the sustainability and reinforcement of the segmented health care arena.

Are there reasons to be worried about the 'caretelization' of residential care?

Successive governments have encouraged both the marketization and the privatization of the residential and nursing care sector. This paper describes how the large corporate providers continue to increase their share of the market through a continual process of mergers, takeovers and acquisitions. Market analysis suggests that this trend is set to continue. The name given to this phenomenon in this paper is `caretelization'. The process of caretelization is examined in the context of New Labour's public sector modernization agenda. The paper raises questions of whether continued caretelization is more or less likely to help New Labour achieve certain aims of modernization. For example, New Labour often talks of `putting people themselves in the driving seat of the public services'. It is argued that, with caretelization, not only is public accountability diminished, but key principles such as consumer choice and user involvement are likely to be compromised by allowing ownership of residential and nursing care to be dictated by market forces. Such developments raise questions about both New Labour's desire and its capability to manage the forces of neo-liberalism.