1,721,001 research outputs found
Study protocol for the development, trial, and evaluation of a strategy for the implementation of qualification-oriented work organization in nursing homes
No full textAbstract
Background
Staffing ratios in nursing homes vary among the federal states of Germany, but there are no rational grounds for these variations. In a previous study, a new instrument for the standardized calculation of staffing requirements in nursing homes was developed (
Algorithm
1.0). The development was based on a new empirical data collection method that derives actual and target values for the time and number of care interventions provided.
Algorithm
1.0 found an increased requirement of 36% of staff in German nursing homes. Based on these results, the German legislature has commissioned a model program to trial and evaluate a complex intervention comprising increased staffing combined with strategies for organizational development.
Methods
The mixed-methods study consists of (i) developing a concept for restructuring the work organization, (ii) the application of this concept combined with increased staffing in 10 nursing homes (complex intervention), and the further development of the concept using a participatory and iterative formal evaluation process. The intervention consists of (a) quantitative measures of increased staffing based on a calculation using
Algorithm
1.0 and (b) qualitative measures regarding organizational development. The intervention will be conducted over one year. The effects of the intervention on job satisfaction and quality of care will be evaluated in (iii) a comprehensive prospective, controlled summative evaluation. The results will be compared with ten matched nursing homes as a control group. Finally, (iv) prototypical concepts for qualification-oriented work organization, a strategy for the national rollout, and the further development of
Algorithm
1.0 into
Algorithm 2.0
will be derived.
Discussion
In Germany, there is an ongoing dynamic legislation process regarding further developing the long-term care sector. The study, which is the subject of the study protocol presented here, generates an evidence-based strategy for the staffing requirements for nursing homes.
Ethics and dissemination.
This study was approved by the Ethics Committee of the German Association of Nursing Science (Deutsche Gesellschaft für Pflegewissenschaft) on 02.08.2023 (amended on 20.09.2023). Research findings are disseminated through presentations at national and international conferences and publications in peer-reviewed scientific journals.
Trial registration number
: German Clinical Trails Register DRKS00031773 (Date of registration 09.11.2023).GKV-SpitzenverbandUniversität Bremen 50110000783
Chinese nurses in Germany : Literature review and expert surveys on the opportunities and limits of employment of Chinese nursing staff in Germany
No full textThe shortage of nurses is not only a problem in Germany, but also in many other western and eastern countries in and outside of Europe. One approach to coping with the already existing skills shortage in nursing, which is expected to aggrevate in the future, is to recruit care personnel from other countries, from so-called third countries, including China. So far, there have been many individual references to the potential of and possible issues with recruiting skilled nurses from China, but there is no systematic overview of the opportunities of employing Chinese nursing staff in Germany. In order to be able to better assess the benefits of recruiting nursing staff from China, the author systematically compiled an empirical record of the associated risks and potentials in her paper on the basis of guided expert interviews
Pflegerische Versorgung alter Menschen
No full textDie Pflege hat eine zentrale Rolle in der Versorgung alter Menschen. Sie trägt dazu bei, dass alte Menschen trotz Einschränkungen, z.B. in der Selbstständigkeit, ein Leben in Würde und Selbstbestimmung führen können. Renommierte Autorinnen und Autoren konkretisieren, welches genau das Ziel der Pflege von alten Menschen sein soll und wie die Qualität in der Langzeitpflege weiterentwickelt und gemessen werden kann. Weitere Beiträge thematisieren Herausforderungen und Konzepte in der spirituellen Begleitung von zu pflegenden Menschen und hinsichtlich des Einsatzes von digitalen Technologien. Schließlich werden rechtliche und qualifikatorische Rahmenbedingungen diskutiert sowie Chancen und Desiderata von Pflegeforschung herausgearbeitet
Theory of midwifery- professional identity- construction in the context of interprofessional collaboration and medicalization of birth
No full textMidwifery care is provided by several health professions, but is not always successful. Up to now research on collaboration in obstetrical care is limited. Aim of this research is to explore the working conditions of interprofessional work in the clinical setting and examine the subjective perspective of midwives on collaboration. Data from 20 participant observations and 14 interviews in the clinical setting are part of the analysis. The a Theory of midwifery-professional identity-construction in the context of interprofessional collaboration and medicalization of birtha stresses the influence of professional identity in the collaboration with others. The professional identity of midwives is characterized by several parts of identity. They are built in a process of identity-construction. Different parts of the identity can include contrasting believes. Midwifery-professional identity-construction is shown on a range of autonomous to subordinated work. In this way midwives cope with the heterogeneous demands of the work situation in the clinical setting
„Boah, es hätte an so vielen Punkten anders sein müssen.“ – Ausgewählte Ergebnisse der qualitativen Panelstudie ,Entwicklungsaufgaben in der beruflichen Pflegeausbildung‘
No full textUm Pflegeauszubildende in ihren Entwicklungsprozessen gezielt unterstützen zu können, ist es grundlegend, eine verstehende Perspektive auf die subjektiven Lernprozesse zu entwickeln und Erkenntnisse über die wahrgenommenen Bedürfnisse, Interessen und Defizite zu gewinnen. Da derzeit entsprechende empirische Erkenntnisse über die subjektiven Bildungsgänge von Pflegeauszubildenden fehlen, wird mit dieser kumulativen Dissertation das Ziel verfolgt, die Entwicklungsaufgaben von Pflegeauszubildenden zu rekonstruieren, um die Perspektive der Lernenden bei der Entwicklung von Curricula und formalen Bildungsangeboten berücksichtigen zu können.
Mit Bezug auf die Bildungsgangtheorie und das Konzept der Entwicklungsaufgaben werden daher die Aneignungsprozesse von Auszubildenden in der Pflege empirisch untersucht. Um die Verläufe rekonstruieren zu können, wurde eine qualitative Panelstudie mit drei Erhebungszeitpunkten geplant und durchgeführt. Dazu wurden 26 Auszubildende der dreijährigen Pflegeausbildung in Deutschland rekrutiert. Die Daten wurden nach dem ersten, zweiten und am Ende es dritten Ausbildungsjahres mittels leitfadengestützter episodischer Interviews erhoben und mit der rekonstruktiv-hermeneutischen Analyse nach Kruse (2015) ausgewertet.
Für das erste Ausbildungsjahr wurden fünf Entwicklungsaufgaben identifiziert, die sich auch für das zweite und dritte Ausbildungsjahr bestätigen ließen, sich jedoch in den Deutungs- und Bearbeitungsmustern unterscheiden: (1) Pflegebeziehung gestalten, (2) persönlichen Umgang mit Grenzsituationen entwickeln, (3) Entwicklung eines Verständnisses von sich selbst in der Welt, (4) Rollenfindung in Institutionen sowie (5) Pflegekompetenz entwickeln. In den jeweiligen Einzelarbeiten werden die Entwicklungsaufgabe Pflegebeziehung gestalten im ersten
Ausbildungsjahr, die Entwicklung aller fünf Entwicklungsaufgaben vom ersten in das zweite Ausbildungsjahr sowie die Entwicklungsaufgabe Pflegekompetenz entwickeln über alle drei Ausbildungsjahre analysiert und diskutiert. Es wird deutlich, dass zwar Entwicklungen bzw. Erfahrungsschichtungen stattfinden, die Entwicklungsaufgaben aber weitgehend selbstständig durch informelles Lernen bearbeitet werden, sodass eine begleitende Handlungsreflexion und theoretische Durchdringung fehlt. Die Auszubildenden entwickeln keine klaren Vorstellungen über die Besonderheiten professioneller Pflege und erweitern diese auch nicht umfassend. In Zukunft wird zu überprüfen sein, ob sich die Deutung und die Bearbeitung der Entwicklungsaufgaben durch die neuen gesetzlichen Vorgaben verändern. Basierend auf den Forschungsergebnissen, besteht die weiterführende Aufgabe, die Erkenntnisse pflegedidaktisch aufzubereiten, die Rahmenlehrpläne und Curricula zu überprüfen und ggf. anzupassen sowie ausbildungsphasenspezifische Angebote für Auszubildende zu entwickeln
Intuition as a component of nursing action in outpatient care - Originating contexts and features of intuitive action
No full textThe research work examines the originating contexts, components and features of intuitive nursing action in outpatient care. In the theoretical section of the work, the basic content of nursing action within the realm of nursing science and in the care sector of outpatient care is set out. Following on from this, there follows a description of the research subject, intuition. Here, the theoretical and research-based existing knowledge on the phenomenon of intuition is incorporated from the key reference disciplines of nursing science and the discipline of nursing. The empirical examination aimed at recording the phenomenon of intuition in outpatient care rests on the foundations of qualitative social research. The epistemological basis is symbolic interactionism. In order to uncover an empirically-founded theory, the grounded-theory methodology was used. The methods of data gathering formed a triangulation of participatory observation with video documentation, and guided interviews with video analysis. As a result, two modes of nursing action were identified as components of an action model, in the form of a slide presentation of intuitive action. The action model comprises a conceptual, case-related design by caregivers for their actions in relation to care recipients. It reflects the normality of action, and functions as an orientation framework for nursing actions. Intuition as a situation-linked trigger for action leads on the one hand to routine actions which correspond to the model and contribute towards its consolidation. On the other hand, intuition triggers actions which deviate from the model of the caregiver and contribute to its expansion. The intuitive actions are presented in the form of manual (e.g. as routine), linguistic (e.g. as coding) and materialized actions (e.g. physical touching). Intuition in outpatient care constitutes individualized, situation-linked knowledge of action oriented towards everyday professional work, which is based in particular on empirical knowledge and cognitive abilities. The intuitive actions may be understood as a skill of caregivers for the purpose of structuring their complex everyday professional work. Intuition - understood as a skill - also means that caregivers grasp situations rapidly and sufficiently, solve or anticipate problematic situations, and generate understanding and cooperation with care recipients. Here, the results also reveal misdirecting intuition.Intuitive action in outpatient care is not an isolated single performance by a caregiver, but a component of an interactive-dialogical action mechanism, which integrates the worlds of meaning and lifestyle habits of the care recipients. The results are to be understood as a contribution to nursing science aimed at adding reflection and discussion to the body of knowledge relating to intuitive knowledge of practice and to develop it further in conceptual terms. The results may contribute to a scientifically-grounded action orientation in practice, and professional self-monitoring within the discipline
A Theory of the Recognition of Homosexualities in Geriatric Care : the Life Situation of Older Lesbian Women and Gay Men in Need of Care
No full textThis study investigates the life situation of lesbian women and gay men in need of care in stationary or outpatient geriatric care based on qualitative interviews with affected persons as well as healthcare professionals. These interviews were evaluated by means of the methodology of Grounded Theory (GT). Based on empirical data a theory of the recognition of homosexualities in geriatric care was generated, its pioneering basic research should set new standards in future subject and lived body orientated (nursing) care for homosexual persons in need of care. It should bring ground-braking changes in the care of other minorities as well. The study shows how experiencing emotional attention, legal equalisation and social esteem improve the wellbeing and social integration of homosexual persons in need of care. It also shows that the absence of one or more forms of recognition can be damaging to peoplea s self-reference (identity) and also lead to social isolation
Embedding Sustainability in the Nursing Curriculum
No full textAnthropogenic climate change has major consequences for humans and the environment. The reciprocal relationship between environment and health is becoming apparent with 4.4% of global greenhouse gas emissions being attributable to healthcare provision. Embedding sustainability in nursing curricula can encourage nurses to practise the full extent of their skills, expand their health promotion role addressing ecological public health threats and take significant leadership roles in sustainable health policy. The NurSusTOOLKIT provides evidence-based information supporting practice and promoting nurse education in health and sustainability
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