Sven Schwabe1, Jutta Bleidorn2, Andreas Günther3, Olaf Krause4,5, Nils Schneider4, Juliane Poeck2. 1. Institut für Allgemeinmedizin und Palliativmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. schwabe.sven@mh-hannover.de. 2. Institut für Allgemeinmedizin, Universitätsklinikum Jena, Jena, Deutschland. 3. Fachbereich Feuerwehr, Stadt Braunschweig, Braunschweig, Deutschland. 4. Institut für Allgemeinmedizin und Palliativmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. 5. Zentrum für Medizin im Alter, Diakovere Henriettenstift Hannover, Hannover, Deutschland.
Abstract
BACKGROUND: Emergencies in nursing homes lead to frequent utilization of emergency medical services and emergency department visits, which are frequently assessed as avoidable and do not comply with the patients' wishes. Emergency management is complicated by structural conditions, uncertainty and difficulties in communication between the treating healthcare professionals. OBJECTIVE: In the framework of the NOVELLE research project a model for a recommendation for action was developed in an interprofessional process to structure the emergency management in nursing homes. MATERIAL AND METHODS: The research process was organized according to the grounded theory as a constant interplay of data collection, analysis and concept development. From January to April 2021 a total of 6 focus group interviews were conducted with 24 nurses, physicians and experts from medical ethics and 1 guideline interview with an expert from the field of medical law. All interviews were performed as video conferences. They were digitally recorded, transcribed verbatim and coded with MAXQDA software. RESULTS: Recommendations for organizing and improving the emergency management are structured into three components: 1) initial assessment, 2) structured assessment including nursing evaluation and integration of patient treatment preferences and 3) organization of further treatment. Components include actions, results and consequences and can be arranged in the form of an algorithm. DISCUSSION: Recommendations for improvement of emergency management should enhance the competences of nursing staff, respect patient treatment preferences, consider situational conditions and support communication with external medical and care providers.
BACKGROUND: Emergencies in nursing homes lead to frequent utilization of emergency medical services and emergency department visits, which are frequently assessed as avoidable and do not comply with the patients' wishes. Emergency management is complicated by structural conditions, uncertainty and difficulties in communication between the treating healthcare professionals. OBJECTIVE: In the framework of the NOVELLE research project a model for a recommendation for action was developed in an interprofessional process to structure the emergency management in nursing homes. MATERIAL AND METHODS: The research process was organized according to the grounded theory as a constant interplay of data collection, analysis and concept development. From January to April 2021 a total of 6 focus group interviews were conducted with 24 nurses, physicians and experts from medical ethics and 1 guideline interview with an expert from the field of medical law. All interviews were performed as video conferences. They were digitally recorded, transcribed verbatim and coded with MAXQDA software. RESULTS: Recommendations for organizing and improving the emergency management are structured into three components: 1) initial assessment, 2) structured assessment including nursing evaluation and integration of patient treatment preferences and 3) organization of further treatment. Components include actions, results and consequences and can be arranged in the form of an algorithm. DISCUSSION: Recommendations for improvement of emergency management should enhance the competences of nursing staff, respect patient treatment preferences, consider situational conditions and support communication with external medical and care providers.
Authors: Leah Nemiroff; Emily Gard Marshall; Jan L Jensen; Barry Clarke; Melissa K Andrew Journal: J Am Med Dir Assoc Date: 2019-05-27 Impact factor: 4.669
Authors: Sabine E Lemoyne; Hanne H Herbots; Dennis De Blick; Roy Remmen; Koenraad G Monsieurs; Peter Van Bogaert Journal: BMC Geriatr Date: 2019-01-21 Impact factor: 3.921