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Evaluation of electronic nursing process documentation in the acute inpatient setting: A mixed methods convergent parallel design Abstract: Background: To identify potential improvements in the quality of nursing process documentation, it is essential to record the baseline situation, considering the perspectives of the nursing staff. Aims: The study aimed to evaluate electronic nursing process documentation in an acute inpatient setting, taking into account the views of nursing staff. Methods: A mixed-methods convergent parallel design was applied. In the quantitative part of the study, an extended Q-DIO (Quality of Nursing Diagnoses, Interventions and Outcomes) document analysis (n = 30) was conducted and analyzed descriptively. In the qualitative part, semi-structured expert interviews (n = 6) were conducted and analyzed using structured content analysis. Quantitative and qualitative results were then combined based on the phases of the nursing process and compared for convergence and divergence. Results: The results for the aspects of nursing assessment, nursing diagnoses and nursing goals revealed divergence. For instance, the quantitative data indicated good quality in nursing diagnoses, whereas nurses expressed differing views on the necessity of documenting these diagnoses. Convergences were observed in the planning and implementation of nursing interventions, as well as in nursing evaluation. Conclusions: The evaluation revealed potential for optimization. When implementing the recommendations, human, technical and organizational factors must be considered, as they are interdependent.

Experienced individual discrimination among nursing professionals with and without migration background: a cross-sectional study Abstract: Background and aims: In Germany only few, mostly qualitative, studies have been conducted on the experiences of discrimination among nursing professionals. Therefore, the aim of this study was to identify the types and reasons of discrimination experienced by nursing professionals on an individual level in their interactions with patients. Method: A quantitative cross-sectional study was conducted via an online survey in two hospitals and two nursing care facilities in Germany from July to October 2022. The Everyday Discrimination Scale (EDS) was used to assess discrimination. Data were analysed descriptively. Results: The study involved 302 nursing professionals with and without a migration background (NPwMB/NPwoMB), of whom 73 had a migration background. NPwMB experienced (almost) all of the experiences surveyed more frequently at least "once a week" or "(almost) daily" than NPwoMB. The differences were not statistically significant. Both NPwMB and NPwoMB attributed their experiences of discrimination to their gender and age. In addition, NPwMB experienced discrimination on the basis of ethnic origin. Conclusions: The results suggest that NPwMB and NPwoMB experience high levels of discrimination in their interactions with patients for a variety of reasons. To confirm and contextualize the results, further studies (including qualitative ones) are needed. This study can serve as a basis for future research.

Influence of non-pharmacological measures on the sleep quality of geriatric residents: a mixed-methods study Abstract: Background: Older people often suffer from sleep disorders, and insufficient sleep can have an impact on morbidity and mortality. Aim: The aim was to create, implement and evaluate a catalogue of non-pharmacological measures for improving sleep quality in geriatric long-term care. Method: This research project is divided into three phases: (1) needs analysis, (2) development of a catalogue of measures and (3) implementation and evaluation. Data collection for the needs analysis was carried out using a mixed-methods-approach. Information on sleep experiences was collected through guided interviews (n = 9) with residents. In the quantitative survey (n = 55), using the Pittsburgh Sleep Quality Index (PSQI), data on the quality of residents' sleep was collected. A catalogue of non-pharmacological measures to promote sleep was subsequently created using a focus group comprising participants from the nursing sector (n = 13). This catalogue was then implemented in tow geriatric wards. The evaluation part was divided into a pre- and post-survey using the PSQI (n = 24) to review the measures taken. Results: In the evaluation of the PSQI, the pre-survey yielded a mean value of 8,1 (SD = 0,8), which indicates poor sleep behaviour. In the post-survey, a mean value of 5,9 (SD = 0,8) was determined, which corresponds to healthy sleep behaviour. Conclusions: It was shown that non-pharmacological sleep-promoting measures could have a positive influence on sleep quality.

Overcoming mental health crises at home: a qualitative study on the perspectives of people with mental illness Abstract: Background: In recent years, various outreach psychiatric care models have been established in Germany and their effectiveness has been proven. Despite these promising results and evident benefits, these care models have not yet been widely implemented. Aim: This qualitative study investigates the key factors and experiences of psychiatric home treatment from the perspective of people with mental illnesses in Germany. Methods: Episodic, semi-structured interviews were conducted with 18 individuals diagnosed with mental illnesses according to ICD-10 (F2X, F3X, F6X), all of whom were receiving care within outreach mental health services: psychiatric outpatient clinics, community psychiatric nursing, Assertive Community Treatment, and home treatment equivalent to inpatient care. The interviews were analyzed using thematic coding based on Flick's methodology. Results: The study identifies four key factors: role of the caregiver, therapeutic measures, living environment and treatment characteristics. Conclusion: The results emphasize the central role of the caregiver, who has a positive influence on the success of the therapy, particularly through empathy, humanity and professional competence. Individualized measures and support in the living environment strengthen autonomy and stability. The key factors indicate that further development of the home treatment is necessary.

Sensor systems for the care of people with wandering behavior in hospital: A qualitative study on subjective experiences Abstract: Background: Hospital stays pose a particular challenge for people with cognitive impairments. In particular, behaviours such as wandering - undirected or uncontrolled walking around - can be stressful for both patients and nursing staff. Technological solutions, such as RFID-based sensor systems, offer support, but also raise ethical and practical questions. Research question/Aim: The aim of the study was to investigate the subjective experience of patients, staff and relatives when using an RFID-based sensor system in hospital. Methods: The study followed a qualitative triangulation design in which interviews with patients (n = 3) and nursing staff (n = 6) as well as participant observation were used as data sources. The data material was analysed based on the grounded theory coding method. Results: The sensor system was used for mobile patients with wandering. Carers experienced the system as promoting safety and relieving stress. Patient perspectives ranged from support, interest and scepticism to a rather negative attitude. Conclusions: The system strengthens caregivers' sense of security but requires careful ethical and legal consideration when used. As patients often have only a limited understanding of the technological context, future research should improve education and communication in order to promote acceptance and self-determination.

Rehospitalizations after tracheostomy tube insertion in pediatrics: a quantitative retrospective cross-sectional study Abstract: Background: Caring for children with tracheostomy tubes is a major challenge for families and requires comprehensive training in handling the tracheostomy tube. Despite available training programs, frequent rehospitalizations are observed. The causes and timing of these readmissions remain unclear. Objective: This study identifies the timing, frequency, and causes of rehospitalizations in tracheostomized children. Methods: A quantitative retrospective cross-sectional study was conducted involving 22 tracheostomized patients who had been under the care of a tertiary children's hospital in the German-speaking part of Switzerland for at least five years following tracheostomy insertion. Results: Most rehospitalizations (22%) occurred within the first six months after discharge and steadily declined thereafter. This pattern applied to both elective and emergency rehospitalizations. The most common reason for emergency rehospitalizations was respiratory infections. Factors such as the need for a ventilator or oxygen, age, language, or support at home showed no influence on the number of rehospitalizations. Conclusion: Continuous support for tracheostomized children and their families, particularly during the first six months after discharge, is crucial to minimize rehospitalizations. Equally important is training in the management of respiratory infections in the home environment.

Interdisciplinary, research-based teaching format for participatory technology development in nursing: a mixed methods study Abstract: Background: Digital assistance technologies offer great potential to support and relieve the burden of care when they are tailored to the requirements of everyday care and developed in collaboration with users. Aim: The objective was to develop and pilot an interdisciplinary, research-oriented teaching format (IFL) to train students of computer science (bachelor's degree) and health and nursing sciences (master's degree) in robotics development, participatory research, and interdisciplinary collaboration. Methods: The twelve-month IFL was divided into an idea phase and a development phase with a focus on teaching participatory and interdisciplinary skills. A mixed methods design with pre-post surveys and focus group interviews was used for evaluation to assess the impact on collaboration and the conditions for success for such teaching formats. Results: The piloted IFL led to the development of a proof of concept for robotics-assisted wound documentation. While the attitude of computer science students toward interdisciplinary collaboration improved, a negative trend was observed among nursing students. Focus group interviews emphasized the importance of clear structures, curricular anchoring, and practical tasks for successful collaboration. Conclusions: Students are in favor of IFL with practical relevance to their future professional practice. Such teaching formats promote interdisciplinary collaboration as well as the personal and professional development of students.

Reasons given by students with university entrance qualification to study for nursing training and against nursing studies - Results of an E-Survey Abstract: Background: Despite the efforts towards academization in nursing and the recommendation of the German Council of Science and Humanities to provide up to 20% of healthcare professionals with higher education qualifications, the academization rate for primary qualifying courses was only 0.97% in 2022. The proportion of those entitled to study in nursing training amounted to 15.6% overall. Aim: This study examines the reasons why those with university entrance qualifications decide in favor of nursing training and thus against studying nursing. Method: A nationwide online survey was conducted in Germany between February and April 2024 reached nursing trainees with a higher education entrance qualification (N = 625). Results: The results show that the desire for practical work (51.9%) is the main reason against studying nursing, followed by the intention to study only after training (35.4%). Other important factors are a lack of information about nursing studies (33.8%) and financial aspects (33.1%). Conclusions: There are knowledge deficits regarding the financing of studies as well as the equivalence of studies and training, particularly with regard to practical orientation and learning periods in practical placements. The findings are relevant for the further application to potential students and development of higher education nursing training.

Background: Primary nursing (Process Responsible Nursing; PRN) is a nursing organization model, practiced in intensive care units (ICUs), but implementation is challenging. This paper focuses on the qualitative process analysis of the development and implementation of PRN in an ICU at a German university hospital. Aims: Aim was to record the perception of changes in nursing practice due to the introduction of PRN and obtain information on implementation and further optimization perceived by nurses. Method: A qualitative process analysis was done. Data collection took place at three defined times (immediately before implementation and 6 and 12 months after) and each included a focus group interview (FG) and a 5-day ICU ward process analysis (WA) in the form of participant observation. The analysis of FG and WA was carried out according to Kuckartz's content-structuring qualitative content analysis. Findings: The main categories communication, care planning and integration of patients and relatives in care and 13 subcategories with a cross-sectional category could be identified. Positive effects of PRN were found, particularly concerning relatives. The optimization potential included handover, visit appointments, the documentation system and adjustments to the visiting times. Conclusion: The qualitative analysis was able to show changes during the introduction of PRN, e.g. in communication and care planning, but also challenges like visit appointments or the documentation system in nursing practice.

Advance care planning in the acute hospital: A qualitative analysis of terms and conditions Abstract: Background: Advance Care Planning (ACP) is an internationally established concept aimed to facilitate anticipatory care planning in the event of future inability to consent. In Germany, ACP is currently not regularly offered to patients in acute care hospitals. Aim: We aimed to identify preconditions for implementation of ACP in acute care hospitals in Germany through review of the international literature and expert interviews. Methods: A systematic literature search was carried out in the databases MEDLINE and CINAHL for internationally used strategies for implementing ACP in acute care hospitals. Consecutively, a guide for interviews with experts to evaluate the strategies was developed. Interviews were analyzed by qualitative content analysis according to Mayring. Results: Out of 13 included publications, 17 preconditions were identified and assigned to 16 categories after evaluation by experts. In international ACP programs, it was described how to proceed and organize the ACP conversation. German experts emphasized that appropriate preconditions, such as sufficient time resources and training, must be granted, whereas the literature search revealed the conversation process and organization as important determinants. Conclusions: The implementation of ACP programs is conceivable, but requires specific conditions as legal regulation and defining and structuring of the processes.