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"Take a break - Time-out for me": A practice project to promote a healthy rest break Abstract. Background: Breaks are essential for physical and mental health. In health care professions breaks are often cancelled or interrupted. Nursing staff should be enabled to take breaks regularly and without any interruptions. They should be given alternative options to organize their breaks. Methods: A pre-post survey was carried out with one group by means of questionnaires. The two break models "Feel good manager" and "I'm away" were tested by the nursing staff, followed by a debriefing meeting. Results: Before this project none of the nurses had rated his/her satisfaction regarding the breaks as "very good" or "good". This changed during the project to 45,5% (t₁) and 22,2% (t₂). None of the nurses felt "very well" or "well" recovered before the project. An increase to 54,6% (t₁) respectively 33,3% could be asserted. Only 7,1% (t₀) indicated to take their breaks "always" or "usually" in "full-length". With the break model "Feel good manager" it changed to 100% and with the model "I am away" to 33,3%. The amount of interruptions could be reduced from 4 (t₀) to 2 (t₁) and 0 (t₂). Discussion: These break models are not applicable arbitrarily by other wards at will. Instead, individual situation analysis should be carried out with according adjustments. These models cannot be tested in case of lack of break areas or absence of personnel. Conclusion: The described project procedure can be transferred to other wards.

The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design Abstract: Background: Most patients in acute care hospitals experience movement limitations due to surgery or a general deterioration of their condition. Therefore, nurses need a high level of competence in movement promotion. Aim: The aim of this study was to evaluate the feasibility of a three-day advanced kinaesthetics training course followed by six months of practical support to promote kinaesthetic competence in inpatient acute care and the competence development achieved as a result. Methods: The evaluation of the nurses' effectiveness was conducted using a pre- and post-measurement of kinaesthetic competence through a self-assessment questionnaire and an observation protocol. The evaluation of feasibility was done through a semi-structured questionnaire. Results: Eight nurses rated their kinaesthetics competence as good before (mean: 10,8 on a scale of 4-16) and very good after the intervention (mean: 13,2). The kinaesthetics trainer assessed the competence before as sufficient (mean: 9,4 on a scale of 4-16) and very good (mean: 14,5) after the practical support. The need to make practical support more flexible is highlighted in the qualitative data. Conclusion: The results demonstrate that a three-day training followed by six months of practical support has a positive impact on nurses' kinaesthetic competence.

The implementation of clinical assessment by nurses in Switzerland: A cross-sectional study from the nursing perspective Abstract: Background: Clinical assessment is a core competency of BSc and MSc prepared nurses in Switzerland. However, influencing factors of its implementation and the experience in the interprofessional team has been studied little so far. Objective: The aim of this study was to explore how often clinical assessment skills are used by BSc and MSc graduated nurses in Switzerland, to identify facilitating and hindering factors for implementation and to investigate the nurses experience of the implementation in the interprofessional team. Method: We used an exploratory, descriptive research design employing a cross-sectional study of the convenience sample of BScN and MScN graduates in Switzerland. 264 questionnaires were analysed quantitatively and 149 written statements as part of the survey qualitatively. Results: Respondents indicated that they routinely only use 18.9% of the 53 assessment skills they were trained in. The "respiratory system", "abdomen", "skin" and "mental status" were used most frequently. MScN graduates use respiratory assessments and BScN graduates use abdominal assessments more frequently. Lack of time and interruptions, lack of influence on patient care and specialty specific skills are hindering factors for the implementation. Better conditions at the institutional level and appreciation within the interprofessional team can make an encouraging contribution in future. Conclusion: This study illustrates, that the theory-practice transfer of clinical assessment in Switzerland needs to be further promoted.

Voluntary abstinence from food and fluid. The relatives' perspective: An integrative review Abstract. Background: Unbearable states of suffering can cause a premature wish to die. Voluntary stopping of eating and drinking (VSED) offers a way to autonomously realize this wish. Relatives play a significant role in the process of realizing VESD. So far, it is unclear how relatives experience the supporting process. Aim: This review intends to systematically record experiences of accompanying relatives. Method: Within the framework of an integrative review, we conducted research in MEDLINE^®, CINAHL^® and PsychINFO^®, as well as supplementary research. The selection was based on defined inclusion and exclusion criteria. For the synthesis, we used a thematic model. Results: From the four included studies, it emerged that the accompanying relatives accepted the family members' wish to die. They defended the realization of this wish with responsibility and advocacy until the death of the person wishing to die. As a result of their caring commitment, they neglected their own needs. Most relatives assessed the accompaniment as peaceful and dignified. Conclusion: Accompanying the VSED process represents an emotional tightrope walk with unfamiliar challenges for relatives. The results can contribute to a deeper understanding of relatives' needs. In this way, the findings can stimulate the derivation of suitable support offers.

Background: Occupational stress, dissatisfaction, higher risk for chronical and psychological disorders impairs the well-being of care nurses staff and maintaining the quality of elderly and disabled care. However, few studies have compared the psychological and physical stress in nurses working in inpatient and outpatient care settings. Aim: The aim of the present study was to compare perceived stress, workload and psychosomatic complaints in nurses working in inpatient and outpatient care settings. Methods: 158 care nurses working in geriatric and disabled care participated in the quantitative cross-sectional survey study. Comparisons of stress, workload and psychosomatic complaints were made between the inpatient and outpatient care group. Results: Nurses working in the outpatient care reported more subjective experience of stress and more workload compared to nurses working in inpatient care. Additionally, nurses working in outpatient care reported more psychosomatic complaints compared to nurses in inpatient care. Conclusions: Our results suggest that inpatient and outpatient nurses experience their nursing activities differently stressful. In future research the differential stress factors need to be explored to provide adequate job training and develop stress prevention programs.

Using the TRAPD method to translate the revised MISSCARE Survey from English into German: Revised MISSCARE-Austria Abstract. Background: Questionnaire translations in German-speaking nursing science rely on methods using first- and back-translation techniques despite increasing criticism. In contrast, the TRAPD method is recognized as best practice in intercultural social research. However, experience with the application of this method in German-speaking nursing science is lacking. Aim: To describe the utilization of the TRAPD method using the example of the translation of the revised MISSCARE Survey from English into German and to discuss necessary adaptations, advantages, and limitations of this approach. Methods: An adapted version of the team-based translation method TRAPD was implemented through the steps: preparation, translation, review, adjudication, pretest, and documentation, based on the GESIS guidelines for intercultural questionnaire translation. Results: The new revised MISSCARE Austria instrument consists of 85 items. For the majority of the items, equivalent terms or phrases were found that allowed for a straightforward translation. For some items an adaptation was necessary due to cultural, measurement- and construct-related aspects. Translation equivalence regarding challenging items was examined with the first author and promoted by multiple cognitive pretesting with nurses. Conclusions: Our study strengthens the argument that the TRAPD method is appropriate for translating measurement instruments in German-speaking nursing science. However, this example shows that further experience with this method is necessary for its further development for our discipline.

Development of an advanced practice nurse (APN) role for nutrition management: A needs assessment using a mixed methods approach Abstract. Background: Nurses are attributed to play a key role in nutrition management. This field has emerged to be a subject of advanced nursing practice. Aim: Conducting a needs assessment on the role profile of an advanced practice nurse (APN) in nutrition management according to the PEPPA framework. Methods: Mixed methods design. In a cross-sectional study on the current practice, the diagnostic accuracy of nurses' nutrition screening using Nutritional Risk Screening (NRS 2002) compared with independent assessment by a nutrition expert using NRS 2022 was examined. In case of a positive screening result, reasons were determined using an in-depth assessment. In addition, semi-structured, guideline-based interviews were conducted and content-analysed. Results: The identification of patients at risk by nurses' nutrition screening showed a need for improvement (sensitivity: 56%, specificity: 96%; n = 195). Commonly identified reasons for (risk of) malnutrition (n = 51) were lack of desire to eat/lack of appetite or increased caloric needs due to illness. Development opportunities and expectations for an APN were specified based on the interviews (n = 20). They refer to skill enhancement, support within the interprofessional team in complex treatment cases and a stronger nursing role in nutrition management. Conclusions: Based on the needs assessment, the APN's areas of responsibility were identified and assigned to the Hamric model, and implementation strategies could be derived.

Evaluation of the implementation of non-pharmacological measures for the prevention and treatment of delirium: A retrospective cohort study Abstract. Background: Delirium is burdensome for the affected patients, their relatives, hospital staff and the health care system. Preventing delirium with targeted multicomponent interventions is therefore essential. Aim: To investigate the implementation of defined non-pharmacological, preventive, and supportive measures in patients with an increased risk of delirium and/or delirium by the hospital's directions. Methods: In this observational study, routine data from 175 hospitalized patients were included. Data on delirium prevention, treatment and presence of delirium were extracted from the patient records and analyzed using appropriate statistical methods. Group comparisons were made between the medical/surgical clinic and the delirium/no delirium group. Results: Of the 175 patients, 31 had delirium. For delirium prevention, measures to improve oxygen supply, excretion, pain and mobility were most frequently implemented and measures such as improving cognition and communication were least frequently implemented. In the case of delirium, measures to modify risk factors, ensure safety, as well as prophylaxis were applied most frequently. Between the two clinics and between the delirium/no delirium group significant differences in the frequency of these measures were shown. Conclusion: The differences in frequency of implementation provide preliminary evidence that clinic-specific delirium prevention, early detection, and treatment may be needed.