Dying in Hospitals - Optimization of care in the dying phase (StiK-OV) - Results of an online survey

Background: Hospitals are the most frequent place of death in Germany (47%), but at the same time, the least preferred one - for both patients and their relatives. To optimize care in the dying phase by using a bottom-up approach, the StiK-OV project aims to implement and evaluate specific measures on different non-palliative wards at two university hospitals. In the first phase of the project, we assess the current state of care in the dying phase on different wards. Method(s): We conducted an online survey with national health care professionals consisting of seven open questions on important aspects, facilitators, barriers and needs for improvement as well as Covid-19 pandemic specifics regarding care in the dying phase. Qualitative data was analyzed thematically. Result(s): Of 67 participants, 66% work in clinical practice as nursing staff (52%) and physicians (30%) and 34% in management or administration. As relevant topics of care in the dying phase, we identified involvement of relatives, symptom control, patient-centeredness, professional competencies, as well as time, space and human resources. Participants state a need for improvement regarding these topics. During the pandemic, involvement of relatives and patient-centeredness were difficult to maintain due to visiting restrictions and higher workload, resulting in patient isolation and dying in loneliness. Discussion(s): The survey revealed common topics of importance which should be targeted by ward-specific measures. Difficulties due to the pandemic have to be accounted for to achieve optimal care in the dying phase under exceptional circumstances. Conclusion(s): The survey gave insights on care in the dying phase from the perspective of health care professionals that can help to develop and implement situation-specific measures to significantly improve the quality of care during the dying phase in hospitals. A bottom-up approach aims to increase the staff motivation to implement respective measures.

Dying in Hospitals - Optimization of Care in the Dying Phase (StiKOV): Results of an Online Survey

Background/aims: Hospitals are the most frequent place of death in Germany (47%) but also the least preferred one - for both patients and relatives. The project 'StiK-OV' aims to optimize care for dying patients in hospitals using a bottom-up approach. Therefore specific measures on non-palliative wards at two university hospitals will be implemented and evaluated. In the first project phase, the current state of non-specialist inpatient care in the dying phase was assessed. Methods: Online survey with national health care professionals in the field of care in the dying phase. The survey consisted of seven open-ended questions on important issues, facilitators, barriers and needs for improvement regarding the care for patients dying in hospitals as well as COVID-19 pandemic specifics. Qualitative data was analyzed thematically. Results: Of 67 participants, 66% worked in clinical practice, 34% in managerial positions. We identified five relevant topics of care in the dying phase: involvement of relatives;symptom control;patient-centeredness;professional competencies;as well as time, space and human resources. Participants aimed to uphold patient-centeredness as a priority in the dying phase despite reporting needs for improvement in all topics: 'Everything that is good for the patient is allowed.' This contrasts with the experience during the pandemic, when involvement of relatives and patient-centerednesswere hard to maintain due to visiting restrictions and high workload - leading to patient isolation and dying in loneliness. Conclusions: The survey revealed common topics on care in the dying phase from the perspective of health professionals to be targeted by ward-specific measures. Difficulties due to the pandemic have to be considered for optimal care in the dying phase under exceptional circumstances. The results can help to develop and implement context-specific measures to improve quality of hospital care during the dying phase.

How the COVID-19 pandemic affects palliative care inpatients and outpatients without a COVID-19 diagnosis and their families-a qualitative interview study

Background: During humanitarian crises like a pandemic, healthcare systems worldwide face unknown challenges. It is likely that the COVID-19 pandemic (C-pandemic) affects care structures and processes in palliative care and thus the patients cared for. Little is known about the situation of non-COVID-19 palliative patients during the pandemic. Aim: The study aims to explore and describe the effect of the current C-pandemic on the needs of patients without a COVID-19 diagnosis and their relatives in palliative care units and specialist palliative home care. Methods: Qualitative, semi-structured interviews with patients and their relatives in palliative care units or specialist palliative home care, verbatim transcription, and qualitative content analysis following the framework approach. The framework is developed inductively. Results: 31 interviews were conducted with patients/relatives (16/15) in palliative care units/specialist palliative home care (20/11) from June 2020-January 2021. Identified needs are mostly independent of the C-pandemic and correspond to those arising from a palliative life situation in general. Themes related to the C-pandemic were (1) concerns about an infection, (2) concerns about the overall social situation, and (3) effects of the pandemic on general care. We identified a change in the relatives' role as caregivers: Restriction on visits limit relatives to fulfill their role in palliative care units. In specialist palliative home care, relatives are concerned about the balance between preserving social contacts at the end of life and preventing infection by reducing social contacts. Conclusion: Needs at the end of life remain identical in the context of the C-pandemic but become more multifaceted as additional C-pandemic needs emerge. With regard to the C-pandemic special attention should be given to the needs of relatives as caregivers.

A pre-registered short-term forecasting study of COVID-19 in Germany and Poland during the second wave.

Disease modelling has had considerable policy impact during the ongoing COVID-19 pandemic, and it is increasingly acknowledged that combining multiple models can improve the reliability of outputs. Here we report insights from ten weeks of collaborative short-term forecasting of COVID-19 in Germany and Poland (12 October-19 December 2020). The study period covers the onset of the second wave in both countries, with tightening non-pharmaceutical interventions (NPIs) and subsequently a decay (Poland) or plateau and renewed increase (Germany) in reported cases. Thirteen independent teams provided probabilistic real-time forecasts of COVID-19 cases and deaths. These were reported for lead times of one to four weeks, with evaluation focused on one- and two-week horizons, which are less affected by changing NPIs. Heterogeneity between forecasts was considerable both in terms of point predictions and forecast spread. Ensemble forecasts showed good relative performance, in particular in terms of coverage, but did not clearly dominate single-model predictions. The study was preregistered and will be followed up in future phases of the pandemic.

Yes, We Can (?) - A Critical Review of the COVID-19 Semester

The COVID-19 crisis has caused an extreme situation for higher education institutions around the world, where exclusively virtual teaching and learning has become obligatory rather than an additional supporting feature. This has created opportunities to explore the potential and limitations of virtual learning formats. This paper presents four theses on virtual classroom teaching and learning that are discussed critically. We use existing theoretical insights extended by empirical evidence from a survey of more than 850 students on acceptance, expectations, and attitudes regarding the positive and negative aspects of virtual teaching. The survey responses were gathered from students at different universities during the first completely digital semester (Spring-Summer 2020) in Germany. We discuss similarities and differences between the subjects being studied and highlight the advantages and disadvantages of virtual teaching and learning. Against the background of existing theory and the gathered data, we emphasize the importance of social interaction, the combination of different learning formats, and thus context-sensitive hybrid learning as the learning form of the future. © 2021, Springer Nature Switzerland AG.