Zwischen Traum und Trauma - Aufbau und Betrieb einer Kohortenstation für Patient_innen mit COVID-19 in einem Akutspital - Eine Fallstudie.

Between dream and distress - Setting up and running a cohort ward for COVID-19 Patients at an acute hospital - A case study Abstract. Background: In the context of the pandemic, hospitals must be able to care for COVID-19 patients within a very short timeframe. OBJECTIVE: Description of the setting up of a cohort ward for patients with COVID-19 on a surgical ward including the development of the nursing team. METHODS: The intrinsic retrospective case study describes the situation, identifies special phenomena in a reflective manner and links them to existing knowledge. Data were anecdotal, routine data were collected in the context of nursing practice development. RESULTS: Setting up the cohort ward in a Swiss hospital consisted of structural and technical planning, infection control measures, the establishment of interprofessional structures, and internal communication. During the four-week operation, 71 patients were treated. The use of practice development methodology initiated a cultural change. The reflection describes a field of tension between "dream and distress": As a dream, the lived experience of optimal care, with well-functioning processes, sufficient material, sufficient personnel and a very good interprofessional cooperation was evaluated. Distress in the form of high infection rates as well as psychological and physical stress did not occur. After the cohort ward was closed, there was a risk working back in normal operations based on existing economical and organizational conditions, with the knowledge that a different cooperation and organization is possible. CONCLUSIONS: Positive experiences from the "crisis mode" should be used to further develop essential operations during normal times.

[Delirium at the Hospital - Nursing effort and risk of falling: A Routine data analysis]. / Delir im Akutspital ­ Pflegeaufwand und Sturzrisiko.

Delirium at the Hospital - Nursing effort and risk of falling: A Routine data analysis Abstract. Background: In order to reduce the risks and symptoms of delirium, a total hospital guideline for delirium prevention and management was established. To date, there have been few findings on the implementation of the guideline. Question / Aim: The aim of this study was to analyse data collected by application of the Delirium Observation Screening Scale and on the use of care measures for the prevention and treatment of delirium. As part of this analyses, also associations between the screening outcomes (symptoms of confusion) and the implementation of care measures and the rate of fall events, respectively, were examined in patients aged 70 and older. Method: In a non-experimental correlative cross-sectional study, routine data from the patient administration program PatWeb and the patient documentation system WiCare-Doc were analyzed over a period of four months. Results: Patients with symptoms of confusion received twice the duration of delirium-specific care compared to patients without symptoms of confusion. Their risk of falling was 4.4 times higher and after a fall event they received a significantly longer period of delirium specific care. Conclusions: The results show that the care of patients with delirium is intensive. Time is the prerequisite for care adapted to this patient group. The transfer of knowledge into practice must be strengthened to further enable nurses in implementing the prevention and management of delirium. The development of an "Advanced Practice Nurse Delirium" is also recommended for practice development and as support for every day nursing care.

Perspectives From Family Caregivers of Persons With Spinal Cord Injury in Hospital Versus Rehabilitation: A Pilot Study.

PURPOSE: The study aims to assess differences in family preferences for involvement in the ongoing care of a hospitalized family member with spinal cord injury based on whether the patient was hospitalized for initial rehabilitation (Group R) or hospitalized to treat secondary complications (Group C). DESIGN: Explorative cross-sectional design. METHOD: Family members rated the importance and experience of involvement on five subscales of the Patient Participation in Rehabilitation Questionnaire. Differences among the importance and experience scores between the groups were tested using the Mann-Whitney U test. FINDINGS: Group C scored the importance to be involved significantly higher than Group R (M = 3.17 vs. M = 4.04, p =.01). No other significant differences between groups were detected. CONCLUSION: Family members of patients hospitalized for secondary complications want greater involvement in care compared to those hospitalized for rehabilitation. CLINICAL RELEVANCE: Results indicate the need for tailored interventions using a family-centered approach and ongoing needs assessment.