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Bolte C, Wefer F, Stulgies S, Tewesmeier J, Lohmeier S, Hachmeister C, Günther S, Schumacher J, Mohemed K, Rudolph V, Krüger L. [Post-resuscitation talk in the intensive care unit : Living interprofessionalism-a must have!]. Med Klin Intensivmed Notfmed 2024; 119:268-276. [PMID: 38564000 DOI: 10.1007/s00063-024-01129-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/09/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND In the context of medical care, healthcare professionals are confronted with cardiopulmonary resuscitation, which can have long-term effects on the participants. OBJECTIVE The aim was to develop, implement, and evaluate a protocol-supported post-resuscitation talk for practice in the intensive care unit of a university hospital. MATERIALS AND METHODS Within the evidence-based nursing working group, university-qualified nurses performed a systematic literature search in CareLit (hpsmedia, Hungen, Germany), the Cochrane Library (Cochrane, London, England), LIVIVO (Deutsche Zentralbibliothek für Medizin, Cologne, Germany), and PubMed/MEDLINE (U.S. National Library of Medicine, Bethesda, MD, USA) as well as using the snowball principle. Based on the results, the post-resuscitation talk and a debriefing protocol were developed and consented in a multiprofessional team. Additionally, a questionnaire to analyze the current situation (t0) and evaluate the implementation (t1) was developed. RESULTS Implementation of the post-resuscitation talk was conducted from August 2021. The t0 survey took place from June to July 2021 and for t1 from February to March 2022. In t0, fewer interprofessional reflections were carried out after resuscitations in the category always or frequently (17.5%, n = 7) than in t1 (50.0%, n = 13). The rate of initiated improvement interventions was increased (t0: 24.3%, n = 9 vs. t1: 59.1%, n = 13). The results show promotion of multiprofessional collaboration in t0 and t1, and potential for optimization in the debriefing protocol in t1. CONCLUSION Implementation of a post-resuscitation talk in hospitals is a useful tool for the structured interprofessional follow-up of resuscitation events. The results demonstrated initial positive effects and potential for optimization.
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Affiliation(s)
- Christina Bolte
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Arbeitsgruppe Reanimation, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Stabsstelle Fort- und Weiterbildung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Franziska Wefer
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Institut für Pflegewissenschaft, Medizinische Fakultät und Universitätsklinik Köln, Universität zu Köln, Köln, Deutschland
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Sonja Stulgies
- Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Jutta Tewesmeier
- Medizinische Bibliothek, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Sarah Lohmeier
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Christopher Hachmeister
- Arbeitsgruppe Reanimation, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Kardiologische Intensivstation A 1.2, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Simeon Günther
- Arbeitsgruppe Reanimation, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Kardiologische Intensivstation A 1.2, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Jana Schumacher
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Kawa Mohemed
- Klinik für Allgemeine und Interventionelle Kardiologie/Angiologie, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Volker Rudolph
- Klinik für Allgemeine und Interventionelle Kardiologie/Angiologie, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Lars Krüger
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
- Stabsstelle Projekt- und Wissensmanagement/Pflegeentwicklung Intensivpflege, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
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Wefer F, Krüger L, Waldréus N, Köpke S. Non-pharmacological interventions to reduce thirst in patients with heart failure or hemodialysis: A systematic review and meta-analysis. Heart Lung 2024; 67:33-45. [PMID: 38653004 DOI: 10.1016/j.hrtlng.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Thirst is a frequent and burdening symptom in many patients, especially in patients with chronic heart failure (CHF) and/or receiving hemodialysis (HD). As drug therapies are not feasible, non-pharmacological strategies are needed to reduce thirst and thirst-related burden. OBJECTIVES To identify non-pharmacological interventions aiming to reduce thirst in patients with CHF and/ or HD, to describe intervention components, and to evaluate the effectiveness of these interventions. METHODS In February 2024, we completed a systematic search in MEDLINE via PubMed, Livivo, CINAHL, Cochrane Library and Web of Science. Two reviewers independently screened titles, abstracts, and full texts, performed critical appraisal and data extraction. We checked risk of bias with the checklists of the Joanna Briggs Institute and the Cochrane Risk of Bias tool and calculated meta-analyses for sufficiently homogeneous studies using fixed-effects models. RESULTS We included 15 intervention studies applying non-pharmacological interventions including chewing gum (n = 8), low-sodium diet (n = 2), acupressure (n = 1), frozen strawberries (n = 1), fluid timetables (n = 1), ice cubes and mouthwash (n = 1), and a psychological intervention (n = 1). Sample sizes varied between 11 and 88 participants. Eleven intervention studies showed a reduction of thirst as intervention effect. Meta-analyses for chewing gum showed no significant effect on thirst using a visual analogue scale (IV: -2,32 [-10.37,5.73]; p = 0.57) or the dialysis thirst inventory (IV: -0.26 [- 1.83, 1.30]; p = 0.74). Quality of studies was moderate to low. CONCLUSION Results indicate that various non-pharmacological interventions could be helpful to reduce thirst in patients with CHF or HD, but important uncertainty remains.
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Affiliation(s)
- Franziska Wefer
- Institute of Nursing Science, University of Cologne, Medical Faculty & University Hospital Cologne, Cologne, Germany; Heart and Diabetes Center NRW, Care Development, Care Directorate, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany.
| | - Lars Krüger
- Heart and Diabetes Center NRW, Care Development, Care Directorate, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Nana Waldréus
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden; Theme Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Sascha Köpke
- Institute of Nursing Science, University of Cologne, Medical Faculty & University Hospital Cologne, Cologne, Germany
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Krüger L, Mannebach T, Wefer F, Lohmeier S, Stork V, Gosmann E, Kaltwasser A. [Suctioning in intubated and tracheotomized patients : A narrative review]. Anaesthesiologie 2024:10.1007/s00101-024-01400-w. [PMID: 38625537 DOI: 10.1007/s00101-024-01400-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Endotracheal suctioning in intubated or tracheotomized critically ill patients is a daily task of various professional groups in intensive and emergency medicine; however, a German language summary of current evidence is lacking. OBJECTIVE The aim is to develop a narrative overview of current evidence on endotracheal suctioning of intubated or tracheotomized patients in the clinical setting. MATERIAL AND METHODS A literature search was conducted in the databases Cinahl, Cochrane Library, Livivo, and Medline via PubMed by nurses with an academic degree. In addition, a hand search and applying the snowball principle were performed. Following a successful critical appraisal, all English and German language publications addressing endotracheal suctioning in the context of hospital care were included. RESULTS A total of 23 full texts were included. After developing 6 main topics on endotracheal suction 19 articles were considered in the reporting. The results showed, among others, that routine deep suctioning once per shift is contraindicated and that the catheter should be advanced no more than 0.5-1 cm beyond the distal end of the tube or tracheal cannula. Closed suction catheters offer advantages, especially for staff protection, although studies are heterogeneous. Further training of staff is obligatory. CONCLUSION Few conclusive studies on endotracheal suction could be found; however, with the available evidence initial conclusions can be drawn which should be considered in, for example, internal standard operating procedures. Further research is needed.
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Affiliation(s)
- Lars Krüger
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
- Stabsstelle Projekt- und Wissensmanagement/Pflegeentwicklung Intensivpflege, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Deutschland.
| | - Thomas Mannebach
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Franziska Wefer
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Institut für Pflegewissenschaft, Medizinische Fakultät und Universitätsklinik Köln, Universität zu Köln, Köln, Deutschland
| | - Sarah Lohmeier
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Vanessa Stork
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Evelin Gosmann
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
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Wefer F, Möhler R, Dichter MN, Mühring A, Gummert J, Köpke S. Nurse-based counselling on thirst in patients with advanced chronic heart failure : Study protocol for a pilot before-after study and process evaluation. Med Klin Intensivmed Notfmed 2024; 119:147-153. [PMID: 38097772 PMCID: PMC10902023 DOI: 10.1007/s00063-023-01091-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/25/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Many patients with chronic heart failure (CHF) are critically ill and experience increased thirst. Study aims are to develop and evaluate a nurse-based counselling intervention to promote self-care competencies related to thirst in hospitalised patients with advanced CHF eligible or listed for heart transplantation. METHODS A mixed-methods approach will be adapted with three study phases: (1) development of the nurse-based counselling intervention, (2) feasibility testing and training of nurses, and (3) implementation of the intervention and, evaluation of initial effects and process measures. In phase (1), interviews with hospitalised patients with advanced CHF listed for heart transplantation (n = 10), focus groups (n = 2) and a Germany-wide survey with nurses will be performed. In phase (2), experts experienced with caring for patients with advanced CHF and patients with advanced CHF will be consulted for content validation and pretest of the counselling intervention. The training concept for nurses will be evaluated using questionnaires. In phase (3), a pilot before-after study will be conducted (n = 60). Primary patient-related outcome for the pilot study is thirst intensity using a numeric rating scale. Furthermore, a process evaluation (interviews with patients [n = 10], survey with nurses and physicians) will be performed. Quantitative data will be analysed descriptively, and qualitative data will be analysed using content analysis. Mean values of thirst intensity of the individual measurement points will be evaluated as interrupted time-series analysis using regression analyses. CONCLUSION The development and implementation of a counselling intervention is influenced by various factors. Therefore, it is important to consider all factors throughout the process from development to evaluation.
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Affiliation(s)
- Franziska Wefer
- Care Development, Care Directorate, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany, Georgstr.11, 32545.
- Institute of Nursing Science, Medical Faculty and University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany.
| | - Ralph Möhler
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
| | - Martin N Dichter
- Institute of Nursing Science, Medical Faculty and University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany
| | - Andrea Mühring
- Transplantation unit, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Jan Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Sascha Köpke
- Institute of Nursing Science, Medical Faculty and University Hospital Cologne, University of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany
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Krüger L, Wefer F, Mannebach T, Zwiener C, Beyer D, Y Soto AR, Lohmeier S, Teigeler J, Wittemeier C, Rinsche N, Siegling C, Mertins E, Schramm R, Langer G. [Development and implementation of primary nursing in the intensive care unit: evaluation in mixed-methods design.]. Pflege 2023. [PMID: 37997625 DOI: 10.1024/1012-5302/a000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Development and implementation of primary nursing in the intensive care unit: evaluation in mixed-methods design. Abstract:Background: In a university hospital, the development and implementation of Primary Nursing (Prozessverantwortliche Pflege, PP) in a pilot intensive care unit was initiated. To develop the roles of nurses with and without process responsibility a working group PP was founded while taking into account the skill-grade mix. Aim: The working group aimed to develop the roles of process-responsible nurses (PP) and nurses (P), as well as to plan and implement the implementation process. Methods: Development and piloting steps were taken based on the recommendations of the Medical Research Council. At three measurement points, the instrument for recording nursing systems (IzEP©) was used quantitatively and a focus group interview, as well as a ward process analysis, were used qualitatively in t0 (as-is analysis before development and piloting), t1 (6 months after implementation) and t2 (12 months after implementation). Results: PP mainly take over the care process's design and control. The IzEP© analysis showed that room care was practiced in t0 with 50.0%. The values increased towards PP from 74.0% in t1 to 83.5% in t2. Qualitatively obtained data supported these results and showed further optimization potential for practice. Conclusions: The results prove the successful implementation of PP in practice. For the development and implementation of new nursing roles, the involvement of the affected nurses is mandatory.
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Affiliation(s)
- Lars Krüger
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Franziska Wefer
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Thomas Mannebach
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Christoph Zwiener
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Denis Beyer
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - André Ramos Y Soto
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Sarah Lohmeier
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Jonathan Teigeler
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Christine Wittemeier
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Nicole Rinsche
- Intensivstation E 0.1, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Christian Siegling
- Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Esther Mertins
- Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - René Schramm
- Klinik für Thorax- und Kardiovaskularchirurgie, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Gero Langer
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Mannebach T, Krüger L, Hermes C, Cakmak S, Beaneke R, Kirchhoff P, Konstanty L, Kricke J, Luckau P, Zimmermann T, Wefer F. [Treatment algorithm: nasal care in critically ill patients]. Med Klin Intensivmed Notfmed 2023; 118:576-578. [PMID: 37391603 DOI: 10.1007/s00063-023-01041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Affiliation(s)
- Thomas Mannebach
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Lars Krüger
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
- Stabsstelle Projekt- und Wissensmanagement/Pflegeentwicklung Intensivpflege, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Deutschland.
| | - Carsten Hermes
- Hochschule für Angewandte Wissenschaften Hamburg (HAW Hamburg), Alexanderstr. 1, 20099, Hamburg, Deutschland
- Studiengang "Erweiterte Klinische Pflege M.Sc. und B.Sc.", Akkon-Hochschule für Humanwissenschaften, Berlin, Deutschland
| | - Seyma Cakmak
- Stabsstelle Pflegeentwicklung, Marien-Hospital gGmbH, Wesel, Deutschland
| | - Rebecca Beaneke
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Pia Kirchhoff
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Lara Konstanty
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Jana Kricke
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Patricia Luckau
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Tilo Zimmermann
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Franziska Wefer
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Institut für Pflegewissenschaft, Medizinische Fakultät und Universitätsklinik Köln, Universität zu Köln, Köln, Deutschland
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Krüger L, Weiss C, Hermes C, Dierkes F, Oldag A, Peper L, Tropmann J, Vogt S, Wefer F. [Treatment algorithm: eye care for critically ill patients]. Med Klin Intensivmed Notfmed 2023; 118:483-486. [PMID: 37318533 DOI: 10.1007/s00063-023-01025-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Lars Krüger
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
- Stabsstelle Projekt- und Wissensmanagement/Pflegeentwicklung Intensivpflege, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinik der Ruhr-Universität Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Deutschland.
| | - Claudia Weiss
- Chirurgische Intensivstation, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Carsten Hermes
- Studiengang "Erweiterte Klinische Pflege M.Sc und B.Sc.", Akkon-Hochschule für Humanwissenschaften, Berlin, Deutschland
- Hochschule für angewandte Wissenschaften Hamburg (HAW), Hamburg, Deutschland
| | - Franziska Dierkes
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Anne Oldag
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Lisa Peper
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Jenny Tropmann
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Sarah Vogt
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Franziska Wefer
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Institut für Pflegewissenschaft, Medizinische Fakultät und Universitätsklinik Köln, Universität zu Köln, Köln, Deutschland
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Krüger L, Mannebach T, Zittermann A, Wefer F, von Dossow V, Rojas Hernandez S, Gummert J, Langer G. Patientinnen- und patientenbezogene Auswirkungen von prozessverantwortlicher Pflege. Med Klin Intensivmed Notfmed 2023; 118:257-262. [PMID: 36971803 PMCID: PMC10160145 DOI: 10.1007/s00063-023-00998-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/08/2023] [Indexed: 03/29/2023]
Abstract
Abstract
Background
Since January 2022, a primary nursing system called process-responsible nursing (PP) has substituted the standard room care system in an intensive care unit (ICU) at our institution. The process of the development and implementation of PP is already being evaluated in a separate study as an actual analysis prior to implementation, as well as after 6 and 12 months.
Aim
This pilot randomized controlled trial (RCT) aims to test the feasibility of an RCT. For this purpose, the duration of delirium, among other things, will be compared in the project ICU with the results of standard care in another ICU at the university hospital. As secondary aims, the incidence of delirium, anxiety, the satisfaction of relatives, and the effects of PP on nurses will be assessed.
Methods
It is planned to recruit about 400–500 patients over a period of one year. They will be allocated to PP or standard care. Delirium will be assessed using the Confusion Assessment Method for Intensive Care Units by specifically trained nurses three times a day. Anxiety in patients, the satisfaction of relatives, and the effects of PP on nurses will be evaluated using the numeric rating scale, a standardized questionnaire, and a focus group interview, respectively.
Expected results
The primary hypothesis is that compared to usual care PP reduces the duration of delirium by at least 8 h. Additional hypotheses are that PP reduces anxiety in patients and increases the satisfaction of relatives.
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Affiliation(s)
- Lars Krüger
- Project and Knowledge Management/Care Development intensive care, Care Directorate, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345 Bad Oeynhausen, Germany
| | - Thomas Mannebach
- Surgical Intensive Care Unit E 0.1, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345 Bad Oeynhausen, Germany
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345 Bad Oeynhausen, Germany
| | - Franziska Wefer
- Care Development, Care Directorate, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345 Bad Oeynhausen, Germany
- Institute for Nursing Science, Medical Faculty and University Hospital Cologne, University of Cologne, Gleueler Straße 176–178, 50935 Cologne, Germany
| | - Vera von Dossow
- Institute of Anesthesiology and Pain Therapy, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345 Bad Oeynhausen, Germany
| | - Sebastian Rojas Hernandez
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345 Bad Oeynhausen, Germany
| | - Jan Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345 Bad Oeynhausen, Germany
| | - Gero Langer
- Institute of Health and Nursing Sciences, German Center for Evidence-based Nursing, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
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Krüger L, Hauß A, Oldag A, Ritter S, Schulz T, Vogt S, Wefer F. [Treatment algorithm: oral hygiene in orally intubated patients]. Med Klin Intensivmed Notfmed 2023; 118:122-124. [PMID: 36112156 DOI: 10.1007/s00063-022-00954-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Lars Krüger
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
- Stabsstelle Projekt- und Wissensmanagement/Pflegeentwicklung Intensivpflege, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Deutschland.
| | - Armin Hauß
- Geschäftsbereich Pflege - Pflegewissenschaft, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Anne Oldag
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Sandra Ritter
- Klinik für Neurologie mit Experimenteller Neurologie, Pflegedienst (Intensivstation), Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Tijana Schulz
- Klinik für Neurologie mit Experimenteller Neurologie, Pflegedienst (Intensivstation), Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Sarah Vogt
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Franziska Wefer
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Institut für Pflegewissenschaft, Medizinische Fakultät und Universitätsklinik Köln, Universität zu Köln, Köln, Deutschland
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Wefer F, Inkrot S, Waldréus N, Jaarsma T, von Cube M, Kugler C. Translation and Psychometric Evaluation of the German Version of the Thirst Distress Scale for Patients With Heart Failure. J Cardiovasc Nurs 2022; 37:378-385. [PMID: 37707971 DOI: 10.1097/jcn.0000000000000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In patients with chronic heart failure, thirst can be perceived as an intensive and burdensome symptom, which may have a negative impact on patients' quality of life. To initiate thirst-relieving interventions, assessment of thirst and its related distress is essential. At the time of this study, no instrument was available to evaluate thirst distress in patients with heart failure in Germany. OBJECTIVE The aims of this study were to translate the "Thirst Distress Scale for patients with Heart Failure" (TDS-HF) from English into German and to test validity and reliability of the scale. METHODS The English version of the TDS-HF was translated into German. A linguistically and culturally sensitive forward-and-backward translation was performed. Psychometric evaluation included confirmatory factor analysis, reliability in terms of internal consistency, and concurrent validity. RESULTS Eighty-four hospitalized patients (mean age, 72 ± 10 years; 29% female; mean left ventricular ejection fraction, 36% ± 12%; 62% New York Heart Association functional classes III-IV, 45% on fluid restriction) from an acute care hospital were involved in the study. The item-total correlation ranged from 0.58 to 0.78. Interitem correlations varied between 0.37 and 0.79. Internal consistency was high, with a Cronbach α of 0.89. There was a high correlation between the total score of the TDS-HF and the visual analog scale to assess thirst intensity ( r = 0.72, P ≤ .001), and a low correlation with fluid restriction ( r = 0.35, P = .002). CONCLUSIONS The evaluation of the German TDS-HF showed satisfactory psychometric properties in this sample. The instrument is usable for further research and additional psychometric testing.
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Krüger L, Bolte C, Fröhlich M, Heide K, Schumacher J, Oldag A, Wolter B, Lauenroth H, Wefer F. [Delirium prevention and management: Development and implementation of a non-pharmacological catalog of measures in the acute setting]. Pflege 2022; 35:302-311. [PMID: 35333108 DOI: 10.1024/1012-5302/a000880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Delirium prevention and management: Development and implementation of a non-pharmacological catalog of measures in the acute setting Abstract. Background: In October 2018, a new delirium management concept was developed in a university hospital for cardiovascular diseases. As part of a multi-professional approach, the previously established "Evidence-based Nursing working group (AK EBN)", consisting of academically qualified nurses from the hospital, was involved in the implementation process. Aim: The AK EBN aimed to identify effective non-pharmacological interventions to prevent and treat delirium and to establish how these interventions could influence delirium rates in hospital patients. Methods: The EbN method was employed to address the study question applying the PICO framework (Behrens & Langer, 2016) as the bases for systematic searches in different databases. Relevant studies were identified, data were extracted, displayed in tables and discussed within the AK using established critical appraisal tools for quality assessment. Results: Despite a heterogeneous study sample, results showed that there is meaningful evidence for the effectiveness of intervention bundles on the reduction of delirium rates. Bundles include for example, aspects of orientation and noise reduction. As a result, a catalogue of non-pharmacological interventions, communication aids, and a guide for involving caregivers in the prevention and treatment of delirium were developed. Additionally, continuing training events held by the participants of AK EBN were organized. Conclusions: To promote the successful implementation of projects in practice, the involvement of all stakeholders is important. As part of a skill-grade-mix, nurses made an important contribution in this multi-professional project.
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Affiliation(s)
- Lars Krüger
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Christina Bolte
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Mandy Fröhlich
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Kristina Heide
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Jana Schumacher
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Anne Oldag
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Björn Wolter
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Hanni Lauenroth
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
| | - Franziska Wefer
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen
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Krüger L, Mannebach T, Rahner M, Timpe F, Wefer F, Nydahl P. Learning in one minute: survey of the One Minute Wonder Network. Med Klin Intensivmed Notfmed 2022; 117:159-167. [PMID: 34982192 PMCID: PMC8725639 DOI: 10.1007/s00063-021-00892-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Continuous education of clinicians improves quality of care. One Minute Wonder (OMW) summarize best practice knowledge on one page that can be hung on a wall and can be read during waiting times of just one minute. OMW are a fast, efficient and easy-to-adapt educational method and can easily be shared. Since 2018, an interprofessional network has been set up for OMW in German-speaking countries, but the benefits have not been evaluated yet. AIM The primary objective of this evaluation study was to examine whether and to what extent the members of the OMW network used OMW for training in different settings. Secondary objectives were subjective educational gain, OMW as a training method, and OMW-related structures and processes. METHODS An online survey within the OMW network with 301 members over a period of 3 weeks in 2020 was conducted. Descriptive statistics were used for data analysis. RESULTS Response rate was 62.8% (n = 191). Most participants have used OMW for < 6 months (32.5%, n = 62), developed 1-10 OMW (42.4%, n = 81) by themselves and changed them infrequently (43.5%, n = 74). Topics were most often nursing interventions (79.6%, n = 152), diseases (71.2%, n = 136), drugs (64.4%, n = 123) and others. Participants reported that OMW extended professional knowledge, stimulated them to reflect on their work and are useful for sharing best practice knowledge. Authors of OMW were most often nurses (53.9%, n = 103), who were inspired by the OMW network or by questions of the team. CONCLUSION Participants use OMW in practice to share best practice knowledge.
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Affiliation(s)
- Lars Krüger
- Continuing Education Intensive Care, Surgical Intensive Care Unit E 0.1, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Germany.
| | - Thomas Mannebach
- Surgical Intensive Care Unit E 0.1, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Germany
| | - Marianne Rahner
- Institute for Public Health and Nursing Research, University Bremen, Grazer Straße 4, 28359, Bremen, Germany
| | - Fabian Timpe
- Care Development, Care Directorate, St. Bernward Hospital GmbH Hildesheim, Treibestraße 9, 31134, Hildesheim, Germany
| | - Franziska Wefer
- Care Development, Care Directorate, Heart and Diabetes Center NRW, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Germany
| | - Peter Nydahl
- Nursing Research, Department of Anaesthesia and Operative Intensive Care Medicine, University Hospital Schleswig-Holstein, House V40, Brunswiker Str. 10, 24105, Kiel, Germany
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