Annemarie Kesselring

Professionelle Pflege – Entwicklung und Inhalte einer Definition

Die hier vorgestellte Definition professioneller Pflege wurde von Mitarbeiterinnen des Instituts fur Pflegewissenschaft der Universitat Basel in Zusammenarbeit mit der Expertengruppe des Projektes «Zukunft Medizin Schweiz» der Schweizerischen Akademie der Medizinischen Wissenschaften entwickelt. Ausgangspunkt waren bestehende Definitionen und eine Liste erwunschter Inhalte. Mittels Ansatzen der Grounded Theory wurden mogliche Inhalte bearbeitet und ein erster Entwurf geschrieben. In mehreren Feedback-Runden wurde dieser zur jetzt vorliegenden Definition verfeinert. Professionelle Pflege wird in zwei Kernsatzen definiert. Inhaltlich geht es um das Fordern und Erhalten von Gesundheit, das Vorbeugen von gesundheitlichen Schaden und das Unterstutzen von Menschen in der Behandlung und im Umgang mit Auswirkungen von Krankheiten und deren Therapien. Ziel sind bestmogliche Behandlungs- und Betreuungsergebnisse sowie eine bestmogliche Lebensqualitat in allen Phasen des Lebens bis zum Tod fur die betreuten Menschen...

Visions for the future – Nursing as a profession in health care in the German speaking part of Switzerland

Social, scholarly, and technical changes and changes in health politics have a lasting influence on the nursing profession. The development of nursing science programs can be seen in this context and institutions, which offer educational programs for nurses, have to orient them toward the new demands of the profession. Up to now in the German-speaking realm, published data, which describe the changes the nursing profession can expect, have not been available, nor have possible future fields of activity of nursing been examined. In order to close this gap, a group of opinion leaders and experts in nursing in German-speaking Switzerland were studied. Eighty-one people were surveyed by means of a questionnaire, and ten people were interviewed in-depth. The results reflect the visions and perspectives of the nursing profession of the future in German-speaking Switzerland. The expectation is that nursing should deal increasingly with sociopolitical changes and that the main issues of nursing with regard to type of client and locations where care is given will change. A re-orientation toward strengthening professional identity is called for in the following areas: involvement in determining and shaping decisions in politics and health politics; taking entrepreneurial initiatives; building clinical practice on caring, patient preferences, and evidence; making professional training and continuing education clinically-oriented as well as the development and the establishment of nursing science. Through a re-orientation, nursing should be better able to meet the challenges, which it faces because of health and social problems in the population. A great discrepancy exists between the expectations for nursing in the future and present reality. The challenge will be to see whether it will be possible to close the gap between visions and reality by means of training, continuing education, and changes in clinical practice.Gesellschaftliche, gesundheitspolitische, wissenschaftliche und technische Veranderungen beeinflussen die Pflege als Beruf nachhaltig. Die Entwicklung pflegewissenschaftlicher Studiengange ist in d...

Developing and establishing an advanced nursing practice for HIV abd AIDS patients.

Die Entwicklung und Etablierung einer erweiterten und vertieften Pflegepraxis («Advanced Nursing Practice») ist ein wichtiger Schritt in Richtung einer zukunftsorientierten Pflege. An der HIV-Sprec...Developing and establishing an advanced nursing practice is an essential step toward future-oriented nursing care. An action research process was initiated to establish advanced nursing practice at the HIV clinic of the outpatient department at the University Hospital Basel with the goal to offer advanced nursing care to patients. Participatory action research allows generating knowledge about a social system while at the same time tempts to promote social change. The most important goal is to constantly analyse, improve, and evaluate nursing care for patients and family caregivers. Advanced nursing practice in HIV/AIDS is based on solid knowledge regarding the illness and current therapies. Central concepts are caring, clinical experiences, evidence based practice, and patient preferences. Through a systematic step-by-step process, the nurses at the HIV clinic are being better educated and more experienced in these concepts. An essential aspect of advanced nursing practice is the specialization of each nurse in a self selected topic within HIV/AIDS care. These nurses now offer new services such as medication management and adherence support, health maintenance and prevention, and symptom management. This ongoing process of learning while establishing advanced nursing practice in HIV/AIDS, enables the nurses to face future changes in health care in a proactive way.Die einstmals vorwiegend akut verlaufende Infektionskrankheit HIV/Aids hat sich in den westlichen Industrielandern seit Anfang und verstarkt seit Mitte der 90er Jahre zu einer chronisch-progredienten Krankheit gewandelt. Eine Folge dieser Entwicklung ist, dass mehr Menschen mit HIV/Aids in unserer Gesellschaft leben. In der Schweiz wurden im Jahr 2001 664 Personen neu mit HIV diagnostiziert, und 33 Menschen starben an Aids (BAG, 2002). Momentan leben insgesamt rund 25000 Menschen mit HIV/Aids in der Schweiz (BAG, 2002). Wie bei anderen chronisch-progredienten Krankheiten sind auch bei HIV/ Aids akute wie chronische Phasen zu beobachten, wahrend denen die Betroffenen mit den vielfaltigsten Symptomen und opportunistischen Erkrankungen leben (Irwin, 1998; Holzemer, Henry, Nokes, Corless, Brown, Powell-Cope, Turner & Inouye, 1999; Bartlett & Gallant, 2000). Institut fur Pflegewissenschaft, Universitat Basel, Basel, Switzerland1 Medizinische Universitatspoliklinik, HIV-Sprechstunde, Kantonsspital Basel, Basel, Switzerland2

Entwicklung und Etablierung einer erweiterten und vertieften HIV/Aids-Pflegepraxis@@@Developing and establishing an advanced nursing practice for HIV abd AIDS patients.

Die Entwicklung und Etablierung einer erweiterten und vertieften Pflegepraxis («Advanced Nursing Practice») ist ein wichtiger Schritt in Richtung einer zukunftsorientierten Pflege. An der HIV-Sprec...Developing and establishing an advanced nursing practice is an essential step toward future-oriented nursing care. An action research process was initiated to establish advanced nursing practice at the HIV clinic of the outpatient department at the University Hospital Basel with the goal to offer advanced nursing care to patients. Participatory action research allows generating knowledge about a social system while at the same time tempts to promote social change. The most important goal is to constantly analyse, improve, and evaluate nursing care for patients and family caregivers. Advanced nursing practice in HIV/AIDS is based on solid knowledge regarding the illness and current therapies. Central concepts are caring, clinical experiences, evidence based practice, and patient preferences. Through a systematic step-by-step process, the nurses at the HIV clinic are being better educated and more experienced in these concepts. An essential aspect of advanced nursing practice is the specialization of each nurse in a self selected topic within HIV/AIDS care. These nurses now offer new services such as medication management and adherence support, health maintenance and prevention, and symptom management. This ongoing process of learning while establishing advanced nursing practice in HIV/AIDS, enables the nurses to face future changes in health care in a proactive way.Die einstmals vorwiegend akut verlaufende Infektionskrankheit HIV/Aids hat sich in den westlichen Industrielandern seit Anfang und verstarkt seit Mitte der 90er Jahre zu einer chronisch-progredienten Krankheit gewandelt. Eine Folge dieser Entwicklung ist, dass mehr Menschen mit HIV/Aids in unserer Gesellschaft leben. In der Schweiz wurden im Jahr 2001 664 Personen neu mit HIV diagnostiziert, und 33 Menschen starben an Aids (BAG, 2002). Momentan leben insgesamt rund 25000 Menschen mit HIV/Aids in der Schweiz (BAG, 2002). Wie bei anderen chronisch-progredienten Krankheiten sind auch bei HIV/ Aids akute wie chronische Phasen zu beobachten, wahrend denen die Betroffenen mit den vielfaltigsten Symptomen und opportunistischen Erkrankungen leben (Irwin, 1998; Holzemer, Henry, Nokes, Corless, Brown, Powell-Cope, Turner & Inouye, 1999; Bartlett & Gallant, 2000). Institut fur Pflegewissenschaft, Universitat Basel, Basel, Switzerland1 Medizinische Universitatspoliklinik, HIV-Sprechstunde, Kantonsspital Basel, Basel, Switzerland2

Visionen für die Zukunft – Die Pflege als Beruf im Gesundheitswesen der Deutschschweiz@@@Visions for the future – Nursing as a profession in health care in the German speaking part of Switzerland

Social, scholarly, and technical changes and changes in health politics have a lasting influence on the nursing profession. The development of nursing science programs can be seen in this context and institutions, which offer educational programs for nurses, have to orient them toward the new demands of the profession. Up to now in the German-speaking realm, published data, which describe the changes the nursing profession can expect, have not been available, nor have possible future fields of activity of nursing been examined. In order to close this gap, a group of opinion leaders and experts in nursing in German-speaking Switzerland were studied. Eighty-one people were surveyed by means of a questionnaire, and ten people were interviewed in-depth. The results reflect the visions and perspectives of the nursing profession of the future in German-speaking Switzerland. The expectation is that nursing should deal increasingly with sociopolitical changes and that the main issues of nursing with regard to type of client and locations where care is given will change. A re-orientation toward strengthening professional identity is called for in the following areas: involvement in determining and shaping decisions in politics and health politics; taking entrepreneurial initiatives; building clinical practice on caring, patient preferences, and evidence; making professional training and continuing education clinically-oriented as well as the development and the establishment of nursing science. Through a re-orientation, nursing should be better able to meet the challenges, which it faces because of health and social problems in the population. A great discrepancy exists between the expectations for nursing in the future and present reality. The challenge will be to see whether it will be possible to close the gap between visions and reality by means of training, continuing education, and changes in clinical practice.Gesellschaftliche, gesundheitspolitische, wissenschaftliche und technische Veranderungen beeinflussen die Pflege als Beruf nachhaltig. Die Entwicklung pflegewissenschaftlicher Studiengange ist in d...