Heidi Petry

Complexity in Caring for an Ageing Heart Failure Population: Concomitant Chronic Conditions and Age Related Impairments

The complexity of caring for the ageing heart failure (HF) population is further complicated by concomitant chronic conditions (i.e., polypharmacy, depression), age related impairments (i.e., hearing, visual and cognitive impairments, impairments in activities of daily living (ADL/IADL), and other issues (e.g., health illiteracy, lack of social support). This paper provides an overview of these risk factors, outlines how they individually and in interplay endanger favourable outcome by putting patients at risk for poor self-management. Moreover, suggestions are made on how these issues could be addressed and integrated in heart failure management by applying gerontological care principles in caring for the ageing heart failure population.

Aging Happens: Experiences of Swiss Women Living Alone

ABSTRACT The purpose of this study was to give beginning insights into how aging is experienced by women living alone in Switzerland. A feminist methodology was used to gather and interpret 17 interviews conducted with a selected group of 9 older women living alone. Interviews were taped and transcribed for hermeneutic analysis; major themes were developed. Aging happens, Independence, Being vulnerable, Memory and aging, and If I had been a boy were the themes discovered. These experiences represent how aging is shaped by individual life courses, sociocultural conditions along with gender and class.

Unterstützung des Pflegeprozesses durch die elektronische Pflegeprozessdokumentation (UEPD)

BACKGROUND Electronic nursing documentation systems, with standardized nursing terminology, are IT-based systems for recording the nursing processes. These systems have the potential to improve the documentation of the nursing process and to support nurses in care delivery. AIM This article describes the development and initial validation of an instrument (known by its German acronym UEPD) to measure the subjectively-perceived benefits of an electronic nursing documentation system in care delivery. METHOD The validity of the UEPD was examined by means of an evaluation study carried out in an acute care hospital (n = 94 nurses) in German-speaking Switzerland. Construct validity was analyzed by principal components analysis. RESULTS Initial references of validity of the UEPD could be verified. The analysis showed a stable four factor model (FS = 0.89) scoring in 25 items. All factors loaded ≥ 0.50 and the scales demonstrated high internal consistency (Cronbachs α = 0.73 – 0.90). Principal component analysis revealed four dimensions of support: establishing nursing diagnosis and goals; recording a case history/an assessment and documenting the nursing process; implementation and evaluation as well as information exchange. CONCLUSIONS Further testing with larger control samples and with different electronic documentation systems are needed. Another potential direction would be to employ the UEPD in a comparison of various electronic documentation systems.

[Support of the nursing process through electronic nursing documentation systems (UEPD) – Initial validation of an instrument].

BACKGROUND Electronic nursing documentation systems, with standardized nursing terminology, are IT-based systems for recording the nursing processes. These systems have the potential to improve the documentation of the nursing process and to support nurses in care delivery. AIM This article describes the development and initial validation of an instrument (known by its German acronym UEPD) to measure the subjectively-perceived benefits of an electronic nursing documentation system in care delivery. METHOD The validity of the UEPD was examined by means of an evaluation study carried out in an acute care hospital (n = 94 nurses) in German-speaking Switzerland. Construct validity was analyzed by principal components analysis. RESULTS Initial references of validity of the UEPD could be verified. The analysis showed a stable four factor model (FS = 0.89) scoring in 25 items. All factors loaded ≥ 0.50 and the scales demonstrated high internal consistency (Cronbachs α = 0.73 – 0.90). Principal component analysis revealed four dimensions of support: establishing nursing diagnosis and goals; recording a case history/an assessment and documenting the nursing process; implementation and evaluation as well as information exchange. CONCLUSIONS Further testing with larger control samples and with different electronic documentation systems are needed. Another potential direction would be to employ the UEPD in a comparison of various electronic documentation systems.

Sicheres Sprechen und Schlucken bei tracheotomierten, beatmeten Patientinnen und Patienten auf der Intensivstation

Background: Between 4 to 45 % of intensive care patients suffer from prolonged ventilator dependence. Due to impeded weaning, verbal communication is impossible. The tracheal cannula affects breathing and swallowing. The Passy Muir speaking valve (PMV) allows patients on ventilators to speak. It counteracts pharyngeal as well as laryngeal desensitization and prevents an insufficient swallowing reflex. Aim and methods: To implement the PMV, we conducted a multiprofessional practice- and quality development project. The objective was to ensure safe swallowing and communicating for ventilated patients with tracheostoma. Results: Intensive care nurses, doctors and physiotherapists assessed patient safety as being high. In nine patients with 51 PMV applications, we observed three undesirable events in terms of dyspnea and oxygen desaturation. On one occasion, it was necessary to remove the PMV. Conclusion: A combination of mandatory training for the entire treatment team, presence of two professionals during PMV application, and a newly developed guiding document resulted in a high level of patient safety. By means of PMV, ventilated intensive care patients are able to communicate verbally and to swallow better. Complications can be identified early and solved effectively.

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...

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...