Abstract Background The cluster randomized controlled trial interprof ACT evaluated the effects of a complex intervention designed to improve collaboration between general practitioners (GPs) and registered nurses (RNs) in nursing homes (NHs). The intervention includes six components (“Name badges”, “Mandatory availability rules”, “Designated contact persons”, “Standardized GPs’ home visits”, “Pro re nata medication”, “Shared goal setting”). The findings showed a nonsignificant reduction in hospital admissions in the intervention group (IG) compared to the control group (CG) within twelve months. The aims of this process evaluation were to describe (1) the dose, reach and fidelity of implementation (“implementation performance”), (2) the effects on the quality of RN-GP collaboration, and (3) potential moderating factors. Methods Process evaluation with a mixed-methods triangulation design involving all clusters (17 NHs per IG and CG) and 323 nursing home residents (NHRs) (n = 166 IG, n = 157 CG): We collected quantitative and qualitative data from multiple perspectives (e.g., RNs, GPs, NHRs) at several measurement points. We quantitatively compared groups by means of medians, interquartile ranges, proportions (all outcome domains) or Mann‒Whitney U tests (implementation performance) and analyzed qualitative data inductively via content analysis. The key findings were triangulated narratively and via a joint display. Results Compared to those in the CG, we noted relevant improvements in the implementation of “Name badges”, “Mandatory availability rules”, “Designated contact persons” and “Pro re nata medication” in ≥50% of the IG clusters, of which the group difference for “Mandatory availability rules” reached statistical significance. The implementation performance of IG clusters was moderated by resource-related and other organizational attributes of NHs and GP offices and attributes of involved professionals, especially their attitudes and awareness. Implementation of the components induced greater standardization of care processes together with positive changes in interprofessional communication and coordination among GPs and RNs. Conclusions Implementation of the interprof ACT components varied between components and NHs but showed potential for improving RN-GP collaboration. The standardization of shared care procedures emerged as a key mediator for improvement. For larger and more sustainable implementation we recommend a stronger focus on locally available resources and communication of potential benefits for all involved parties. Trial registration ClinicalTrials.gov, NCT03426475; registered 07 February 2018, https://www.clinicaltrials.gov/study/NCT03426475?lead=NCT03426475%26;rank=1 .

BACKGROUND:In some countries, direct access to physiotherapy for patients with musculoskeletal complaints has been introduced in order to ensure needs-based care. Patients can seek physiotherapy treatment directly without a doctor's prescription at the expense of their health insurance. Reviews show clinical advantages compared to referral-based access. The aim of this study was to investigate the need, possible care models and requirements for model projects of relevant stakeholders in Germany. METHODS:A qualitative study design was chosen to answer the research questions. Data collection involved a semi-structured, guide-assisted focus group and individual interviews on the perspectives of physiotherapy (n = 3), medicine (n = 3), patients (n = 2), payers (n = 4), politics (n = 2), and medical law (n = 2). Data were analyzed deductively-inductively using a thematic-structuring content analysis. RESULTS:A total of 16 people took part in 11 individual interviews and one focus group (n = 5). All the perspectives planned were represented. The interview results indicate very heterogeneous views on the perceived need for and the design of direct access. Model projects are mainly considered necessary and should be conducted with comparable methodology in several German federal states in various settings. CONCLUSION:In the German context, where there is disagreement among stakeholders about the need for direct access to physiotherapy, there is a nationwide need for research to clarify unresolved issues through pilot projects. This study provides an overview of the perspectives and thereby essential information for the further development of healthcare in Germany.

Background:Professional pride is considered a positive emotion toward one's occupation. To date, there has been little research on professional pride among nurses, and the construct - including its defining characteristics, sources, and influencing factors - is still poorly understood. Objective:Our study aimed to explore how German nurses in acute care experience professional pride, including its sources and influencing factors, and the situations in which it arises. Methods:Qualitative interpretative study using data from semi-structured interviews and focus groups with a purposive sample of nurses working in a German university hospital and subsequent framework analysis. Results:We conducted 13 interviews with 17 nurses working in general wards, high-dependency units, and intensive care units at a German university hospital in May and June 2022. We found that the nurses experience both stable and situational professional pride and identified factors that promote and inhibit their feelings of pride. Individual pride sources include nurses' attitudes towards the profession, their knowledge and competencies, and their care activities and successes. External factors that seem to influence whether these sources can be activated and sustained in actual practice include societal and organizational factors as well as workplace acknowledgement and appreciation. Especially nurses' implicit and explicit evaluations of care and treatment episodes seem to play a central role for their experience of professional pride. Conclusions:Based on our data, we developed a preliminary conceptional model of nurses' professional pride as well as a working definition of this construct. Our findings can be used as a basis for future research which should focus on the transferability of the conceptual model to other settings and regions. Further research should also aim to develop psychometrically robust instruments to measure nurses' professional pride and assess the effects of targeted interventions. Tweetable abstract:A qualitative study that provides a preliminary conceptual model of nurses' professional pride and proposes a working definition.

Interprofessional education is considered an important strategy for improving interprofessional collaboration in healthcare practice. The aim of the interEdu project was to develop a longitudinal core curriculum to strengthen interprofessional competencies in undergraduate nursing education. The study was conducted using a mixed methods design with qualitative and standardized interviews and evidence syntheses. The results were triangulated via joint displays and were discussed in an expert workshop. The curriculum was designed by the interprofessional project team based on these results. The interEdu curriculum comprises nine chapters. The central element is a framework of interprofessional competencies, which forms the basis of competence descriptions that are formulated over three years of nursing education. It has a spiral structure and offers modules and learning units based on the situational principle. In order to facilitate a transfer between the different learning venues, appropriate learning methods are recommended. These are learner-centered to support collaborative learning and self-directed learning. The interEdu curriculum will be used to longitudinally integrate interprofessional education into educational programs for nursing and other healthcare professions. In particular, the spiral structure and the interprofessional competencies formulated longitudinally over the whole undergraduate education cycle should contribute to the continuous development of competencies.

Hintergrund Zur Sicherung einer bedarfsgerechten Versorgung wurde in einigen Ländern der physiotherapeutische Direktzugang für Patient*innen mit muskuloskelettalen Beschwerden eingeführt. Die Betroffenen können direkt ohne ärztliche Verordnung physiotherapeutische Behandlung zu Lasten der Krankenversicherung in Anspruch nehmen. Übersichtsarbeiten zeigen klinische Vorteile im Vergleich zum überweisungsgebundenen Zugang. Ziel dieser Studie war es, den Bedarf, mögliche Versorgungsmodelle und Anforderungen an Modellvorhaben aus Sicht der beteiligten Interessengruppen in Deutschland zu untersuchen. Methoden Es wurde eine qualitative Studie mittels semistrukturierter leitfadengestützter Fokusgruppen- und Einzelinterviews mit Vertreter*innen der Physiotherapie (n = 3), Medizin (n = 3), Patient*innen (n = 2), Kostenträger (n = 4), Politik (n = 2) und des Medizinrechts (n = 2) durchgeführt. Die Auswertung erfolgte deduktiv-induktiv mittels thematisch-strukturierender Inhaltsanalyse. Ergebnisse Insgesamt nahmen 16 Personen an 11 Einzelinterviews und einer Fokusgruppe (n = 5) teil. Es konnten alle geplanten Perspektiven abgebildet werden. Die Interviewergebnisse weisen sehr heterogene Sichtweisen zum wahrgenommenen Bedarf und zur Ausgestaltung eines Direktzugangs auf. Modellvorhaben werden überwiegend als notwendig angesehen und sollten mit vergleichbarer Methodik in mehreren Bundesländern in diversen Settings durchgeführt werden. Schlussfolgerungen Für den deutschen Kontext besteht bei Unstimmigkeit der Akteure über den Direktzugangsbedarf ein flächendeckender Forschungsbedarf, um in Modellvorhaben offene Fragen zu klären. Diese Studie liefert detaillierte Einblicke in die unterschiedlichen Standpunkte der Interessengruppen und damit wichtige Informationen für die Weiterentwicklung der Heilmittelversorgung in Deutschland.

Background Pandemic preparedness requires complementary tasks and a coordinated approach with multidirectional interaction between research, contribution-based healthcare, and public health services. The National Pandemic Plan provides the strategic framework for preparedness and emphasizes the importance of cross-sectoral cooperation. Practice-oriented approaches to regional stakeholder collaboration are only partly described so far and are further refined in this study. Objective and Method The BMFTR funded project PREPARED collected best practice examples from three healthcare regions (Frankfurt, Dresden, Bonn) and derived checklists for regional networks for pandemic preparedness and management. To this end, guided focus group discussions with 29 health experts were held in May 2023 and evaluated using content analysis. Stakeholders were selected based on a combination of typical cases and heterogeneous groups. Results The study identified five key stakeholder groups in regional care networks: 1) laboratory logistics, 2) public administration, 3) emergency and rescue services, 4) medical care, and 5) nursing and social support. The analysis of best practice examples highlighted the importance of transparent information presentation, cross-sectoral cooperation, and standardized procedures. Recommendations were derived from this analysis with the aim of strengthening resilience and networking at the state level in a sustainable manner. These included the establishment of a central coordination office, the standardization of hygiene standards, continuous monitoring, and the integration of emergency services and training programs. Based on these results, practical checklists were developed to support regional providers in crisis management. Conclusion The study identified key strategies for effective regional pandemic preparedness and response: i) close and binding regional cooperation, ii) the establishment of cross-sector networks, and iii) standardized communication and coordination structures as well as flexible checklists for pandemic management. These approaches focus on strengthening the resilience of the healthcare system and enabling a flexible response to crisis situations.

Nursing prioritization and rationing decisions in acute care hospitals during the Covid-19 pandemic: a qualitative study Abstract:Background: The Covid-19 pandemic has put decisions regarding prioritization and rationing of care resources on the health policy agenda. The effects on the allocation of nursing resources in clinical practice are unclear. Aim: In order to derive implications for future pandemic situations, we analyzed the extent to which decisions were made about the distribution of resources in acute inpatient care and how bottlenecks were dealt with. Methods: We conducted semi-structured interviews with nursing staff (n = 16) and nursing team leaders (n = 10) in five acute-care clinics in Germany and analyzed them inductively using thematic framework analysis. Results: In acute inpatient care under pandemic conditions, prioritization and rationing decisions were made, such as the postponement or reduction of nursing measures, in order to overcome pandemic-specific challenges. These decisions affected certain patient groups and certain near- and distant-patient services, in particular fundamental care measures, such as support with personal hygiene and nutrition, as well as access to acute inpatient care. The decisions were made implicitly rather than according to evidence-based criteria. Conclusions: Nursing prioritization and rationing decisions were made during the pandemic. These decisions are similar to comparable decisions outside of the pandemic, particularly in terms of insufficient evidence base, and emphasize the need for empirically based decision criteria.

BACKGROUND AND OBJECTIVE:Violence in nursing care is a frequent phenomenon both towards nurses and towards care recipients. In Germany, there is a lack of scientifically developed and evaluated interventions and concepts for the prevention of violence. The aim of this study is to analyze the implementation of the participative development and evaluation of a multimodal concept for violence prevention (PEKo) project in three settings. INTERVENTION AND METHODS:The aim of the project is to develop and implement facility-specific measures by multiprofessional teams. To evaluate the success of the implementation, quantitative data from an employee survey and process data regarding implementation fidelity, dose and outreach of PEKo were analyzed. RESULTS:The PEKo was implemented between 2021 and 2023 in 42 nursing homes, 7 outpatient care services and 12 hospitals. All components were offered and were implemented in the majority of outpatient care services and hospitals and in approximately half of the nursing homes. A total of 91 measures were implemented in the facilities during the intervention period, 443 employees took part in the survey and reported more exchange and changes in dealing with violence. DISCUSSION:The PEKo appears to promote awareness and confidence in all settings. Limitations were observed in terms of fidelity in the long-term inpatient care. The results suggest that continuous external support is crucial for sustainable implementation. The active involvement of care recipients should be given greater consideration in interventions.

Gewalt in der Pflege ist ein häufiges Phänomen, sowohl gegenüber Pflegenden als auch gegenüber Menschen mit Pflegebedarf. Für Deutschland fehlen wissenschaftlich entwickelte und evaluierte Interventionen und Konzepte zur Gewaltprävention. Ziel dieser Arbeit ist die Analyse des Implementierungserfolgs des Gewaltpräventionsprojekts „Partizipative Entwicklung und Evaluation eines multimodalen Konzeptes zur Gewaltprävention (PEKo)“ in 3 Settings. Das Projekt zielt auf die Entwicklung und Umsetzung einrichtungsspezifischer Maßnahmen durch multiprofessionelle Teams. In der stationären und ambulanten Langzeitpflege sowie in Krankenhäusern wurden quantitative Daten einer Beschäftigtenbefragung sowie Prozessdaten hinsichtlich Umsetzungstreue, Grad der Umsetzung und Reichweite von PEKo analysiert. PEKo wurde zwischen 2021 und 2023 in 42 Pflegeeinrichtungen, 7 ambulanten Pflegediensten und 12 Krankenhäusern umgesetzt. Alle Komponenten wurden im ambulanten Setting und im Krankenhaus mehrheitlich umgesetzt, in der stationären Langzeitpflege in etwa der Hälfte der Einrichtungen. Im Interventionszeitraum wurden insgesamt 91 Maßnahmen in den Einrichtungen umgesetzt. An der Befragung nahmen 443 Beschäftigte teil und berichteten über mehr Austausch und sichtbare Veränderungen im Umgang mit Gewalt. Das Projekt scheint in allen Settings Sensibilisierung und Handlungssicherheit zu fördern. Einschränkungen zeigten sich bei der Umsetzungstreue in der stationären Langzeitpflege. Die Ergebnisse deuten darauf hin, dass eine kontinuierliche externe Unterstützung für eine nachhaltige Umsetzung entscheidend ist. Die aktive Einbindung von Menschen mit Pflegebedarf sollte bei Interventionen stärker berücksichtigt werden.

People receiving home care (PRHC) usually have complex healthcare needs that require the involvement of informal caregivers and health professionals. Interprofessional collaboration is an important element of person-centred home care, which is often insufficiently implemented. This study aims to explore current practices of collaboration in the home care setting and develop an interprofessional person-centered care concept. The care concept was developed iteratively by incorporating theory and evidence and involving interest holders. The evidence was synthesized from a literature review, semistructured interviews with PRHC (n = 20) and relatives (n = 21), three mono-professional focus groups each with nurses (n = 17), general practitioners (n = 14) and therapists (n = 21). The findings were discussed in four mixed focus groups (n = 37). Qualitative data were analysed using content analysis. In addition, a survey involving PRHC and relatives (n = 37), nurses (n = 70), general practitioners (n = 33) and therapists (n = 81), and eight best-practice cases were explored based on nine home visit observations, 29 interviews and shadowings using principles of grounded theory. The quantitative data were analysed descriptively. Finally, the care concept was outlined in an expert workshop (n = 25) and finalised in a co-creation workshop (n = 12). The developed interprofessional, person-centered care concept for PRHC includes five components: the designation care coordinators, an initial joint home visit, a secure digital communication system, a dedicated phone number for quick contact, and additional joint meetings as needed. The approach highlights individualized, goal-oriented care plans, sustained and effective interprofessional collaboration, and active engagement of PRHC and their relatives in refining and delivering care in accordance with their own goals and needs. An accompanying logic model supports systematic guidance for planning, implementation, and evaluation, enhancing the likelihood of success and ensuring a transparent, well-structured process. Interprofessional, person-centred approaches to home care in Germany should focus on improving communication, shared responsibility and joint care planning between PRHC, relatives and healthcare professionals. The aim of the developed care concept is to improve quality of life and reduce hospital admissions of PRHC. This concept will first be evaluated and refined in a cluster randomized controlled trial. This study is registered on ClinicalTrials.gov as NCT05149937 on 03/11/2021. Study part A completed.

The number of residents in nursing homes and the complexity of their care needs increase. A higher rate of nurses with higher qualification level is associated with a positive impact on patient outcomes such as quality of care, reduction of unplanned hospitalizations and emergency department use, and mortality. In Germany, defined role profiles for registered nurses with Bachelor’s degree in long-term care are lacking and only few of these nurses work in direct resident care. To develop a new role profile for nurses with expanded competencies to improve care for residents with complex care needs in long-term care. Design: Mixed-methods intervention development study following the PEPPA framework (Participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation, and evaluation). We conducted sub-studies: 1. Three systematic literature reviews (on complex care needs, reasons for unplanned nursing home transfers to acute care, and context factors for decisions about transfers). 2. A multiple case study including five cases of nursing home residents to identify root-causes for unplanned transfers to acute care. Data collection: residents’ chart reviews and semi structured interviews with residents (n = 3), family (n = 4), and care providers (n = 11). Data analysis: root-cause analysis with event flow diagrams and qualitative content analysis of interviews to identify fields of action for the role profile. 3. Two participatory stakeholder workshops (n = 18 participants) to develop and refine intervention components and implementation strategies. The new role profile comprises four competence areas: 1. Managing chronic diseases; 2. Empowerment and communication; 3. Person-centered care network; and 4. Organization. Main implementation strategy enabling nurses to fulfil the role profile is a 300-h additional qualification program. Further strategies on the organizational level are shared goal setting and allowing for adaptability of the intervention by defining mandatory and optional intervention components. The participatory intervention development approach resulted in a new role profile for nurses with Bachelor’s degree focusing on direct resident care. Feasibility, perceived usefulness and potential clinical effects of the intervention will be tested in a pilot trial with a cluster-randomized design and process evaluation. Prospectively registered on August 20th, 2021 at the German registry for clinical trials (DRKS00025773).

Being of older age is associated with chronic conditions and multimorbidity, which may lead to complex care needs of the persons affected. Residents in care homes are more often hospitalised than older adults living at home, and hospitalisations are often unplanned. It not sufficiently clear, how processes preceding unplanned hospitalisations are characterised, who is involved, what their decisions and competencies are, and what is needed to prevent such situations. We aimed to identify major causal factors for unplanned hospitalisations, potential fields of actions and goals for care. We conducted a multiple case study including a root-cause analysis based on cases of residents in care homes with unplanned acute care incidents as key events. We extracted data from 5 care home residents’ records and interviewed 18 involved parties (health professionals, residents, relatives) in two facilities. We analysed data from 8 weeks preceding the key event on case base with event flow diagrams and qualitative content analysis of case-related interviews. Based on causal factors for gaps in care we derived fields of action and goals for care. Across cases, major causal factors were insufficient management of chronic diseases, disrupted interprofessional collaboration processes, and lack of individualised protocol application. We developed 31 fields of action with goals for care and clustered these into 7 overarching meta-themes: geriatric nursing processes; interprofessional collaboration; empowerment of residents; health promotion and prevention; communication processes; management; values, standards and guidelines. Caring for residents with complex care needs in long-term care requires nurses with expanded skills in clinical nursing, cooperation and communication. The results of this study contribute to the development of a new role profile for these nurses in German long-term care homes and specify relevant fields of action and goals for care. An advisory board including resident representatives discussed and supported the project in repeated consultation meetings throughout the research process. The study was positively evaluated by the ethics committee of the University of Lübeck (file number 21–301) and registered prospectively at the German register for clinical trials (DRKS00025773). German Register for clinical trials: DRKS00025773. Registered prospectively on 20th of August 2021.

Zusammenfassung: Hintergrund: Die Covid-19-Pandemie brachte Priorisierungs- und Rationierungsentscheidungen von Versorgungsressourcen auf die gesundheitspolitische Agenda. Unklar sind die Auswirkungen auf die Allokation pflegerischer Ressourcen in der klinischen Praxis. Ziel: Um Implikationen für zukünftige Pandemien abzuleiten, wurde untersucht, inwieweit es in der akutstationären Pflege zu Entscheidungen über die Verteilung von Ressourcen kam und wie mit Engpässen umgegangen wurde. Methoden: In fünf Akutkliniken in Deutschland wurden halbstrukturierte Interviews mit Pflegefachpersonen (n = 16) und Pflegeteamleitungen (n = 10) durchgeführt und induktiv mittels Thematic-Framework-Analyse ausgewertet. Ergebnisse: In der akutstationären Pflege unter Pandemiebedingungen wurden Priorisierungs- und Rationierungsentscheidungen wie die zeitliche Verschiebung oder Reduktion von Pflegemaßnahmen getroffen, um pandemiespezifische Herausforderungen zu bewältigen. Diese Entscheidungen betrafen bestimmte Patientengruppen und patientennahe und -ferne Leistungen, insbesondere fundamentale Pflegemaßnahmen wie die Unterstützung bei der Körperpflege und bei der Ernährung, sowie den Zugang zur akutstationären Versorgung. Die Entscheidungen wurden eher implizit und nicht nach evidenzbasierten Kriterien getroffen. Schlussfolgerungen: Während der Pandemie wurden pflegerische Priorisierungs- und Rationierungsentscheidungen getroffen. Diese ähneln vergleichbaren Entscheidungen außerhalb der Pandemie, insbesondere in der unzureichenden Evidenzbasierung, und unterstreichen den Bedarf für empirisch fundierte Entscheidungskriterien.

BACKGROUND/AIM:Evidence-based practice (EBP) provides an important basis for improving both the quality of care and patient safety. Formulating a research question, searching the literature, and critical appraisal are crucial to developing evidence-based practice. The aim of this survey was to provide an overview of how these topics are integrated into bachelor's degree programs in nursing in Austria, Germany, and the German-speaking part of Switzerland. We also aimed to show how teachers implement these subjects and how they experience and assess the implementation.METHOD:We conducted an exploratory cross-sectional study using an online survey sent out to program directors and teaching staff of all 58 bachelor's degree programs in nursing in Austria, Germany and the German-speaking part of Switzerland. For data collection, a questionnaire was developed containing items on general teaching conditions, contents, and methods of evidence-based nursing practice, as well as on the estimated thematic interest of students. The data were analysed descriptively.RESULTS:The program directors returned 24 questionnaires (41%). Of 75 questionnaires forwarded to the faculty, 17 (23%) were received from nine programs. On average, 5.6 teaching units (SD 2.6) are used for formulating a research question, 10 teaching units (SD 4.1) for literature review, and 11.3 teaching units (SD 6.9) for critical appraisal. Half of the teaching staff indicated that linkages between education and nursing care practice have been established. The traditional teaching method of frontal teaching is used predominantly. Student interest in topics was rated as moderate by most teachers.CONCLUSIONS:Topics on evidence-based practice are an integral part of bachelor's degree programs in nursing in German-speaking countries. An increase in teaching units, active learning methods and the growing interconnection between education and practice could improve the acquisition of competencies and attitudes of students regarding EBP and further advance its implementation in practice.

Background About one million people in need of home care in Germany are assisted by 15,400 home care services. Home healthcare is mostly a complex endeavour because interprofessional collaboration is often challenging. This might negatively impact patient safety. The project interprof HOME aims to develop an interprofessional person-centred care concept for people receiving home care in a multistep approach. In one of the work packages we explored how people receiving home care, relatives, nurses, general practitioners, and therapists (physiotherapists, occupational therapists, and speech therapists) perceive collaboration in this setting. Methods Semi-structured interviews were conducted with 20 people receiving home care and with 21 relatives. Additionally, we worked with nine monoprofessional focus groups involving nurses of home care services ( n = 17), general practitioners ( n = 14), and therapists ( n = 21). The data were analysed by content analysis. Results Three main categories evolved: “perception of interprofessional collaboration”, “means of communication”, and “barriers and facilitators”. People receiving home care and relatives often perceive little to no interprofessional collaboration and take over a significant part of the organisational coordination and information exchange. Interprofessional collaboration in steady care situations does exist at times and mostly occurs in coordination tasks. Contact and information exchange are rare, however, interprofessional personal encounters are sporadic, and fixed agreements and permanent contact persons are not standard. These trends increase with the complexity of the healthcare situation. Joint collaborations are often perceived as highly beneficial. Means of communications such as telephone, fax, or e-mail are used differently and are often considered tedious and time-consuming. No interprofessional formal written or electronic documentation system exists. Personal acquaintance and mutual trust are perceived as being beneficial, while a lack of mutual availability, limited time, and inadequate compensation hinder interprofessional collaboration. Conclusions Interprofessional collaboration in home care occurs irregularly, and coordination often remains with people receiving home care or relatives. While this individual care set-up may work sufficiently well in low complex care situations, it becomes vulnerable to disruptions with increasing complexity. Close interactions, joint collaboration, and fixed means of communication might improve healthcare at home. The findings were integrated into the development of the person-centred interprofessional care concept interprof HOME. Trial registration This study is registered on the International Clinical Trails registry platform ClinicalTrials.gov as NCT05149937 on 03/11/2021.

Background: In the COVID-19 pandemic, novel regional services and communication channels emerged across all sectors of the German healthcare system. To contribute to pandemic preparedness, this study aims to describe newly established services in response to the COVID-19 pandemic from a stakeholder perspective and to examine the interprofessional communication channels, applying a nationwide cross-sectional approach. Methods: A nationwide sample of German healthcare stakeholders comprising general practitioners, associations of statutory health insurance physicians, hospital medical directors, local health departments, rescue coordination centres, medical directors of emergency services, outpatient nursing services, nursing homes, community care access centres, and hospital nursing managers was surveyed. A web-based questionnaire asked for their level of participation in newly implemented regional COVID-19 services and communication channels. Stakeholders' level of recommendation was measured using the Net Promotor Score (NPS), a metric that assesses their satisfaction towards the services surveyed. Results: In total, 1312 healthcare stakeholders participated in the survey. Diagnostic centres (23.0-90.9%), COVID-19 wards in hospitals (40.5-92.1%), emergency medical vehicles designated solely for COVID-19 patients (16.5-68.4%), and crisis intervention teams (11.6-30.6%) exhibited the highest rates of engagement. The services receiving the highest recommendation for future use were COVID-19 focus practices (NPS: 33.4-43.7), COVID-19 wards in hospitals (NPS: 47.6-84.4), transportation of COVID-19 patients exclusively by predefined professional groups (NPS: 12.5-36.4), and newly implemented digitally supported nursing services (NPS: 58.3-100.0). Telephones emerged as the most frequently used communication channel (58.0-96.7%), while email was the primary digital channel (23.7-81.5%). Conclusions: During the COVID-19 pandemic, Germany experienced significant variation in the implementation of pandemic-related services across healthcare sectors, with stakeholders prioritising services built on existing healthcare structures. Developing a proactive digital infrastructure to connect healthcare professionals from different sectors is crucial for better future pandemic management.

HintergrundEvidenzbasierte Praxis (EBP) stellt eine wichtige Grundlage für die Verbesserung der Qualität der Pflege und der Sicherheit von Menschen mit Pflegebedarf dar. Die Formulierung einer Forschungsfrage, die Literaturrecherche und die kritische Bewertung sind entscheidend für die Entwicklung einer evidenzbasierten Praxis. Ziel dieser Studie war es, einen Überblick darüber zu gewinnen, wie diese Themen in die Bachelor-Pflegestudiengänge in Österreich, Deutschland und der deutschsprachigen Schweiz integriert sind und wie Lehrende die Inhalte umsetzen bzw. die Umsetzung erleben und einschätzen.MethodeWir führten eine explorative Querschnittstudie mit Online-Befragung unter den Studiengangsleitungen und Lehrpersonen aller 58 Bachelor-Pflegestudiengänge in Österreich, Deutschland und der deutschsprachigen Schweiz durch. Dazu wurde ein Fragebogen zu den allgemeinen Rahmenbedingungen, Lehrinhalten und -methoden der evidenzbasierten Pflegepraxis sowie zum thematischen Interesse der Studierenden entwickelt. Die Ergebnisdaten wurden deskriptiv analysiert.ErgebnisseDie Studiengangsleitungen schickten 24 Fragebögen (41%) zurück. Von 75 Fragebögen, die an die Lehrpersonen weitergeleitet wurden, gingen 17 (23%) aus neun Studiengängen ein. Im Durchschnitt stehen 5,6 Lehreinheiten (LE) à 45 Minuten (SD 2,6) für die Formulierung einer Forschungsfrage, 10 LE (SD 4,1) für die Literaturrecherche und 11,3 LE (SD 6,9) für die kritische Bewertung zur Verfügung. Die Hälfte der Lehrenden gab an, dass Verknüpfungen mit der Praxis stattfinden. Überwiegend wird die traditionelle Lehrmethode Frontalunterricht angewandt. Das thematische Interesse der Studierenden wurde von den meisten Lehrenden als mittelmäßig eingeschätzt.SchlussfolgerungenThemen zur evidenzbasierten Praxis sind fester Bestandteil von Bachelor-Pflegestudiengängen im deutschsprachigen Raum. Eine Erhöhung der Lehreinheiten, aktive Lernmethoden und eine zunehmende Verknüpfung mit der Praxis könnten den Erwerb von Kompetenzen und Einstellungen bei Studierenden bezüglich EBP verbessern und deren Implementierung in der Praxis stärken.