Background/Objectives: Postoperative Delirium (POD) is a frequent complication in older patients undergoing elective surgery. Although multicomponent interventions are effective, deficits in interdisciplinary communication and intersectoral collaboration persist. This study developed and evaluated the "Geriatric Delirium Pass (GeDePa)", a paper-based tool to systematically document risk factors for POD across care settings. Methods: A multi-method design was applied, comprising (i) a structured literature review, (ii) semi-structured expert interviews, and (iii) a standardized online survey utilizing the RAND/UCLA Appropriateness Method (RAM). A total of 21 healthcare professionals (general practitioners, geriatricians, anaesthetists, surgeons, and nurses) were recruited from Salzburg, Austria, and South Tyrol, Italy (2023-2024). Results: Healthcare professionals confirmed the GeDePa's practical applicability for early POD risk detection across care settings. The expert rating using the RAM Disagreement Index (DI) method deemed all 45 risk factors as sufficiently relevant and, with the exemption of two risk factors (alcohol use, intraoperative complications), feasible. A detailed analysis provided a more differentiated picture, with full consensus reached for only 18 items. Several factors with uncertain consensus (e.g., cognitive impairment and polypharmacy) were retained based on strong evidence in the literature. Others were excluded despite high ratings if they were considered redundant or impractical (e.g., detailed intraoperative complications). In total, 38 of the 45 risk factors were retained. Conclusions: The GeDePa is a feasible and relevant tool for structured delirium risk assessment and enhancing interdisciplinary communication between primary and hospital care. The finalized German and Italian versions are now available and will undergo further testing and implementation in clinical practice.

Experiences of nurses on sensor-based fall prevention in long-term care: Results of the mixed methods study "Sensi-Care" Abstract: Background: Falls are common in long-term care. Sensor technology offers potential for preventing and analysing falls, enhances residents' autonomy and supports nurses. Successful implementation is strongly dependent on their acceptance. Aim: The "SensiCare" project accompanies the implementation of sensor-based fall prevention in long-term care. In an initial phase of the project nurses' experiences and evaluations regarding the benefits of the technology were examined. Methods: In this mixed methods study, semi-structured expert interviews were conducted with 19 nurses from German-speaking regions and analysed using content analysis. A standardized online expert rating was applied with 49 nurses to validate and consolidate the findings. The synthesis was carried out in a joint display. Results: Nurses reported predominantly positive experiences with sensor technologies. According to that, these technologies alleviate workload by detecting fall risks and enabling quick responses after a fall. They also help analyse falls and optimize preventive measures. In use, nurses experience confidence and the benefits of the technologies. Integration into the care process and timesaving were highlighted as important factors for acceptance. Conclusion: Nurses, especially those with a high level of technical competence and experience with sensors, recognize the benefits of sensor technologies. Active involvement in the implementation of the technology promotes its safe and efficient use.

Zusammenfassung: Hintergrund: Stürze sind ein häufiges Ereignis in der Langzeitpflege. Sensortechnologien bieten Potenziale zur Prävention und Analyse von Stürzen, erhöhen die Autonomie der Bewohner_innen und unterstützen Pflegefachpersonen. Ein erfolgreicher Einsatz ist maßgeblich von deren Akzeptanz abhängig. Ziel: Das Projekt „SensiCare“ begleitet die Implementierung einer sensorbasierten Sturzprävention in der Langzeitpflege. In einer ersten Projektphase wurden Erfahrungen und Einschätzungen von Pflegefachpersonen bezüglich des Technologienutzens untersucht. Methodik: In der Mixed-Methods-Studie wurden semistrukturierte Experteninterviews mit 19 Pflegefachpersonen aus dem deutschsprachigen Raum geführt und inhaltsanalytisch ausgewertet. Zur Validierung und Vertiefung erfolgte ein standardisiertes Online-Expertenrating mit 49 Pflegefachpersonen. Die Synthese erfolgte mittels Joint Display. Ergebnisse: Die Pflegefachpersonen berichteten überwiegend positive Erfahrungen mit Sensortechnologien. Diese entlasten demnach, indem sie Sturzgefahren erkennen und schnelle Reaktionen nach Stürzen ermöglichen. Sie helfen bei der Analyse von Stürzen und optimieren Präventionsmaßnahmen. Im Gebrauch erfahren sie Sicherheit und den Nutzen der Technologien. Die Integration in den Pflegeprozess und Zeitersparnis sind wichtige Akzeptanzfaktoren. Schlussfolgerung: Pflegefachpersonen, vor allem jene mit hoher Technikkompetenzüberzeugung und Erfahrung mit Sensoren, erkennen den Nutzen von Sensortechnologien. Eine aktive Beteiligung in der Implementierung der Technologie fördert den sicheren und effizienten Einsatz.

Due to demographic changes, the need for healthcare among older persons is expected to increase. Modern technologies, such as digital health applications and telecare solutions embedded into the care practice, offer potential solutions. Evidence on healthcare professionals' acceptance of digital technologies and their technological readiness is rather scarce. This study assesses the factors on technological readiness regarding a prototypical virtual healthcare assistant among nurses in Austria and Germany through an online survey (n = 289). Utilizing the extended Unified Theory of Technology Use and Acceptance model and structural equation modeling, the study shows that socioeconomic attributes influence views on technology beyond factors of technology acceptance. Technological affinity, skepticism, and views toward digitalization in healthcare are mainly relevant to explain certain attitudes toward virtual healthcare assistant solutions. The findings highlight the necessity to expand existing theoretical frameworks with social factors to better understand technological readiness in healthcare.

PURPOSE:Falls and pressure ulcers are serious complications impacting care quality in nursing homes. Sensor technologies can help prevent these adverse events through continuous monitoring and timely intervention. This scoping review, following JBI guidelines, evaluated the effects of sensor-based fall and pressure ulcer prevention in long-term care and the experiences of patients and healthcare professionals. METHODS:The review included primary studies, reviews, and protocols published from 2014 to 2023. Screening, data extraction, and quality appraisal were conducted independently by two authors using MMAT and JBI tools. RESULTS:A total of 31 studies were included: 22 on fall prevention, eight on pressure ulcer prevention, and one addressing both. User-based sensors were effective in preventing both falls and pressure ulcers. Accelerometers enhanced sensitivity for fall detection and adherence to repositioning protocols. Context-based sensors, such as Doppler, webcams, and Kinect, showed variable precision and false alarm rates, while range sensors demonstrated high precision. Context-based accelerometers were promising for pressure ulcer prevention, but pressure sensors provided inconsistent data. Additional manual assessments enhanced sensor data accuracy. Patients preferred non-obtrusive, user-friendly sensors, while healthcare professionals emphasized the need for seamless integration into care routines. Both groups valued real-time monitoring and alert capabilities, though privacy and data security remained concerns. CONCLUSIONS:Sensor technologies show potential in enhancing patient safety and care quality in long-term care, though further refinement is needed for context-based sensors in pressure ulcer prevention. Integrating these technologies with standard care can improve outcomes, but addressing privacy and ethical issues is essential for broader acceptance.

BACKGROUND:The prevention of postoperative delirium (POD) in older adults requires interprofessional collaboration among all healthcare professionals (HCP) involved in the continuum of care. OBJECTIVE:This study investigated the question of how HCPs experience the interprofessional prevention of POD in older adults within the continuum of care. Additionally, it examined the challenges and desired changes in the intersectoral communication and collaboration for prevention of POD. METHODS:This multicenter study was carried out with a qualitative research approach. To explore the experiences of HCPs a total of 21 semistructured expert interviews were conducted with general practitioners, geriatricians, anesthesiologists, surgeons and nurses across the 2 study regions Salzburg County and South Tyrol. The interviews were analyzed using content analysis. RESULTS:The results show that the interviewed HCPs already implement measures to prevent POD but these predominantly focus on identifying patients at risk in the inpatient sector. Information about risk factors is not systematically shared between disciplines or across the intersectoral continuum of care. Structures and processes for intersectoral communication and collaboration in the prevention of POD over the continuum of care are largely missing. CONCLUSION:To improve the prevention of POD in older adults efforts should be made to enhance intersectoral and interprofessional collaboration and communication between the HCPs involved. The development of a shared instrument for the systematic identification and documentation of relevant risk factors across the continuum of care could support the prevention of POD.

Due to demographic changes, the need for healthcare among older persons is expected to increase. Modern technologies, such as digital health applications and telecare solutions embedded into the care practice, offer potential solutions. Evidence on healthcare professionals' acceptance of digital technologies and their technological readiness is rather scarce. This study assesses the factors on technological readiness regarding a prototypical virtual healthcare assistant among nurses in Austria and Germany through an online survey (n = 289). Utilizing the extended Unified Theory of Technology Use and Acceptance model and structural equation modeling, the study shows that socioeconomic attributes influence views on technology beyond factors of technology acceptance. Technological affinity, skepticism, and views toward digitalization in healthcare are mainly relevant to explain certain attitudes toward virtual healthcare assistant solutions. The findings highlight the necessity to expand existing theoretical frameworks with social factors to better understand technological readiness in healthcare.

Für die Prävention des postoperativen Delirs (POD) bei älteren Patient:innen ist die interprofessionelle Zusammenarbeit aller am Versorgungskontinuum beteiligten Healthcare Professionals (HCP) zentral. Die Studie geht der Frage nach, wie die HCP die interprofessionelle Prävention des POD bei älteren Patient:innen im Versorgungskontinuum erleben, und welche Herausforderungen und Änderungswünsche sie an die intersektorale Kommunikation und Zusammenarbeit zur Prävention des POD haben. Diese multizentrische Studie wurde mit einem qualitativen Forschungsansatz durchgeführt. Zur Exploration der Erfahrungen der HCP wurden in Salzburg und der Region Südtirol insgesamt 21 semistrukturierte Experteninterviews mit Allgemeinmediziner:innen, Geriater:innen, Anästhesist:innen, Chirurg:innen und Pflegefachpersonen geführt und inhaltsanalytisch ausgewertet. Die Ergebnissen zeigen, dass die HCP Maßnahmen zur Prävention des POD setzen, diese sich aber primär auf die Identifikation von Risikopatient:innen im intramuralen Bereich beschränken. Informationen zu den Risikofaktoren werden interdisziplinär und intersektoral nicht systematisch ausgetauscht. Strukturen und Prozesse zu Kommunikation und Zusammenarbeit in der Prävention des POD über das Versorgungskontinuum hinweg sind kaum vorhanden. Zur Prävention des POD bei älteren Patient:innen sollten vermehrt Anstrengungen unternommen werden, die intersektorale, interprofessionelle Zusammenarbeit und Kommunikation der beteiligten HPC zu verbessern. Ein gemeinsames Instrument zu systematischer Erfassung und Dokumentation der relevanten Risikofaktoren über das Versorgungskontinuum hinweg könnte dabei die Prävention des POD unterstützen.

This study explores the sustainability of advanced practice nurse (APN) roles, identifying key factors that influence their persistence and effectiveness. A qualitative descriptive design and the World Cafe method were used to gather insights from 12 APNs, students, and researchers at an international congress. Findings revealed that sustainability requires robust professional networks, leadership support, role clarity, and proactive policies. Recommendations include fostering mentorship, stakeholder engagement, and continuous professional development. These findings emphasize the need for health care systems to adopt structured strategies to sustain and integrate APN roles effectively for improved health care outcomes. (c) 2025 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

Zusammenfassung. Hintergrund: Zunehmend mehr Personen der Altersgruppe 80+ werden im Setting ICU behandelt. Das Erleben Intensivpflegender dabei wurde bisher noch kaum untersucht. Ziel: Um die alltägliche pflegerische Praxis in der Versorgung alter Patient_innen auf der ICU besser verstehen zu können, soll das handlungsanleitende Wissen von Intensivpflegekräften untersucht und in ihren Orientierungen und Typiken dargestellt werden. Methode: Im Rahmen des interpretativen Paradigmas wurden drei leitfadengestützte Gruppendiskussionen mit insgesamt 14 Intensivpflegekräften eines österreichischen Klinikums durchgeführt und mit der Dokumentarischen Methode nach Bohnsack ausgewertet. Ergebnisse: Fünf Orientierungen charakterisieren das Wissen und die Handlungen der Intensivpflege in Bezug auf alte Patient_innen: der Respekt des Patient_innenwillens, die Suche nach ethischer Begründung, die Schönheit des Berufs, die eigene Reflexion des professionellen Handelns sowie das Erleben eines teilweise fehlgeleiteten Gesundheitssystems. Die übergeordnete handlungsleitende Typik ist eine Advokatorenschaft in der Vertretung der Interessen der sehr alten Patient_innen. Schlussfolgerung: Die vielschichtigen Erfahrungen der Intensivpflegekräfte sind von persönlichen, zwischenmenschlichen und strukturellen Herausforderungen geprägt, aber ebenso von positiven Erfahrungen. Die Erkenntnisse bieten Ansatzpunkte, um sowohl die Situation Pflegender als auch hochaltriger Patient_innen auf Intensivstationen zu verbessern.

Background comprehensive medication management (CMM) can reduce medication-related risks of falling. However, knowledge about inter-individual treatment effects and patient-related barriers remains scarce.Objective to gain in-depth insights into how geriatric patients who have fallen view their medication-related risks of falling and to identify effects and barriers of a CMM in preventing falls.Design complementary mixed-methods pre-post study, based on an embedded quasi-experimental model.Setting geriatric fracture centre.Methods qualitative, semi-structured interviews framed the CMM intervention, including a follow-up period of 12 weeks. Interviews explored themes of falling, medication-related risks, post-discharge acceptability and sustainability of interventions using qualitative content analysis. Optimisation of pharmacotherapy was assessed via changes in the weighted and summated Medication Appropriateness Index (MAI) score, number of fall-risk-increasing drugs (FRID) and potentially inappropriate medications (PIM) according to the Fit fOR The Aged and PRISCUS lists using parametric testing.Results thirty community-dwelling patients aged >= 65 years, taking >= 5 drugs and admitted after an injurious fall were recruited. The MAI was significantly reduced, but number of FRID and PIM remained largely unchanged. Many patients were open to medication reduction/discontinuation, but expressed fear when it came to their personal medication. Psychosocial issues and pain increased the number of indications. Safe alternatives for FRID were frequently not available. Psychosocial burden of living alone, fear, lack of supportive care and insomnia increased after discharge.Conclusion as patients' individual attitudes towards trauma and medication were not predictable, an individual and longitudinal CMM is required. A standardised approach is not helpful in this population. Graphical Abstract(AI: created with Artificial Intelligence).

Nurses' common experiences of old age and intensive care: A qualitative study Abstract. Background: Increasingly more people in the 80+ age group are receiving treatment in the ICU-setting. The related critical care nurses' experience has been the subject of very few studies. Aim: To better understand the everyday nursing practice in the care of old patients in the ICU setting, the knowledge of critical care nurses that guides their actions will be examined and presented in terms of their orientations and typologies. Method: Within the interpretative paradigm, three guideline-based group discussions were conducted with a total of 14 critical care nurses from an Austrian clinic. Data was analyzed using the documentary method according to Bohnsack. Results: Five orientations characterize the knowledge and the actions of critical care nurses relating to old patients: the respect for the patients' will, the search for ethical justification, the beauty of the job, the own reflection of professional actions as well as the perception of a partly misguided health care system. The superior action-guiding typology is advocacy in the representation of the very old patients' interests. Conclusions: The multi-faceted experiences of critical care nurses are characterized by personal, interpersonal, and structural challenges, but also by positive experiences. The findings offer approaches to improve the care situation for nurses as well as for old people in intensive care units.

Introduction Pharmacotherapy is critical in geriatric fallers owing to the vulnerability of this population. Comprehensive medication management can be an important strategy to reduce the medication-related risk of falling in this patient group. Patient-specific approaches and patient-related barriers to this intervention have rarely been explored among geriatric fallers. This study will focus on establishing a comprehensive medication management process to provide better insights into patients’ individual perceptions regarding their fall-related medication as well as identifying organisational and medical-psychosocial effects and challenges of this intervention. Methods and analysis The study design is a complementary mixed-methods pre-post study which follows the approach of an embedded experimental model. Thirty fallers aged at least 65 years who were on five or more self-managed long-term drugs will be recruited from a geriatric fracture centre. The intervention consists of a five-step (recording, reviewing, discussion, communication, documentation) comprehensive medication management, which focuses on reducing the medication-related risk of falling. The intervention is framed using guided semi-structured pre-post interventional interviews, including a follow-up period of 12 weeks. These interviews will assess patients’ perceptions of falls, medication-related risks and gauge the postdischarge acceptability and sustainability of the intervention. Outcomes of the intervention will be measured based on changes in the weighted and summated Medication Appropriateness Index score, number of fall-risk-increasing drugs and potentially inadequate medication according to the Fit fOR The Aged and PRISCUS lists. Qualitative and quantitative findings will be integrated to develop a comprehensive understanding of decision-making needs, the perspective of geriatric fallers and the effects of comprehensive medication management. Ethics and dissemination The study protocol was approved by the local ethics committee of Salzburg County, Austria (ID: 1059/2021). Written informed consent will be obtained from all patients. Study findings will be disseminated through peer-reviewed journals and conferences. Trial registration number DRKS00026739.

INTRODUCTION:Telecare can be an effective way to deliver healthcare to patients' homes. Avatar or virtual agent-equipped technologies have the potential to increase user engagement and adherence to telecare. This study aimed to identify telecare interventions assisted by avatars/virtual agents, reflect the concepts of telecare and give an overview on its outcomes. METHODS:A scoping review guided by the PRISMA-ScR checklist was conducted. MEDLINE, CINAHL, PsycINFO and grey literature were searched through 12 July 2022. Studies were included if patients were remotely cared for by healthcare professionals and received telecare interventions assisted by avatars/virtual agents in their homes. Studies underwent quality appraisal, and were synthesized along the dimensions 'study characteristics', 'intervention' and 'outcomes'. RESULTS:Out of 535 records screened, 14 studies were included, reporting the effects of avatar/virtual agent-assisted telecare interventions, tailored to specific patient groups. Telecare interventions mainly focused on teletherapy and telemonitoring. Telecare services were rehabilitative, preventive, palliative, promotive and curative. Modes of communication were asynchronous, synchronous or a mix of both. Tasks of the implemented avatars/virtual agents comprised delivering health interventions, monitoring, assessment, guidance and strengthening agency. Telecare interventions led to improved clinical outcomes and higher adherence. Most studies reported sufficient system usability and high satisfaction among participants. CONCLUSIONS:Telecare interventions were overall target group related and integrated in a service model. This combined with the use of avatars and virtual agents leads to improved adherence to telecare in the home setting. Further studies could account for relatives' experiences with telecare.

Geriatric patients in the emergency department: Development of an ANP role from the perspective of the multiprofessional team Abstract. Background: Ever-increasing numbers of geriatric patients lead to challenges in emergency departments (ED). Aim: The aim of this study is to identify the need for change in emergency care and discuss the integration of an Advanced Practice Nurse (APN) based on the practical experience of nurses and physicians. The focus lies on the interdisciplinary cooperation. Methods: Within the scope of a qualitative research approach, guided interviews with five physicians and seven nurses from two Austrian emergency departments were conducted. The qualitative content analysis according to Mayring was used for data analysis. Results: Five central main categories emerged. Nurses and physicians describe growing challenges in the care of geriatric patients in emergency departments due to a high workload, time pressure and lack of resources as well as a healthcare supply that does not meet the specific needs of geriatric patients. The integration of geriatric specialised nurses was associated with an improved patient care. Based on the structure, process and outcome criteria of the Nursing Role Effectiveness Model (NREM), the core components of an ANP role are described. Conclusion: The expansion of nursing competences and the development of defined care pathways should be further accelerated. The findings integrated in the NREM form the groundwork for the role description of the Geriatric Practice Nurse (GPN) in the ED.