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Entwicklung der professionellen Pflege vor dem Hintergrund des demografischen Wandels Entwicklung der professionellen Pflege vor dem Hintergrund des demografischen Wandels
... As in other countries, the number of people in need of care is increasingly noticeably in Germany, and in order to ensure that they are provided for, an increase in the demand for health care workers is anticipateda demand that can hardly be satisfied [1,2]. ...
... burnout), pension for reduced work capacity or application for a pension for reduced work capacity in T2. 2 e.g. accident injuries, acute illnesses (e.g. ...
Background:
Until now there has been a lack of effective screening instruments for health care workers at risk. To counteract the forecast shortage for health care workers, the offer of early interventions to maintain their work ability will become a central concern. The Nurse-Work Instability Scale (Nurse-WIS) seems to be suitable as a screening instrument and therefore a prospective study of a cohort of nursing staff from nursing homes was undertaken to validate the Nurse-Work Instability Scale (Nurse-WIS).
Methods:
The follow-up data was used to test the sensitivity, specificity and the predictive values of the Nurse-WIS. The participants answered a questionnaire in the baseline investigation (T1) and in a follow-up 12 month after baseline. The hypothesis was that geriatric care workers with an increased risk according to the Nurse-WIS in T1 would be more likely to have taken long-term sick leave or drawn a pension for reduced work capacity in T2.
Results:
396 persons took part in T1 (21.3% response), 225 in T2 (42.3% loss-to-follow-up). In T1, 28.4% indicated an increased risk according to the Nurse-WIS. In T2, 10.2% had taken long-term sick leave or had drawn a pension for reduced work capacity. The sensitivity is 73.9% (95%-CI 55.7%-92.3%), the specificity is 76.7% (95%-CI 71.2%-82.8%). The ROC AUC indicated a moderate precision for the scale, at 0.74 (95%-CI 0.64-0.84). The PPV of the Nurse-WIS is 26.6%, and the NPV is 96.3%. For those with an increased risk according to the Nurse-WIS, the probability in T2 of long-term sick leave or a pension for reduced work capacity is around eight times higher (OR 8.3, 95%-CI 2.90-23.07). Persons who had indicated a long-term sick leave or made an application for a pension for reduced work capacity in T1 had a 17 times higher risk (OR 17.4, 95%-CI 3.34-90.55).
Conclusion:
The German version of the Nurse-WIS appears to be a valid instrument with satisfactory predictive capabilities for recording an impending long-term sick leave. Whether the Nurse-WIS can be used as a screening tool which helps to design risk adjusted prevention programs for the afflicted nurse should be studied.
... Neighboring Germany also suffers from a nursing shortage. According to Hackmann (2010), there will be about 4.4 million nursing cases by 2050, meaning an increase of 270%. In the future, care will be provided less frequently by family caregivers and increasingly by professional institutions such as home care services and nursing homes (Schönrock et al., 2015). ...
... As a result of demographic changes in Germany, the number of people in need of care will increase significantly in the years ahead. According to Hackmann [3] there will be approximately 4.4 million nursing cases by 2050. In other words, the proportion of individuals needing professional nursing care will increase by 270 %. ...
Background:
Demographic changes will lead to a growing demand for healthy, motivated healthcare workers (HCW) in the years ahead. Along with well-targeted prevention, knowledge of occupational health and safety and infection precaution is essential for a healthy working life. In this context back-friendly working methods and protection from infectious diseases are necessary in elderly care.
Methods:
In 2012, a survey was conducted in nine residential and two semi-residential nursing homes, as well as in one home care service in the Schwerin area of northeast Germany. Four hundred and seventy three HCWs were asked to fill in a questionnaire on what they knew about aspects of occupational health and safety such as vaccinations and preventative measures administered by occupational physicians, hygiene, back-friendly working methods and infection prevention. The statistical evaluation was descriptive, with a comparison between job title. Differences were examined with chi square or Fisher's exact test.
Results:
The response rate was 28 % (n = 132). The largest group of respondents (36 %) were qualified geriatric HCWs. More than 74 % of employees felt well informed about opportunities for precautionary checks and vaccination by occupational physician, and 93 % utilized these opportunities. When it came to assigning modes of transmission to specific infectious diseases, only 23 % of participants were well informed, and one in three (31 %) care assistants was inadequately informed. Fewer than half of participants could correctly name the indications for hand disinfection. Only 66 % of the HCWs said they were aware of training offers for the management of multidrug-resistant organisms in their institution. They did know about possible aids to back-friendly working, although gaps in knowledge were apparent. Only 59 % of respondents knew that care utensils should preferably be stored at working height so as to reduce awkward body postures.
Conclusions:
Employees in elderly care are well informed about the range of precautionary occupational medical examinations and take advantage of this offering. Questions in the survey regarding hygiene management were answered in a competent manner. On the other hand some gaps in the knowledge about infection prevention and occupational safety became apparent. Differences between qualified and unqualified participating professionals occurred only in the knowledge of infectious diseases and pathogens and the associated path of infection. The extent to which training can help to improve infection prevention and occupational health and safety should be investigated.
... The observed risk for leaving geriatric nursing complies with the results of a study investigating the nursing situation in Germany. Independent of the reason for leaving the profession it is shown that personnel in geriatric nursing have a shorter duration (8.4 years) in the profession than nursing personnel in hospitals (13.7 years) [26]. This premature drop-out of geriatric nurses is also confirmed in the NEXT study [27], showing that geriatric nurses are more likely to intend to leave their job than nurses working in the hospital. ...
Work-related musculoskeletal pain- particularly back pain - is an important individual and socioeconomic problem. The Back College for the insurance holders of the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) is based on a multimodal concept and has been evaluated with respect to pain relief and continuing in the nursing profession.
In a retrospective cohort study, the participants in the Back College from 2009 to 2011 were surveyed in writing. Besides demographic data, the survey covered information on qualification, length of employment, institution, employment status, periods of inability to work, applicability of working techniques and continuation in the profession. Back pain was recorded at three time points - T1 (before the Back College), T2 (directly after the Back College) and T3 (at the time of the survey). Pain changes were submitted to tests for paired samples. Multivariate logistic analysis was applied to determine potential factors influencing unfavourable changes in pain or leaving nursing due to back pain.
The survey covered 1,282 insurance holders, with a response rate of 80%. Statistically significant reductions in pain were found for the whole group and for all subgroups. For persons who predominantly worked in old people's homes and who did not take part in refresher services, an increased odds ratio was found for unfavourable changes in pain (OR: 1.9 or 1.4, respectively). Persons with a qualification in geriatric nursing or in intensive care/OP/anaesthesia had an increased risk of leaving nursing due to back pain (OR: 2.5 in each case). An increased risk of leaving was also found for persons who did not take part in workplace support (OR: 2.9).
Within the context of the study design, the multimodal concept of the Back College is clearly related to relief of back pain. The Back College appears to be less successful for geriatric nurses and persons with qualifications in intensive care/OP/anaesthesia. Further studies are needed to ascertain why some participants experience less relief in stress from the working techniques they have learnt.
http://www.inqa.de/SharedDocs/PDFs/DE/Projekte/praxislernort-demo-prax-pflege-abschlussbericht.pdf?__blob=publicationFile
An increasing demand for both formal and informal care is likely to result from the ongoing demographic transition at the same time as there is a further move away from the traditional domestic division of labour. Public policy-making that aims at increasing the supply of informal care necessitates knowledge about the relative importance of various incentives for individual care providers. This paper takes as a point of departure that the willingness to supply informal care is partly explained by the extent to which it adversely affects labour-market outcomes and analyses the effect on labour-market outcomes of providing informal care to one's elderly parent(s) among the 50+ of Europe. Data from SHARE (Survey of Health, Ageing, and Retirement in Europe) was used to examine the association between, on the one hand, hours of informal care provided and, on the other, (1) the probability of employment, (2) hours worked, and (3) wages, respectively. The results suggest that giving informal care to one's elderly parents is associated with significant costs in terms of foregone labour-market opportunities and that these adverse effects vary between countries.