Pflege
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The opening of pediatric units for co-admission of parents brought a clear change in the professional understanding of pediatric nursing. In all areas of work this creates new challenges for pediatric nurses. Besides professional competences of caring for ill children they now require competences in guiding and counselling parents, offering them effective strategies for coping with stressful experiences in connection with the illness of their child. ⋯ Cognitive as well as emotional coping mechanisms of children are presented, from which ways to counsel parents and to care for children in painful situations may be deduced. In a care situation trusting relationships between nurse, child and parents are essential. How children build trust should be a topic of research and discussion as well as the specific characteristics of a professional relationship between nurse and patient.
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Falls among (elderly) patients are common in institutional settings. Falls may lead to fright, pain, slight or severe injuries, they may increase the duration of the hospital stay, patient discomfort and affect the quality of life. We conducted a prospective study to evaluate the incidence of patient falls in a public hospital (300 beds) in the city of Zurich and to test a fall report form to assess patients after the event. 372 falls were reported during the 12 month evaluation period from 1996 to 1997 (6.7 falls per 1000 patient days) in 9 wards with 184 beds for patients requiring both acute care and/or longer term geriatric rehabilitation. 207 (56%) of the falls remained without detectable consequences, 6 (1.6%) of the patients suffered from serious (fracture), and 89 (24%) from slight injuries (contusions, abrasions, lacerations). ⋯ No peaks during the day in the time of falling were seen. The hospital management recommended the use of an official incident reporting from (fall-protocol) for all units since January 1998. The development of a hospital-wide fall prevention program is being prepared.
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Given today's developments in public health, nursing will be forced to manage different care services in the future. Nurses' growing responsibilities and the complexity of decision-making increase the necessity of a discussion of ethics in nursing. ⋯ This problem is analyzed according to Thiroux's ethical principles. The limits of casuistry lie in the fact that each person is accountable for his own decision in a specific situation without having a relevant context to refer to.
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Findings of health science as to the incidence and dynamics of health problems and the knowledge to optimize health promotion, prevention and patient treatment as well as international comparisons indicate that the potentials of nursing--understood as a system of nurses, nursing institutions and nursing science differentiated in itself--are not exhausted to their full extent within the German system of social health assurance. Following the introductory reflections on the relation between public health and nursing, being relatively young multi-disciplines of health science in Germany, this paper tries to identify and to describe the related deficiencies and approaches for their rectification by means of the four phases of the Public Health Action Cycle--assessment: of problems and fixing of priorities; policy formulation: selection, negotiation and fixing of strategies; assurance: organisation, implementation and control as well as evaluation: evaluation of the strategy and its results. This paper is the revised version of the basic lecture that the author gave on the occasion of the Fourth International Symposium of Nursing Science in Osnabrück in November 1996.