Search

Background: Maintaining safety is critical in home mechanical ventilation (HMV). It is co-determined by the availability of reliable technical aids and their correct application. Ensuring safe aid supply is part of the aid providers'́ legal mandate. However, whether and how this is achieved is largely unknown. Therefore, the tasks of technical aid providers, associated requirements and challenges with special regards to educational and safety aspects were investigated., Methods: For this purpose, episodic interviews were conducted between July and December 2020 with a purposive sample of field representatives of eleven technical aid providers. Between one and six persons participated in each of the interviews, resulting in a total sample of 25 persons (14 field representatives without management function, ten with management function, one director). Given the conditions during the COVID-19 pandemic, six interviews took place face-to-face and five as web meetings. Interviews were analysed using qualitative content analysis., Results: From the interviewees'́ perspective, the most important safety-related measure is the legally required and individually tailored initial instruction in a safe aid application. Additional safety-related tasks comprise counselling, e. g. for prescribing physicians and users (patients, relatives, nursing service employees), regular home visits, and the provision of a technical emergency service. Interviewees indicate that safety risks emerge primarily from a lack of skills and a high staff turnover among professional caregivers. This, they state, challenges building up and maintaining competencies among nursing staff. Other safety risks arise from healthcare fragmentation, lacking coordination, cooperation, and accountability of the professionals involved. Respondents address these challenges pragmatically by providing additional services, like ongoing caregiver training, care coordination and support roles., Discussion: Maintaining safety in ventilation-associated technical aid supply must be considered a crucial component of the overall HMV care processes, in which safety currently cannot be taken for granted. Field representatives of technical aid providers address the existing challenges with selective and intuitive strategies, some of which exceed their legal mandate., Conclusion: Improving safety in home care can be supported by establishing Advanced Nursing Practice roles in nursing services. The systematic further development of roles and tasks of staff of technical aid providers should be clarified within an overarching discourse on viable approaches to cross-sectoral and interprofessional HMV care., (Copyright © 2023. Published by Elsevier GmbH.)

An online-survey addressed to horse owners and -holders in Germany (G) and Switzerland (CH) was conducted with the goal to evaluatepreferences in equine health services, the frequency of consultations per horse and year and if there were differences between the two countries.The people were asked, for which problem they consulted an equine health provider. Providers were categorized into conventional veterinary,manual or alternative treatments, farrier of hoof care services and others. Influences of age, education and income of the respondentson the kind of chosen provider and the frequency of consultations were also investigated. A total of 3'013 people responded to the questionnaire,with a mean completion rate of 72.25%. Of these, 746 were excluded due to incomplete responses (362 G, 384 CH) so that intotal 2'267 questionnaires were included in the study. 1'146 respondents originated from the German speaking part of Switzerland and1'101 from the German federal states Baden-Wuerttemberg, Hessen, Bavaria, Thuringia and North Rhine-Westphalia. The origin wasunknown for 20 respondents, so that they were excluded from the country-comparisons (and only from these). From the German respondents1.3% were male, 98.7% female, from the Swiss respondents 15.7% male and 84.3% female. Of the respondents 236 people were between18 and 21 years old, 643 between 22 and 30 years old and 1'320 people were older than 30 years, no one was younger than 18 yearsof age. Of the total 2'267 respondents 11'346 providers were consulted at least once, in Switzerland in total 5'146 providers and in Germany6'108 providers (and 92 from the 20 people with unknown origin). Nearly half (49%) of all consultations were made due to problemswith the locomotor system, 39% due to internal diseases, 9% due to neurological disorders, 1.7% due to injuries and 0.25% due to unspecificproblems (e.g. weight loss). Most frequently the conventional veterinary treatment was appointed (21% CH, 18% G). In second placewas the equine dentist, in third place the farrier or hoof care service, and in fourth place the osteopath. The least frequently appointed werethe nutritionists, animal psychologists and pain therapists. The percentage distribution of appointed providers was significantly different betweenGermany and Switzerland (p<0.05). Regarding the frequency providers were consulted per horse and year, Switzerland and Germanydiffered significantly (p<0.05) with exception of the farrier or hoof care service, the animal psychologists and nutritionists. Farriers or hoofcare services were most frequently appointed more than 3 times per horse and year in both countries, whereas the nutritional and animalpsychologist consultations were not appointed by the majority (89% respectively 97% CH and 90% respectively 97% G). In Switzerland theconventional veterinary treatment was mostly appointed only once a year (44% CH, 18.4% G), and in Germany mostly 2–3 times per horseand year (50.9% G, 39.4% CH). Respondents from Switzerland consulted in average 4.5 providers and from Germany in average 5.5 providersper year. From Germany 42.8% and from Switzerland 25.4% of the people answered, that they changed their providers and the percentageof people who changed their providers lowered with increasing age category. Education level and income also influenced the typeof provider which was chosen. The present study gives an overview on equine health providers consulted in Switzerland and Germany [ABSTRACT FROM AUTHOR]

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)