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Nursing quality report reveals shortcomings in nursing homes
The quality of patient care in nursing homes has improved noticeably, but there are still major deficits. Every fifth inhabitant is still tied up with a fixation. This is the result of the third nursing quality report of the medical service of the health insurance companies.
Overall, there is a positive trend in nursing quality, but deficits persist in various areas, such as nutrition and pain therapy, according to the statements in the third nursing quality report. Conditions in nursing homes have improved overall since 2007, but the care of thousands of people in need of care is still not adequate.
The basis of the 3rd nursing quality report was the data from the quality checks of the medical service from July 2009 to December 2010. In the 18 months, the medical service had checked 16,000 homes and outpatient services. They checked the care situation of around 62,000 residents and 45,000 outpatients. A regular unannounced inspection of inpatient care facilities by the medical service has been mandatory since the nursing care reform came into force in 2008 and has been carried out at least once a year since 2011. The data obtained show that a positive trend can be observed overall. "The good news is that the quality of care has developed positively," emphasized the board of the umbrella organization of statutory health insurance, Gernot Kiefer, when the 3rd care quality report was presented on Tuesday in Berlin.
Deficiencies in nutrition and high risk of pressure ulcers However, the care quality report also reveals clear deficits in different care areas. For example, the report found deficiency in nutrition in five percent of the residents, which was associated with an average weight loss of 34 percent in those affected. After all, 79.5 percent of the needy residents were supported in eating, an increase of around 15 percent compared to 2007. However, adequate nutrition for all those in need of care is still not guaranteed today.
It is also worrying that many people in need of care are at increased risk of pressure sores because they are moved or relocated too rarely. According to the report, around 50 percent of the patients were at risk of bedsores, but only 60 percent of those in need were adequately cared for. The measures required for the prophylaxis of pressure ulcers, such as a regular change of storage, were therefore omitted just as often as in the investigation period of the second care quality report from 2007.
The care quality report also identified some deficits in the care of dementia patients. According to studies by the medical service, around 61 percent of residents in Germany are suffering from dementia. For those affected, there are offers for exercise; Communication and perception of particular importance. According to the nursing quality report, 76.3 percent of the needy receive appropriate offers - around ten percent more than in 2007. In itself, this is a gratifying trend, but in more than 40 percent of dementia patients, nursing staff does not pay sufficient attention to their well-being, according to the Assessment of the medical service.
The nursing quality report also reveals that in just under a fifth of those in need of care, the medication required was not properly documented and stored. According to information from the medical services, 95 percent of the patients need support in dealing with medication and 82 percent of the residents of the home receive proper administration. Difficulties exist, however, particularly with the medication of pain patients. In almost half of the possible pain patients, the nurses did not assess the pain and around six percent of those in need of care who were prescribed pain therapy by the doctor did not receive any pain medication, the examiners criticize. Dr. Peter Pick, the managing director of the medical service, also criticized "that too many sedatives are prescribed in nursing homes".
Fixation of those in need of long-term care continues to be widespread In the third quality care report, the medical service also massively criticized the still relatively widespread fixation of patients. The report comes to the conclusion that around 14,000 residents have been subjected to "freedom-restricting measures". Mostly these are barred beds, but belts are also used here regularly. According to the report, ten percent of those affected lack the judicial order actually required for this. Every fifth resident is affected by such measures.
Despite the deficits that were identified in the 3rd nursing quality report, the managing director of the medical service, Dr. Peter Pick, a positive assessment of the development in the nursing sector. "The quality of care in Germany is mostly good," emphasized the expert. At the same time, however, Pick pointed out that "in central care areas - such as nutrition, pressure ulcers (bedsores) - a relevant group of 20 to 40 percent of those in need of care are not cared for in accordance with recognized standards". There is still an acute need for action in individual institutions. (fp)
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Image: Gerd Altmann / pixelio.de