LVR-Klinikum Düsseldorf Hospital of the Heinrich-Heine University ...

documenting all types of nursing information. The Directors
of Nursing at the LVR decided in favour of the NANDA-I
system of classifying nursing diagnoses. NANDA-I appeared
to be particularly well suited to their purpose, having been
globally tested longer than any rival system. Also, other
institutions in the German-speaking countries had already
gathered experiences with its implementation.
As a consequence, since 2004 all members of the LVR-
Klinikum’s nursing staff have been (and still are) undergoing
training courses – division by division – to diagnose nursing
requirements, to integrate the required measures into the
therapeutic process and to record the procedure in the KIS.
NANDA-I nursing diagnoses enable the users of the system
to represent individually relevant situations of patients and
their family members as well as the responsibilities of the
nursing staff in a differentiated and flexible manner.
Implementation of a comprehensive decubitus,
fall and wound management
This includes the following elements:
s Design and implementation of internal nursing
standards, based on the national standards of the
German Network of Quality Development in Nursing, in
close coordination with the Nursing Academy
s Provision of training courses
s Risk assessment, using rating scales and checklists
s Design of a protocol to record the number and severity
of falls and of a decubitus reporting form
s Annual evaluation of the incidences for falls and
decubitus
s Introduction of suitable materials for hospital beds, hip
protectors, low bedsteads
s Structural alterations: lighting concepts, floor
coverings
s Design and implementation of a wound anamnesis and
a report form to record the development of wounds
s Provision of training for two staff members, one each
from the Divisions of Neurology and Gerontopsychiatry,
to help them acquire certification as wound healing
experts from the Initiative for Chronic Wounds (ICW)
s Provision of advice to wound experts who are assessing
chronic wounds at the hospital
HealtHcare
Implementation of a de-escalation management
This includes the following elements:
s Design and implementation of nursing standards in the
treatment of fixated and isolated patients
s Introduction of a “risk of violent behaviour” checklist
and a standardised instrument for recording aggressive
incidents
s Annual evaluation of the aggressive incident recording
tool (SO-AS-R)
s Provision of training for two staff members to help
them qualify as tutors in de-escalation and protection
techniques
s Introduction of comprehensive compulsory training
programmes in de-escalation and protection
techniques
Launch of new group activities and
nursing strategies, for example:
s NADA ear acupuncture in the Division of Dependence
Disorders
s Well-being programme to train the patients’ ability to
enjoy themselves (various divisions)
s Yoga group in the Division of Child and Adolescent
Psychiatry and Psychotherapy
s Psychoeducation
s Validation in the Division of Gerontopsychiatry
In addition, first aid training programmes were conducted
by a specifically qualified staff member who has been
assigned to assume special responsibilities in the event
of an emergency (emergency equipment management,
in situ advice, etc.), and a position was established for a
“Professional Development and Quality Assurance Manager
for Nursing” who will report directly to the Director
of Nursing and be in charge of in-house professional
development and the implementation of measures and
systems designed to develop the range of services and to
ensure their permanently high quality.
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