Thomas Fischer (@ProfessorPflege), Evangelische Hochschule Dresden
The full guideline documents in German are available here: https://www.awmf.org/leitlinien/detail/ll/184-002.html
Under the auspices of the German Society for Nursing Science (www.dg-pflegewissenschaft.de) a comprehensive guideline on the provision of community care under the conditions of the COVID-19 pandemic has been developed. A team of nurses, social scientists, physicians as well as carer and patient representatives reviewed the international literature, collated the relevant official German regulations, and discussed implications for home care in Germany.
33 recommendations for community care/home care providers and in particular registered nurses were developed. These are based on evidence from the literature, some of which originates from past pandemics, where available. However, for many relevant aspects of home care no evidence could be identified from the literature. In this case, recommendations are based on expert consensus.
The guideline includes recommendations on:
- the implementation of infection control measures while maintaining social inclusion and quality of life;
- the support of family and informal carers;
- interprofessional collaboration.
The development process followed guidance from the Association of Scientific Medical Societies in Germany (AWMF). In addition to the German Society for Nursing Science, the German Society for Family Medicine (DEGAM) and the German Society for Gerontology and Geriatrics (DGGG), among others, endorsed the guideline. It was independently reviewed by the German Network for Quality Development in Nursing (DNQP).
This guideline is a “living” document and will be updated regularly. New information on personal protection of healthcare workers and immunisation will be included shortly.
In addition, more general learnings from the guideline development process are:
- Family and informal carers are faced with enormous challenges and do not receive adequate support;
- Patient and family education need to be established as a central pillar of nursing care in the community. However, currently it is neither part of the standard services available to consumers nor is adequate reimbursement available for providers of community care;
- Interprofessional collaboration between nurses, GPs and other health care providers is lacking, because of dysfunctional integration of services in the community and a lack of reimbursement;
- Lack of research activities directed at home care/community care.
These issues impede the responsiveness and sustainability of the primary care and home care/community care response to the COVID-19 pandemic in Germany.