Treatment care

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Blood pressure measurement is subject to prescription as treatment care

As treatment care or rare special care in social legislation activities are understood to be on medical prescription nurses in the field of health and medical care , the pediatric care , and elder care are provided. These tasks include wound care , dressing changes , administration of medication, blood pressure and blood sugar measurement and medical assistance. The "treatment care " can be carried out on an inpatient or outpatient basis. In contrast, all nursing activities that serve the basic care of the person in need of care , for example personal hygiene , are referred to as basic care or direct care.

Both terms are considered out of date in nursing science .

History of the term

The pair of terms “basic and treatment care” was introduced in German-speaking countries in 1967 by the hospital economist Siegfried Eichhorn . The two terms emerged as translations from an English-language work from 1954. The dualism associated with this division of nursing practice between the provision of basic physical needs and medically prescribed activities was abandoned with a changing professional understanding and the emergence of nursing science in favor of a more holistic approach. In 2004 textbooks for nursing professions rejected the use of the terms if they were still mentioned. However, they were included in Section 37 of Book V of the Social Security Code (SGB V) and are also used there, although there is no legal definition .

Monika Krohwinkel adopted this terminology in the revision of her care model in 2013 and explains: “... The terms basic care and treatment care should be viewed as outdated. Instead, reference should be made to nursing and nursing's collaborative tasks, as was justified, examined and developed in the study on promoting process maintenance in connection with the management model. In this model, the main tasks and responsibilities of occupational nursing are not primarily assigned to the employee tasks for other professional groups, but rather to person-centered nursing in the direct nursing process, documentation and the person-oriented organization of nursing processes with the corresponding allocation of personnel, time and material resources. "

Legal basis in Germany

The concept of treatment care was included in the provisions of the fifth book of the Social Security Code on home nursing and is described in SGB ​​XI on long-term care insurance .

Treatment care measures may only be carried out and documented by specialist nurses in home nursing and inpatient care facilities. The term “specialist” refers to nurses who can prove an exam in one of the three nursing professions or a nursing degree in at least three years of training. The nursing professions exclusively include health and nurses, geriatric nurses, health and pediatric nurses.

In the area of ​​long-term care insurance there is no statutory minimum requirement for training or professional experience.

Up until 2007, inpatient treatment care services were either covered by the flat rate case or were included in the total budget of the nursing homes and thus free of charge for the health insurance companies. In 2007, the financing of treatment care was theoretically not taken over by the long-term care funds like basic care , but was billed individually as a service of the health insurance companies . This has been customary in outpatient care for a long time, here the medically necessary care is taken over on a prescription and is billed to the health insurance company. However, the health insurances regularly assume that if care allowance is granted, treatment care is also covered.

Treatment care services

In the directive on the regulation of home nursing care , the following activities are named as treatment care services that can be prescribed and approved:

  • Suctioning the upper airways; Bronchial toilet
  • Operation and monitoring of a ventilator
  • Bladder lavage
  • Blood pressure measurement
  • Blood glucose testing
  • Pressure ulcer treatment
  • Checking and supplying drainages
  • Support of stool elimination by means of enema (enema, enema), digital rectal removal
  • Fluid balance
  • intravenous infusions
  • subcutaneous infusions
  • Inhalations
  • subcutaneous and intramuscular injections
  • Instillation
  • Supply of a suprapubic catheter
  • Catheterization of the urinary bladder to drain urine
  • special patient observation
  • Symptom control in palliative care patients
  • Insertion and change of a nasogastric tube
  • Dispensing and administering medication; Carrying out the rehabilitation of MRSA carriers with a confirmed diagnosis
  • Care of a percutaneous endoscopic gastrostomy (PEG)
  • Psychiatric home nursing
  • Ostomy Treatment
  • Changing and maintaining tracheostomy tubes
  • Care of a central venous catheter (CVC)
  • Applying and changing wound dressings or supporting and stabilizing dressings; Applying or removing a compression bandage; Put on or take off medically prescribed compression stockings or tights

Austria

In Austria, treatment care is described in the so - called jointly responsible activity area of health and nursing, whereby the doctor is responsible for ordering and the nurse is responsible for implementation. Any medical prescription must be given in writing before it is carried out. In justified exceptional cases, the order can only be given orally for home nursing, but must be added in writing within 24 hours.

literature

  • Nicole Menche (Ed.): Pflege heute , Urban & Fischer bei Elsevier, 4th edition: July 4th, 2007, ISBN 343726771X
  • Liliane Juchli , Edith Kellnhauser , Susanne Schewior-Popp, Franz Sitzmann, Ursula Geißner, Martina Gümmer, Lothar Ulrich (eds.): THIEMEs care: Experience professionalism , Thieme, Stuttgart, 10th edition, April 2004, ISBN 3135000109
  • Ulrike Brög-Kurzemann, Hannes Sieber, Bernhard Weh: Basic care. Treatment care : structured according to AEDL , Vincentz Network GmbH & Co KG, 2000, ISBN 3878706200

Web links

Individual evidence

  1. ↑ www.g-ba.de Guideline of the Federal Joint Committee on the regulation of home nursing. As of September 2018. Accessed February 1, 2019.
  2. ↑ Heiner Friesacher: Theory and Practice of Nursing Action: Justification and Draft of a Critical Theory of Nursing Science, p. 192 f. Osnabrück University Press at V&R unipress GmbH, Osnabrück 2007, ISBN 978-3-89971-403-6 . Online: limited preview in Google Book search
  3. ↑ Michael Seidel: Treatment care in the disabled aid - guidelines for inpatient facilities of the working group health policy of the professional associations of the disabled aid, 2009. (PDF; 615 kB) Retrieved on August 15, 2011 .
  4. ↑ a b Beate Rennen-Allhoff: Handbook of nursing science. Study edition, p. 771 ff. Juventa Verlag, Weinheim 2003, ISBN 978-3-7799-0785-5 . Online: limited preview in Google Book search
  5. ↑ cf. also Müller 2001, Bartholomeycik 2005
  6. ↑ Krohwinkel, Monika. Promotional process maintenance with integrated ABEDLs. Research, theory and practice. Verlag Hans Huber: Bern 1st edition 2013, p. 154.
  7. ↑ Text of the law: Book of the Social Code, Eleventh Book, Social Care Insurance, Section 14. Accessed on August 16, 2011 .
  8. ↑ Robert Roßbruch u. SG Speyer: For the delegation of nursing care measures in inpatient care for the elderly . 2003 ( online [PDF]). PDF; 340 kB
  9. ↑ Stefan Görres u. a .: Strategies for quality development in nursing and care: Genesis, structures and future orientation of quality development in the care of people with care and assistance needs, p. 164 ff. Hüthig Jehle Rehm publishing group, Heidelberg 2005, ISBN 978-3-8114- 3449-3 . Online: limited preview in Google Book search
  10. ↑ §37 and 92 SGB V; §42, 43, 51 SGB XI and §43a Nursing Services Supplementary Act
  11. ^ Thomas Klie: Long-term care insurance: Introduction. Dictionary. Legal text SGB XI with justification and circular from the long-term care insurance funds. Ancillary laws. Materials. , Vincentz Network GmbH & Co KG, 2005, ISBN 387870125X , page 71
  12. ↑ www.g-ba.de Guideline of the Federal Joint Committee on the regulation of home nursing. As of September 2018, p. 3, 17–38. Retrieved February 8, 2019.
  13. ↑ §15 of the Austrian Health and Nursing Act GuKG