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Abstract Background Demographic changes in Germany are increasing the number of outpatient care recipients, who often resort to emergency care due to difficulties accessing timely outpatient medical care. Previous studies suggest that early detection and telemedical interventions could reduce unnecessary hospitalizations. The new form of healthcare aims to provide continuous, flexible healthcare for outpatient care recipients using digital technologies to detect health deteriorations and facilitate interventions at home. The goal of our study is to evaluate, whether the number of emergency situations and hospital stays will be reduced, and health outcomes will be improved compared to standard care. Methods In this prospective non-randomized complex intervention study with a pragmatic approach, we aim to evaluate a new form of healthcare focused on establishing an interdisciplinary network for outpatient care in the homes of care-dependent individuals. Utilizing a digital interactive health diary, health data will be gathered from participants, caregivers, and healthcare providers, covering both stable primary care and acute situations. A telemedical network will coordinate measures, including non-medical aid, nursing care, and medical assistance. A total of 1,500 participants will be recruited for the intervention group, matched with a control group from health insurance data. A second control group with n=300 will provide self-reported measures. The study is planned to span eight quarters, with data collected from the digital interactive health diary and health insurance records. Evaluation perspectives include health insurance, patients, and healthcare providers, assessing utilization and costs compared to standard care, health status, health-related quality of life, care dependency, interdisciplinary cooperation, and usability of the new technology. Discussion Demographic change results in a larger older people population, exacerbating mobility issues and care dependency, worsened by the shortage of medical personnel. Stay@Home – Treat@Home aims to enable home health monitoring and care, reducing hospitalizations. The digital interactive health diary supports direct communication, allows remote monitoring, and empowers patients and caregivers to manage health changes. Nursing aid personnel and physicians can access entries for informed interventions. The development of the digital interactive health diary aims to improve the situation of care-dependent individuals. Evaluating its effectiveness and efficiency is crucial for the development and implementation of new technologies. Trial registration German Clinical Trials Register, ID: DRKS00034260, registered on May 14, 2024 (retrospectively registered): https://drks.de/search/de/trial/DRKS00034260 and https://who.int/clinical-trials-registry-platform/network/who-data-set .

Abstract Aim To identify factors for and perceived consequences of nursing errors by nursing staff in home care services in correlation with qualification, work experience, working hours and trainings. Background Patient safety has increasingly been brought into focus of politics and care practices over the past few years. However, little evidence has been provided yet on nursing errors in out‐of‐hospital settings. Design A cross‐sectional study. Methods Randomized sample of 107 home care services and 656 nurses and nursing assistants recruited from all 16 federal states in Germany. Results Missing trainings on error management within the past 2 years were identified to be an important factor for mistakes regarding hygienic measures and medication administration. However, most errors arose in documentation without any significant differences in qualification, work experience, training and working hours. Conclusion Findings indicate that insufficient hygiene and medication administration might be reduced by implementing error management trainings on a regular basis in home care services.

Abstract Background The use of technical solutions and conventional mobility supporting aids can support the independence of people into old age in their own homes. However, we found relatively few empirical investigations on the effects and costs of these systems. Methods The aim of the study was to investigate usability, user satisfaction and the correlation between costs and benefits of different built-in smart home solutions and conventional mobility supporting tools in the home of elderly, partially care-dependent tenants (> 65 years). A cross-sectional survey was conducted from February to March 2018 with tenants of a housing association in apartments equipped with smart home technology and conventional mobility supporting tools. The response rate in the intervention group was n = 37 persons (out of 46 tenants with installed smart home and conventional solutions) and in the control group n = 64 persons (out of 100 tenants without built-in smart home and conventional solutions). Data were collected by a written questionnaire regarding usability and satisfaction of the tenants with the built-in smart home solutions and conventional mobility supporting tools. In addition, both the intervention and the control group were asked general questions about communication, safety and how to deal with the need for long-term care in their own living environment. Results Results showed that with regard to usability, satisfaction and price performance ratio of the installed smart home solutions, the installation of the corresponding solutions with an overall score of 1.41 (on a scale of 1 (very good) to 6 (unsatisfactory)) was mostly positively evaluated by the tenants. Overall, users rated the installed smart home solutions better than the conventional mobility supporting tools (such as handholds and increased balcony floor level). Conclusions Analysis of the price performance ratio showed that smart home solutions are generally more expensive than conventional tools, but also contribute significantly to an increased security of the tenants, and thus may enable longer living in a familiar environment. We recommend modularized offers consisting of various components of smart home solutions, since this significantly reduces installation costs and allows for an individual composition according to requirements. Moreover, smart home solutions should be considered to be listed as medical aids.

Purpose: The purpose of this study was to evaluate associations among use of walking aids, mobility status, and occurrence of urinary incontinence (UI) in geriatric patients residing in nursing homes, and to examine associations between UI severity (frequency and amount) and its impact on health-related quality of life (QoL)., Design: Multicenter descriptive cross-sectional prevalence study., Subjects and Setting: A total of 2044 patients from nursing homes were included in the study. A majority were female (72.0%), the mean age of participants was 82.1 years (SD 11.2), their mean body mass index was 26.1 (SD 5.4), and their mean Care Dependency Scale score was 46.0 (SD 18.2), indicating a medium to high care dependency. The study setting was 30 nursing homes throughout Germany from 2014 to 2015., Methods: Data were collected by trained nurses using a standardized data collection form to collect information about demographic characteristics, health conditions, mobility status measured according to the Elderly Mobility Scale (EMS), UI, and QoL measured using the International Consultation of Incontinence Questionnaire Short Form (ICIQ-SF)., Results: The prevalence of UI was 69.7% (n = 1804). Analysis of variance showed that, in 1659 nursing home residents with information on UI, 572 reported a medium amount of leakage with a mean impact on health-related QoL of 2.2 (SD 2.2, P < .001) on a scale from 0 (no impact) to 10 (very high impact). The mean of the impact on QoL in 235 residents who reported a large amount of leakage was 2.4 (SD 3.0, P < .001). In 1741 residents with information on the frequency of UI, 637 reported being urinary incontinent more than once a day with a mean impact on QoL of 2.2 (SD 2.1, P < .001) and 359 residents with permanent UI stated a mean impact on QoL of 2.1 (SD 2.8, P < .001). According to the bivariate association of UI with use of walking aids, the highest prevalence of UI (61.2%) was in patients who did not use any walking aids. The Chi-square Automatic Interaction Detector (CHAID) of the relationship between mobility according to the EMS and UI indicated that 71.1% of all patients with UI did not use any walking aids, although their mobility status had been reduced., Conclusions: Findings indicate a significant association between impaired mobility and UI in nursing home residents. Chronic, severe urinary incontinence exerted the greatest impact on health-related QoL. Therefore, we recommend measures to preserve or regain mobility to minimize or prevent UI in geriatric residents and patients and, thus, increase their health-related QoL.