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Abstract Background PRiVENT (PRevention of invasive VENTilation) is an evaluation of a bundle of interventions aimed at the prevention of long-term invasive mechanical ventilation. One of these elements is an e-learning course for healthcare professionals to improve weaning expertise. The aim of our analysis is to examine the implementation of the course in cooperating intensive care units. Methods The course has been developed through a peer review process by pulmonary and critical care physicians in collaboration with respiratory therapists, supported by health services researchers and a professional e-learning agency. The e-learning platform “weLearn” was made available online to participating healthcare professionals. Feedback on the e-learning programme was obtained and discussed in quality circles (QCs). We measured the acceptance and use of the programme through access statistics. Results The e-learning course “Joint Prevention of Long-Term Ventilation” consists of 7 separate modules with practice-oriented training units as well as a cross-module area and corresponding interactive case studies. Users can receive 23 CME (continuing medical education) credits. The platform was released on July 1, 2021. By June 28, 2023, 214 users from 33 clinics had registered. Most users (77–98%) completed the modules, thus performing well in the test, where 90–100% passed. In the QCs, the users commended the structure and practical relevance of the programme, as well as the opportunity to earn CME credits. Conclusion Especially for medical staff in intensive care units, where continuous training is often a challenge during shift work, e-learning is a useful supplement to existing medical training. Trial registration The PRiVENT study is registered at ClinicalTrials.gov (NCT05260853) on 02/03/2022.

Abstract Background Long-term invasive mechanical ventilation (IMV) is a major burden for those affected and causes high costs for the health care system. Early risk assessment is a prerequisite for the best possible support of high-risk patients during the weaning process. We aimed to identify risk factors for long-term IMV within 96 h (h) after the onset of IMV. Methods The analysis was based on data from one of Germany's largest statutory health insurance funds; patients who received IMV ≥ 96 h and were admitted in January 2015 at the earliest and discharged in December 2017 at the latest were analysed. OPS and ICD codes of IMV patients were considered, including the 365 days before intubation and 30 days after discharge. Long-term IMV was defined as evidence of invasive home mechanical ventilation (HMV), IMV ≥ 500 h, or readmission with (re)prolonged ventilation. Results In the analysis of 7758 hospitalisations, criteria for long-term IMV were met in 38.3% of cases, of which 13.9% had evidence of HMV, 73.1% received IMV ≥ 500 h and/or 40.3% were re-hospitalised with IMV. Several independent risk factors were identified (p

Introduction: In the context of a GP-based care programme, we implemented an admission, discharge and follow-up programme. Description: The VESPEERA programme consists of three sets of components: pre-admission interventions, in-hospital interventions and post-discharge interventions. It was aimed at all patients with a hospital stay participating in the GP-based care programme and was implemented in 7 hospitals and 72 general practices in southwest Germany using a range of strategies. Its’ effectiveness was evaluated using readmissions within 90 days after discharge as primary outcome. Questionnaires with staff were used to explore the implementation process. Discussion: A statistically significant effect was not found, but the effect size was similar to other interventions. Intervention fidelity was low and contextual factors affecting the implementation, amongst others, were available resources, external requirements such as legal regulations and networking between care providers. Lessons learned were derived that can aid to inform future political or scientific initiatives. Conclusion: Structured information transfer at hospital admission and discharge makes sense but the added value in the context of a GP-based programme seems modest. Primary care teams should be involved in pre- and post-hospital care. Abstrakt Einleitung: Im Rahmen der hausarztzentrierten Versorgung wurde ein Programm zur Verbesserung von Krankenhausaufnahmen und -entlassungen sowie der Nachsorge implementiert. Beschreibung: Das VESPEERA-Programm bestand aus verschiedenen Komponenten, die vor der Aufnahme, während des Krankenhausaufenthalts sowie nach der Entlassung durchgeführt wurden. Das Programm richtete sich an alle Patienten mit einem Krankenhausaufenthalt, die an der hausarztzentrierten Versorgung teilnahmen und wurde in 7 Krankenhäusern und 72 Hausarztpraxen in Südwestdeutschland unter Anwendung einer Reihe von Strategien implementiert. Seine Wirksamkeit wurde anhand des primären Endpunkts “Rehospitalisierungen innerhalb von 90 Tagen nach der Entlassung” bewertet. Anhand einer Fragebogenbefragung beim Personal wurde der Implementierungsprozess untersucht. Diskussion: Ein statistisch signifikanter Effekt konnte nicht gefunden werden, die Effektgröße war jedoch ähnlich wie bei anderen Interventionen. Die Interventionstreue war gering. Kontextfaktoren, die die Implementierung beeinflussten, waren unter anderem verfügbare Ressourcen, externe Anforderungen wie gesetzliche Vorschriften und die Vernetzung von Leistungserbringern. Es wurden Schlussfolgerungen gezogen, die für künftige politische oder wissenschaftliche Initiativen hilfreich sein können. Schlussfolgerung: Eine strukturierte Informationsweitergabe bei der Aufnahme und Entlassung aus dem Krankenhaus ist sinnvoll, doch scheint der zusätzliche Nutzen im Rahmen der hausarztzentrierten Versorgung begrenzt. Teams der Primärversorgung sollten in die prä- und poststationäre Versorgung einbezogen werden. Schlagwörter: Übergänge in der Versorgung; Einweisungsmanagement; Nachsorge nach Entlassung; Krankenhauswiederaufnahmen; Versorgungskontinuität; starke Primärversorgung; integrierte Versorgung