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Background In the research network of German university palliative care centers (PallPan), as part of Network University Medicine (NUM), recommendations for action were developed in regard to the care provided for seriously ill and dying patients during a pandemic. For this purpose, the experiences and needs of hospital staff working closely with patients outside of specialized palliative care units during the first wave of the COVID-19 pandemic were also examined. Materials and methods Nationwide online survey of 8,882 physicians, nurses and therapists working in acute inpatient care in the period from December 2020 to January 2021 by means of a newly developed and piloted questionnaire on changes, burdens and cooperation with specialized palliative care. Grouping based on the changes in the number of seriously ill and dying people in the first wave of the pandemic. Due to the exploratory character of the survey, the data were analyzed descriptively. Results 505/8882 completed questionnaires were evaluated (5.7 %). 167/505 (33.1 %) of the respondents reported a lower quality of care for the critically ill and dying. 464/505 (91.8 %) reported exemptions in place for visiting the dying. The most frequently mentioned stress factor was the perceived loneliness of the seriously ill and dying 437/505 (86.5 %), followed by stricter hygiene rules 409/505 (81 %), increased workload 372/505 (73.3 %) and perceived psychological stress on relatives and survivors 395/505 (78.2 %). 141/505 (27.9 %) of respondents used Tablet PCs to support patient-family communication. 310/505 (61.4 %) involved palliative care professionals in patient care, and 356/505 (70.5 %) of respondents found other palliative care services helpful. Conclusion Experiences and suggestions for improving palliative care in pandemic times are integrated into the PallPan recommendations for action. Family visits should be allowed and supplemented by digital offers. Palliative Care should also be integrated into

Eine invasive mechanische Beatmung kann beendet werden durch sofortige (palliative) Extubation oder durch schrittweise Reduktion der Beatmung mit Belassen des Beatmungszugangs (terminales Weaning). Beide Verfahren sind ethisch gleichwertig und im Alltag durchfuhrbar, sodass individuelle Patientenfaktoren und die Erfahrung des Behandlungsteams ausschlaggebend sind. Im Vordergrund steht immer das Ziel: Patient und Angehorige sollen nicht leiden.

Background A palliative care team is recognized as a quality indicator in the consultation and care of patients with a tumor disease and is used nationally (92 %) in the National Cancer Institutes, model of the German Comprehensive Cancer Center (CCC). This begs the question of how palliative care teams are presently integrated into the CCCs. Method From July to August 2017, a paper-based quantitative survey of 16 locations of the CCCs, supported to that date, gathered information on the existence, personnel situation, use and prospects of a specialized inpatient palliative care service. The survey was addressed to the heads of the palliative medical units of the CCCs. The data were evaluated in SPSS (frequency, median, mean, range). Results Fifteen CCCs took part in the survey (response 94 %). Thirteen of the fifteen CCCs have a service that also treats palliative patients. Twelve of thirteen CCCs of these are attainable during regular working hours (8a. m.-4p. m. on weekdays). All services are staffed by physicians, additional eleven are staffed by nurses. Seven services are besides physicians and nurses joined by other professions. In 2016, 4482 median co-treatments were provided by the services, 80 % of these as additional charges without revenue and without codable OPS. In 2017, five centers plan to charge ZE 2017-133, two centers ZE 60 and three centers both intend to charge ZE 2017-133. Conclusions Services for palliative patients exist generally in the German CCCs, but only half of them satisfy the condition of multi-professionality required for the fulfillment of the german guidelines. The new surcharge introduced in 2017, which can be charged on an hourly basis, could create improvements in this regard and contribute to cost recovery. Thus, contrary to the previous arrangement, essential and reasonable performances with a time of treatment of less than seven days can be charged.