[The Neumarkt concept of nursing case responsibility: A framework for consequent and person-centred realization of the nursing process]

The Neumarkt concept of nursing case responsibility: A framework for consequent and person-centred realization of the nursing process Abstract. Background: An essential requirement for the realization of person-centred practice is a practice environment, that supports the forming of professional nurse-patient-relationships. Therefore, Klinikum Neumarkt implemented in context of practice development a concept for nursing case responsibility, that offers a framework for a person-centred and systematic coordination of the nursing process. Because of the existing conflict between economic and nursing interests, it is essential to prove the effectiveness of the concept. Aim: Our aim was the exploration of the effects of the concept implementation from the patient's as well as the interprofessional team's perspective, including the economic implications. Methods: The multiperspective evaluation was conducted with individual interviews and an economic analysis of hospital routine data. Results: The patients and the interprofessional team perceive a person-centred care and coordination of the nursing process. They also point out the required resources. The economic results show a significantly increased revenue through better documentation of complex nursing situations of patients included in the concept (Odds ratio: 4.00, 95%-Confidence Interval [2.15; 8.01], p < 0.001). Discussion: The results provide evidence of the efficacy of the concept for a systematic, person-centred coordination of the nursing process and justify an increased use of resources needed. Limitations and transfer: The implementation of the concept is a drastic change for everyone involved and needs to be embedded in a strategic practice development.

Displacement trauma: complex states of personal, collective and intergenerational fragmentation and their intergenerational transmission

Originally presented at the Journal's one day conference entitled 'Displacement: Contemporary Traumatic Experience' held in London in November 2019, this paper expands on the author's theory of the implicit psychological organizing gestalt, an associated pattern of psychic functions which operate in an integrated way to simultaneously structure and organize our experience of self-cohesion and self-continuity. The gestalt, which implicitly links the formation of psychic skin, body image, cultural skin and both personal and cultural identity with place, functions as an emergent non-conscious permanent presence or background 'constant'. It develops over time and emerges out of embodied emotional experiencing with the total environment - both human and non-human. The author argues that it is the rupture of this gestalt and the disorganizing consequences of its loss which underlies the experience of displacement trauma. If disruptions in the formation of the gestalt and/or its later rupture remain unrecognized and unrepresented then the absence creates a void which can be intergenerationally transmitted. Case material is presented which describes this and which highlights the ways in which the gestalt can contribute to our understanding of collective displacement anxiety, cultural trauma and cultural complexes.