National Preventive Mechanism
In the view of the NPM, supervisory controls concentrate above all on structural
circumstances (staffing ratios, staff qualifications, occupancy rates and other
issues related to staffing) and nursing processes. Because the focus on quality of
processes and structures remains limited, very few indications concerning the
quality of nursing and care services are available to supervisory authorities.
Objective indicators of quality nursing, such as the number of restrictions of
freedom, the frequency and consequences of falls, the number and severity of
pressure sores, the emergence of catheter infections, drug administration errors,
weight loss, etc. are collected by supervisory authorities on a rudimentary
basis during regulatory controls, but are not made available for use in order
to make comparisons between institutions. A systematic approach as part of
a comprehensive quality assurance concept would also make it possible to
measure the level of satisfaction with nursing and care services for residents,
relatives and staff. A transparent and rigorous quality assessment of nursing
care outcomes is only in its infancy in Austria, as was substantiated in detail in
the 2013 report by Gesundheit Österreich GmbH (or GÖG – national research
and planning institute for health care).
In October 2016 investigations were initiated by the public prosecutors’ office
in a nursing home in Lower Austria, which had repeatedly been awarded
the National Quality Certificate for residential and nursing homes in Austria
(NQC). Four nurses in a ward are suspected of having subjected nursing care
patients to serious physical abuse over a period of months. Amongst other
things it was reported that whilst they were working night shifts together,
hairspray was sprayed into the faces of the patients, faeces was stuffed into
their mouths and essential spirits were rubbed into their eyes and genitals.
NQC does not safeguard against violence
and abuse
The NQC is an award for homes that have introduced particular quality
management systems and that make systematic efforts – over and beyond
compliance with statutory requirements – to achieve the best possible
individual quality of life. Here too, despite the external evaluation carried
out by the NQC, it can be the case that nursing care results differ significantly
from standards that have supposedly been achieved. In terms of preventive
aspects, the question arises for the NPM as to which safeguards would have
been required in order to avoid abuse or at least to be able to recognise it at a
significantly earlier stage. This aspect will be considered by the NPM after the
2017 findings of Commission 6 have been presented.
In the face of this sobering conclusion, the Jubiläumsfonds of the Austrian
National Bank must be thanked for providing the NPM its support which
made possible realisation of a practical study. This study carried out by Petra
Niederhametner (project head: Stefan Titscher, university professor emeritus)
is dedicated to the prevention of human rights violations in nursing homes
and psychiatric wards. It considers the issue of where vulnerable situations
from a human rights perspective arise and how they can be defused. Risks and
preventive measures are addressed in detail in eight of the main monitoring
Prevention study „Avoiding violations of
human rights“
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