Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Publication Date: 2010-10-09
    Description: Critical care medicine frequently involves decisions and measures that may result in significant consequences for patients. In particular, mistakes may directly or indirectly derive from daily routine processes. In addition, consequences may result from the broader pharmaceutical and technological treatment options, which frequently involve multidimensional aspects. The increasing complexity of pharmaceutical and technological properties must be monitored and taken into account. Besides the presence of various disciplines involved, the provision of 24-hour care requires multiple handovers of significant information each day. Immediate expert action that is well coordinated is just as important as a professional handling of medicine's limitations.Intensivists are increasingly facing professional quality management within the ICU (Intensive Care Unit). This article depicts a practical and effective approach to this complex topic and describes external evaluation of critical care according to peer reviewing processes, which have been successfully implemented in Germany and are likely to gain in significance.
    Description: Alle intensivmedizinischen Maßnahmen haben in der Regel tief greifende Konsequenzen für den Patienten, auch Fehler, die sich direkt oder indirekt aus den täglichen Prozessen ergeben. Aus immer breiteren medikamentösen und apparativen Therapiemöglichkeiten ergeben sich zunehmend mehrdimensionale Sichten, die nicht selten weitere Konsequenzen nach sich ziehen. Fortwährend komplexere Medikamentenwirkungen und technische Funktionen müssen stets kontrolliert und bedacht werden. Die 24-stündige Versorgung der Patienten macht die tägliche Präsenz von unterschiedlichen Kollegen erforderlich, große Mengen von Informationen müssen mehrmals täglich übertragen werden. Schnelles, koordiniertes Handeln durch Experten ist ebenso notwendig wie der professionelle Umgang mit den Grenzbereichen der Medizin.Ein professionelles Qualitätsmanagement in der Intensivmedizin rückt zunehmend in den Fokus der Intensivmediziner. Dieser Artikel bietet einen praxisnahen und effektiven Ansatz, das komplexe Thema des Qualitätsmanagement in der Intensivmedizin unkompliziert und effizient anzugehen. Die externe Evaluation in Form von intensivmedizinischen Peer Reviews wird hierbei näher beschrieben, als ein Verfahren, welches in Deutschland bereits sehr erfolgreich umgesetzt wird und zukünftig weiter an Bedeutung gewinnen wird.
    Keywords: peer review ; quality management ; intensive care medicine ; evidence based medicine ; effectiveness ; Peer Review ; Qualitätsmanagement ; Intensivmedizin ; evidenzbasierte Medizin ; Effektivität ; ddc: 610
    Language: English
    Type: article
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    Publication Date: 2010-09-28
    Description: In order to improve quality (of therapy), one has to know, evaluate and make transparent, one's own daily processes. This process of reflection can be supported by the presentation of key data or indicators, in which the real as-is state can be represented. Quality indicators are required in order to depict the as-is state.Quality indicators reflect adherence to specific quality measures. Continuing registration of an indicator is useless once it becomes irrelevant or adherence is 100%. In the field of intensive care medicine, studies of quality indicators have been performed in some countries. Quality indicators relevant for medical quality and outcome in critically ill patients have been identified by following standardized approaches.Different German societies of intensive care medicine have finally agreed on 10 core quality indicators that will be valid for two years and are currently recommended in German intensive care units (ICUs).
    Description: Um die (Behandlungs-)Qualität zu verbessern, muss man die eigenen Alltagsprozesse kennen und evaluieren, Transparenz erzeugen. Die Reflexion kann durch die Präsentation von Kennzahlen oder Indikatoren unterstützt werden, in denen der tatsächliche IST-Zustand dargestellt wird. Um dieses IST aufzuzeigen werden Qualitätsindikatoren benötigt. Qualitätsindikatoren zeigen den Erreichungsgrad einer spezifischen Qualität hin. Stellt sich ein Indikator als nicht mehr relevant heraus oder wird ein Erreichungsgrad von 100% erzielt, ist die weitere Erfassung eines solchen Indikators überflüssig.Für die Intensivmedizin gibt es in unterschiedlichen Ländern Untersuchungen von Qualitätsindikatoren. In standardisierten Verfahren wurden jeweils verschiede Indikatoren detektiert, die eine Relevanz besitzen in Hinblick auf die medizinische Behandlungsqualität und damit auf das Outcome von Intensivpatienten. In enger Abstimmung haben in Deutschland die intensivmedizinischen Fachgesellschaften 10 Kern-Qualitätsindikatoren für die Intensivmedizin verabschiedet, die mit einer Gültigkeit von 2 Jahren für deutsche Intensivstationen empfohlen werden.
    Keywords: quality indicators ; quality management ; intensive care medicine ; quality of therapy ; outcome ; Qualitätsindikator ; Qualitätsmanagement ; Intensivmedizin ; Behandlungsqualität ; Outcome ; ddc: 610
    Language: English
    Type: article
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    facet.materialart.
    Unknown
    German Medical Science GMS Publishing House; Düsseldorf
    In:  Jahrestagung der Arbeitsgemeinschaft für medizinisches Bibliothekswesen (AGMB); 20170925-20170927; Wien; DOC17agmb03 /20170717/
    Publication Date: 2017-07-17
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
    Signatur Availability
    BibTip Others were also interested in ...
  • 4
    facet.materialart.
    Unknown
    German Medical Science; Düsseldorf, Köln
    In:  Jahrestagung der Gesellschaft für Medizinische Ausbildung - GMA; 20061110-20061112; Köln; DOC06gma149 /20061023/
    Publication Date: 2006-10-23
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
    Signatur Availability
    BibTip Others were also interested in ...
  • 5
    facet.materialart.
    Unknown
    German Medical Science; Düsseldorf, Köln
    In:  Jahrestagung der Gesellschaft für Medizinische Ausbildung - GMA; 20061110-20061112; Köln; DOC06gma151 /20061023/
    Publication Date: 2006-10-23
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
    Signatur Availability
    BibTip Others were also interested in ...
  • 6
    facet.materialart.
    Unknown
    German Medical Science GMS Publishing House; Düsseldorf
    In:  18. Deutscher Kongress für Versorgungsforschung (DKVF); 20191009-20191011; Berlin; DOC19dkvf163 /20191002/
    Publication Date: 2019-10-03
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
    Signatur Availability
    BibTip Others were also interested in ...
  • 7
    ISSN: 1432-1238
    Keywords: Airway occlusion pressure ; Mechanical ventilation ; Weaning ; Respirator technology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The airway occlusion pressure, P0.1, is an index for the neuro-muscular activation of the respiratory system. It has been shown to be a very useful indicator for the ability of patients receiving ventilatory support to be weaned from mechanical ventilation. Since the standard measurement technically complex, it is not widely available for clinical purposes. For that reason a P0.1 measurement technique was developed as an integrated function in a standard respirator (Evita, Dräger, Lübeck, Germany). This technique is easy to use and does not need any further equipment. We validated this new technique by comparing it to standard P0.1 measurements in a mechanical lung model as well as in ventilated patients. In the lung model we found a correlation between the Evita measurement and standard measurements ofr=0.99. In 6 ventilated patients the correlation wasr=0.78. Since the Evita P0.1 and the standard measurement had to be performed during two different breaths, this little poorer correlation in patients may be due to a significant breath-by-breath variability in P0.1. Comparing the Evita P0.1 and the standard measurement within one breath resulted in a clearly better correlation (r=0.89). We conclude that this new measurement technique provides and easy and accurate P0.1 measurement using standard respiratory equipment when tested in a lung model. In patient measurements the method is less precise, which is probably due to the variable waveforms of the inspiratory driving pressure seen in patients, for example when intrinsic PEEP is present. However, the new method makes the P0.1 measurement as a “bed-side” method clinically available, although the values should be interpreted cautiously.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 23 (1997), S. 1105-1107 
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 9
    ISSN: 1432-1238
    Keywords: Key words Prostacyclin ; Nitric oxide ; Hypoxic pulmonary vasoconstriction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To compare the effect of different concentrations of inhaled nitric oxide and doses of nebulized prostacyclin on hypoxia-induced pulmonary hypertension in pigs.¶Design: Prospective, controlled animal study.¶Setting: Animal research facilities of an university hospital.¶Interventions: After reducing the fraction of inspired oxygen (FIO2) from 1.0 to 0.1, two groups of five pigs each were submitted to inhalation of three concentrations of nitric oxide (5, 10 and 20 ppm) or three doses of prostacyclin (2.5, 5, 10 ng × kg–1× min–1).¶Results: All doses of prostacyclin and concentrations of nitric oxide resulted in a decrease in mean pulmonary arterial pressure and pulmonary vascular resistance when compared to hypoxic ventilation (p 〈 0.001) which was independent of the dose or concentration of either drug used. While inhalation of nitric oxide caused a reduction in mean pulmonary arterial pressure back to values obtained during ventilation with FIO2 1.0, values achieved with prostacyclin were still significantly higher when compared to measurements prior to the initiation of hypoxic ventilation. However, direct comparison of the effect of 20 ppm nitric oxide and 10 ng × kg–1× min–1 prostacyclin on mean pulmonary arterial pressure revealed no differences between the drugs. All other hemodynamic and gas exchange parameters remained stable throughout the study.¶Conclusions: Inhalation of clinically used concentrations of nitric oxide and doses of prostacyclin can decrease elevated pulmonary arterial pressure in an animal model of hypoxic pulmonary vasoconstriction without impairing systemic hemodynamics or gas exchange.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 10
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...