Quality indicators in intensive care medicine for Germany - fourth edition 2022.

The measurement of quality indicators supports quality improvement initiatives. The German Interdisciplinary Society of Intensive Care Medicine (DIVI) has published quality indicators for intensive care medicine for the fourth time now. After a scheduled evaluation after three years, changes in several indicators were made.

Disrupting and diversifying the values, voices and governance principles that shape biodiversity science and management.

With climate, biodiversity and inequity crises squarely upon us, never has there been a more pressing time to rethink how we conceptualize, understand and manage our relationship with Earth's biodiversity. Here, we describe governance principles of 17 Indigenous Nations from the Northwest Coast of North America used to understand and steward relationships among all components of nature, including humans. We then chart the colonial origins of biodiversity science and use the complex case of sea otter recovery to illuminate how ancestral governance principles can be mobilized to characterize, manage and restore biodiversity in more inclusive, integrative and equitable ways.

Fish, People, and Systems of Power: Understanding and Disrupting Feedback between Colonialism and Fisheries Science.

AbstractThis essay explores shifting scientific understandings of fish and the evolution of fisheries science, and it grapples with colonialism as a system of power. We trace the rise of fisheries science to a time when Western nation-states were industrializing fishing fleets and competing for access to distant fishing grounds. A theory of fishing called "maximum sustainable yield" (MSY) that understands fish species in aggregate was espoused.

Indicators are Relational: Navigating Knowledge and Power in the Development and Implementation of Coastal-Marine Indicators.

In many environment and resource management contexts (e.g., integrated coastal management, ecosystem-based fisheries management), indicator selection and development are perceived as a largely technical, bureaucratic, and scientific challenge.

Lessons from bright-spots for advancing knowledge exchange at the interface of marine science and policy.

Evidence-informed decision-making is in increasing demand given growing pressures on marine environments. A way to facilitate this is by knowledge exchange among marine scientists and decision-makers. While many barriers are reported in the literature, there are also examples whereby research has successfully informed marine decision-making (i.

The future development of intensive care quality indicators - a methods paper.

Medical quality indicators (QI) are important tools in the evaluation of medical quality. Their development is subject to specific methodological requirements, which include practical applicability. This is especially true for intensive care medicine with its complex processes and their interactions.

[Stressors for patients in the intensive care unit : An analysis taking controllability into consideration].

Objective: Studies on stress factors for patients in intensive care units (ICU) have so far concentrated on whether certain stressors have occurred or how stressful they were. There are no studies on stress for patients in ICUs that measured both the perception of stress and the chances perceived to control it; however, loss of control can result in long-term psychopathological consequences, such as depression or posttraumatic stress disorder. Therefore, a questionnaire was developed to evaluate the influence of controllability on perception of stress.

Clinical Nutrition in Critical Care Medicine - Guideline of the German Society for Nutritional Medicine (DGEM).

Purpose: Enteral and parenteral nutrition of adult critically ill patients varies in terms of the route of nutrient delivery, the amount and composition of macro- and micronutrients, and the choice of specific, immune-modulating substrates. Variations of clinical nutrition may affect clinical outcomes. The present guideline provides clinicians with updated consensus-based recommendations for clinical nutrition in adult critically ill patients who suffer from at least one acute organ dysfunction requiring specific drug therapy and/or a mechanical support device (e.

[DGEM Guideline "Clinical Nutrition in Critical Care Medicine" - short version].

Purpose: Variations of clinical nutrition may affect outcome of critically ill patients. Here we present the short version of the updated consenus-based guideline (S2k classification) "Clinical nutrition in critical care medicine" of the German Society for Nutritional Medicine (DGEM) in cooperation with 7 other national societies. The target population of the guideline was defined as critically ill adult patients who suffer from at least one acute organ dysfunction requiring specific drug therapy and/or a mechanical support device (e.

[Peer Review for Quality Management in Intensive Care Medicine].

We report on the German Peer Review procedure for the quality management of Intensive Care Wards. The third up-date of the quality-indicators was published in 2017. The Peer Review Procedure, its organization, the development of quality indicators in Germany and their benefit for the patients is introduced.

Intermediate care units : Recommendations on facilities and structure.

A growing number of patients with increasingly complex or specialized diseases are being treated in hospitals worldwide. The treatment requirements of some of these patients are exceeding the capacity of standard nursing units. However, the severity of these diseases or the treatment requirements for these specific clinical pictures do not always justify admission to an intensive care unit.

Quality indicators in intensive care medicine for Germany - third edition 2017.

Quality improvement in medicine is depending on measurement of relevant quality indicators. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI) from the year 2013 underwent a scheduled evaluation after three years. There were major changes in several indicators but also some indicators were changed only minimally.

[Adequate fluid resuscitation in septic shock with high catecholamine doses].

Background: Appropriate fluid resuscitation is a fundamental aspect for the hemodynamic management of septic shock patients and should ideally be achieved before vasopressors and positive inotropic substances are administered. The development of hemodynamic monitoring has revealed that in some cases patients had been improperly treated with high-dose catecholamines for initially insufficient fluid resuscitation. The aim of this study was to show that in some cases it is possible to actively reduce catecholamines by a volume challenge adapted according to the individual patient needs.

[Limitations of modern surgical intensive care medicine].

The attitude of humility in the context of surgical intensive care medicine incorporates a serving attitude towards the patient and the recognition of limitations in intensive care medicine. Limitations are set in the indications for intensive care medicine, in that which is medically possible and reasonable as well as ethically by the will of the patient which is binding for physicians. Furthermore, there are limitations due to available resources, due to the personal knowledge and abilities of the physician and the intensive care treatment team and due to the equipment in the intensive care ward.

The German quality indicators in intensive care medicine 2013--second edition.

Quality indicators are key elements of quality management. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI) from the year 2010 were recently evaluated when their validity time expired after two years. Overall one indicator was replaced and further three were in part changed.

Diffuse postoperative peritonitis -- value of diagnostic parameters and impact of early indication for relaparotomy.

Objective: Current criteria for performing relaparotomy for suspected peritonitis are non explicit and based on non-quantitative, subjective arguments or hospital practice. The aim of this study was to determine the value of routinely used clinical and diagnostic parameters in early detection of postoperative, diffuse peritonitis (PP). Furthermore, the prognosis and outcome after early indication for relaparotomy in patients with PP compared to community-aquired peritonitis (CAP) was evaluated.

[Delirium and intensive care unit syndrome].

Delirium and intensive care unit (ICU) syndrome are frequently seen postoperatively, especially in intensive care. Hospital mortality and complication rates are higher in patients with these disorders. Delirium is characterized by disturbance of consciousness and cognition and short development time.

Release of vancomycin and teicoplanin from a plasticized and resorbable gelatin sponge: in vitro investigation of a new antibiotic delivery system with glycopeptides.

Background: The aim of this study was to evaluate the efficacy of sustained release of vancomycin and teicoplanin from a resorbable gelatin glycerol sponge, in order to establish a new delivery system for local anti-infective therapy.

Materials And Methods: 60 plasticized glycerol gelatin sponges containing either 10 or 20% gelatin (w/v) were incubated in vancomycin or teicoplanin solution at 20 degrees C for either 1 or 24 h. In vitro release properties of the sponges were investigated over a period of 1 week by determining the levels of vancomycin and teicoplanin eluted in plasma using fluorescent polarization immunoassay.

[Pulmonary zygomycosis--a rare angioinvasive fungal infection].

Zygomycosis caused by Rhizopus species is an aggressive and rapidly progressive opportunistic fungal infection in immunocompromised patients. It comprises mucocutaneous, rhinocerebral, pulmonary, urological and disseminated infections. Predisposing factors are immunosuppression owing to severe diseases, immunological defects or metabolic disturbances like diabetic ketoacidosis.

[Recurrent Candida sepsis with prolonged respiratory failure and severe liver dysfunction].

Systemic mycoses, especially pulmonary diseases and septicemia are observed increasingly at intensive care units. Essential risk factors for development of candidosis are the expanded use of antibiotics and immunocompromised patients, caused either as a result of a severe underlying disease or iatrogenically induced after organ transplantation. Candida albicans is the most frequent pathogen in microbiological findings.