Der Einfluss einer digitalen klinischen Dokumentation auf die Patientensicherheit in einem Universitätsklinikum

The ultimate goal of digitalization in healthcare is optimized, safe and efficient patient care. To achieve this goal, the E-Health Act stipulates that every patient receives a digital data pool with all health-relevant information that all healthcare providers can access. In this way, competencies are to be combined and costs and time expenditure can be reduced. The basis for this project is a digital documentation of all medical facilities. The Department of Oral and Maxillofacial Surgery at Göttingen University Hospital has been working with a digital patient file in the Meona software since June 2020. In this study, 100 analog and 100 digital patient files were analyzed to clarify whether digital documentation can contribute to greater patient safety. Using common statistical mean and group comparisons, data quality and quantity of both sample groups were compared.The analysis revealed superior quality of the digital documentation compared to the paperfiles. The better overview, traceability and readability that result of digitally documented clinical data offer great advantages in the area of patient and employee safety. When it comes to medication, the digital file is also superior to the analog file thanks to e.g. its precise orders and color markings. The digital signature and perfect readability also offer advantages in terms of communication as well as legal protection. Digital documentation therefore represents an elemental part on the way to safe and optimized patient care.Höchstes Ziel der Digitalisierung im Gesundheitswesen ist eine optimierte, sichere und effiziente Patientenversorgung. Das E-Health-Gesetz sieht zum Erreichen dieses Ziels vor, dass jeder Patient einen Datenpool mit allen gesundheitlich relevanten Daten erhält, auf den alle Akteure des Gesundheitswesens zugreifen können. Auf diese Weise sollen Kompetenzen vereint sowie Kosten- und Zeitaufwand gesenkt werden. Grundlage für dieses Vorhaben ist eine digitale Dokumentation der medizinischen Einrichtungen. In der Abteilung für Mund-, Kiefer- und Gesichtschirurgie des Universitätsklinikums Göttingen wird seit Juni 2020 mit der digitalen Patientenakte in der Software Meona gearbeitet. In dieser Studie wurden 100 analoge und 100 digitale Patientenakten miteinander verglichen, um zu klären, ob eine digitale Dokumentation zu einer größeren Patientensicherheit beitragen kann. Mittels gängiger statistischer Mittelwert- und Gruppenvergleiche wurden Datenqualität und -quantität beider Stichprobengruppen verglichen.Die Analyse ergab eine überlegene Qualität der digitalen Dokumentationsform. Die bessere Übersicht, Rückverfolgbarkeit und Leserlichkeit der Einträge in digitaler Form bieten große Vorteile auf dem Gebiet der Patienten- und Mitarbeitersicherheit. Auch in Bezug auf die Medikation ist die digitale Akte durch präzise Anordnungen und farbliche Markierungen als Kontrollinstanz der analogen Akte überlegen. Die digitale Signatur und einwandfreie Leserlichkeit bieten außerdem Vorteile hinsichtlich Kommunikation und rechtlicher Absicherung. Eine digitale Dokumentation stellt somit einen elementaren Baustein auf dem Weg zu einer sicheren und optimierten Patientenversorgung dar

Guideline-adherent inpatient psychiatric psychotherapeutic treatment of behavioral and psychological symptoms of dementia. Normative definition of personnel requirements

Dementia is of increasing medical and societal relevance. Hospitalization of dementia patients is mostly due to behavioral and psychological symptoms of dementia (BPSD). There is a need for sufficient qualified personnel in hospitals in order to be able to effectively treat these symptoms. This study aims at identifying the personnel requirements for guideline-conform, evidence-based inpatient treatment concepts for patients with BPSD and to compare these with the resources defined by the German psychiatric personnel regulations (Psych-PV). Furthermore, it was the aim to identify how often patients with dementia received non-pharmacological therapy during inpatient treatment. Based on the current scientific evidence for treatment of BPSD, a schedule for a multimodal non-pharmacological treatment was defined and based on this the corresponding personnel requirements were calculated. Using the treatment indicators in psychiatry and psychosomatics (VIPP) database as a reference, it was calculated on what proportion of treatment days patients were classified into G1 according to the German Psych-PV and at least once received more than two treatment units per week. For the implementation of a guideline-oriented and evidence-based treatment plan, a higher need for personnel resources than that provided by the Psych-PV was detected in all areas. Currently patients with dementia who received at least more than two treatment units per week during inpatient hospitalization, were classified into G1 according to German Psych-PV on 17.9 % of treatment days. Despite evidence for the efficacy of non-pharmacological treatment measures on BPSD, these forms of treatment cannot be sufficiently provided under the current conditions. The realization of a new quality controlled therapeutic concept is necessary to enable optimized treatment of patients with BPSD

Evolution of psychosocial burden and psychiatric symptoms in patients with psychiatric disorders during the Covid-19 pandemic

The Covid-19 pandemic highly impacts mental health worldwide. Patients with psychiatric disorders are a vulnerable risk population for worsening of their condition and relapse of symptoms. This study investigates the pandemic-related course of psychosocial burden in patients with pre-existing mental disorders. With the newly developed Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) psychosocial burden has been traced retrospectively (1) before the pandemic (beginning of 2020), (2) at its beginning under maximum lockdown conditions (March 2020), and (3) for the current state after maximum lockdown conditions (April/May 2020). The Goe-BSI also integrates the Adjustment Disorder New Module (ADNM-20), assesses general psychiatric symptoms, and resilience. A total of 213 patients covering all major psychiatric disorders (ICD-10 F0-F9) were interviewed once in the time range from April, 24th until May 11th, 2020. Across all diagnoses patients exhibited a distinct pattern with an initial rise followed by a decline of psychosocial burden (p < 0.001, partial η2 = 0.09; Bonferroni-corrected pairwise comparisons between all three time-points: p < 0.05 to 0.001). Female gender and high ADNM-20 scores were identified as risk factors for higher levels and an unfavorable course of psychosocial burden over time. Most psychiatric symptoms remained unchanged. Trajectories of psychosocial burden vary in parallel to local lockdown restrictions and seem to reflect an adaptive stress response. For female patients with pre-existing mental disorders and patients with high-stress responses, timely and specific treatment should be scheduled. With the continuation of the pandemic, monitoring of long-term effects is of major importance, especially when long incubation times for the development of mental health issues are considered