Praxisleitfaden Organspende

Der Praxisleitfaden Organspende orientiert sich am Aufbau und dem Inhalt der Richtlinie Spendererkennung der Bundesärztekammer. Kernelement der Richtlinie ist, dass die intensivmedizinisch tätige Ärzteschaft im Krankenhaus eine Organspende bei potenziellen Organspendern ermöglichen muss, wenn ein prinzipieller Wunsch zur Organspende besteht. Der Praxisleitfaden vermittelt das relevante Wissen zur Erkennung von potentiellen Organspendern und das Vorgehen bei diesem im komplexen klinischen Alltag eher seltenen Ereignisses. Auch der Spendeprozess wird im Hinblick auf die Spendererkennung grundlegend erörtert. Das Buch wendet sich an Ärztinnen und Ärzte auf den Intensivstationen, an die Transplantationsbeauftragten sowie an alle Health Professionals, die bei potenziellen Organspendern konfrontiert werden können

Praxisleitfaden Organspende

The Organ Donation Practice Guide is based on the structure and content of the donor identification guidelines of the German Medical Association. The core element of the guideline is that doctors working in intensive care medicine in hospitals must enable organ donation from potential organ donors if there is a fundamental wish to donate organs. The practical guide provides the relevant knowledge for recognizing potential organ donors and the procedure for this event, which is rather rare in complex everyday clinical practice. The donation process is also fundamentally discussed with regard to donor identification. The book is aimed at doctors in intensive care units, transplant officers and all health professionals who may be confronted with potential organ donors

Praxisleitfaden Organspende

Der Praxisleitfaden Organspende orientiert sich am Aufbau und dem Inhalt der Richtlinie Spendererkennung der Bundesärztekammer. Kernelement der Richtlinie ist, dass die intensivmedizinisch tätige Ärzteschaft im Krankenhaus eine Organspende bei potenziellen Organspendern ermöglichen muss, wenn ein prinzipieller Wunsch zur Organspende besteht. Der Praxisleitfaden vermittelt das relevante Wissen zur Erkennung von potentiellen Organspendern und das Vorgehen bei diesem im komplexen klinischen Alltag eher seltenen Ereignisses. Auch der Spendeprozess wird im Hinblick auf die Spendererkennung grundlegend erörtert. Das Buch wendet sich an Ärztinnen und Ärzte auf den Intensivstationen, an die Transplantationsbeauftragten sowie an alle Health Professionals, die bei potenziellen Organspendern konfrontiert werden können

Regional anaesthesia, local anaesthetics and the surgical stress response

Epidural anaesthesia has the potential to improve patients' outcome after major surgical procedures by reducing postoperative morbidity and duration of recovery. Possible benefits include the attenuation of cardiac complications, an earlier return of gastrointestinal function associated with an increase in patients' comfort overall, decreased incidence of pulmonary dysfunction, beneficial effects on the coagulation system and a reduction in the inflammatory response. The underlying mechanisms, however, remain unclear. Since local anaesthetics (LAs), reabsorbed from the epidural space, seem to contribute to these effects, it is not easy to differentiate between the systemic effects of LAs and the effects of neuraxial blockade by epidural anaesthesia. Thus, in patients not able or willing to receive intra- and/or postoperative epidural analgesia, systemic administration of LAs may be considered to be a new therapeutic approach for the prevention of postoperative disorders by modulation of the peri- and postoperative inflammator

Growing Pains at Hospitals: Opportunities and Issues of Service Expansion in Maximum Care

PurposeDue to the demographic change morbidity raises the demand for medical hospital services as well as a need for medical specialization, while economic and human resources are diminishing. Unlike other industries hospitals do not have sufficient data and adequate models to relate growing demands and increasing performance to growth in staff capacity and to increase in staff competences.MethodBased on huge medical data sample covering the years from 2010 to 2014 with more than 150,000 operations of the Department for Anesthesiology at the University Hospital Muenster, Germany, comparisons are drawn between the development of medical services and the development of personnel capacity and expertise.ResultsThe numbers of surgical operations increased by 21% and “skin incision to closure” time by 17%. Simultaneously, personnel capacity grew by 16% largely resting upon recruiting first-time employees. Expertise measured as “years of professional experience” dwindled from 10 years to 5.4 years on average and staff turnover accelerated.ConclusionStatic benchmark data collected at fixed reference dates do not sufficiently reflect the nexus between capacity and competence and do not reflect the dynamic changes in a hospital’s requirements for expertise and specialization, at all. Staff turnover leads to a loss of experience, which jeopardizes patient safety and hampers medical specialization. In consequence of the dramatic shortage of medical specialists, drop-off rates must be reduced and retention rates must be increased. To that end, working conditions need to be fundamentally converted for a multigeneration, multicultural, and increasingly female workforce

Growing Pains at Hospitals: Opportunities and Issues of Service Expansion in Maximum Care

Purpose Due to the demographic change morbidity raises the demand for medical hospital services as well as a need for medical specialization, while economic and human resources are diminishing. Unlike other industries hospitals do not have sufficient data and adequate models to relate growing demands and increasing performance to growth in staff capacity and to increase in staff competences. Method Based on huge medical data sample covering the years from 2010 to 2014 with more than 150,000 operations of the Department for Anesthesiology at the University Hospital Muenster, Germany, comparisons are drawn between the development of medical services and the development of personnel capacity and expertise. Results The numbers of surgical operations increased by 21% and “skin incision to closure” time by 17%. Simultaneously, personnel capacity grew by 16% largely resting upon recruiting first-time employees. Expertise measured as “years of professional experience” dwindled from 10 years to 5.4 years on average and staff turnover accelerated. Conclusion Static benchmark data collected at fixed reference dates do not sufficiently reflect the nexus between capacity and competence and do not reflect the dynamic changes in a hospital’s requirements for expertise and specialization, at all. Staff turnover leads to a loss of experience, which jeopardizes patient safety and hampers medical specialization. In consequence of the dramatic shortage of medical specialists, drop-off rates must be reduced and retention rates must be increased. To that end, working conditions need to be fundamentally converted for a multigeneration, multicultural, and increasingly female workforce