ApplikaS : Applikationenkatalog für nicht-medizinische Supportleistungen in Spitälern

Um die Komplexität der vielseitigen Daten - auch in den nicht-medizinischen Supportleistungen in Spitälern [FM in HC] - im Hinblick auf mehr Transparenz handhaben zu können, sind Spitäler auf den Einsatz von geeigneten und sinnvoll abgestimmten Softwareapplikationen angewiesen. Bisher wurde der Integration und Abstimmung der nicht-medizinischen Applikationen sowohl in der Theorie, als auch in der Praxis wenig Beachtung geschenkt. Ziel war es daher, durch Befragungen eine Übersicht über die Situation der eingesetzten Applikationen im Bereich der nicht-medizinischen Supportleistungen zu erhalten und aufgrund von Recherchen zu eruieren, welche Applikationen auf dem Markt in Bezug auf eine möglichst umfangreiche Funktionalitäten-Abdeckung für den Spitalbetrieb vorhanden und geeignet sind. Diese Grundlagen sollen einerseits die Ausgangslage beleuchten und somit FM in HC- und auch IT-Verantwortliche in der Thematik sensibilisieren und andererseits auch Anbietern den Bedarf an Abstimmung innerhalb des FM-Bereichs aufzeigen. Der Applikationenkatalog ApplikaS ist, zusammen mit dem Kennzahlenmodell KenmoS und dem Prozessmodell PromoS, Teil des Referenzmodells für nicht-medizinische Supportleistungen in Spitälern RemoS und Basis für den Leitfaden zum Einsatz von SAP für das Facility Management im Gesundheitswesen LesapS und das Assessment-, Simulations- und Benchmarking-Tool für das Facility Management im Gesundheitswesen

Promoting the high-quality recycling of plastics from demolition waste and enhancing the use of recycled materials in construction products in accordance with the European plastics strategy : final report

This study presents in detail: the use of plastic products and the opportunities for recyclate use in the construction sector, quantities of plastic used, take-back systems, recycling techniques, current recyclate use and plastic construction product packaging.Potentials for increasing high-quality recyclate use were identified. Existing hurdles and options for action for industry and politics are presented. Current recyclate use as well as its potential use are strongly dependent on the application area of plastics. The biggest hurdles for the use of recycled materials are product life time, dismantling and technical requirements

Version 1.0 – based on German original

In order to be able to handle the complexity of the various data with regard to more transparency – also in the non-medical support services in hospitals [FM in HC] – hospitals are dependent on suitable and usefully aligned software applications. Until recently, the integration and alignment of the non-medical applications was given scant attention both in theory as wall as in practice. The goal was therefore to gain an overview of the situation of the implemented applications by means of a survey and, on the basis of research, to determine which applications are available on the market and suitable to cover as many functionalities in the hospital operations as possible. These fundamentals should firstly shed light on the current situation and thus sensitize managers of FM in HC and as well as those in IT to the topic, and secondly, reveal the requirements for alignment within the FM area to the suppliers. The Application Catalogue ApplikaS, together with the Key Performance Indicator Catalogue KenkaS and the Process Model PromoS are part of the Reference Model for Non-Medical Support Services in Hospitals RemoS and the basis for the Guideline for applying SAP for the Facility Management in Healthcare in Healthcare LesapS and the IT-supported Assessment, Simulation and Benchmarking Tool for Facility Management in Healthcare. All topics mentioned are documented separately in detail and can, together via interlinks to other documents, be downloaded and thus implemented under www.zhaw.ch/ifm/fm-healthcare/remos/en

Förderung einer hochwertigen Verwertung von Kunststoffen aus Abbruchabfällen sowie der Stärkung des Rezyklateinsatzes in Bauprodukten im Sinne der europäischen Kunststoffstrategie

In dieser Studie werden detailliert dargestellt: die Verwendung von Kunststoffprodukten und Möglichkeiten des Rezyklateinsatzes im Baubereich, verwendete Kunststoffmengen, Rücknahmesysteme, Verwertungstechniken, aktueller Rezyklateneinsatz und Bauproduktverpackungen aus Kunststoff. Potentiale zur Steigerung des hochwertigen Rezyklateinsatzes wurden identifiziert und bestehende Hürden und Handlungsoptionen für Politik und Wirtschaft dargestellt. Aktueller Rezyklateinsatz sowie technische und mengenmäßige Potentiale sind stark abhängig vom Einsatzbereich der Kunststoffe. Die größten Hürden für einen Rezyklateinsatz sind dabei Produktlebensdauer, Rückbaufähigkeit und technische Anforderungen

Modeling risk for severe adverse outcomes using angiogenic factor measurements in women with suspected preterm preeclampsia

Introduction: Preeclampsia (PE) is a pregnancy-specific syndrome associated with adverse maternal and fetal outcomes. Patient-specific risks based on angiogenic factors might better categorize those who might have a severe adverse outcome. Methods: Women evaluated for suspected PE at a tertiary hospital (2009–2012) had pregnancy outcomes categorized as ‘referent’ or ‘severe’, based solely on maternal/fetal findings. Outcomes that may have been influenced by a PE diagnosis were considered ‘unclassified’. Soluble fms-like tyrosine kinase (sFlt1) and placental growth factor (PlGF) were subjected to bivariate discriminant modeling, allowing patient-specific risks to be assigned for severe outcomes. Results: Three hundred twenty-eight singleton pregnancies presented at ≤34.0 weeks' gestation. sFlt1 and PlGF levels were adjusted for gestational age. Risks above 5 : 1 (10-fold over background) occurred in 77% of severe (95% CI 66 to 87%) and 0.7% of referent (95% CI <0.1 to 3.8%) outcomes. Positive likelihood ratios for the modeling and validation datasets were 19 (95% CI 6.2–58) and 15 (95% CI 5.8–40) fold, respectively. Conclusions: This validated model assigns patient-specific risks of any severe outcome among women attending PE triage. In practice, women with high risks would receive close surveillance with the added potential for reducing unnecessary preterm deliveries among remaining women. © 2015 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd

Enhanced susceptibility to infections in a diabetic wound healing model

<p>Abstract</p> <p>Background</p> <p>Wound infection is a common complication in diabetic patients. The progressive spread of infections and development of drug-resistant strains underline the need for further insights into bacterial behavior in the host in order to develop new therapeutic strategies. The aim of our study was to develop a large animal model suitable for monitoring the development and effect of bacterial infections in diabetic wounds.</p> <p>Methods</p> <p>Fourteen excisional wounds were created on the dorsum of diabetic and non-diabetic Yorkshire pigs and sealed with polyurethane chambers. Wounds were either inoculated with 2 × 10⁸Colony-Forming Units (CFU) of <it>Staphylococcus aureus </it>or injected with 0.9% sterile saline. Blood glucose was monitored daily, and wound fluid was collected for bacterial quantification and measurement of glucose concentration. Tissue biopsies for microbiological and histological analysis were performed at days 4, 8, and 12. Wounds were assessed for reepithelialization and wound contraction.</p> <p>Results</p> <p>Diabetic wounds showed a sustained significant infection (>10⁵CFU/g tissue) compared to non-diabetic wounds (p < 0.05) over the whole time course of the experiment. <it>S. aureus</it>-inoculated diabetic wounds showed tissue infection with up to 8 × 10⁷CFU/g wound tissue. Non-diabetic wounds showed high bacterial counts at day 4 followed by a decrease and no apparent infection at day 12. Epidermal healing in <it>S. aureus</it>-inoculated diabetic wounds showed a significant delay compared with non-inoculated diabetic wounds (59% versus 84%; p < 0.05) and were highly significant compared with healing in non-diabetic wounds (97%; p < 0.001).</p> <p>Conclusion</p> <p>Diabetic wounds developed significantly more sustained infection than non-diabetic wounds. <it>S. aureus </it>inoculation leads to invasive infection and significant wound healing delay and promotes invasive co-infection with endogenous bacteria. This novel wound healing model provides the opportunity to closely assess infections during diabetic wound healing and to monitor the effect of therapeutical agents <it>in vivo</it>.</p

Aus neuen Erkenntnissen folgen neue Herausforderungen : Digital Support in nicht-medizinischen Bereichen im Spital

Mit der Einführung des Fallpauschalensystems DRG in den Schweizer Spitälern wurde die Sensibilisierung auf die Kosten und deren Strukturen erhöht. Die Abrechnung der medizinischen Leistungen erfolgt seither nach genauen Vorgaben. Die dazu notwendige Unterstützung durch digitale Werkzeuge und Software ist gewährleistet. Ebenso sind die Spitäler dank der standardisierten Erhebung in der Lage, Kennzahlen in den medizinischen Bereichen zu generieren und zu vergleichen. Für den nicht-medizinischen Supportbereich (FM) sind allerdings noch keine einheitlichen Standards und z.T. nur grobe Kennwerte verfügbar. Man geht von rund 30 % der Gesamtkosten für den ganzen FM-Bereich aus resp. von 10 – 14 % der Fallkostenpauschale für Anlagenutzungskosten