Universitatsklinikum Marburg und Giessen

Marburg an der Lahn, Germany

Universitatsklinikum Marburg und Giessen

Marburg an der Lahn, Germany
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Jacke C.O.,University of Heidelberg | Kalder M.,Universitatsklinikum Marburg und Giessen | Koller M.,University of Regensburg | Wagner U.,Universitatsklinikum Marburg und Giessen | Albert U.S.,Universitatsklinikum Marburg und Giessen
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2012

Public health research depends on empirical information that is based on data of high quality. The aim of this study was to apply the current guidelines developed by the Technology and Methodology Platform for Networked Medical Research (TMF) for the independent assessment and enhancement of data quality. A clinical register of female breast cancer patients from two periods (N=389 of 1996-1997 and N=488 of 2003- 2004) was used. To check the plausibility, organization, and correctness of the data quality levels, data quality indicators (DQI) were chosen, operationalized, and the variance ratios of normative-analytic-defined thresholds were calculated. Significant deviations led to data improvement, which included the commonly known source data verification (SDV). A summary data quality score was calculated before and after application of the guidelines. Eleven out of 24 DQIs were tested. Data quality systematically increased from 51.6 to 67.7%. The guidelines facilitate a systematic assessment and improvement of data quality with a reasonable use of resources. This target-oriented procedure allows for a high transparency of the available data quality, which is essential for health research. © 2012 Springer-Verlag.

Tripp J.,Deutscher Fachverband fur Verhaltenstherapie und Psychotherapeutische Praxis | Schweiger U.,University of Lübeck | Strohm W.,Gesellschaft fur Angewandte Psychologie und Verhaltensmedizin APV | Stromberg C.,Gesellschaft fur Ausbildung in Psychotherapie GAP | Quaschner K.,Universitatsklinikum Marburg und Giessen
Verhaltenstherapie | Year: 2015

The reform concept of a 'Direktausbildung', which includes a mainstreaming of the structure of psychotherapy training to the structure of other academic health professions with an academic program that is regulated by national licensing regulations and followed by an advanced training program, is received with significant criticism in the professional community. The criticism in particular is that, in a development analogous to medical specialist training, the quality of the current psychotherapy training cannot be maintained. To put this discussion on a sound basis, we offer arguments on what in our view contributes to the quality of psychotherapeutic training and provide empirical evidence on the quality of psychotherapeutic training and advanced medical training. Shown are consequences for a future advanced training, which are deemed necessary to ensure a high quality of competence acquisition: The training should offer a combination of practical training on the job under supervision combined with established training elements, such as theory workshops and promotion of personal competencies (Selbsterfahrung). Various patient care settings and patient groups should be included in the training. The previous psychotherapy training institutes (Ausbildungsinstitute) should continue to play a central role as advanced training institutes (Weiterbildungsinstitute) and cooperate with other advanced training facilities. The acquisition of competence should be defined in detail and should be verifiable, and psychotherapist chambers would have an important function as a surveillance and accreditation institution. In order to implement these quality features, the training structures must be equipped with sufficient financial means. © 2015 S. Karger GmbH, Freiburg..

Aust H.,Universitatsklinikums Giessen und Marburg GmbH | Wulf H.,Universitatsklinikum Giessen und Marburg | Vassiliou T.,Universitatsklinikum Marburg und Giessen
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie | Year: 2013

Up to the present day, pain management in the ICU (Intensive Care Units)is a unresolved clinical problem due to patient heterogeneity with complex variation inetiopathology and treatment of the underlying diseases. Therefore, therapeutic strategies in terms of standard operating procedure (SOP) are a necessary to improve the pain management for intensive care patients. Common guidelines for analgosedation are often inadequate to reflect the clinical situation. In particular, for an ICU setting without permanent presence of a physician a missing pain management SOP resulting in delayed pain therapy caused by a therapeutic uncertainty of the nurse staff. In addition to our pre-existing SOP for analgosedation we implemented a pain management SOP for our interdisciplinary, anaesthesiologic ICU. A exploratory survey among the nurse staff was conducted to assess the efficacy of the SOP. The results of the evaluation after a 6 month follow-up indicated a faster onset of pain management and good acceptance by the nursing staff.

Krakow K.,Asklepios Neurological Hospital Falkenstein | Sitzer M.,Klinikum Herford | Rosenow F.,Universitatsklinikum Marburg und Giessen | Steinmetz H.,Goethe University Frankfurt | Foerch C.,Goethe University Frankfurt
Cerebrovascular Diseases | Year: 2010

Background: In this study, we tried to identify predictors of acute poststroke seizures (aPSS) in stroke patients. Methods:We analyzed a large prospective hospital-based stroke registry in Germany. 58,874 patients with the diagnosis of transient ischemic attack (TIA), ischemic stroke (IS) or intracerebral hemorrhage (ICH) were admitted within 24 h after symptom onset. Predictors for aPSS were identified using multivariate regression analysis adjusted for age, gender, stroke severity, vascular risk factors, acute nonneurologic infection, history of TIA and length of hospital stay. Results: aPSS occurred in 0.7% of patients with TIA (mean duration of hospitalization 8 days), in 2.2% of patients with IS (12 days) and in 5.1% of patients with ICH (13 days). A lower age, a higher stroke severity, acute nonneurologic infection, a history of diabetes mellitus and a history of preceding TIA were identified to be independent predictors of aPSS in IS, whereas younger age, acute infection and a history of TIA were found predictive for aPSS in ICH. Conclusions: This study characterized so far unknown predictors of aPSS and may help to improve the identification of patients with a high risk of aPSS. Copyright © 2010 S. Karger AG, Basel.

Wack C.,Universitatsklinikum Marburg und Giessen | Zettl R.,Universitatsklinikum Marburg und Giessen | Ruchholtz S.,Universitatsklinikum Marburg und Giessen
Trauma und Berufskrankheit | Year: 2010

Delayed diagnosis with often fatal consequences for the patient still occurs far too frequently and in a variety of injury types. Typical constellations include for example common, generally well-known diseases with rare complications, which can be worsened by additional therapy or concomitant diseases, such as the case presented here of an atypical femur fracture while under bisphosphonate therapy. Other examples include rarer injury types which, when identified late, are associated with serious complications, such as potentially life-threatening supraaortic vascular injury, as also presented in this article. Since multislice CTA has proved to be a safe diagnostic method for identifying the latter in patients with high-speed trauma to the head, neck and/or thorax, it should be considered for screening examinations as part of shockroom treatment. © Springer-Verlag 2010.

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