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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. Other indicators were not changed or only minimally. The focus remained strongly on relevant treatment processes like management of analgesia and sedation, mechanical ventilation and weaning, and infections in the ICU. Another focus was communication inside the ICU. The number of 1ndicators remained the same. The development method was more structured and transparency was increased by adding new features like evidence levels or author contribution and potential conflicts of interest. These quality indicators should be used in the peer review in intensive care, a method endorsed by the DIVI. Other forms of measurement and evaluation are also reasonable, for example in quality management. This fourth edition of the quality indicators will be updated in the future to reflect the recently published recommendations on the structure of intensive care units by the DIVI.

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Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recommendation 8: Creating the culture and addressing barriers for children's visits The visit of children in an ICU is also a management task. Recommendation 1: Plan the visit of children in the interprofessional team First, patients (if conscious), parents, children, and clinicians agree to the visit (see Fig. Whereas worldwide visiting regulations in paediatric ICUs are mostly open for children's visits, very heterogeneous policies exist in ICUs for adult patients [[4]]. 1 Flowchart for children visiting the ICU Recommendation 2: Strengthen parental competencies The decision to let children visit a critically ill patient depends on the will of the parents/caregivers. [Extracted from the article]

Most patients appreciated the virtual visits, and staff valued this as quality-increasing compromise due to isolation regulations. Virtual visits/photos can be a good way to bridge the time when a patient cannot be visited in real. Video visits with critical care patients is also useful in case families cannot be present due to long distances, own illness, or other circumstances; and even those type of visits might prevent patients from delirium [[4]]. [Extracted from the article]

This article provides insight into a German intensive care unit in a surgery department. It describes the nursing care, nursing management monitoring and infection surveillance practices of the unit. We also describe the national educational pathway of a German nurse, which differs from those in other countries. The overview can help understand the context of German critical care nursing. [ABSTRACT FROM AUTHOR]

Objective: Cochlear implantation trauma causes both macroscopic and inflammatory trauma. The aim of the present study was to evaluate the effectiveness of the TNF-alpha inhibitor etanercept applied after cochlear implantation trauma on the preservation of acoustic hearing. Design: Guinea pigs were randomly assigned to three groups receiving cochlear implantation trauma by cochleostomy. In one group, the site was sealed by bone cement with no further treatment. A second group was additionally implanted with an osmotic minipump delivering artificial perilymph into the scala tympani for seven days. In the third group, etanercept 1 mg/ml was added to artificial perilymph. Hearing was assessed by auditory brainstem responses at 2, 4, 6, and 8 kHz prior to and after surgery and on days 3, 5, 7, 14, 28. Study sample: Fifteen healthy guinea pigs. Results: The trauma led to threshold shifts from 50.3 dB ± 16.3 dB to 68.0 dB ± 19.3 dB. Hearing thresholds were significantly lower in etanercept-treated animals compared to controls on day 28 at 8 kHz and from day 3 onwards at 4 and 2 kHz (p < 0.01; two-way RM ANOVA / Bonferroni t-test). Conclusion: The application of etanercept led to preservation of acoustic hearing after cochlear implantation trauma. [ABSTRACT FROM AUTHOR]