IT adoption of clinical information systems in Austrian and German hospitals: results of a comparative survey with a focus on nursing.
ABSTRACT: BACKGROUND: IT adoption is a process that is influenced by different external and internal factors. This study aimed1. to identify similarities and differences in the prevalence of medical and nursing IT systems in Austrian and German hospitals, and2. to match these findings with characteristics of the two countries, in particular their healthcare system, and with features of the hospitals. METHODS: In 2007, all acute care hospitals in both countries received questionnaires with identical questions. 12.4% in Germany and 34.6% in Austria responded. RESULTS: The surveys revealed a consistent higher usage of nearly all clinical IT systems, especially nursing systems, but also PACS and electronic archiving systems, in Austrian than in German hospitals. These findings correspond with a significantly wider use of standardised nursing terminologies and a higher number of PC workstations on the wards (average 2.1 PCs in Germany, 3.2 PCs in Austria). Despite these differences, Austrian and German hospitals both reported a similar IT budget of 2.6% in Austria and 2.0% in Germany (median). CONCLUSIONS: Despite the many similarities of the Austrian and German healthcare system there are distinct differences which may have led to a wider use of IT systems in Austrian hospitals. In nursing, the specific legal requirement to document nursing diagnoses in Austria may have stimulated the use of standardised terminologies for nursing diagnoses and the implementation of electronic nursing documentation systems. Other factors which correspond with the wider use of clinical IT systems in Austria are: good infrastructure of medical-technical devices, rigorous organisational changes which had led to leaner processes and to a lower length of stay, and finally a more IT friendly climate. As country size is the most pronounced difference between Germany and Austria it could be that smaller countries, such as Austria, are more ready to translate innovation into practice.
Project description:BACKGROUND:Infection prevention and control (IPC) is crucial for patient safety. The World Health Organization (WHO) has released various tools to promote IPC. In 2018, the WHO released the Infection Prevention and Control Assessment Framework (IPCAF) that enables acute care healthcare facilities to evaluate IPC structures and practices. Data regarding IPC implementation in Austria are scarce. To deliver insights into this topic and promote the IPCAF within the Austrian IPC community, we decided to invite all Austrian hospitals participating in the German nosocomial infection surveillance system to conduct a self-assessment using the WHO IPCAF. METHODS:The IPCAF follows the eight WHO core components of IPC. A German translation of the IPCAF was sent to 127 Austrian acute care hospitals. The survey period was from October to December 2018. Participation in the survey, data entry and transfer to the German national reference center for surveillance of healthcare-associated infections was on a voluntary basis. RESULTS:Altogether, 65 Austrian hospitals provided a complete dataset. The overall median IPCAF score of all hospitals was 620 (of a possible maximum score of 800), which corresponded to an advanced level of IPC. Of the 65 hospitals, 38 achieved an advanced IPC level. Deeper analysis of the different core components yielded diverse results. Scores were lowest for core components on multimodal strategies for implementation of IPC interventions, and IPC education and training. Around 26% (n?=?17) of hospitals reported that the local IPC team was not steadily supported by an IPC committee. Senior clinical staff was not present in the IPC committee in 23% (n?=?15) of hospitals. Only 26% (n?=?17) of hospitals reported employing at least one IPC professional per ?250 beds. Surveillance for multidrug-resistant pathogens was not conducted in 26% (n?=?17) of hospitals. CONCLUSIONS:Implementation of IPC key aspects is generally at a high level in Austria. However, potentials for improvement were demonstrated, most prominently with regard to staffing, IPC education and training, effective implementation of multimodal strategies, and involvement of professional groups. Our survey demonstrated that the IPCAF is a useful tool for IPC self-assessment and can uncover deficits even in a high-income setting like Austria.
Project description:Medical education is gaining in significance internationally. A growing interest in the field has been observed in German-speaking countries (Austria, Germany, Switzerland) since the early 2000s. This interest is not, however, reflected in an increase in the number of publications on medical education of German-speaking authors in international professional journals. The following investigation examines the potential use of active participant numbers of German-speaking researchers at AMEE conferences as a means of measuring said development.The AMEE conference proceedings from the categories poster presentations, short communications, research papers and plenary presentations from the years 2005-2013 were examined for evidence of Austrian, German and Swiss participation. The abstracts were subsequently analysed in terms of content and categorised according to study design, methodology, object of study, and research topic.Of the 9,446 analysed abstracts, 549 contributions show at least one first, last or co-author from Austria, Germany or Switzerland. The absolute number of contributions per conference varied between 44 in 2010 and 77 in 2013. The percentage fluctuated between 10% in 2005 and 4.1% in 2010. From the year 2010 onwards, however, participation increased continually. The research was predominantly descriptive (62.7%). Studies on fundamental questions of teaching and learning (clarification studies) were less frequent (4.0%). For the most part, quantitative methods (51.9%) were implemented in addressing subjects such as learning and teaching methods (33%), evaluation and assessment (22.4%) or curriculum development (14.4%). The study population was usually comprised of students (52.5%).The number of contributions from Austria, Germany and Switzerland peak at the beginning and at the end of the evaluated period of time. A continual increase in active participation since 2005 was not observed. These observations do not reflect the actual increase of interest in medical education research in German-speaking countries.
Project description:Many steppe species reach their (north)westernmost distribution limit in western Central Europe. This also applies to Poa badensis, a rare steppe plant of calcareous rock/sand vegetation. To explore potential differences in reproductive success and genetic composition of peripheral populations, we analysed the absolute (north)westernmost occurrences in Western Germany and populations at the western margin (Eastern Austria) and the centre (Central Hungary) of the Pannonicum, representing a part of the continuous range. Specifically, we discuss the genetic and reproductive constitution of the (north)westernmost exclave and draw conclusions on the species' biogeographical and conservation history in this region. Therefore, we used two independent molecular marker systems (AFLPs, cpDNA sequences) and a set of performance parameters. Overall, lowest regional genetic diversity was found in Western Germany, which is mainly a result of the specific history of two populations. However, this low genetic diversity was not accompanied by reduced reproductive success. The Eastern Austrian populations showed reduced genetic diversity and predominantly reduced performance, interpreted as a consequence of small population sizes. Central Hungarian populations showed the overall highest genetic diversity and comparatively high performance values. We observed high admixture and haplotype sharing between Austrian and Hungarian populations, indicating gene flow among these regions. In contrast, we interpreted the increased population differentiation within, and the clear distinctiveness of the German exclave as a long-term isolation of these (north)westernmost occurrences. Our results, overall, prove the good constitution of these populations and, together with their particular biogeographical history, highlight their conservation value.
Project description:This is a report on the first identified cases of coronavirus disease 2019 (COVID-19) in Austria. The first documented case was a person who stayed in Kühtai, Tyrol, from 24 to 26 January 2020, and had been infected by a Chinese instructor in Starnberg (Germany) between 20 and 22 January. This counts as a German case since her diagnosis was eventually made in Munich (Germany) on 28 January. On 25 February, two cases imported from Italy were diagnosed in Innsbruck but again no secondary cases were identified in Austria. The first three infections of Austrian inhabitants were detected on 27 February in Vienna. The two resulting clusters finally included 6 (source of initial infection unknown) and 61 cases. Most likely, Italy was the source of the latter cluster. On 12 March the first fatal case of COVID-19 in Austria was reported, a 69-year-old Viennese who died in a Vienna hospital after returning from a cruise ship tour in Italy. On 6 March three autochthonously acquired cases were reported in the Tyrol, all related to the ski resort Ischgl. Of the first 14 Islandic COVID-19 cases infected in Ischgl, 11 had already returned to Iceland on 29 February. We consider that the incriminated barkeeper, who tested PCR positive on 7 March, was neither the primary case nor a superspreader. In our opinion, undetected transmission of SARS-CoV?2 had been ongoing in Ischgl prior to the first laboratory confirmed cases. Our data also underline that the introduction of SARS-CoV?2 into Austria was not one single event.
Project description:Porcine epidemic diarrhea (PED) is a syndrome that is characterized by rapidly spreading watery diarrhea affecting pigs of all ages, but with major effects on suckling piglets. The disease, as well as the causative Alphacoronavirus, the Porcine epidemic diarrhea virus (PEDV), was first described in Europe in the 1970s and since then has spread over many Asian and American countries, where it recently led to devastating effects on swine health and pork industry. While the disease was seldom reported in Europe within the last few decades, a few recent reports re-emergence of PED in German pig farms. The hitherto isolated German strain seems to be closely related to a low pathogenic PEDV variant from the USA. This case report describes the first detection of PEDV in Austria.Reduced feed uptake and occasional diarrhea were observed in December 2014 in a group of fattening pigs, kept on an Austrian swine farm. The concerned pigs had been recently purchased from Germany. Within a few weeks, diarrhea became apparent also in pigs of Austrian origin, which were kept in a different stable on the same farm. Gastrointestinal symptoms among fattening pigs were generally mild, quickly resolving and did not lead to death. PEDV RNA was identified by RT-qPCR in pooled feces and serum and PEDV antibodies were detectable in serum in both groups of pigs. Phylogenetic analysis of the nearly complete PEDV spike gene shows that the Austrian PEDV strain is highly similar to other strains involved in recent outbreaks in Western and Central Europe.This is the first report demonstrating the presence of PEDV in Austria. The virus was probably introduced by purchasing piglets from a German source, which underlines the significance of trans-boundary animal trade for the distribution of highly contagious diseases, such as PED.
Project description:From 15-16 June 2018, the 25th Annual Meeting of the German Society for Newborn Screening (Deutsche Gesellschaft für Neugeborenenscreening, DGNS) was held at the Van Swieten Hall of the Medical University of Vienna, Vienna, Austria. For the first time, this annual meeting was held outside Germany and organized by Maximilian Zeyda, PhD and Vassiliki Konstantopoulou, MD (conference presidents), directors of the Austrian Newborn Screening located at the Dept. of Pediatrics at the Medical University of Vienna. A local scientific board formed by Maximilian Zeyda and Vassiliki Konstantopoulou selected presentations from abstracts that were submitted by scientists of 7 countries, highlighting one purpose of this meeting, which was to foster contact and exchange of newborn screening labs of central European countries. Abstracts of invited lectures, oral communications, and posters presented during the meeting are collected in this report.
Project description:Acute lymphoblastic leukemia (ALL) is a malignant disease of the white blood cells. The etiology of ALL is believed to be multifactorial and likely to involve an interplay of environmental and genetic variables. We performed a genome-wide association study of 355?750 single-nucleotide polymorphisms (SNPs) in 474 controls and 419 childhood ALL cases characterized by a t(12;21)(p13;q22) - the most common chromosomal translocation observed in childhood ALL - which leads to an ETV6-RUNX1 gene fusion. The eight most strongly associated SNPs were followed-up in 951 ETV6-RUNX1-positive cases and 3061 controls from Germany/Austria and Italy, respectively. We identified a novel, genome-wide significant risk locus at 3q28 (TP63, rs17505102, P(CMH)=8.94 × 10(-9), OR=0.65). The separate analysis of the combined German/Austrian sample only, revealed additional genome-wide significant associations at 11q11 (OR8U8, rs1945213, P=9.14 × 10(-11), OR=0.69) and 8p21.3 (near INTS10, rs920590, P=6.12 × 10(-9), OR=1.36). These associations and another association at 11p11.2 (PTPRJ, rs3942852, P=4.95 × 10(-7), OR=0.72) remained significant in the German/Austrian replication panel after correction for multiple testing. Our findings demonstrate that germline genetic variation can specifically contribute to the risk of ETV6-RUNX1-positive childhood ALL. The identification of TP63 and PTPRJ as susceptibility genes emphasize the role of the TP53 gene family and the importance of proteins regulating cellular processes in connection with tumorigenesis.
Project description:BACKGROUND:COVID-19 has spread rapidly around the world. The Austrian government implemented a lockdown on 16 March to contain further spread of the disease. We investigated the effects of lockdown on acute upper gastrointestinal (GI) bleeding in Austria. METHODS:We contacted 98 Austrian hospitals performing emergency endoscopies. The hospitals were asked to report upper GI endoscopies performed for recent hematemesis, melena, or both, and exhibiting endoscopically visible signs of bleeding. The study period was from 3 weeks before (calendar Week 9) to 3 weeks after (Week 14) initiation of the lockdown. RESULTS:61?% of Austrian hospitals, and importantly all major state hospitals, responded. A total of 575 upper GI bleedings occurred during the 3 weeks before and 341 during the 3 weeks after initiation of lockdown (40.7?% reduction). There was a 54.6?% decline in nonvariceal bleeding events at Week 14 compared with Week 9 (89 vs. 196), whereas rates of variceal hemorrhage did not change (15 vs. 17). CONCLUSIONS:National lockdown resulted in a dramatic decrease in upper GI bleeding events in Austrian hospitals.
Project description:The mosquito Aedes japonicus japonicus, originally restricted to temperate East Asia, is now widespread in North America and more recently has become established in Europe. To ascertain the putative number of separate introductions to Europe and examine patterns of expansion we analyzed the genetic makeup of Ae. j. japonicus populations from five cemeteries in North Rhine-Westphalia and Rhineland-Palatinate, two western German federal states, as well as of specimens from populations in Belgium, Switzerland, and Austria/Slovenia. To do so, we genotyped individual specimens at seven pre-existing polymorphic microsatellite loci and sequenced part of the nad4 mitochondrial locus. We found evidence of two different genotypic signatures associated with different nad4 mitochondrial haplotypes, indicating at least two genetically differentiated populations of Ae. j. japonicus in Europe (i.e. two distinct genotypes). Belgian, Swiss, and Austrian/Slovenian populations all share the same genotypic signature although they have become differentiated since isolation. Contrary to expectations, the German Ae. j. japonicus are not closely related to those in Belgium which are geographically nearest but are also highly inbred. German populations have a unique genotype but also evidence of mixing between the two genotypes. Also unexpectedly, the populations closest to the center of the German infestation had the highest levels of admixture indicating that separate introductions did not expand and merge but instead their expansion was driven by punctuated human-mediated transport. Critically, the resulting admixed populations have higher genetic diversity and appear invasive as indicated by their increased abundance and recent spread across western Germany.
Project description:BACKGROUND:Cardiac catheterization is one of the most widely performed cardiac interventional procedures worldwide. The Austrian National Catheterization Laboratory Registry (ANCALAR), started in 1992, collects annual data on cardiac catheterization in Austria. The registry enables in-depth understanding of the dynamics of cardiac catheterization procedures and their use across 34 cardiac catheterization laboratories in Austria. METHODS:Data from ANCALAR on cardiac catheterization including the latest data for 2017, voluntarily provided by centers with cardiac catheterization laboratories, were analyzed. Where possible, international comparisons in therapeutic and interventional cardiac procedures are made with Switzerland and Germany. RESULTS:Internationally, Austria ranks alongside the top countries in Europe. Whilst the number of people undergoing routine percutaneous coronary interventions (PCI) remains stable, complex and acute interventions are increasing year by year in Austria. CONCLUSION:Evidence from ANCALAR revealed that Austria is another example of the difficulties of weighing current guidelines with new emerging evidence and resulting real-life clinical practice in the dynamic world of interventional cardiology.