Zusammenfassung
Patientensicherheit ist ein wesentliches Paradigma der Intensivmedizin. Zahlreiche Berichte zeigten einen dringenden Bedarf für Intensivstationen auf, die Sicherheit von Schlüsselprozessen, z. B. der Medikamentenverabreichung, zu verbessern. Ein erster Schritt sind eine erhöhte Aufmerksamkeit für und die Wahrnehmung von Fehlern. Der Einsatz von Fehlerberichtssystemen, die auf der Meldung durch das Personal basieren, erwies sich als praktikabel und trägt zu einer Risikoreduktion bei. Ein fortgeschrittener Ansatz inkludiert die aktive Suche nach Schwachstellen im System und setzt einen kulturellen Wandel voraus. Eine offene Kommunikation und der Informationsaustausch zwischen Berufsgruppen sind hierfür eine Voraussetzung. Für etliche Interventionen konnte eine Reduktion von Fehlern oder unerwünschten Ereignissen gezeigt werden. Wichtige Komponenten sind Arbeitsumgebung und Arbeitsbelastung, Personalausstattung, Fähigkeiten und Kompetenzen, Kommunikation sowie die Standardisierung von Routineprozessen.
Abstract
Patient safety is an essential paradigm in the practice of intensive care medicine. Several reports have demonstrated an urgent need for intensive care units (ICUs) to improve the safety of key processes, such as the administration of drugs. A very first step in the effort to reduce the number of adverse events is to raise awareness and to recognize errors. The use of critical incident reporting systems with self-reporting has been shown to be practicable and to contribute to a considerable risk reduction. A more advanced approach includes the active search for hazards and system flaws and requires a sustained cultural change. Open communication and interprofessional exchange of information are essential in the development of such a safety culture. Several interventions have been shown to reduce errors or to decrease the number of adverse events. Important factors are working environment, workload and staffing, skills and competency, communication and management of standard operations.
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Valentin, A. Patientensicherheit in der Intensivmedizin. Intensivmed 48, 233–242 (2011). https://doi.org/10.1007/s00390-011-0263-0
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DOI: https://doi.org/10.1007/s00390-011-0263-0