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Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin 4/2012

01.05.2012 | Leitthema

Kommunikation in der Intensivmedizin

verfasst von: Dr. G. de Heer, S. Kluge

Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin | Ausgabe 4/2012

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Zusammenfassung

Die Kommunikation nimmt auf der Intensivstation eine Schlüsselrolle ein. Bei einer relevanten Anzahl von Patienten und Angehörigen tritt ein posttraumatisches Stresssyndrom nach dem Intensivaufenthalt auf, welches noch Jahre persistieren kann. Durch regelmäßige, offene und empathische Gespräche mit Patienten und Angehörigen kann die Häufigkeit und Schwere dieser Erkrankung abgemildert werden. Bei Ärzten und Pflegekräften von Intensivstationen ist die Prävalenz an Burnout-Syndromen hoch. Auslöser sind meist Konflikte im Team, hohe Arbeitsbelastung und „End-of-life“-Situationen. Eine kollegiale Kommunikation verringert den Anteil an Erschöpfungssyndromen, interprofessionelle Gesprächsrunden stellen die Grundlage für eine gesunde Teamstruktur dar. Mangelhafte Kommunikation, z. B. in Notfallsituationen oder bei Übergaben, gefährdet die Patientensicherheit und führt im schlimmsten Fall zu Behandlungsfehlern. Maßnahmen zur Verbesserung der Kommunikation auf der Intensivstation müssen daher in jedem Fall ergriffen werden.
Literatur
1.
Zurück zum Zitat Azoulay E, Metnitz B, Sprung CL et al (2009) End-of-life practices in 282 intensive care units: data from the SAPS 3 database. Intensive Care Med 35:623–630PubMedCrossRef Azoulay E, Metnitz B, Sprung CL et al (2009) End-of-life practices in 282 intensive care units: data from the SAPS 3 database. Intensive Care Med 35:623–630PubMedCrossRef
2.
Zurück zum Zitat Azoulay E, Timsit JF, Sprung CL et al (2009) Prevalence and factors of intensive care unit conflicts: the conflicus study. Am J Respir Crit Care Med 180:853–860PubMedCrossRef Azoulay E, Timsit JF, Sprung CL et al (2009) Prevalence and factors of intensive care unit conflicts: the conflicus study. Am J Respir Crit Care Med 180:853–860PubMedCrossRef
3.
Zurück zum Zitat Brindley PG, Reynolds SF (2011) Improving verbal communication in critical care medicine. J Crit Care 26:155–159PubMedCrossRef Brindley PG, Reynolds SF (2011) Improving verbal communication in critical care medicine. J Crit Care 26:155–159PubMedCrossRef
4.
Zurück zum Zitat Davydow DS, Desai SV, Needham DM, Bienvenu OJ (2008) Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med 70:512–519PubMedCrossRef Davydow DS, Desai SV, Needham DM, Bienvenu OJ (2008) Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med 70:512–519PubMedCrossRef
5.
Zurück zum Zitat Embriaco N, Azoulay E, Barrau K et al (2007) High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med 175:686–692PubMedCrossRef Embriaco N, Azoulay E, Barrau K et al (2007) High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med 175:686–692PubMedCrossRef
6.
Zurück zum Zitat Garrouste-Org M, Willems V, Timsit JF et al (2010) Opinions of families, staff, and patients about family participation in care in intensive care units. J Crit Care 25:634–640CrossRef Garrouste-Org M, Willems V, Timsit JF et al (2010) Opinions of families, staff, and patients about family participation in care in intensive care units. J Crit Care 25:634–640CrossRef
7.
Zurück zum Zitat Graf J, Driesch A von den, Koch KC, Janssens U (2005) Identification and characterization of errors and incidents in a medical intensive care unit. Acta Anaesthesiol Scand 49:930–939PubMedCrossRef Graf J, Driesch A von den, Koch KC, Janssens U (2005) Identification and characterization of errors and incidents in a medical intensive care unit. Acta Anaesthesiol Scand 49:930–939PubMedCrossRef
8.
Zurück zum Zitat Granja C, Lopes A, Moreira S et al (2005) Patients‘ recollections of experiences in the intensive care unit may affect their quality of life. Crit Care 9:R96–109PubMedCrossRef Granja C, Lopes A, Moreira S et al (2005) Patients‘ recollections of experiences in the intensive care unit may affect their quality of life. Crit Care 9:R96–109PubMedCrossRef
9.
Zurück zum Zitat Guntupalli KK, Fromm RE Jr (1996) Burnout in the internist–intensivist. Intensive Care Med 22:625–630PubMedCrossRef Guntupalli KK, Fromm RE Jr (1996) Burnout in the internist–intensivist. Intensive Care Med 22:625–630PubMedCrossRef
10.
Zurück zum Zitat Henrich NJ, Dodek P, Heyland D et al (2011) Qualitative analysis of an intensive care unit family satisfaction survey. Crit Care Med 39:1000–1005PubMedCrossRef Henrich NJ, Dodek P, Heyland D et al (2011) Qualitative analysis of an intensive care unit family satisfaction survey. Crit Care Med 39:1000–1005PubMedCrossRef
11.
Zurück zum Zitat Heyland DK, Dodek P, Rocker G et al (2006) What matters most in end-of-life care: perceptions of seriously ill patients and their family members. CMAJ 174:627–633PubMedCrossRef Heyland DK, Dodek P, Rocker G et al (2006) What matters most in end-of-life care: perceptions of seriously ill patients and their family members. CMAJ 174:627–633PubMedCrossRef
12.
Zurück zum Zitat Hunziker S, Tschan F, Semmer NK et al (2010) Human factors in resuscitation: lessons learned from simulator studies. J Emerg Trauma Shock 3:389–394PubMedCrossRef Hunziker S, Tschan F, Semmer NK et al (2010) Human factors in resuscitation: lessons learned from simulator studies. J Emerg Trauma Shock 3:389–394PubMedCrossRef
13.
14.
Zurück zum Zitat Lautrette A, Darmon M, Megarbane B et al (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356:469–478PubMedCrossRef Lautrette A, Darmon M, Megarbane B et al (2007) A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 356:469–478PubMedCrossRef
15.
Zurück zum Zitat Li P, Stelfox HT, Ghali WA (2011) A prospective observational study of physician handoff for intensive-care-unit-to-ward patient transfers. Am J Med 124:860–867PubMedCrossRef Li P, Stelfox HT, Ghali WA (2011) A prospective observational study of physician handoff for intensive-care-unit-to-ward patient transfers. Am J Med 124:860–867PubMedCrossRef
16.
Zurück zum Zitat Manojlovich M, DeCicco B (2007) Healthy work environments, nurse-physician communication, and patients‘ outcomes. Am J Crit Care 16:536–543PubMed Manojlovich M, DeCicco B (2007) Healthy work environments, nurse-physician communication, and patients‘ outcomes. Am J Crit Care 16:536–543PubMed
17.
18.
Zurück zum Zitat Nelson JE, Meier DE, Oei EJ et al (2001) Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med 29:277–282PubMedCrossRef Nelson JE, Meier DE, Oei EJ et al (2001) Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med 29:277–282PubMedCrossRef
19.
Zurück zum Zitat Nelson JE, Puntillo KA, Pronovost PJ et al (2010) In their own words: patients and families define high-quality palliative care in the intensive care unit. Crit Care Med 38:808–818PubMedCrossRef Nelson JE, Puntillo KA, Pronovost PJ et al (2010) In their own words: patients and families define high-quality palliative care in the intensive care unit. Crit Care Med 38:808–818PubMedCrossRef
20.
Zurück zum Zitat O’Mahony N (2011) Nurse burnout and the working environment. Emerg Nurse 19:30–37 O’Mahony N (2011) Nurse burnout and the working environment. Emerg Nurse 19:30–37
21.
Zurück zum Zitat Peris A, Bonizzoli M, Iozzelli D et al (2011) Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients. Crit Care 15:R41PubMedCrossRef Peris A, Bonizzoli M, Iozzelli D et al (2011) Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients. Crit Care 15:R41PubMedCrossRef
22.
Zurück zum Zitat Petrovic MA, Aboumatar H, Baumgartner WA et al (2012) Pilot implementation of a perioperative protocol to guide operating room-to-intensive care unit patient handoffs. J Cardiothorac Vasc Anesth 26:11–16PubMedCrossRef Petrovic MA, Aboumatar H, Baumgartner WA et al (2012) Pilot implementation of a perioperative protocol to guide operating room-to-intensive care unit patient handoffs. J Cardiothorac Vasc Anesth 26:11–16PubMedCrossRef
23.
Zurück zum Zitat Poncet MC, Toullic P, Papazian L et al (2007) Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med 175:698–704PubMedCrossRef Poncet MC, Toullic P, Papazian L et al (2007) Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med 175:698–704PubMedCrossRef
24.
Zurück zum Zitat Pronovost PJ, Thompson DA, Holzmueller CG et al (2006) Toward learning from patient safety reporting systems. J Crit Care 21:305–315PubMedCrossRef Pronovost PJ, Thompson DA, Holzmueller CG et al (2006) Toward learning from patient safety reporting systems. J Crit Care 21:305–315PubMedCrossRef
25.
Zurück zum Zitat Quenot JP, Rigaud JP, Prin S et al (2012) Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices. Intensive Care Med 38:55–61PubMedCrossRef Quenot JP, Rigaud JP, Prin S et al (2012) Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices. Intensive Care Med 38:55–61PubMedCrossRef
26.
Zurück zum Zitat Reader TW, Flin R, Mearns K, Cuthbertson BH (2009) Developing a team performance framework for the intensive care unit. Crit Care Med 37:1787–1793PubMedCrossRef Reader TW, Flin R, Mearns K, Cuthbertson BH (2009) Developing a team performance framework for the intensive care unit. Crit Care Med 37:1787–1793PubMedCrossRef
27.
Zurück zum Zitat Schmidt C, Ramsauer B, Witzel K (2008) Risk management in hospitals: standard operating procedures in aviation as a model for structuring medical communication. Z Orthop Unfall 146:175–178PubMedCrossRef Schmidt C, Ramsauer B, Witzel K (2008) Risk management in hospitals: standard operating procedures in aviation as a model for structuring medical communication. Z Orthop Unfall 146:175–178PubMedCrossRef
28.
Zurück zum Zitat Schroedl CJ, Corbridge TC, Cohen ER et al (2011) Use of simulation-based education to improve resident learning and patient care in the medical intensive care unit: a randomized trial. J Crit Care Schroedl CJ, Corbridge TC, Cohen ER et al (2011) Use of simulation-based education to improve resident learning and patient care in the medical intensive care unit: a randomized trial. J Crit Care
29.
Zurück zum Zitat Sprung CL, Cohen SL, Sjokvist P et al (2003) End-of-life practices in European intensive care units: the Ethicus Study. JAMA 290:790–797PubMedCrossRef Sprung CL, Cohen SL, Sjokvist P et al (2003) End-of-life practices in European intensive care units: the Ethicus Study. JAMA 290:790–797PubMedCrossRef
30.
Zurück zum Zitat Williams M, Hevelone N, Alban RF et al (2010) Measuring communication in the surgical ICU: better communication equals better care. J Am Coll Surg 210:17–22PubMedCrossRef Williams M, Hevelone N, Alban RF et al (2010) Measuring communication in the surgical ICU: better communication equals better care. J Am Coll Surg 210:17–22PubMedCrossRef
Metadaten
Titel
Kommunikation in der Intensivmedizin
verfasst von
Dr. G. de Heer
S. Kluge
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 4/2012
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226
DOI
https://doi.org/10.1007/s00063-011-0060-3

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