Skip to main content
Log in

Kommunikation in der Intensivmedizin

Communication in intensive care medicine

  • Leitthema
  • Published:
Medizinische Klinik - Intensivmedizin und Notfallmedizin Aims and scope Submit manuscript

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.

Abstract

Communication plays a crucial role in the intensive care unit. Posttraumatic stress syndromes develop in a significant number of patients and their relatives after being in an intensive care unit. The syndromes may persist for several years. Regular open and empathic communication with patients and family members reduces the frequency and severity of the disease. Among the physicians and nurses in the intensive care unit, there is a high prevalence of burnout syndrome. The precipitating factors are mostly conflicts within the working staff, work overload and end-of-life situations. Working team communication reduces the rate of exhaustion syndromes. Rounds of discussions among the work groups are the basis for a healthy team structure. Inadequate communication, e.g., during emergencies or shift change, endangers the safety of patients and in the worst case, results in treatment mistakes. Measures for improved communication in the intensive care unit should always be implemented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. 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 35:623–630

    Article  PubMed  Google Scholar 

  2. 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 180:853–860

    Article  PubMed  Google Scholar 

  3. Brindley PG, Reynolds SF (2011) Improving verbal communication in critical care medicine. J Crit Care 26:155–159

    Article  PubMed  Google Scholar 

  4. Davydow DS, Desai SV, Needham DM, Bienvenu OJ (2008) Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med 70:512–519

    Article  PubMed  Google Scholar 

  5. 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 175:686–692

    Article  PubMed  Google Scholar 

  6. 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 25:634–640

    Article  Google Scholar 

  7. 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 49:930–939

    Article  PubMed  CAS  Google Scholar 

  8. 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:R96–109

    Article  PubMed  Google Scholar 

  9. Guntupalli KK, Fromm RE Jr (1996) Burnout in the internist–intensivist. Intensive Care Med 22:625–630

    Article  PubMed  CAS  Google Scholar 

  10. Henrich NJ, Dodek P, Heyland D et al (2011) Qualitative analysis of an intensive care unit family satisfaction survey. Crit Care Med 39:1000–1005

    Article  PubMed  Google Scholar 

  11. 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 174:627–633

    Article  PubMed  Google Scholar 

  12. Hunziker S, Tschan F, Semmer NK et al (2010) Human factors in resuscitation: lessons learned from simulator studies. J Emerg Trauma Shock 3:389–394

    Article  PubMed  CAS  Google Scholar 

  13. Janssens U, Graf J (2010) Family conference. Intensivmed 47:35–42

    Article  Google Scholar 

  14. 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 356:469–478

    Article  PubMed  CAS  Google Scholar 

  15. 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 124:860–867

    Article  PubMed  Google Scholar 

  16. Manojlovich M, DeCicco B (2007) Healthy work environments, nurse-physician communication, and patients‘ outcomes. Am J Crit Care 16:536–543

    PubMed  Google Scholar 

  17. Maslach C (1979) Burned-out. Can J Psychiatr Nurs 20:5–9

    PubMed  CAS  Google Scholar 

  18. Nelson JE, Meier DE, Oei EJ et al (2001) Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med 29:277–282

    Article  PubMed  CAS  Google Scholar 

  19. 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 38:808–818

    Article  PubMed  Google Scholar 

  20. O’Mahony N (2011) Nurse burnout and the working environment. Emerg Nurse 19:30–37

    Google Scholar 

  21. 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:R41

    Article  PubMed  Google Scholar 

  22. 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 26:11–16

    Article  PubMed  Google Scholar 

  23. Poncet MC, Toullic P, Papazian L et al (2007) Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med 175:698–704

    Article  PubMed  Google Scholar 

  24. Pronovost PJ, Thompson DA, Holzmueller CG et al (2006) Toward learning from patient safety reporting systems. J Crit Care 21:305–315

    Article  PubMed  Google Scholar 

  25. 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 38:55–61

    Article  PubMed  CAS  Google Scholar 

  26. Reader TW, Flin R, Mearns K, Cuthbertson BH (2009) Developing a team performance framework for the intensive care unit. Crit Care Med 37:1787–1793

    Article  PubMed  Google Scholar 

  27. 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 146:175–178

    Article  PubMed  CAS  Google Scholar 

  28. 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. Sprung CL, Cohen SL, Sjokvist P et al (2003) End-of-life practices in European intensive care units: the Ethicus Study. JAMA 290:790–797

    Article  PubMed  Google Scholar 

  30. Williams M, Hevelone N, Alban RF et al (2010) Measuring communication in the surgical ICU: better communication equals better care. J Am Coll Surg 210:17–22

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Die korrespondierende Autorin gibt für sich und ihre Koautoren an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to G. de Heer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Heer, G., Kluge, S. Kommunikation in der Intensivmedizin. Med Klin Intensivmed Notfmed 107, 249–254 (2012). https://doi.org/10.1007/s00063-011-0060-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00063-011-0060-3

Schlüsselwörter

Keywords

Navigation