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Patientensicherheit in der Anästhesie und Intensivmedizin

Maßnahmen zur Verbesserung

Patient safety in anesthesiology and intensive care medicine

Measures for improvement

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Zusammenfassung

Dank der raschen technischen Entwicklung sowie diverser Strategien zur Fehlerbeobachtung und -vermeidung gilt die Intensivmedizin und Anästhesiologie als ein sicheres Fach. Der Verabschiedung der „Patient Safety in the ICU: The Vienna Declaration“ der ESICM vom Oktober 2009 sowie der „Helsinki Declaration on Patient Safety in Anaesthesiology“ der ESA und EBA vom Juni 2010 ist es zu verdanken, dass europaweit festgelegt wurde, welche der erprobten Sicherheitskonzepte als unerlässlich zu werten sind. Viele der allgemein bekannten Strategien haben ihren Ursprung in primär nichtmedizinischen Bereichen, wie beispielsweise der zivilen Luftfahrt, und sind dort nicht mehr wegzudenken. Solche „high reliability organisations“ können diesbezüglich als Vorbilder für das Gesundheitswesen angesehen werden. Critical-Incident-Reporting-Systeme zur Meldung von Beinahezwischenfällen, Crisis-Resource-Management zur Verbesserung von Teamwork und kommunikativen Fähigkeiten sowie Checklisten, wie die WHO-Checkliste, zählen zu konkreten Umsetzungen dieser Art. Des Weiteren wurden standardisierte Medikamentenbeschriftungen, Händedesinfektion, Techniken für die Patientenübergabe und die realitätsnahe Ausbildung am Simulator als Maßnahmen zur Verbesserung der Patientensicherheit exemplarisch für diesen Beitrag ausgewählt.

Abstract

Technical improvements as well as various strategies for error detection and error prevention have made intensive care medicine and anesthesiology a safe medical specialty. Due to the introduction of “Patient safety in the ICU: the Vienna declaration” of the European Society of Intensive Care Medicine (ESICM) from October 2009 and the “Helsinki declaration on patient safety” of the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology (EBA) from June 2010, there are now specific recommendations for all hospitals in Europe concerning the safety measures that are considered to be of essential importance. Many of today’s well-known safety strategies have been originally developed in non-medical environments, as for instance civil aviation. Such high reliability organizations may serve as examples in the medical domain. Critical incident reporting systems, crisis resource management and checklists, e.g. the World Health Organization (WHO) checklist, are safety approaches of this kind. In addition to these, standardized drug labelling, hand disinfection, techniques for patient handover and simulation-based training have been exemplarily selected for this article as measures that can increase patient safety.

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  1. Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin CCM/CVK, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland

    C. Rosenthal, F. Balzer, W. Boemke &  C. Spies

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  1. C. Rosenthal
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  2. F. Balzer
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C Rosenthal und F Balzer haben zu gleichen Teilen zu dieser Arbeit beigetragen.

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Rosenthal, C., Balzer, F., Boemke, W. et al. Patientensicherheit in der Anästhesie und Intensivmedizin. Med Klin Intensivmed Notfmed 108, 657–665 (2013). https://doi.org/10.1007/s00063-012-0182-2

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