Karagiannidis C, Kluge S, Riessen R, Krakau M, Bein T, Janssens U
Lungenklinik Köln-Merheim, ARDS und ECMO-Zentrum, Abteilung Pneumologie, Intensiv- und Beatmungsmedizin, Kliniken der Stadt Köln und Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland.
Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Med Klin Intensivmed Notfmed. 2019 May;114(4):327-333. doi: 10.1007/s00063-018-0457-3. Epub 2018 Jul 9.
Compared to other countries, Germany has the highest number of intensive care unit (ICU) beds, but, despite this, a shortage in ICU care is evident. Currently, little comprehensive data on ICU staffing and on subsequent closure of ICU beds are available. The current survey therefore aimed to systematically investigate the closure of ICU beds.
A survey was performed among authorized professional trainers in ICU medicine.
Overall, a shortage of ICU beds following bed closure was evident in 76% of all ICU floors with 22% reporting daily ICU bed closure. In 47%, two ICU beds were not available. Emergency care was unrestricted in only 18%, while restrictions were reportedly frequent or even constant in 30%. The main reasons for ICU bed closure were the unavailability of ICU nurses (44%) and the co-existing unavailability of nurses and physicians (19%). On average, the nurse/patient ratio was 1:2.5 in the morning, 1:2.6 in the afternoon, and 1:3.1 in the night shift.
ICU bed closure regularly occurs in Germany. The underlying main reason has been identified to be the unavailability of ICU nursing staff. This is suggested to directly interfere with emergency care. For this reason, an action plan is urgently needed.
与其他国家相比，德国拥有数量最多的重症监护病房（ICU）床位，但即便如此，ICU护理短缺的问题依然明显。目前，关于ICU人员配备以及随后ICU床位关闭的综合数据很少。因此，本次调查旨在系统地研究ICU床位的关闭情况。
对ICU医学领域的授权专业培训师进行了一项调查。
总体而言，在所有ICU楼层中，76%的楼层在床位关闭后出现了ICU床位短缺的情况，22%的楼层报告称每天都有ICU床位关闭。在47%的楼层，有两张ICU床位无法使用。只有18%的楼层急诊护理不受限制，而据报告，30%的楼层经常或甚至持续存在限制。ICU床位关闭的主要原因是ICU护士短缺（44%）以及护士和医生同时短缺（19%）。平均而言，早班护士与患者的比例为1:2.5，中班为1:2.6，夜班为1:3.1。
在德国，ICU床位关闭的情况经常发生。已确定根本原因是ICU护理人员短缺。这被认为直接影响了急诊护理。因此，迫切需要制定一项行动计划。
