Reifarth Eyleen, Naendrup Jan-Hendrik, Garcia Borrega Jorge, Altenrath Lisa, Shimabukuro-Vornhagen Alexander, Eichenauer Dennis Alexander, Kochanek Matthias, Böll Boris
Klinik I für Innere Medizin, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Med Klin Intensivmed Notfmed. 2024 May;119(4):253-259. doi: 10.1007/s00063-024-01127-x. Epub 2024 Mar 18.
Effective handoffs in the intensive care unit (ICU) are key to patient safety.
This article aims to raise awareness of the significance of structured and thorough handoffs and highlights possible challenges as well as means for improvement.
Based on the available literature, the evidence regarding handoffs in ICUs is summarized and suggestions for practical implementation are derived.
The quality of handoffs has an impact on patient safety. At the same time, communication in the intensive care setting is particularly challenging due to the complexity of cases, a disruptive work environment, and a multitude of inter- and intraprofessional interactions. Hierarchical team structures, deficiencies in feedback and error-management culture, (technical) language barriers in communication, as well as substantial physical and psychological stress may negatively influence the effectiveness of handoffs. Sets of interventions such as the implementation of checklists, mnemonics, and communication workshops contribute to a more structured and thorough handoff process and have the potential to significantly improve patient safety.
Effective handoffs are the cornerstone of high-quality and safe patient care but face particular challenges in ICUs. Interventional measures such as structuring handoff concepts and periodic communication trainings can help to improve handoffs and thus increase patient safety.
重症监护病房(ICU)中有效的交接班是患者安全的关键。
本文旨在提高对结构化和全面交接班重要性的认识,并强调可能面临的挑战以及改进方法。
基于现有文献,总结了有关ICU交接班的证据,并得出实际实施的建议。
交接班质量对患者安全有影响。同时,由于病例的复杂性、工作环境的干扰性以及大量的专业间和专业内互动,重症监护环境中的沟通极具挑战性。层级式团队结构、反馈和错误管理文化的缺陷、沟通中的(技术)语言障碍以及巨大的身心压力可能会对交接班的有效性产生负面影响。一系列干预措施,如实施检查表、记忆法和沟通工作坊,有助于实现更结构化和全面的交接班过程,并有可能显著提高患者安全。
有效的交接班是高质量和安全患者护理的基石,但在ICU中面临特殊挑战。诸如构建交接班概念和定期进行沟通培训等干预措施有助于改善交接班,从而提高患者安全。