Zusammenfassung
Hintergrund
Weltweit stehen sog. „cardiac arrest teams“ (CAT) zur innerklinischen Notfallversorgung bereit. Zur Prävention werden „medical emergency teams“ (MET) eingesetzt. Die vorliegende Studie untersucht die innerklinische Notfallversorgungsstruktur an niederländischen Kliniken.
Methodik
Es wurden strukturierte Interviews durchgeführt („mixed methods design“). Erfasst wurden die Struktur der innerklinischen Notfallversorgung und die Ausbildung der Klinikmitarbeiter. Einbezogen wurden 9 niederländische Universitätskliniken (Gruppe 1), 9 Kliniken der Schwerpunktversorgung (Gruppe 2) und 9 Kliniken der Grundversorgungsstufe (Gruppe 3).
Ergebnisse
Insgesamt 25 Kliniken (93%) nahmen an den Interviews teil, von denen 21 (78%) in die Untersuchung integriert wurden. Alle untersuchten Kliniken stellten mindestens ein CAT. Vier der 21 Kliniken (19%) hatten zusätzlich ein MET zur Prävention innerklinischer Notfälle. Unterschiede bestanden hinsichtlich der nächtlichen innerklinischen Notfallversorgung und der Ausbildung des Personals in Abhängigkeit von der Versorgungsstufe.
Diskussion
Bei allen Kliniken war eine strukturierte Notfallversorgung durch spezielle Notfallteams implementiert. Die Prävention durch MET ist erweiterungsfähig. Um die innerklinische Notfallversorgung weiter zu verbessern, bieten sich konsequente Notfallschulungen auf Normalstationen an.
Abstract
Background
Throughout the world there are so-called cardiac arrest teams (CAT) for in-hospital emergency care. In addition medical emergency teams (MET) are integrated for the prevention of in-hospital emergency situations. The present investigation investigated the structure of emergency care in Dutch hospitals.
Methods
The investigation was performed using structured interviews (mixed methods design). The survey covered the structure of in-hospital emergency care as well as the training of the CAT members. A total of 9 university hospitals (group 1), 9 secondary care hospitals (group 2) and 9 primary care hospitals (group 3) were included in the investigation.
Results
A total of 25 physicians agreed to be interviewed (93%) of which 21 were included in the present investigation (78%). Regardless of the level of care, all examined hospitals had at least one CAT and 4 of the 21 hospitals had, in addition, a MET for the prevention of in-hospital emergencies (19%). With respect to the in-hospital emergency night time medical care and the skills of the staff, there were differences between the examined hospitals.
Conclusions
In all hospitals there was a structured emergency care by special emergency teams. The in-hospital emergency prevention by MET needs improvement. A possibility to improve the emergency care of hospitalized patients is to train the staff on normal wards.
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Danksagung
Die Autoren danken allen Teilnehmern an der vorliegenden Untersuchung für ihre Bereitschaft, die in der jeweiligen Klinik implementierten Notfallsysteme darzustellen und zu erläutern.
Interessenkonflikt
Der korrespondierende Autor weist auf folgende Beziehung hin: Die vorliegende Untersuchung enthält Daten der Promotionsarbeit von Anna Bergmann.
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Wiese, C., Bergmann, I., Bergmann, A. et al. Struktur der innerklinischen Notfallversorgung in niederländischen Kliniken unterschiedlicher Versorgungsstufen. Notfall Rettungsmed 13, 131–137 (2010). https://doi.org/10.1007/s10049-009-1266-2
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DOI: https://doi.org/10.1007/s10049-009-1266-2
Schlüsselwörter
- Innerklinisches Notfallmanagement
- Innerklinischer Notfall
- Innerklinisches Notfallteam (CAT)
- Innerklinisches Präventionsteam (MET)
- Herz-Lungen-Wiederbelebung