[Neurointensive care in Germany : Results of an inspection of intensive care units]

Nervenarzt. 2018 Feb;89(2):147-155. doi: 10.1007/s00115-017-0446-4.
[Article in German]

Abstract

Background: The situation of neurointensive care in Germany is unclear.

Objectives: An inspection of neurointensive wards should help to clarify the situation.

Materials and methods: On the occasion of stroke unit certification audits, 320 intensive care units (39 independent neurological and 20 neurosurgical, 6 combined neurological/neurosurgical, 253 interdisciplinary intensive wards) were inspected.

Results: On the 39 neurological and the 20 neurosurgical intensive care units, a physician with intensive care specialization was available in 92% and 100% of units, respectively, and a physician with authorization for intensive care training was available in 74% and 80% of units, respectively. A whole day shiftwork existed in 59% and 55% of units, respectively. On the interdisciplinary wards a physician with intensive care specialization was available in 76% and a physician with authorization for intensive care training was available in 52% of units. A whole day shiftwork existed in 64% of units. A full-time neurological/neurosurgical presence during business hours was found only in 18% of units.

Conclusions: The neurological/neurosurgical presence and the opportunities for intensive care training on the interdisciplinary wards are not sufficient. There is an urgent need for improvement.

Keywords: Inspection of wards; Intensive care training; Neurointensive care; Presence; Shiftwork.

MeSH terms

  • Critical Care / organization & administration*
  • Curriculum
  • Education, Medical, Graduate
  • Germany
  • Humans
  • Intensive Care Units / organization & administration*
  • Interdisciplinary Communication
  • Intersectoral Collaboration
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / therapy*
  • Neurology / education
  • Neurosurgery / education
  • Patient Care Team / organization & administration