Immer mehr Patienten, die einen Intensivaufenthalt überleben und von der Beatmung nicht entwöhnt werden können oder mit verbleibender Trachealkanüle ohne Beatmung, werden in der außerklinischen Intensivpflege betreut. Dies stellt einen erheblichen Kostenfaktor im Gesundheitswesen dar. Dieser Artikel bietet einen Überblick über die wesentlichen Vorgaben für die Verordnung, Indikationen, Versorgungsmöglichkeiten und den Prozess der Überleitung in das ambulante Umfeld.
Abstract
Outpatient intensive nursing care offers individuals who require specialized intensive nursing care on a permanent basis the opportunity to survive outside of an intensive care unit in an ambulatory environment. With advancements in surgical and intensive medical practices, coupled with demographic changes in the population resulting in a higher number of older, multimorbid patients, the available treatment options have been continuously extended. Many patients survived their intensive care stays but could not be weaned from ventilation or they had to retain a tracheal cannula, even without ventilation therapy. Presently, this group constitutes the majority of patients receiving outpatient intensive nursing care in Germany and represents a substantial cost factor in healthcare. The care of these patients is governed by the Guideline of the Joint Federal Committee on the Prescription of Outpatient Intensive Nursing Care (AKI-RL), which is based on the Intensive Care and Rehabilitation Strengthening Act (GKV-IPReG) 2021.
Schlüsselwörter
außerklinische Intensivpflege - außerklinische Beatmung - Weaningversager - Trachealkanülenpersistenz - Heimbeatmung - outpatient intensive nursing care - outpatient mechanical ventilation - weaning failure - tracheal cannula persistence - home ventilation
