Status of Cardiac Surgical Intensive Care Medicine in Germany during 2013: A Report on Behalf of the German Society for Thoracic and Cardiovascular Surgery

Abstract

Background This report summarizes the results of a voluntary survey designed to assess the current situation of cardiac surgical intensive care medicine in Germany in 2013.

Methods A standardized questionnaire concerning detailed information about structural characteristics of cardiac surgical intensive care units (ICUs) was sent to all German departments performing cardiac surgery.

Results Participation quota resp. response rate was 100%. Compared with previous surveys since 1998, the total number of available intensive care capacities for patients after cardiac surgery increased to 1,404 beds, whereas the proportion of cardiac surgical ICUs decreased to 59% with a simultaneous increase of interdisciplinary ICUs. The proportion of cardiac surgeons acting as director of an ICU declined to 36%. The physicians' teams were predominantly interdisciplinary (74%). More than half of the directors were board-certified intensivists (54%), with a peak of 81% in ICUs run by cardiac surgeons. Human resources development in the ICU showed divergent trends with an increase of physicians and a decrease of nurses. Half of all ICUs (50%) and two-thirds of cardiac surgical ICUs (65%) offer an accredited training program for intensive care medicine.

Conclusion The results of this survey corroborate that intensive care medicine represents a substantial and important part of cardiac surgery. However, efforts are necessary to keep this attitude alive for the future.

Keywords

cardiac surgery - intensive care medicine - survey

• References

• 1 Statistisches Bundesamt. . Grunddaten der Krankenhäuser 2011 (March 12, 2013 . Available at: http://www.destatis.de/DE/Publikationen/Thematisch/Gesundheit/Krankenhaeuser/GrunddatenKrankenhaeuser2120611117004.pdf?__blob=publicationFile . Accessed November 23, 2013
• 2 Beckmann A, Funkat AK, Lewandowski J , et al. Cardiac surgery in Germany during 2012: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg 2014; 62 (1) 5-17
• 3 Australian and New Zealand Intensive Care Society. . Centre for Outcome and Resource Evaluation. Annual Report 2011–12, Available at: http://www.anzics.com.au/downloads/cat_view/4-centre-for-outcome-and-resource-evaluation-core/84-core-annual-reports . Accessed November 23, 2013
• 4 Jorch G, Kluge S, König F , et al. Empfehlungen zur Struktur und Ausstattung von Intensivtherapiestationen – Kurzversion –. DIVI 2011; 2: 78-86
• 5 Isfort M, Weidner F, Gehlen D. Pflege-Thermometer 2012. Eine bundesweite Befragung von Leitungskräften zur Situation der Pflege und Patientenversorgung auf Intensivstationen im Krankenhaus. Deutsches Institut für angewandte Pflegeforschung e.V. (dip), Köln. 2012 . S.15
• 6 Van den Heede K, Lesaffre E, Diya L , et al. The relationship between inpatient cardiac surgery mortality and nurse numbers and educational level: analysis of administrative data. Int J Nurs Stud 2009; 46 (6) 796-803
• 7 Gajic O, Afessa B. Physician staffing models and patient safety in the ICU. Chest 2009; 135 (4) 1038-1044
• 8 Kim MM, Barnato AE, Angus DC, Fleisher LA, Kahn JM. The effect of multidisciplinary care teams on intensive care unit mortality. Arch Intern Med 2010; 170 (4) 369-376
• 9 Map I. Getting Started Kit: Multidisciplinary Rounds How-to Guide. Cambridge, MA: Institute for Healthcare Improvement; 2010. . Available at: http://www.ihi.org/knowledge/Pages/Tools/HowtoGuideMultidisciplinaryRounds.aspx . Accessed October 20, 2013
• 10 Brilli RJ, Spevetz A, Branson RD , et al; American College of Critical Care Medicine Task Force on Models of Critical Care Delivery. The American College of Critical Care Medicine Guidelines for the Defintion of an Intensivist and the Practice of Critical Care Medicine. Critical care delivery in the intensive care unit: defining clinical roles and the best practice model. Crit Care Med 2001; 29 (10) 2007-2019
• 11 Braun JP, Kumpf O, Deja M , et al. The German quality indicators in intensive care medicine 2013—second edition. Ger Med Sci 2013; 11: Doc09
• 12 Kucukarslan SN, Peters M, Mlynarek M, Nafziger DA. Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Intern Med 2003; 163 (17) 2014-2018
• 13 Al-Jazairi AS, Al-Agil AA, Asiri YA, Al-Kholi TA, Akhras NS, Horanieh BK. The impact of clinical pharmacist in a cardiac-surgery intensive care unit. Saudi Med J 2008; 29 (2) 277-281
• 14 Rimawi RH, Mazer MA, Siraj DS, Gooch M, Cook PP. Impact of regular collaboration between infectious diseases and critical care practitioners on antimicrobial utilization and patient outcome. Crit Care Med 2013; 41 (9) 2099-2107
• 15 Afessa B, Gajic O, Keegan MT, Seferian EG, Hubmayr RD, Peters SG. Impact of introducing multiple evidence-based clinical practice protocols in a medical intensive care unit: a retrospective cohort study. BMC Emerg Med 2007; 7: 10
• 16 Markewitz A, Haake N, Trummer G, Beckmann A. Struktur herzchirurgischer Intensivstationen. Ergebnisse einer Umfrage aus dem Jahr 2008. Z Herz- Thorax- Gefäßchir 2009; 23: 155-163