Zusammenfassung
In der klinischen Praxis der Intensivtherapie in Deutschland werden unterschiedliche Strategien zur Sicherung, Fixierung und Pflege des peroralen Endotrachealtubus und der Mundpflege bei beatmeten Patienten angewandt. Es fehlen national verbindliche und allgemein konsentierte Leitlinien oder Empfehlungen hierzu. In einer Umfrage unter Intensivpflegenden wurden die am meisten verbreiteten Vorgehensweisen und Pflegemaßnahmen erfasst. Gemäß Auswertung der Umfrage und der zur Verfügung stehenden internationalen Literatur werden aktuell angewandte Strategien diskutiert. In der Folge dieser Arbeit entstanden Empfehlungen zur Verbesserung der Pflegepraxis unter Berücksichtigung aller Möglichkeiten, der patientenseitigen Notwendigkeiten und der gefundenen Evidenz dazu. Berücksichtigt wurden auch Aspekte der Medizinproduktzweckbestimmung, der Patientensicherheit und der Komplikationsvermeidung sowie Grundlagen qualitätsorientierter Pflegepraxis im Kontext limitierter Pflegeressourcen.
Abstract
There are a wide variety of strategies and methods used in securing and managing the oral endotracheal tube and mouth and oral care in German clinical intensive care nursing for mechanically ventilated patients. There are no nationally recognized guidelines or recommendations on this topic. A survey among intensive care nurses identified the most widely used nursing strategies and methods. Regarding the results of the survey and international literature findings, the commonly used strategies and methods are discussed. Following these discussions, there are recommendations for improving nursing care of orally intubated patients in intensive care, including the aspects of evidence identified, currently used methods and patient needs. Also included are aspects of patient safety, potential complications and quality-orientated nursing care within a system having limited overall nursing care resources.
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Interessenkonflikt. O. Rothaug, A. Müller-Wolff, R. Kaltwasser, R. Dubb und C. Hermes erklären, Honorare für Vorträge von Firmen erhalten zu haben, deren Produkte im Zusammenhang mit dieser Publikation stehen. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Rothaug, O., Müller-Wolff, A., Kaltwasser, R. et al. Praxis der Fixierung des Endotrachealtubus. Med Klin Intensivmed Notfmed 108, 507–515 (2013). https://doi.org/10.1007/s00063-013-0264-9
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DOI: https://doi.org/10.1007/s00063-013-0264-9