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

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.