Zusammenfassung
Hintergrund
Durch den demografischen Wandel gewinnt die Shuntchirurgie eine zunehmende Bedeutung in der gefäßchirurgischen Weiterbildung. Einerseits steigt die Zahl der Eingriffe, andererseits die Komplexität der Fälle. Neue Arbeitszeitmodelle und Dienstzeitregelungen führen zu einem Mangel an praktischer Weiterbildungszeit im Operationssaal.
Fragestellung
Welchen Stellenwert haben Simulationstrainings in der Weiterbildung und welchen Einfluss haben sie auf die Patientensicherheit.
Material und Methoden
Literaturreview und Analyse von zwei 1½-tägigen Shuntkursen am Modell.
Ergebnisse
Um die geforderten Qualitätsstandards zu erreichen, bekommen Simulationstrainings zunehmend Bedeutung. Auch aus Sicht der Patientensicherheit sind solche Trainings sinnvoll. Weltweit gibt es unseres Wissens kaum strukturierte Kurse, um Techniken der Shuntchirurgie zu trainieren.
Schlussfolgerungen
Um die Patientensicherheit zu gewährleisten, müssen Leitlinien entwickelt werden, die im klinischen Alltag Umsetzung finden. Daneben sollten institutionsintern die Abläufe geklärt, Checklisten befolgt und Sicherheitsnetzte geschaffen werden, um für die Patienten eine sichere Behandlung zu gewährleisten. Die Simulation wird dabei in der Zukunft eine wichtige Rolle in der chirurgischen Weiterbildung einnehmen und die Bestrebungen für mehr Patientensicherheit unterstützen.
Abstract
Background
As a result of demographic changes vascular access surgery is gaining in importance in training in vascular surgery. The case numbers as well as the complexity of surgical interventions are continuously increasing; however, new working schedule models and on duty time restrictions lead to a lack of practical training in the operating room.
Objectives
The aim of this study was to assess the relevance of simulation training for patient safety in vascular access surgery.
Material and methods
A literature review as well as an analysis of two vascular access courses each lasting 1.5 days and using a pulsatile arm model were performed.
Results
To meet the high quality standards at least a partial shift in surgical training is taking place from patients to simulation models. Simulation training is recognized as an instrument for patient safety management and is therefore becoming increasingly more important in vascular surgery. It remains unclear whether an intensive practical course using simulation models can improve skills in vascular access surgery.
Conclusions
In order to guarantee patient safety guidelines must be developed, which are applicable in the clinical routine. Additionally, the institutional procedures must be clarified internally, check lists must be followed and safety networks must be established in order to guarantee safe treatment for patients. In the future simulation will play an important role in advanced surgical training and support the efforts to improve patient safety.
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P. Schuch, L.W. Widmer, M.K. Widmer, C. Weiss, A. Assadian, und J. Falkensammer geben an, dass kein Interessenkonflikt besteht.
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Schuch, P., Widmer, L., Widmer, M. et al. Patientensicherheit und deren Bedeutung für die Weiterbildung der Shuntchirurgen. Gefässchirurgie 20, 571–575 (2015). https://doi.org/10.1007/s00772-015-0084-8
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DOI: https://doi.org/10.1007/s00772-015-0084-8