Algorithmen und Verfahrensanweisungen in der Notfallmedizin – Chancen und Risiken

Algorithmen und Standards in Form von SOPs, Verfahrensanweisungen und Leitlinien sind in vielen klinischen Bereichen fest etabliert, so auch in der Notfallmedizin. Sie bieten viele Vorteile und können den Arbeitsfluss unterstützen. Sie dürfen jedoch die Anpassung an die Bedürfnisse des individuellen Patienten nicht behindern.

Abstract

In everyday emergency medicine, the use of algorithms and standards has already become firmly established in many places. When determining treatment procedures, the establishment of standards competes with the individualization of treatment for the specific needs of the patient. If everyone on the team has the same algorithm in mind, this can promote communication and collaboration in the sense of a shared mindset, but it can also encourage fixation errors within the team. Even though algorithms have been shown in studies to be effective in processing specific action steps, simply changing the steps in an algorithm can produce a different result. Thus, they must be developed and tested with care. Cognitive aids can support the daily work routine, but must not replace learning and training, nor the clinical view.

Kernaussagen

• One size doesn’t fit all – Algorithmen sollten eine Anpassung an den individuellen Patienten nicht verhindern.

• Wer nur Standards trainiert, bekommt auch nur Standard im Einsatz – der Umgang mit Situationen, die nicht in einen Algorithmus passen, muss trainiert werden und sollte Teil der Aus- und Weiterbildung sein.

• Algorithmen helfen dem gesamten Team, im gleichen „Mindset“ zu arbeiten, können aber auch Fixierungsfehler im Team fördern.

• Algorithmen können Behandlungsabläufe unterstützen, sind aber nicht unfehlbar; ihre Aktualität muss regelmäßig überprüft werden.

• Kognitive Hilfen können insbesondere in Stresssituationen helfen, Gelerntes korrekt wiederzugeben, sie ersetzen jedoch nicht das Lernen an sich.

• Kognitive Hilfen müssen übersichtlich und intuitiv in der Anwendung sein, sie sollten daher mit Sorgfalt entwickelt, getestet und evaluiert werden.

• Die Anwendung von kognitiven Hilfen sollte auch Teil von Trainings sein, damit der Arbeitsfluss unterstützt und nicht behindert wird.

Schlüsselwörter

Standards - kognitive Hilfen - Notfallmedizin - SOPs - Algorithmen

Keywords

standards - emergency medicine - cognitive aids - SOPs - algorithms

Publication History

Article published online:
08 June 2022

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