Effekte eines Maßnahmenbündels an einem kommunalen Krankenhaus auf Prophylaxe, Therapie und Inzidenz von Übelkeit und Erbrechen sowie die innerbetrieblichen Abläufe, Einstellung der Mitarbeiter und der Patientenzufriedenheit

Übelkeit und Erbrechen in der postoperativen Phase (PONV) stellt eine der häufigsten und lästigsten Nebenwirkungen einer Allgemeinanästhesie dar. Eine Senkung der PONV-Inzidenz ist somit aus Patientensicht aber auch aus der Perspektive von Mitarbeitern und Krankenhausleitung, also letztlich allen St...

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Bibliographic Details
Main Author: Röck, Jürgen
Contributors: Eberhart, Leopold (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2019
Online Access:PDF Full Text
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Postoperative nausea and vomiting (PONV) is one of the most common and annoying side effects of general anesthesia. A reduction in PONV incidence is therefore desirable from a patient's perspective as well as from the perspective of staff and hospital management, ultimately all stakeholders in the hospital. The present study shows how the introduction of a comprehensive package of measures at a clinic for anesthetics of extended basic and standard care could improve structures, processes and ultimately also the results with regard to PONV. The measures evaluated in this study included employee education, motivation of the anesthesia team, preparation of a standard operating procedure manual (SOP) paralleled by an extended pharmacological portfolio against PONV as well as a patient survey. By comparing the situation before and after the introduction of the package of measures, the resulting changes could be objectified. These were clearly recognizable in the changed attitude of both the medical and nursing staff of the anesthesia clinic. In parallel, the prescription frequency and quality of antiemetics and corresponding PONV-reducing anesthetic techniques increased. As a result, a significant decrease in the incidence of PONV, in particular a significantly reduced incidence of particularly severe courses of nausea and vomiting was recorded. This resulted in a measurably higher patient satisfaction. The changes brought about show that a well designed and consistently implemented set of measures can bring about lasting positive effects in a hospital organism. This is a positive example of successful change management.