[Improving clinical competences and skills-collaborative learning strategies in intensive care medicine]. / Klinische Handlungskompetenzen gemeinsam verbessern ­ interprofessionelles Lernen in der Intensivmedizin.

This article examines the competencies required from intensive care nurses and physicians regarding complex patient care in the intensive care unit. Traditional training methods and structures in critical care are put into context with the contemporary educational requirements. The goals are promotion of the interprofessional cooperation between nurses and physicians as well as a comparison between previous educational methods and their implications on the resulting skills. Clinical competences are defined as the result of basic professional training as well as further education, which can improve the quality of patient care. Options for improving teaching are shown through the presentation of the various learning venues for theory and clinical practice. Contemporary skills labs and simulation trainings are discussed as a useful supplement to traditional approaches such as traditional nursing practice instruction. It will also be discussed how collaborative learning between nurses and physicians at all levels of training can lead to better patient care by increasing the individual and shared competences.

The occurrence of acute postoperative confusion in patients after cardiac surgery.

This study quantified the occurrence of acute confusion in cardiac surgery patients at three German hospitals. A total of 867 patients, 22-91 years old, were examined each nursing shift postoperatively for 5 days for the presence of acute confusion using a modified version of the Glasgow Coma Scale and Confusion Rating Scale. The night shifts and the third postoperative day showed the most frequent periods of occurrence. Confusional state was noted in patients ranging from 10.5% for patients aged <70, to 40.7% for patients >80 years of age. Those found at increased risk were patients of increasing age and coexisting disease. Targeted nursing interventions for patients at increased risk of acute confusion may decrease this complication.