Article
Pharmacotherapy safety at the ambulant and in-patient interface on surgical wards
Arzneimitteltherapiesicherheit an der Schnittstelle Ambulant-Stationär auf chirurgischen Stationen
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Published: | November 25, 2013 |
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Background: Since more than four years a pharmacist performs the drug anamnesis of surgical patients who are treated at the university medical center Bergmannsheil Bochum.
Materials and Methods: To settle the medication the pharmacist speaks with every patient and confers with the general practitioner, a family member or their residential care home for the elderly if necessary. Medical products which are not available in the hospital are automatically ordered by the pharmacist and are delivered to the ward by the next day at latest. The medication is screened with regard to interactions, dosage, the adaptation to organ dysfunctions and daily intake rhythms. If it is indicated the pharmacist adjusts the medication and consults the responsible surgical physician.
Results: At the ambulant and in-patient interface there are often difficulties in completely ascertaining a patient’s ambulant medication and transcribing it to the medication available in the hospital. Especially elderly patients and patients admitted for emergency reasons are often not able to adequately report their medication. At this point a clinical pharmacist can relieve the surgical physicians organisationally. Moreover, he can positively contribute with his expertise in view of pharmacotherapies. The professional knowledge of the pharmacist and the interdisciplinary collaboration increases the pharmacotherapy and patient safety.
Conclusion: Aim of the project is a prompt and complete ascertainment of the ambulant medication and its conversion to medication available in the hospital to ensure a consistent drug therapy and an increase in patient safety. The surgical physicians and the nursing thereby benefit from a temporal relief and also by the daily presence of the pharmacist at the wards, which improves the interdisciplinary collaboration. With the screening of interactions, dosage, the adaptation to organ dysfunctions and daily intake rhythms the medication is optimised pharmacologically by the pharmacist.
The pharmacist has the chance to bridge the ambulant and in-patient interface and improves the pharmacotherapy and patient safety.