1019 / Drug therapy evidence into practice - a clinical pharmacist service

GERMANY
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Medication / IV Fluids
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Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
Aims of the evidence-based Drug Information Service for nurses and medical doctors run by clinical pharmacists:

To provide unbiased, up-to-date, evidence-based answers to drug-therapy-related enquiries of nurses and medical doctors just in time at the „point of care“ applying a systematic quality-assured evidence based approach. The enquiries can refer to individual patients or patient groups.
To establish a centralized service in the hospital pharmacy department to reduce cost and personal ressources while intensifying interdisciplinary team work within the hospital.
To promote patient safety by ensuring safe and economic use of drugs and knowledge translation into practice.
Description of the Patient Safety Practice
 
Drug therapy is the cornerstone of medical therapies. In spite of national and local clinical guidelines including drug regimens there is a need for individualized desicions facing multimorbidity and multifaceted chronic diseases and consequently complexity of drug combinations prescribed. In clinical practice lots of enquiries of nurses and medical doctors related to drug use are not answered in time to ensure patient safety.
US-american studies showed a reduction in mortality in hospitals with drug information centers.
The service –staffed by two pharmacists and one pharmacy technician– includes a telefon hotline, printed evidence-based answers sent by email or telefax to the enquirer, point of care-consulting and a permanently updated intranet information platform. 2013 over 2000 complex enquiries, 52% by medical doctors and 39% by nurses arising in 42 medical departments of our hospital were managed by the clinical pharmacists of the Drug-Information-Service. Answering time was over two hours for 2%, between 30 and 120 minutes for 44% and under 30 minutes for 52% of the enquiries. 76% of the enquiries needed an instant or same-day answer.
Experienced hospital pharmacists search the literature and evaluate the findings in a systematic approach to increase patient safety during drug therapy. The process includes five steps:
1. Obtaining background information
2. Systematic evidence-based search of the literature (including latest print information and specialized databases)
3. Evaluation, analysis and synthesis of the data
4. Patient-indiviualized conclusion and response
5. Documentation and transfer of information
All answers get documented in a documentation system of the german hospital pharmacy association which is permanently refined to fit drug information pharmacist needs.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
No
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
We evaluated as posters:
enquiries of intensive care wards
enquiries related to dosage
drug interaction enquiries
quality signals in the category drug administration enquiries
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Yes
Specification of implementation in another health care setting(s)
Hospital
Successful implementation's level  of this Patient Safety Practice across settings
Yes, across multiple local/national health systems
Involved health care staff
 
Pharmacists
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Not relevant
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
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Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
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Short description of the service users' level of involvement
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Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
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Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
Yes
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Not sufficient human resources available
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
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Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Yes
Description of used incentives, if any.
Presentations in different specialities of the Hospital to show the potential of the service for nurses and medical doctors.
Intranet Information platform.
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Dr. Vetter-Kerkhoff Cornelia
Country: GERMANY
Organisation: Krankenhausapotheke Klinikum der Universität München
E-mail: Cornelia.Vetter@med.lmu.de
Phone: 0171-5178565
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