1041 / Medication management in palliative care

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
Patient involvement There is no specified text here
Topic of the reported practice
Quality management system
Aim and the benefit of the Patient Safety Practice
 
The aim of the project is to increase drug safety, ensure medication continuity and decrease patients’ symptom burden through a pharmacist-led medication management pathway.

Pharmacological management of distressing symptoms is one of the cornerstones of palliative care. While the claim to monitor drug use in palliative care is neither surprising nor new, the associated opportunities and challenges are multifaceted and demand special knowledge and experience. Palliative care patients often take > 5 drugs. Medication regimens can be complex, require a regular review, and need to be evaluated. The differentiation between an adverse drug reaction and a progression of the underlying disease is challenging. Each symptom and medication needs to be addressed and evaluated regularly – particularly in the context of limited life expectancy. Knowledge of the available drugs, products and resources is crucial to ensure a safe and effective drug treatment in palliative care.
Description of the Patient Safety Practice
 
A pharmacist-led medication management pathway for inpatients of the Department of Palliative Medicine at Munich University Hospital has been developed and implemented.
Newly admitted patients to the palliative care unit are visited by a pharmacist within two days for a comprehensive medication history including information on prescription and non-prescription drugs,
herbals, dietary supplements, vitamins, drug and food allergies (with descriptions if possible), effectiveness, tolerability, practice and problems with drug administration. A medication bag is handed out to the main informal carer as invitation to bring all the medications the patient had been taken at home.
During the inpatient stay, the pharmacist reviews all medications and current problems in the patient chart. Drug related problems (including drug interactions, dose adjustments, duplications, etc.) are identified and addressed.
Before discharge the patients` local retail pharmacy and the general practitioner are contacted and informed about the medication regimen. The patient and/or the informal carers are informed about the medication regimen (indications, dosing times, method of drug administration, etc.) and are provided with a medication plan.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
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
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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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
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Pharmacists
Social workers
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the development of the Patient Safety Practices
During the implementation of the Patient Safety Practices
During the application of the Patient Safety Practice
During the evaluation of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Yes
Short description of the service users' level of involvement
Consultation, such as asking for information
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
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 financial resources available
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
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
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Constanze Rémi
Country: GERMANY
Organisation: University of Munich
E-mail: constanze.remi@med.uni-muenchen.de
Phone: +49-(0)89 7095 4922
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