Franzen Katharina, Lenssen Rebekka, Jaehde Ulrich, Eisert Albrecht
Apotheke des Universitätsklinikums Aachen, AG Klinische Pharmazie und Arzneimittelsicherheit und Klinische Pharmazie, Pharmazeutisches Institut der Universität Bonn.
Klinische Pharmazie, Pharmazeutisches Institut der Universität Bonn.
Ther Umsch. 2014 Jun;71(6):335-42. doi: 10.1024/0040-5930/a000521.
The World Health Organization initiated the project "High5s - Action on Patient Safety". The aim of the High5s project is to achieve a measurable, significant and sustained reduction in the occurrence of five serious patient safety problems within five years, in five countries. One of these patient safety issues is medication reconciliation - the process of assuring medication accuracy at transitions of care. In Germany, eleven hospitals are currently implementing medication reconciliation. Medication reconciliation represents the systematic comparison of the current patient's medication list with the medication list in hospital. For this purpose, Lead Technical Agencies of each participating country translated and adapted the standard operating procedure. This standard operating procedure describes the implementation and the procedure of the medication reconciliation process in detail. This process is divided into three parts. First, the best possible medication history is recorded. Second, based on those records, the responsible physician subsequently prescribes the medication. In the third step, the best possible medication history is compared with the medication orders at admission. During this process, it is likely that some discrepancies will occur. Such discrepancies are discussed with the responsible physician and clarified. A comprehensive acquisition of the best possible medication history is thus particularly important. It will be part of medical records throughout the patients' hospital stay. Thus it will be used as an additional source for comparison and adjustment of patients' medication in order to facilitate optimal drug treatment during the entire hospital stay. The practical implementation of medication reconciliation requires extensive change of the current prescription sheets or prescription software. Thus, this provides a great challenge for many hospitals. Nevertheless, in the Netherlands it has been shown that it is possible to prevent 90 % of unintentional discrepancies with medication reconciliation. A German hospital recently showed a reduction of discrepancies by about 77 %. The use of medication reconciliation to improve clinical endpoints is currently subject of further studies.
世界卫生组织发起了“5S 行动——患者安全项目”。5S 项目的目标是在五年内，在五个国家显著且持续地减少五种严重患者安全问题的发生，并使其可衡量。其中一个患者安全问题是用药核对——在医疗护理转接过程中确保用药准确性的过程。在德国，目前有 11 家医院正在实施用药核对。用药核对是将当前患者的用药清单与医院的用药清单进行系统比较。为此，每个参与国家的主要技术机构对标准操作程序进行了翻译和调整。该标准操作程序详细描述了用药核对过程的实施和步骤。这个过程分为三个部分。首先，尽可能记录完整的用药史。其次，负责的医生随后根据这些记录开出处方。第三步，将尽可能完整的用药史与入院时的用药医嘱进行比较。在此过程中，可能会出现一些差异。这些差异会与负责的医生进行讨论并澄清。因此，全面获取尽可能完整的用药史尤为重要。它将成为患者整个住院期间病历的一部分。因此，它将被用作比较和调整患者用药的额外依据，以便在整个住院期间促进最佳药物治疗。用药核对的实际实施需要对当前的处方单或处方软件进行大量更改。因此，这对许多医院来说是一个巨大的挑战。然而，在荷兰已经表明，通过用药核对有可能预防 90%的无意差异。一家德国医院最近显示差异减少了约 77%。目前，使用用药核对来改善临床终点是进一步研究的课题。
