Analiza izvajanja brezšivne skrbi ob sprejemu bolnikov na Univerzitetni rehabilitacijski inštitut Republike Slovenije – Soča

Dolenc, Maša (author), Kerec - Kos, Mojca (mentor), Petrica, Demetrij (comentor)

Brezšivna skrb pomeni zagotavljanje kontinuirane oskrbe pacienta z zdravili in neprekinjenega prenosa informacij o pacientovem zdravljenju z zdravili pri prehodu med različnimi ravnmi zdravstvenega sistema. Ena od kognitivnih storitev, ki jih vključuje brezšivna skrb, je usklajevanje zdravljenja z zdravili, tj. zagotavljanje točne in popolne informacije o zdravljenju z zdravili pri prehodu med ali znotraj ravni zdravstvene dejavnosti z namenom zmanjšanja pojavljanja neskladij v predpisu zdravil. Z raziskavo smo želeli analizirati izvajanje brezšivne skrbi, ki jo ob sprejemu na Univerzitetni rehabilitacijski inštitut Republike Slovenije - Soča izvaja klinični farmacevt. Cilj je bil pridobitev informacij o pogostosti pojavljanja neskladij v predpisu zdravil med temperaturno listo in zgodovino zdravljenja z zdravili, klasificiranje vrste neskladij, analiza neskladij glede namernosti in dokumentiranosti ter pridobitev informacij o pogostosti upoštevanja farmacevtovega predloga za odpravo neskladij. V analizo smo vključili paciente, ki so bili v prvih treh mesecih leta 2018 sprejeti na dva izbrana bolnišnična oddelka. V raziskavo smo vključili 101 pacienta s povprečno starostjo 58,0 let. Pacienti so imeli v zgodovini zdravljenja z zdravili skupno 922 zdravil, neskladje pa je bilo prisotno pri 388 zdravilih (42,1 %). Vsaj eno neskladje je bilo prisotno pri 89,7 % pacientov, ki so imeli v svoji zgodovini zdravljenja z zdravili vsaj eno zdravilo. Največ zdravil z neskladji je spadalo med zdravila z delovanjem na živčevje (npr. analgetiki, psiholeptiki) in zdravila za bolezni prebavil in presnove (npr. zdravila proti zaprtju, zdravila za kislinsko pogojene bolezni). Najpogosteje klasificirane vrste neskladij so bile ukinitev zdravila (36,3 %), sprememba odmerjanja zdravila (31,2 %) in uvedba zdravila (24,2 %). 33,5 % vseh neskladij je bilo namernih in dokumentiranih, 16,5 % namernih in nedokumentiranih, 16,8 % nenamernih in 33,2 % neopredeljenih. Farmacevtov predlog za odpravo neskladij je bil upoštevan pri 19,9 % nenamernih in neopredeljenih neskladjih. Rezultati naše raziskave kažejo, da je izvajanje brezšivne skrbi ob sprejemu na Univerzitetni rehabilitacijski inštitut Republike Slovenije - Soča pozitivno in koristno, hkrati pa je v prihodnosti treba stremeti k še bolj kakovostnemu izvajanju brezšivne skrbi in usklajevanja zdravljenja z zdravili s pomočjo tesnega in profesionalnega sodelovanja vseh vpletenih zdravstvenih delavcev.

• Language: Slovenian
• Keywords: brezšivna skrb, usklajevanje zdravljenja z zdravili, zgodovina zdravljenja z zdravili, neskladje, Univerzitetni rehabilitacijski inštitut Republike Slovenije - Soča
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2019
• PID: 20.500.12556/RUL-107346
• Publication date in RUL: 02.04.2019

Secondary language

• Language: English
• Title: Analysis of seamless care at patients' admission in University Rehabilitation Institute, Republic of Slovenia - Soča

Abstract

Seamless care means providing continuous medication supply for patient and uninterrupted transfer of information about patient’s medication therapy during patient’s transition between different healthcare settings. Medication reconciliation is one of the cognitive pharmaceutical services that are part of seamless care. It is a process that ensures accurate and complete medication information transfer at interfaces of care, with the aim to reduce the occurrence of medication discrepancies. The purpose of our research was to analyze the process of seamless care performed by clinical pharmacist at patients’ admission to University rehabilitation institute, Republic of Slovenia - Soča. Our goal was to gather information about the frequency of medication discrepancies between medication history and admission orders, classify types of discrepancies, analyze intention and documentation of discrepancies and gather information how often pharmacist’s proposal for discrepancy resolution was accepted. The analysis included patients who were admitted to two chosen hospital wards in the first three months of 2018. The research included 101 patients, whose average age was 58.0 years. Patients’ medication histories contained 922 medications altogether, of which 388 (42.1 %) had identified discrepancies. 89.7 % of patients with at least one medication in their medication history had at least one medication discrepancy. Medications with the most discrepancies were nervous system medication (eg. analgesics, psycholeptics) and alimentary tract and metabolism medication (eg. drugs for constipation, drugs for acid related disorders). Most frequently classified types of discrepancy were drug omission (36.3 %), dosage change (31.2 %) and drug addition (24.2 %). 33.5 % of all discrepancies were intentional and documented, 16.5 % intentional and undocumented, 16.8 % unintentional and 33.2 % unspecified. Pharmacist’s proposal for discrepancy resolution was accepted in 19.9 % of unintentional and unspecified discrepancies. Results of our research show the process of seamless care at admission to University rehabilitation institute, Republic of Slovenia - Soča as positive and useful. However, it is important to strive for even better quality of seamless care and medication reconciliation practice, with close cooperation of all involved healthcare professionals.

• Keywords: seamless care, medication reconciliation, medication history, medication discrepancy, University rehabilitation institute, Republic of Slovenia - Soča