Zum Wohle des Patienten - Arzneimittelsicherheit im Krankenhaus

Die Arzneimittelsicherheit nimmt eine zentrale Stellung im Rahmen der Patientensicherheit ein. Unerwünschte Ereignisse, die Patienten im Krankenhaus erleiden, haben als Ursache oft Medikationsirrtümer und sind im Gegensatz zu einer unerwünschten Arzneimittelwirkung, die bei bestimmungsgemäßen Gebrauch auftritt, vermeidbar. Arzneimittelirrtümer können auf jeder Stufe des Medikationsprozesses entstehen. Es gibt jedoch eine Vielzahl geeigneter Maßnahmen, die den gesamten Medikationsprozess im Krankenhaus sicherer machen können. Ein solcher idealer Medikationsprozess umfasst eine Verschreibungssoftware und eine Arzneimittelauswahl im Krankenhaus, welche mögliche Verwechslungsgefahren berücksichtigt. Weiterhin zählen dazu die Versorgung des Patienten im Unit-dose-System, besondere Aufmerksamkeit bei „Hochrisikomedikamenten”, die Prüfung der ärztlichen Verschreibung durch einen Apotheker sowie eine zentrale Zubereitung von Injektionen und Infusionen. Abschluss dieses Prozesses bildet die „point of care verification”, die vor der Gabe des Medikamentes noch einmal überprüft, dass das richtige Medikament zum richtigen Zeitpunkt beim richtigen Patienten ist.

Medication safety is a key point in the context of patient safety. Adverse drug events, which patients suffer in the hospital, often tely on medication errors and are avoidable contrary to an adverse drug reaction, which arises with intended use. Medication errors can occur on each level of the medication process. Best practices showed that the entire medication process in the hospital can be made safer. Such an ideal medication process covers a computerised physician order entry (CPOE) and a drug selection in the hospital, which considers possible mix-ups. Other best practises are drug distribution in unit-doses, special attention with „high risk medicines” and the supervising of the patients' medication profile by a pharmacist as well as the central preparation of injections and infusions. The end of the proposed ideal process should be a point of care verification which ensures that the right drug with the right patient is at the right time.

Key Words

medication safety - patient safety - medication errors - medication process - computerised physician order entry - drug selection

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