Suchergebnisse

Im Auftrag des Bundesministeriums für Gesundheit wurden im Jahr 2013 Empfehlungen zur Effizienzsteigerung der Pflegedokumentation entwickelt, die in ein Strukturmodell mündeten, welches 2014 einem ersten Praxistest unterzogen wurde. Seit dem 01. Januar 2015 startete auf Initiative des Beauftragten der Bundesregierung für die Belange von Patientinnen und Patienten sowie Bevollmächtigen für Pflege das Projekt zur flächendeckenden Einführung der neuen Pflegedokumentation Strukturmodell. Bis Anfang Juni 2016 registrierten sich bundesweit knapp 10.000 Pflegedienste und stationäre Pflegeeinrichtungen für die Einführung des neuen Dokumentationssystems. Die Implementierung begleitend soll die Zielerreichung der neuen Pflegedokumentation auf der Grundlage der integrierten Strukturierten Informationssammlung SIS – auch im Hinblick auf die Dokumentationsqualität – wissenschaftlich evaluiert werden.

Die Verfasser fragen, in wie weit der Grundsatz "Jeder nach seinen Fähigkeiten, jedem nach seinen Bedürfnissen" in den Teilsystemen der Krankenversorgung und Gesundheitsförderung als gesellschaftliche Grundformel wirksam ist. An den Grenzen des Krankenversorgungssystems stehen - in Gestalt wissenschaftlicher Gutachter - Wärter, die darüber wachen, dass die generalisierte Bedürfnisnorm wirklich nur im Krankheitsfall in Anspruch genommen wird. Für ganz Deutschland nach 1989 und auch in den vergleichend herangezogenen Ländern Tschechien, Schweiz und Italien gilt der individualisierende Grundsatz dieser Norm als selbstverständliche gesetzliche Grundregel des Systems der Krankenversorgung. Wichtig zur Sicherung individueller Bedarfsgerechtigkeit ist die Strategie der Evidenzbasierung, die gesamtgesellschaftlich und individuell Fehl- und Überversorgung ausschließen und im Kontext der wirtschaftlichen und politischen Systeme der Gesellschaft Gerechtigkeit herstellen soll. Hier konnte nachgewiesen werden, dass eine organmedizinische Diagnose zuzüglich externer Therapieerfahrungen zwar notwendige, aber keinesfalls hinreichende Voraussetzungen sind, um individuellen Bedarf feststellen zu können. (ICE2)

Background: Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To date, a framework of nurses' competences on knowledge, skills, and attitudes as to interprofessional pharmaceutical care tasks is missing. Objectives: To reach agreement with experts about nurses' competences for tasks in interprofessional pharmaceutical care. Methods: A two-phase study starting with a scoping review followed by five Delphi rounds was performed. Competences extracted from the literature were assessed by an expert panel on relevance by using the RAND/UCLA method. The experts (n = 22) involved were healthcare professionals, nurse researchers, and educators from 14 European countries with a specific interest in nurses' roles in interprofessional pharmaceutical care. Descriptive statistics supported the data analysis. Results: The expert panel reached consensus on the relevance of 60 competences for 22 nursing tasks. 41 competences were related to 15 generic nursing tasks and 33 competences were related to seven specific nursing tasks. Conclusions: This study resulted in a competence framework for competency-based nurse education. Future research should focus on imbedding these competences in nurse education. A structured instrument should be developed to assess students' readiness to achieve competence in interprofessional pharmaceutical care in clinical practice. ; The research was supported by the Erasmus+ Programme of the European Union (grant number 2018–1-BE02-KA203–046861) and MDMJ accountants, an accountancy service in Belgium that financially supported the Belgian authors, without any conflicts of interest.

Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses' responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework describing potential nursing tasks in PC and to investigate nurses' level of responsibility. A framework of PC tasks and contextual factors was developed based on literature review and previous DeMoPhaC project results. Tasks and context were cross-sectionally evaluated using an online survey in 14 European countries. A total of 923 nurses, 240 physicians and 199 pharmacists responded. The majority would consider nurses responsible for tasks within: medication self-management (86–97%), patient education (85–96%), medication safety (83–95%), monitoring adherence (82–97%), care coordination (82–95%), and drug monitoring (78–96%). The most prevalent level of responsibility was 'with shared responsibility'. Prescription management tasks were considered to be nurses' responsibility by 48–81% of the professionals. All contextual factors were indicated as being relevant for nurses' role in PC by at least 74% of the participants. No task nor contextual factor was removed from the framework after evaluation. This framework can be used to enable healthcare professionals to openly discuss allocation of specific (shared) responsibilities and tasks. ; This research was supported by the Erasmus+ Programme of the European Union [grant number 2018-1-BE02-KA203-046861] and MDMJ accountants, Belgium.

Objectives Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses' roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses' practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists. Design A cross-sectional survey. Setting The study was conducted in 17 European countries, each with their own health systems. Participants Pharmacists, physicians and nurses with an active role in PC were surveyed. Main outcome measures Nurses' involvement in PC, experiences of interprofessional collaboration and communication and views on nurses' competences. Results A total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses' involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC. Conclusions ME, MMA, PEI and prescribing are part of nurses' activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more. ; This work was supported by the Erasmus+Programme of the European Union (grant number 2018-1-BE02-KA203-046861) and MDMJ accountants, an accountancy service in Belgium that financially supported the Belgian authors, without any conflicts of interest.