Retirement and nursing homes
pharmacy in geriatric patients increases the probability of mortality and
morbidity.
In order to make the provision of medication and care planning safer, not
only the individual competence of all those involved in the administration
of medication should be strengthened, but also the cooperation and
communication of all stakeholders (general practitioner, medical specialists,
pharmacists, nursing staff, social support, patient and relatives) improved
and intensified.
But in reality this is lacking to a great extent. In the year under review, the
Medical Chamber of Tyrol sent out a circular – which is in the possession
of the NPM – expressly recommending all practising office-based doctors to
strictly separate medical documentation from nursing documentation in care
facilities. They also hold the view that the nursing staff do not have to be
informed about diagnoses and medical therapy objectives.
It goes without saying that a good collaboration of all professions in the
interest of the patients is essential. However, it is not guaranteed in all care
facilities. “Tribal thinking” on the part of the medical profession – in other
words, the tendency to act separately or even in competition with nursing –
is indefensible and unacceptable as far the NPM is concerned. The Federal
Ministry of Labour, Social Affairs, Health and Consumer Protection was
informed about this. Qualified nursing staff may not be left in the dark about
diagnoses and therapy objectives or where health promotion, prevention,
therapy, rehabilitation, palliation, but also safe medication therapy are
concerned. After all, they are also responsible for measures to improve the
quality of life and should be able to plan the same. Furthermore, the lack of
coordination feeds stressful – and expensive – “revolving door effects” if those
in need of care are alternating between the nursing home and hospitals at
short intervals.
Documentation is not
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Medication reviews by medical, pharmaceutical and nursing staff are long
since established in the Anglo-American region. This type of cooperation is
legally possible in Austria too and is practised in isolated cases. There are
also some care facilities in which general practitioners use the nursing home
documentation system and document visits and treatments themselves. This
helps prevent transcription errors, reduces the workload for nursing staff and
improves the safety of residents. Care facilities in which joint nursing rounds
and case reviews take place demonstrate how the important nursing home/
general practitioner interface can be optimised. The availability of the doctors
is regulated. Treatment by a substitute is guaranteed if the doctor is not on-site
or has other commitments. There are also fixed emergency rules which are
observed by both sides.
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