gms | German Medical Science

Background: In Germany, nursing staff is not offered sufficient education on medication issues considering the patient’s needs in today’s complex medication process. On the other hand, nurses are supposed to communicate effectively with medical doctors and pharmacists. They should watch and document effects and side effects of medication. Local drug therapy safety teams consisting of doctors, pharmacists and nurses should constitute themselves [1].

A pharmacy service has been developed in German residential homes for elderly people. In 2016, the geriatric pharmacist has implemented criteria describing structures, processes and results according to the German National Standards of Nursing [2].

Since, the key question has been: How can geriatric pharmacists contribute to nurses’ education on medication? The aim is to enable nursing staff to become active members of the medication process and to encourage them to address doctors and pharmacists.

Medication plays an important role in care planning, for example in nutrition management, pain management, fall prevention and oral health [3]. Hence, the teaching method “Medication in Care Planning” has been developed.

Materials and methods: The complete training consists of eight modules of five hours each. Questions on education articles and implementation tasks are worked through during practical phases. Alternatively, shorter workshops introduce to the main ideas.

The mediScheme has been developed to visualise the connections between body system, diagnosis and medication. At first, the diagnoses are allocated to the body systems. Secondly, the nurses learn about ATC codes. The first letter representing the anatomic levels of the drugs are put into relation with the body systems.

Methods to enhance transfer effectiveness are included in the training programme.

Discussion: Long-term implementation is a big challenge. Over the years ressources for communication seem to have decreased. It has become increasingly difficult to get a quick answer on the phone. The training offers solutions: participating nurses are enabled to address the doctors during their visits to the residential homes. Nursing staff feels more self-conscious and applies the mediScheme and other tools for documentation showing them to the doctors. Remuneration should be paid for the time necessary for communication.

Results: Nurses explore the connections between medication and care planning. Nurses improve their sense of responsibility and feel safer in communication with doctors and pharmacists than before the training. German Praxisanleiter, practical instructors, apply the mediScheme to teach nurses in training. One nurse in one residential home currently runs a small project to explore the connection between medication and behaviour of a resident in gerontopsychiatry. In this project he talks to the psychiatrist regularly who has deprescribed two medicines.

Conclusion: “Medication in Care Planning” is an effective approach of one geriatric pharmacist to address nursing staff to medication issues. An increasing level of interest towards this continuing education programme can be observed. In one town, regular meetings of doctors, pharmacists and nurses are held once a year. In a second town invitations are prepared in September 2023. It is recommended that all acteurs in the medication process use the same tools, improve their communication skills and speak a language that can be understood by everybody: nurses, carers, patients and people who are able to use German as a second language. More time will be needed to build local drug therapy safety teams.