M Thöns1, M Zenz. 1. Praxisklinik, Witten. email@praxisklinik-witten.de
Abstract
BACKGROUND AND OBJECTIVE: German hospices are subject to a special law on homes. This makes sure that patients' medicine is stored individually. It has to be immediately destroyed when they have died and is not allowed to be used for other patients. This is controlled by a public authority for narcotics. We interviewed German hospices by questionnaire to find out how they deal with this problem. METHODS: A questionnaire with ten items about the care situation and pain therapy was sent to all adult hospices. RESULTS: Of the 101 hospices approached, 54 replied. On average 101 guests were cared for per hospice in 2003, and the average duration was 23 days; 49% used an official solution in accordance with the relevant authorities and 87% an unofficial solution. In 32 (59%) pain measurement was documented by a pain scale (VAS), 67% used a general documentation, and in one case pain measurement was not documented at all. DISCUSSION: Even if 49% of the hospices used an official regulation, 87% used an internal solution. This is economically understandable because the cost of destroyed medicine is estimated at more than 100 Euro/patient. Delayed treatment causing intense pain can occur due to incorrect keeping of medicine pools. Destroying medicine is inconsistent with an economic framework. CONCLUSION: In compliance with a comprehensible documentation and with the consent of the client or heir, the passing on of medicine should be made possible. The Ministry of Health from NRW is in agreement with this.
BACKGROUND AND OBJECTIVE: German hospices are subject to a special law on homes. This makes sure that patients' medicine is stored individually. It has to be immediately destroyed when they have died and is not allowed to be used for other patients. This is controlled by a public authority for narcotics. We interviewed German hospices by questionnaire to find out how they deal with this problem. METHODS: A questionnaire with ten items about the care situation and pain therapy was sent to all adult hospices. RESULTS: Of the 101 hospices approached, 54 replied. On average 101 guests were cared for per hospice in 2003, and the average duration was 23 days; 49% used an official solution in accordance with the relevant authorities and 87% an unofficial solution. In 32 (59%) pain measurement was documented by a pain scale (VAS), 67% used a general documentation, and in one case pain measurement was not documented at all. DISCUSSION: Even if 49% of the hospices used an official regulation, 87% used an internal solution. This is economically understandable because the cost of destroyed medicine is estimated at more than 100 Euro/patient. Delayed treatment causing intense pain can occur due to incorrect keeping of medicine pools. Destroying medicine is inconsistent with an economic framework. CONCLUSION: In compliance with a comprehensible documentation and with the consent of the client or heir, the passing on of medicine should be made possible. The Ministry of Health from NRW is in agreement with this.