[Recording and assessment of medication errors : Experience of the Drug Commission of the German Medical Association]. / Erfassung und Bewertung von Medikationsfehlern : Erfahrungen der Arzneimittelkommission der deutschen Ärzteschaft.

Adverse drug reactions (ADRs) are a common problem in daily clinical practice and they may in part result from medication errors. According to the extended interpretation in the new European pharmacovigilance guideline, medication error-related reactions are classified as ADRs. Therefore, the pharmacovigilance system needs to be adjusted to record medication errors. As a partner in the German pharmacovigilance system, the Drug Commission of the German Medical Association (DCGMA) has set up a project for developing a subsystem for the recording and assessment of medication errors within the existing spontaneous reporting system for ADRs. The aim of the project was to evaluate the feasibility of recording and assessing medication errors within the existing structures and to investigate whether it is possible to deduce risk-reducing strategies from the information obtained by the case reports. In the present narrative review, the experience of the DCGMA with the recording and assessment of medication errors is described. The conclusions and recommendations from the analysis of the reports of medication errors show how they can be used to improve medication safety. The project has closed a gap in pharmacovigilance.

[Prevention of decubitus ulcer: theory and practice]. / Dekubitusprävention: Theorie und Praxis.

In Spring 2001, the Department of Nursing Science, Humboldt-University in Berlin, conducted a pressure ulcer prevalence study on 3012 patients of eleven hospitals. The investigation revealed the use of pressure ulcer prevention on patients with different stages, or without a pressure ulcer. The study also focused on the use of interventions and bed-aids on patients both at risk and not at risk. Interventions without the use of bed-aids were used more often than interventions using bed-aids. The main type of intervention used was the mobilisation of the patient. This was found in all groups (at risk or not at risk; with or without a pressure ulcer). The bed-aids which were most frequently used were pressure-relieving cushions and heel-protectors. Because of the differences in pressure ulcer management among the hospitals, this article also shows evidence on bed-aids and the interventions as known from literature. In four of the interventions as used in practice, the highest degree of evidence could be found. However, in five cases no evidence could be found at all. The comparison of the use in practice and the literature revealed that interventions which are often used as pressure reduction are well tested and can be recommended. However, the (sheep-) skins, which are frequently used, are not reducing the pressure significantly.

[How reliable is the Functional Independence Measure (FMI)?]. / Wie zuverlässig ist das Functional Independence Measure (FIM)?

The Functional Independence Measure (FIM) is an internationally well-known instrument to assess patient autonomy in Activities of Daily Life. In this article the reliability of the instrument will be discussed by the analysis of data gathered on a rehabilitation ward in a Berlin hospital. The sample consists of 154 patients. Each patient was observed by two nurses. In the first phase of the project only one of these two nurses knew the patient well. In the second phase both nurses knew the patient. As expected, the interrater reliability during the second phase was higher than during the first phase of the research. Furthermore high correlations between the items could be computed. The internal consistence of the scale showed values similar to those known from literature. The data proved a high reliability of the instrument.