TDM in pdms – how to digitize? – ongoing

The clinical pharmacist in the interdisciplinary intensive care unit at the hospital of Heidenheim is an established team-member since many years. Especially in therapeutic drug monitoring (TDM) there is a close cooperation. Antibiotic blood levels of intensive care patients are checked frequently in the routine setting and the antibiotic dose is individually adapted. At the afternoon ward round the results are discussed in a multi professional way. Also drug related problems and interactions are resolved together.

As part of digitalization, 2023 a new electronic patient data management system (PDMS) is implemented. Prospectively consisting clinical pharmaceutical services will be digitized and improved to ensure drug safety.

In the project we are developing an individual infection management, including TDM for the PDMS. For antibiotic therapy a dose recommendation is made based on kidney function of the intensive care patient (www.thecaddy.de). Antibiotic standards with indication and daily counter are being created. For patients with antibiotic therapy, blood measurements are initiated automatically through the system with imports of specific data from the PDMS. Therefor transmission errors could be avoided. The measured antibiotic blood level is scrutinized by the clinical pharmacist and the pharmaceutical dose recommendation is visible in the infection management and on the medication site.

Furthermore a pharmaceutical request form will be established. It will be used to prepare and review the multi professional rounds and to document drug related problems and interactions.

The aim of the project is to generate a standardized digital structure for TDM on German intensive care units. It will be possible to translate the model structure and adapt it to other intensive care units. TDM is recommended by national and international guidelines for intensive care patients and the results of the project could be transmitted as a “best-practice-model”.