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DRK Krankenhaus Kirchen

Bahnhofstraße 24
57548 Kirchen

Phone: 02741-6820
Fax: 02741-682-4100
Mail: ed.nehcrik-hk-krd@ofni

https://www.drk-kh-kirchen.de.

Basic information

Number of beds: 279
Number of specialist departments: 10

Number of inpatient cases: 11.336
Number of outpatient cases: 25.856

Hospital owners: DRK Gem. Krankenhaus GmbH Rheinland-Pfalz, Mainz
Type of provider: freigemeinnützig

Specialist departments

Services

Quality

External comparative quality assurance

Further information

External quality assurance according to state law

Bezeichnung
Teilnahme externe Qualitätssicherung	yes

External quality assurance according to the DMP

Diabetes mellitus Typ 1

Die Abteilung Pädiatrie (KI) nimmt an dem DMP Diabetes mellitus Typ 1 (DIA1) seit Januar 2007 teil. In diesem Rahmen beteiligt sich die Abteilung auch an einem externen Qualitätsvergleich (DPV-Benchmarking) der Universität Ulm. Der Kinderklinik wurde ein besonderes Interesse an einer bestmöglichen Versorgung der Patienten bescheinigt.

Participation in other external comparative quality assurance procedures

Implementation of the minimum quantity agreement

Treatment area

Knee joint total endoprostheses

Quantity performed	51
Exception?	No exception

Minimum quantities forecast

Knee joint total endoprostheses

Overall result forecast presentation:	yes
Quantity performed reporting year:	51
Quantity forecast year:	55
Examination by state associations?	yes
Exemption?	yes
Result of the examination by the federal state authorities?	yes
Transitional arrangement?	no

Implementation of resolutions of the Federal Joint Committee on quality assurance (G-BA)

No.	Explanation
CQ07	Measures for quality assurance in the care of pre-term and full-term neonates – perinatal focus

Compliance with staffing requirements

Clarifying chat completed: no
Clarifying chat not completed: no
No participation in clarifying chat: no
Notification of non-fulfilment of nursing care not made: yes

Further training
pursuant to Article 136b, para. 1, sentence 1, no. 1 of the SGB

Number	Group
54	Medical specialists (m/f) , psychological psychotherapists (m/f) and child and adolescent psychotherapists (m/f) who are subject to the obligation to undergo further training*
41	Number of medical specialists (m/f) from no. 1 who have completed a five-year period of further training and are therefore subject to the obligation to provide evidence
41	Number of those persons from no. 2 who have provided proof of further training according to Article 3 of the G-BA regulations

* according to the “Provisions of the Joint Federal Committee for the Further Training of Medical Specialists (m/f), Psychological Psychotherapists (m/f) and Child and Adolescent Psychotherapists (m/f) in Hospitals”

General information

Protection concept against (sexual) violence against children and young people

Advice on prevention and intervention in cases of violence and abuse

According to Section 4 (2) of the Quality Management Guideline, facilities must provide for the prevention of and intervention in cases of violence and abuse as part of their internal quality management. The aim is to prevent, recognise and respond appropriately to abuse and violence, particularly against vulnerable patient groups such as children and adolescents or people in need of help, and also to prevent it within the facility. The respective procedure is aligned with the size of the facility, the range of services and the patients in order to define customised solutions for sensitising the teams as well as other suitable preventative and interventional measures. These may include information materials, contact addresses, training/education, codes of conduct, recommendations for action/intervention plans or comprehensive protection concepts.

Is a protection concept in place? Yes
Measures
- Prevention
  Information gathering on the topic
  Note on the measure
  In den Aufnahmebereichen der Kinderabteilung, den Kinderstationen und den DRK MVZ Praxen sind Aushänge (BZgA/USBKM) zu Gewalt und Missbrauch an Kindern implementiert, mit Notruf und Kontaktdaten.
  Training of employees
  Note on the measure
  Basiswissen, Erkennen von Problem- oder Verdachtsfällen sowie die Vorgehensweise werden im Rahmen von Fall- und Teambesprechungen thematisiert, bzw. vermittelt..
  Education
  Note on the measure
  Wir sensibilisieren unser Personal über die in SK02 angesprochenen Fallbesprechungen.
  Patienten und Angehörige werden ggf. direkt angesprochen.
  Code of conduct with rules for treating children and young people with respect
  Note on the measure
  Der achtsame Umgang mit Kindern- und Jugendlichen ist Bestandteil von Schulungen/Unterweisungen und Teambesprechungen.
  
  Last review of the measure
  01.07.2022 16:46:01
  Other aspects of prevention
  Note on the measure
  Zur Zeit werden die Vorgabedokumente und Informationsunterlagen aktualisiert, dazu zählen Begriffe, Falldefinitionen rechtl. Aspekte , Anamneseerhebung, Körperliche Untersuchung etc.
  Das Krankenhaus verfügt zudem über eine Hinweisgeberplattform über die entsprechende Meldungen erfolgen können.
- Intervention
  Intervention plan - Binding procedure for dealing with child protection cases and in particular suspected (sexual) violence
  Note on the measure
  Bei Verdacht auf Gewalt und sexuellen Missbrauch ist zwingend ein erfahrener Oberarzt einzuschalten, der die erforderlichen Maßnahmen einleitet.
  
  Last review of the measure
  01.07.2022 16:46:01
- Reprocessing
  Recommendations for dealing with/processing cases that have occurred
  Note on the measure
  Die Kinderabteilung des DRK Krankenhaus Kirchen orientiert sich an den Handlungsempfehlungen der TK "Gewalt gegen Kinder", die Aufarbeitung erfolgt im Rahmen von Fallbesprechungen.
  
  Last review of the measure
  01.07.2022 16:46:01
  Other information on recognition
  Note on the measure
  Für die Aufarbeitung, schon bei Verdachtsfällen, werden Fallbesprechungen anhand des Dokumentationsbogens der Bayrischen Ärztekammer, dem Leitfaden Häusl. Gewalt der Ärztekammer NRW und dem darin enthaltenen Dokumentationsbogen durchgeführt.

Commentary on the protection concept

Gemäß § 4 Absatz 2 in Verbindung mit Teil B Abschnitt I § 1 der Qualitätsmanagement-Richtlinie haben sich Einrichtungen, die Kinder und Jugendliche versorgen, gezielt mit der Prävention von und Intervention bei (sexueller) Gewalt und Missbrauch bei Kindern und Jugendlichen zu befassen (Risiko- und Gefährdungsanalyse) und – der Größe und Organisationsform der Einrichtung entsprechend – konkrete Schritte und Maßnahmen abzuleiten (Schutzkonzept). In diesem Abschnitt geben Krankenhäuser, die Kinder und Jugendliche versorgen, an, ob sie gemäß § 4 Absatz 2 in Verbindung mit Teil B Abschnitt I § 1 der Qualitätsmanagement-Richtlinie ein Schutzkonzept gegen (sexuelle) Gewalt bei Kindern und Jugendlichen aufweisen.

Drug therapy safety

Steering committee

Drug commission

Training of employees on AMTS related topics

Electronic support for the admission and anamnesis process (e.g. import of patient master data or medication plans, use of a drug knowledge database, input screen for drugs or anamnesis information)

Electronic support for the supply of patients with drugs

Vorhandensein von elektronischen Systemen zur Entscheidungsunterstützung (z.B. Meona®, Rpdoc®, AIDKlinik®, ID Medics® bzw. ID Diacos® Pharma)

Measures to minimise medication errors

Maßnahmen zur Vermeidung von Arzneimittelverwechslung
Teilnahme an einem einrichtungsübergreifenden Fehlermeldesystem (siehe Kapitel 12.2.3.2)

Measures to ensure seamless drug therapy after discharge

Aushändigung von arzneimittelbezogenen Informationen für die Weiterbehandlung und Anschlussversorgung der Patientin oder des Patienten im Rahmen eines (ggf. vorläufigen) Entlassbriefs
Aushändigung des Medikationsplans
bei Bedarf Arzneimittel-Mitgabe oder Ausstellung von Entlassrezepten

Instruments and measures

The instruments and measures to promote drug therapy safety are presented with a focus on the typical procedures of the medication process in inpatient patient care. A special feature of the medication process in the inpatient environment is the transition management during admission and discharge. The instruments and measures listed below address structural elements, e.g. special IT equipment and work materials, as well as process aspects, such as work descriptions for particularly risky process steps or concepts for securing typical risk situations . In addition, proven measures to avoid or learn from medication errors can be specified. The hospital presents here which aspects it has already dealt with and which measures it has specifically implemented. The following aspects can be presented, if necessary using free text fields:
- Admission to hospital, including anamnesis
; Instruments and measures are presented for determining the old medication (drug history), the subsequent clinical assessment and the switch to the medication available in the hospital (house list), as well as for documenting both the patient's original medication and that for hospital treatment adapted medication.
- Medication process in the hospital
In this context, the following sub-processes are assumed as examples: drug history - prescription - patient information - drug delivery - drug use - documentation - therapy monitoring - result assessment. Instruments and measures for safe medication prescription can be presented, e.g. B. in terms of readability, clarity and completeness of the documentation, but also in terms of area of application, effectiveness, benefit-risk ratio, tolerability (including potential contraindications, interactions, etc.) and resource considerations. Information can also be provided to support reliable medication ordering, delivery and use or administration.
- Discharge
In particular, the measures taken by hospitals can be presented to ensure that information on drug therapy is structured and passed on to doctors and physicians providing further treatment, as well as the appropriate provision of patients with drug information, medication plans and medications. Drug prescriptions are made.

AMTS is the totality of measures to ensure an optimal medication process with the aim of reducing medication errors and thus avoidable risks for patients during drug therapy. A prerequisite for the successful implementation of these measures is that AMTS is practised as an integral part of daily routine in an interdisciplinary and multi-professional approach.

Special instrument-based equipment

Training

Training in other healing professions

HB19 - Nursing professionals

Comment

Ab 2023 bieten wir zusätzlich einen Ausbildungsgang in der Krankenpflegehilfe an, sowie die Teilnahme an der Ausbildung zur bzw. zum Anästhesietechnischer/n-Assistent*in (ATA), Opereationstechnischer/n-Assistent*in (OTA) sowie an der Fachqualifikation der Hebammen (Geburtshelfer*innen).