临床药师参与某三级甲等医院重症医学科抗菌药物使用管理效果评价
Effect Evaluation of Clinical Pharmacists' Participation in the Management of Antibiotic Use in the Intensive Care Unit of a Grade-A Tertiary Hospital
王洪泽 1马名扬 2马莹1
作者信息
- 1. 南京医科大学附属泰州人民医院,江苏 泰州 225300
- 2. 徐州医科大学药学院,江苏 徐州 221004
- 折叠
摘要
目的 提高医院临床科室抗菌药物使用合理性.方法 通过PASS临床药学管理系统与合理用药监测系统收集医院重症医学科 2022 年 1 月至 6 月(干预前)及 2022 年 7 月至 12 月(干预后)抗菌药物使用数据.建立临床药师参与的抗菌药物使用管理PDCA循环,设定目标值为抗菌药物使用强度(AUD)降至 95 DDDs/百人天,并抽取该科室干预前后各 200 份病历评价抗菌药物合理使用情况.结果 干预后,该科室AUD由(107.64±8.79)DDDs/百人天降至(83.25±10.15)DDDs/百人天(P<0.01),抗菌药物的使用率、人均使用金额分别降低 9.31%,938.29 元;非限制使用级、限制使用级、特殊使用级抗菌药物使用率分别降低 0.39%,5.32%,3.60%;出院患者抗菌药物使用率降低 9.31%,单用率升高 9.66%;抽检病例中抗菌药物不合理使用率降低 13.00%,其中干预前主要不合理类型为用法用量不合理、无适应证用药、疗程不合理,干预后为用法用量不合理、疗程不合理.结论 临床药师参与抗菌药物使用管理PDCA循环,能有效控制AUD,提升抗菌药物使用合理性.
Abstract
Objective To promote the rational use of antibiotics in clinical departments of hospitals.Methods The data on the antibiotic use in the Intensive Care Unit of a hospital from January to June 2022(before intervention)and July to December 2022(after intervention)were collected by the PASS clinical pharmacy management system and rational drug use monitoring system.A PDCA cycle for antibiotic use management participated by clinical pharmacists was established,with a target value of antibiotics use density(AUD)decreasing to 95 DDDs/100 person-days.A total of 400 medical records before and after intervention(200 for each time period)in the department were extracted to evaluate the rationality of antibiotic use.Results After intervention,the AUD of the department decreased from(107.64±8.79)DDDs/100 person-days to(83.25±10.15)DDDs/100 person-days(P<0.01),the antibiotic use rate and consumption sum per capita decreased by 9.31%and CNY 938.29,respectively.After intervention,the use rates of antibiotics for non-restricted use,restricted use and special use decreased by 0.39%,5.32%,and 3.60%,respectively.After intervention,the use rate of antibiotics in discharged patients decreased by 9.31%,while the proportion of patients with single use of antibiotics increased by 9.66%.After intervention,the irrational use rate of antibiotics in case samples decreased by 13.00%,the main types of irrational use before intervention were inappropriate usage and dosage,medication without indication,and inappropriate treatment course,those after intervention were inappropriate usage and dosage and inappropriate treatment course.Conclusion Clinical pharmacists participating in the PDCA cycle for antibiotic use management can effectively control the AUD and improve the rationality of antibiotic use.
关键词
抗菌药物使用强度/重症医学科/临床药师/PDCA循环/合理用药Key words
antibiotics use density/Intensive Care Unit/clinical pharmacist/PDCA cycle/rational drug use引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据