江苏三级医院抗菌药物管理调查
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摘要
采用方便抽样与滚雪球抽样的方法,对江苏省内50家三级医院抗菌药物管理现状进行调查。2011年组建抗菌药物管理专业技术团队的医院最多;52%的医院会拨付专项经费支持抗菌药物管理;仅有52%的医院会定期向医师反馈抗菌药物使用情况并进行沟通;门诊未开展抗菌药物处方预审与反馈的占52%,病区为36%;84%的医院计算机系统中使用了抗菌药物管理相关的软件程序;行政干预普遍。以实施抗菌药物管理策略为导向,应进一步完善医院多学科协作的抗菌药物管理团队;为抗菌药物管理活动设立专项经费;注重监测信息的反馈;开发一些应用程序辅助抗菌药物管理;积极开展处方/医嘱预审与反馈;转变管理思路,逐渐弱化行政干预。
A total of 50 tertiary hospitals in Jiangsu Province were investigated by convenient sampling and snowball sampling.The number of hospitals that established the professional team for antimicrobial stewardship in 2011 was the largest; 52% of hospitals allocated special funds to support antimicrobial stewardship activities;Only 52% of hospitals regularly gave feedback on antimicrobial use and communicated to physicians; 46% of hospitals did not conduct pre-audit and feedback on antimicrobial prescriptions in the outpatient department,and22% in wards; 84% of computer systems used antimicrobial stewardship-related software; The administrative interventions were widely used.We should improve the multidisciplinary cooperative antimicrobial stewardship(AMS) team,set up special funds for antimicrobial stewardship activities,pay attention to feedback on monitoring information,develop some applications to assist in the management of antimicrobial stewardship,conduct actively pre-audit and feedback,change management ideas,and gradually weaken administrative intervention.
A total of 50 tertiary hospitals in Jiangsu Province were investigated by convenient sampling and snowball sampling.The number of hospitals that established the professional team for antimicrobial stewardship in 2011 was the largest; 52% of hospitals allocated special funds to support antimicrobial stewardship activities;Only 52% of hospitals regularly gave feedback on antimicrobial use and communicated to physicians; 46% of hospitals did not conduct pre-audit and feedback on antimicrobial prescriptions in the outpatient department,and22% in wards; 84% of computer systems used antimicrobial stewardship-related software; The administrative interventions were widely used.We should improve the multidisciplinary cooperative antimicrobial stewardship(AMS) team,set up special funds for antimicrobial stewardship activities,pay attention to feedback on monitoring information,develop some applications to assist in the management of antimicrobial stewardship,conduct actively pre-audit and feedback,change management ideas,and gradually weaken administrative intervention.
引文
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[9]马欣,尹文强,魏艳,等.国家基本药物制度背景下山东省居民抗菌药物认知与使用现状的调查分析[J].中国药房,2014,25(12):1066-1069
[10]吴林芸,蔡周权,罗军,等.美国抗菌药物管理计划的实施及其启示[J].中国药业,2015(18):9-12
[11]Pedersen CA,Schneider PJ,Scheckelhoff DJ.ASHP National survey of pharmacy practice in hospital settings:monitoring and patient education--2012[J].Am JHealth Syst Pharm,2013,70(9):787-803
[12]沈峥嵘.江苏首发健康大数据报告[N].新华日报,2016-08-30(006)
[13]Avent ML,Hall L,Davis L,et al.Antimicrobial stewardship activities:a survey of Queensland hospitals[J].Australian Health Review,2014,38(5):557-563
[14]杨晓娟,王海银,林海.上海市三级综合医院抗菌药物管理情况调查[J].贵州医药,2016,40(6):649-651
[2]Cook PP,Gooch M.Long-term effects of an antimicrobial stewardship programme at a tertiary-care teaching hospital[J].Int J Antimicrob Agents,2015,45(3):262-267
[3]Alawi MM,Darwesh BM.A stepwise introduction of a successful antimicrobial stewardship program.Experience from a tertiary care university hospital in Western,Saudi Arabia[J].Saudi Med J,2016,37(12):1350-1358
[4]卫生健康委员会.关于持续做好抗菌药物临床应用管理有关工作的通知[EB/OL].[2018-03-16].http://www.moh.gov.cn/yzygj/s7659/201805/c79c998bdf8f4744858051cdfd1e6818.shtml
[5]卫生部.抗菌药物临床应用管理办法[EB/OL].[2018-02-16].http://www.nhfpc.gov.cn/zwgkzt/wsbysj/201205/54645.shtml
[6]Ashiru-Oredope D,Sharland M,Charani EA,et al.Improving the quality of antibiotic prescribing in the NHSby developing a new antimicrobial stewardship programme:start smart-then gocus[J].Journal of Antimicrobial Chemotherapy,2012,67(1):I51-I63
[7]Khawcharoenporn T,Apisarnthanarak A,Mundy LM.National survey of antimicrobial stewardship programs in Thailand[J].Am J Infect Control,2013,41(1):86-88
[8]Jacobs DM,Kuper K,Septimus E,et al.Assessment of antimicrobial stewardship activities in a large metropolitan area[J].J Pharm Pract,2016,29(3):188-193
[9]马欣,尹文强,魏艳,等.国家基本药物制度背景下山东省居民抗菌药物认知与使用现状的调查分析[J].中国药房,2014,25(12):1066-1069
[10]吴林芸,蔡周权,罗军,等.美国抗菌药物管理计划的实施及其启示[J].中国药业,2015(18):9-12
[11]Pedersen CA,Schneider PJ,Scheckelhoff DJ.ASHP National survey of pharmacy practice in hospital settings:monitoring and patient education--2012[J].Am JHealth Syst Pharm,2013,70(9):787-803
[12]沈峥嵘.江苏首发健康大数据报告[N].新华日报,2016-08-30(006)
[13]Avent ML,Hall L,Davis L,et al.Antimicrobial stewardship activities:a survey of Queensland hospitals[J].Australian Health Review,2014,38(5):557-563
[14]杨晓娟,王海银,林海.上海市三级综合医院抗菌药物管理情况调查[J].贵州医药,2016,40(6):649-651