儿童医院多重耐药菌管理的药学方法
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摘要
目的:针对儿童医院多重耐药菌的管理,探索适宜的药学手段。方法:回顾性分析我院2015年全年检出的多重耐药菌病例,对各科检出率、检测标本、检出菌分布情况进行汇总分析。针对2015年的结果,将管理学原理与药学专业手段相结合,整合已有的药学管理措施,提出新的管理措施:(1)建立以各专科临床药师为节点的药事管理体系;(2)完善以合理用药审核为基本点的药事绩效考核体系;(3)建立与临床科主任直接衔接的联络体系。经过2016年的管理提升,汇总分析2017年全年的多重耐药菌病例,检测方法是否有效。结果:经过整改,多重耐药菌检出率有所下降:2015年共检出1214例多重耐药菌感染病例,检出率为1.799%,2017年共检出1377例,检出率为1.601%,下降0.198个百分点;多重耐药菌培养样本合理性增加,菌种分布有轻微变化。结论:从管理学原理出发,结合药学专业,建立适宜的药事管理体系对于医院的多重耐药菌管理工作大有裨益。
Objective:To explore suitable pharmaceutical management that focus on multiple drug-resistant bacteria. Methods:All the cases of multiple drug-resistant bacteria in 2015 were retrospectively analyzed,meanwhile the ward isolating rate,the test specimens,the detection rate of each species were also collected and analyzed. Based on these results,the principles of management and pharmaceutical management methods were combined; new management measures were raised and carried out. The new system contained:(1) pharmaceutical management system in which clinical pharmacists worked as the important node;(2) pharmaceutical comprehensive performance assessment in which prescription monitoring played the fundamental role;(3) contact system which directly linked with wards directors. In2017,all the cases of multiple drug-resistant bacteria were retrospectively analyzed again to check the effect. Results:In 2016,all these management measures were carried out; in 2017,multiple drug-resistant bacteria detection rate got declined. In 2015,1214 cases of multiple drug-resistant bacteria were founded,the relevance ratio was 1.799%; in 2017,1377 cases of multiple drug-resistant bacteria were founded,the relevance ratio was 1.601%; the number of rational cultivating samples had risen,the composition of these strain changed slightly. Conclusion:Establish appropriate pharmaceutical management system which based on principles of management and specialty of pharmacy would be beneficial to the management of multiple drug-resistant bacteria.
Objective:To explore suitable pharmaceutical management that focus on multiple drug-resistant bacteria. Methods:All the cases of multiple drug-resistant bacteria in 2015 were retrospectively analyzed,meanwhile the ward isolating rate,the test specimens,the detection rate of each species were also collected and analyzed. Based on these results,the principles of management and pharmaceutical management methods were combined; new management measures were raised and carried out. The new system contained:(1) pharmaceutical management system in which clinical pharmacists worked as the important node;(2) pharmaceutical comprehensive performance assessment in which prescription monitoring played the fundamental role;(3) contact system which directly linked with wards directors. In2017,all the cases of multiple drug-resistant bacteria were retrospectively analyzed again to check the effect. Results:In 2016,all these management measures were carried out; in 2017,multiple drug-resistant bacteria detection rate got declined. In 2015,1214 cases of multiple drug-resistant bacteria were founded,the relevance ratio was 1.799%; in 2017,1377 cases of multiple drug-resistant bacteria were founded,the relevance ratio was 1.601%; the number of rational cultivating samples had risen,the composition of these strain changed slightly. Conclusion:Establish appropriate pharmaceutical management system which based on principles of management and specialty of pharmacy would be beneficial to the management of multiple drug-resistant bacteria.
引文
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[8]马富艳,吴晓平,华春珍.儿童与成人感染金黄色葡萄球菌耐药性对比分析[J].中华医院感染学杂志,2007,17(3):331-333.
[9]邓文,黄苑辉.小儿重症监护病房多重耐药菌的分析与控制[J].中国医药科学,2012,2(14):164-166.
[2]渠娟娟.持续质量改进在控制多重耐药菌感染作用的研究进展[J].心理医生,2018,24(2):331-332.
[3]蔡薇薇.三级质控在医院药事管理中的应用实践[J].现代医药卫生,2018,34(2):306-308.
[4]熊小雨,刘成军.儿童多重耐药菌的现状研究及防治策略[J].西部医学,2013,25(5):644-645.
[5]Gudiol C,Tubau F,Calatayud L,et al. Bacteraemia due to multidrug-resistant Gram-negative bacilli in cancer patients:risk factors, antibiotic therapy and outcomes[J]. J Antimicrob Chemother,2011,66(3):657-663.
[6]Horasan ES,Ersoz G,Horoz M,et al. Risk factors for infections caused by multidrug-resistant bacteria in patients with solid tumours[J]. Scand J Infect Dis,2011,43(2):107-111.
[7]唐晓燕,谢庆玲,甄宏,等.标准化吸痰法提高痰培养质量的研究[J].广西医学,2014,36(6):836-838.
[8]马富艳,吴晓平,华春珍.儿童与成人感染金黄色葡萄球菌耐药性对比分析[J].中华医院感染学杂志,2007,17(3):331-333.
[9]邓文,黄苑辉.小儿重症监护病房多重耐药菌的分析与控制[J].中国医药科学,2012,2(14):164-166.