信息化方法管理抗菌药物合理使用4年效果分析

Effect of information technology on management of reasonable use of antibiotics in four years

目的利用信息化手段创新住院患者抗菌药物合理使用的管理,探索有效的抗菌药物管理模式。方法采用信息化为支撑的综合管理模式,将获取的抗菌药物指标数据应用于管理过程;同时研发围手术期和特殊类抗菌药物合理使用引导程序镶嵌于HIS系统,＂关口前移＂限制不合理抗菌药物医嘱下达。绘制连续月度抗菌药物与病原学送检变化情况,反映不同管理方法的效果。结果 2011-2014年经过综合管理,月度抗菌药物使用率、特殊类抗菌药物使用率、Ⅰ类切口手术预防用药率由63.65%、36.98%、91.93%下降到41.76%、7.92%、49.31%;术前0.5~2h合理用药比例由7.52%上升至60.18%;病原学送检率由4.47%上升至39.66%;等级医院评审,对各项指标管理效果明显,但易反弹;信息化管理手段可以突破特殊类和外科预防用药管理瓶颈,发挥持久的管理效果。结论信息化方法可获取抗菌药物使用和送检的各项指标,进行数据导航,决策支持。4年来基于信息化的抗菌药物综合管理模式效果明显,并能反映持续改进效果。

OBJECTIVE To take advantage of information technology to innovate the management of reasonable use of antibiotics for hospitalized patients and seek for effective antibiotic management mode.METHODS By means of information technology-supporting comprehensive management mode,the acquired antibiotics index data were applied in the management,the bootstrap program for reasonable use of perioperative and special antibiotics was developed and embedded in the HIS system,pre-real-time monitoring was conduct to restrict the release of doctor′s advice.The chart of monthly antibiotics usage and etiology inspection tendency was drawn to reveal the effects of the different management methods.RESULTS From 2011 to 2014,the monthly utilization rate of antibiotics,utilization rate of special antibiotics,and rate of antibiotic prophylaxis for type I incision surgery dropped from63.65%,36.98%,and 91.93% to 41.76%,7.92%,and 49.31% after the comprehensive management.The proportion of reasonable medication at 0.5-2hours before the surgery increased from 7.52%to 60.18%;the etiological submission rate increased from 4.47% to 39.66%.The hospital accreditation showed that the effects of management of indicators were significant but easily rebounded.The information management means could break through the bottleneck of management of special antibiotics and antibiotics prophylaxis for surgery department and give play to the everlasting management effect.CONCLUSIONThe indicators of the use of antibiotics and etiological submission can be acquired through the information technology so as to conduct the data navigation and decision supporting.The effect of comprehensive management mode of antibiotics based on the information technology is significant in recent 4years,and it can reflect the effect of continuous improvement.