跨学科联动推进抗菌药物合理使用的管理实践

Practice of rational use of antibacterial drugs with interdisciplinary linkage

目的探索一种跨学科合作和多个职能部门联动,共同推进抗菌药物临床合理使用的管理模式,总结综合性医院抗菌药物合理应用的联合监管的新方法。方法分析和归纳既往管理举措,建立使用抗菌药物在医院里的联合干预模式,组建医院抗菌药物临床使用管理专家小组,制定管理制度,实行合理用药软件的实时监控和临床药师的专项点评,将合理用药纳入科室绩效考核,定时组织学习培训等,定期分析和追踪评价管理成效。结果抗菌药物核心质控指标明显改善,住院患者抗菌药物使用率从60.56%下降到51.70%,门急诊患者抗菌药物使用人次比从22.37%下降到8.78%。结论跨学科联动,共同管理抗菌药物的管理模式,推进了抗菌药物核心质控指标的改善,提高了抗菌药物处方(医嘱)的合理率,提高了临床疗效。

Objective To explore an interdisciplinary cooperation and the linkage of multi-functional departments to jointly promote the management mode of rational clinical use of antibiotics, and to summarize a new method of joint supervision of rational use of antibiotics in general hospitals. Methods We analyze and summarize the past management measures, establish a joint intervention model for the use of antibiotics in hospitals, set up an expert group on the clinical use of antibiotics in hospitals, formulate a management system, implement real-time monitoring of rational drug use software and special comments of clinical pharmacists, incorporate rational drug use into department performance appraisal, regularly organize learning and training, and regularly analyze and track management effectiveness. Results Core quality control indicators of antimicrobial agents were significantly improved. The utilization rate of antimicrobial agents in hospitalized patients decreased from 60.56% to 51.70%, and the proportion of antimicrobial users in outpatients and emergency patients decreased from 22.37% to 8.78%. Conclusion Interdisciplinary linkage and joint management of antimicrobial management model promoted the improvement of core quality control indicators of antimicrobial drugs, improved the rational rate of antimicrobial prescription (doctor′s advice), and improved the clinical efficacy.