某三级综合医院临床医师对抗菌药物管理内容认知情况调查与分析

Investigation and analysis of clinicians’ cognition of antibiotics management in a tertiary general hospital

目的调查某三级综合医院临床医师对抗菌药物临床应用管理内容的认知情况,以进一步加强该院对临床抗菌药物的管理。方法选取2020年南通市第一人民医院临床各科室的临床医师为调查对象。采取三基考试形式,分两个场次进行。记录临床医师的答题正确率,比较不同性别、年龄、学历、职称及科室的临床医师抗菌药物管理知识得分,并分析患者、药师意见对临床医师开具抗菌药物处方的影响。结果在临床医师对抗菌药物管理知识的答题中,有6道题的正确率<30%,其中多选题中"国家要求进行专档管理的抗菌药物有哪些?"答题正确率最低,为14.79%。单选题中"越级使用特殊级抗菌药物需在多长时间内完善相关手续?"答题正确率最高,为95.77%。女性临床医师抗菌药物管理知识得分高于男性临床医师(P<0.05);40~50岁临床医师抗菌药物管理知识得分高于其他年龄段(P<0.05);博士学历的临床医师抗菌药物管理知识得分高于本科及硕士学历的临床医师(P<0.05);初级职称的临床医师抗菌药物管理知识得分低于中级职称及高级职称的临床医师(P<0.05);儿科临床医师抗菌药物管理知识得分高于妇科、外科及内科,妇科临床医师抗菌药物管理知识得分高于外科及内科,外科临床医师抗菌药物管理知识得分高于内科(P<0.05)。95.07%的临床医师开具抗菌药物处方不会受到患者的影响;当药师审核处方与医师产生分歧时,95.59%的临床医师会选择与药师讨论,达成一致意见。结论该三级综合医院临床医师对抗菌药物临床应用管理知识欠缺掌握,尤其是男性、<40岁及>50岁、本科及硕士学历、初级职称及内科的临床医师,应有针对性地进行加强,并重视临床药师的参与。

Objective To investigate the cognition of clinicians on the management of clinical application of antibiotics in a tertiary general hospital,so as to further strengthen the management of clinical antibiotics in the hospital.Methods The clinicians in clinical departments of Nantong First People’s Hospital in 2020 were selected as the survey objects.Take the form of three basic examination and conduct it in two sessions.Record the correct rate of clinicians’ answers,compare the scores of clinicians’ antimicrobial management knowledge in different gender,age,educational background,professional title and departments,and the impact of patients’ and pharmacists’ opinions on clinicians’ prescribing antibiotics.Results The correct rate of 6 questions about antimicrobial management knowledge was lower than 30%.Among the multiple topics,"which antimicrobial drugs are required to be managed by the state?" The correct rate was the lowest,14.79%."How long does it take to complete the relevant procedures for the use of special grade antibiotics beyond the grade?",the highest accuracy was 95.77%.The score of antimicrobial management knowledge of female clinicians was higher than that of male clinicians.The score of antimicrobial management knowledge in aged 40-50 was higher than that of other age groups.The score of antimicrobial management knowledge of clinicians with PhD was higher than that of clinicians with bachelor’s and master’s degrees.The score of antimicrobial management knowledge of clinicians with primary title was lower than that of clinicians with intermediate title and senior title(P<0.05).The score of antimicrobial management knowledge of pediatric clinicians was higher than that of gynecological,surgical and internal medicine clinicians,the score of antimicrobial management knowledge of gynecological clinicians was higher than that of surgical and internal medicine clinicians,and the score of antimicrobial management knowledge of surgical clinicians was higher than that of internal medicine clinicians(P<0.05).95.07% of the clinicians prescribed antibacterial drugs will not be affected by the patients.When pharmacists review the prescription and disagree with doctors,95.59% of the clinicians will choose to discuss with pharmacists and reach an agreement.Conclusion The clinicians of the tertiary general hospital lack the knowledge of clinical application and management of antibiotics,especially male clinicians,<40 and >50 years old,with bachelor’s and master’s degrees,primary title and internal medicine,should be strengthened in a targeted manner,and pay attention to the participation of clinical pharmacists.