抗菌药物科学化管理联合项目管理在医院抗菌药物管理中的应用

Application of Joint Project Management for Scientific Management of Antimicrobial Drugs in Hospital Antimicrobial Drug Management

目的:探讨抗菌药物科学化管理(AMS)联合项目管理规范在攀枝花学院附属医院的抗菌药物管理中的应用效果。方法:通过随机抽样,共收集2020年1月-2021年12月攀枝花学院附属医院24000张处方和1200份病历。开展抗菌药物专项点评和病历审核,组建抗菌药物体系,明确工作职责,落实抗菌药物“选”“管”“用”,科学控制各项指标。比较医院抗菌药物目录情况、抗菌药物使用率、住院患者微生物送检率、抗菌药物使用合理性。结果:门诊患者抗菌药物使用率、住院患者抗菌药物使用率、住院患者抗菌药物使用强度及Ⅰ类切口手术预防使用率逐渐呈现下降趋势,住院患者微生物送检率逐渐升高;干预后应用指征、药物选择、用法用量、用药疗程处方合理率高于干预前,差异有统计学意义(P<0.001)。结论:通过实施AMS联合项目管理,可提高医院合理应用抗菌药物水平,减少抗菌药物的使用,减轻患者医疗负担,减缓细菌耐药的发展,提高处方合理率。

Objective:To explore the effectiveness of the scientific management of antimicrobial drugs(AMS)joint project management specification in the management of antimicrobial drugs in the Affiliated Hospital of Panzhihua College.Methods:Through random sampling,a total of 24000 prescriptions and 1200 medical records of the Affiliated Hospital of Panzhihua College from January 2020 to December 2021.A special review and chart audit of antimicrobial drugs was conducted to establish an antimicrobial drug system,clarify work responsibilities,implement the"selection","management"and"use"of antimicrobial drugs,and scientifically control the indicators.The hospital's antimicrobial drug list,antimicrobial drug use rate,inpatient microbiological testing rate and rationality of antimicrobial drug use were compared.Results:The outpatient antimicrobial drug use rate,inpatient antimicrobial drug use rate,inpatient antimicrobial drug use intensity and the use of prophylaxis for Class I incisions gradually showed a decreasing trend,and the inpatient microbiological testing rate gradually increased.After the intervention,the prescription rationality rate of application indications,drug selection,dosage and medication regimen were higher than that before the intervention,and the difference was statistically significant(P<0.001).Conclusion:The implementation of AMS joint project management can improve the rational application of antimicrobial drugs in hospitals,reduce the use of antimicrobial drugs,reduce the medical burden of patients and slow down the development of bacterial drug resistance,and improve the prescription rationalization rate.