基于信息化系统的特殊使用级抗菌药物临床药师审核模式的建立与成效分析

Establishment and effectiveness evaluation of clinical pharmacist consultation model for special grade-antibiotics based on information systems

目的:探索建立符合医院实际的特殊使用级抗菌药物会诊模式,为各级医疗机构落实国家相关管理政策提供参考。方法:依据国家下发的相关文件,结合医院实际情况,多学科协作,基于电子病历和医院信息系统(Hospital informaltion System,HIS)建立特殊使用级抗菌药物会诊模式,并利用PDCA管理工具在实践中不断改进。结果:建立了基于信息化系统的特殊使用级抗菌药物临床药师单人会诊模式,操作性强、时效性高、便捷性好。运行1年后,特殊级抗菌药物使用强度同比下降21.7%,住院患者抗菌药物使用强度持续低于40 DDDs,符合国家要求。碳青霉烯类耐药肠杆菌目细菌和鲍曼不动杆菌检出率下降约8%。同期住院天数下降约1.0 d,成效显著。结论:基于信息化系统的特殊使用级抗菌药物临床药师单人会诊模式可促进抗菌药物合理应用,并为进一步推动抗菌药物科学化管理提供有效方法。

OBJECTIVE To explore the establishment and practice of special grade-antibiotic consultation mode,so as to provide reference for medical institution which plan to establish such a consultation system.METHODS According to the relevant documents issued by the state,and combined with the actual situation of the hospital,a consultation mode for special grade-antibiotics was established based on electronic medical record and HIS system,and continuously improved in practice.RESULTS A special-level antibiotic drug consultation mode performed by clinical pharmacists has been established,which has been proved to be with strong operability,high timeliness and good convenience.After one year of operation,the use intensity of special-grade antibiotics decreased by 21.7%year-on-year,and the intensity of antimicrobial use in inpatients was consistently less than 40 DDDs,which was complied with national requirements.The detection rates of carbapenem-resistant Enterobacteriaceae and Acinetobacter baumannii decreased by about 8%.The mean length of stay in hospital decreased by about 1.0 day.CONCLUSION The special-grade antibiotic consultation mode performed by clinical pharmacists can promote the rational use of antibiotics and provide an effective method for antimicrobial stewardship.