临床药师干预在医院Ⅱ类切口手术围手术期预防用抗菌药物中的价值分析

Analysis of the value of clinical pharmacists'intervention in perioperative prophylactic use of antibiotics for classⅡincision surgery in hospital

目的 评估徐州市第一人民医院Ⅱ类切口手术围手术期预防用抗菌药物的用药合理性,观察临床药师干预在围手术期合理预防性使用抗菌药物中的作用。方法 临床药师通过临床药学管理系统(PASS)抽取Ⅱ类切口手术病历,抽取2018年11月18日~12月18日临床药师干预前的Ⅱ类手术切口病历100份、2019年5月28日~6月24日临床药师干预后的Ⅱ类手术切口病历100份进行研究。对涉及预防使用抗菌药物的病历进行回顾性分析,从抗菌药物的疗程、时机、品种、联合用药、频次、剂量等6个方面进行逐一点评,分析干预前后相关科室预防用抗菌药物的用药合理性变化情况。结果 与干预前相比,大部分科室的Ⅱ类切口围手术期预防用抗菌药物的使用情况有了较大好转。其中,Ⅱ类切口围手术期预防用抗菌药物疗程不合理的发生频次由干预前的57次下降为23次,给药时机不合理的发生频次由干预前的31次下降为10次,总的不合理用药发生频次由109次下降为51次,全院不合理病历数由干预前的63份下降为30份,降幅明显,不合理用药发生率由18.17%下降至8.50%,目标达成。结论 临床药师干预降低了医院Ⅱ类切口手术围手术期预防用抗菌药物的不合理使用率,干预效果明显。

Objective To evaluate the rationality of perioperative prophylactic use of antibiotics for classⅡincision surgery in hospital,and observe the role of clinical pharmacists in perioperative prophylactic use of antibiotics.Methods Clinical pharmacists extracted classⅡincision surgical records through prescription automatic screening system(PASS)for research,including 100 medical records before clinical pharmacists'intervention from November 18 to December 18,2018 and 100 medical records after clinical pharmacists'intervention from May 28 to June 24,2019.Conducted a retrospective analysis of medical records related to the prophylactic use of antibiotics.The rationality of prophylactic use of antibiotics in relevant departments before and after intervention by clinical pharmacists was compared from 6 aspects:course of treatment,timing of use,variety selection,combination use,frequency of use,and dosage.Results Compared with before intervention,the perioperative prophylactic use of antibiotics for classⅡincision surgery in most departments has been greatly improved.Among them,the frequency of irrational courses of antibiotics decreased from 57 times before intervention to 23 times,the frequency of irrational timing of administration decreased from 31 times before intervention to 10 times,the total frequency of irrational use of drugs decreased from 109 times to 51 times,the number of irrational medical records in the whole hospital decreased from 63 records before intervention to 30 records,which was a significant decrease,and the incidence of irrational use of drugs decreased from 18.17%to 8.50%,the target was achieved.Conclusion Clinical pharmacists'intervention has reduced the irrational rate of perioperative prophylactic use of antibiotics for classⅡincision surgery in hospital,and the intervention effect is significant.