普外科医师抗菌药物合理应用认知行为干预效果评价  

Intervention Effect and Appraisal Cognition Behavior of about Rational Antibiotic Usage among General Surgeons

作　　者：史天陆[1] 姜玲[1] 沈爱宗[1] 孙言才[1] 杜德才[1] 张圣雨[1] 刘琳琳[1] 

机构地区：[1]安徽医科大学附属省立医院药剂科,安徽合肥230001

出　　处：《中华医院感染学杂志》2010年第10期1451-1454,共4页Chinese Journal of Nosocomiology

基　　金：卫生部;WHO2008-2009合作项目课题资助(WP/2008/chn/04.07)

摘　　要：目的为不断提高临床医师合理应用抗菌药物知识水平探索有效干预路径。方法采取整群抽样方法 ,对医院普外科医师的抗菌药物认知状况进行调查与干预。结果医师用通用名开具药品的比例由干预前57.7%上升为干预后94.0%(P<0.05);医师对手术患者预防用抗菌药物<30.0%的由干预前4人增加为干预后10人,使用比例30.0%～50.0%由干预前6人增加为干预后14人;用药天数选择<3d的医师明显增多,由干预前12.5%上升为干预后40.6%(P<0.05);干预前后医师选择抗菌药物所考虑的前3位因素均为疗效、感染病原菌、安全性,但干预后有更多医师开始关注细菌耐药状况,由干预前3人增加到干预后12人;干预前后医师对抗菌药物知识掌握主观自我评价均较好;通过定量评价医师专业知识认知情况,干预前人均得分仅为(3.91±1.12)分,干预后上升为(6.06±1.27)分,有所改善(P<0.05)。结论干预后医师抗菌药物认知水平虽有所提高,但总体变化幅度不大,仍有待进一步加强综合管理、交流和培训。OBJECTIVE To explore the pathway of effective intervention to increase among clinicians the cognition knowledge level about rational use of antibiotics.METHODS The cognition about antibiotics knowledge through intervention among general surgeons in our hospital was investigated by cluster sampling.RESULTS The ratio of prescription by China Approved Drug Names increased from 57.7% before intervention to 94.0% after intervention（P〈0.05）.Before intervention only 4 surgeons used antibiotics less than 30% of surgical patients vs 10 surgeons after intervention and 6 vs 10 surgeons（30-50% of surgical patients）.The surgeons who used antibiotics less than 3d increased from 12.5% beforeintervention to 40.6% after intervention（P〈0.05）.The first three factors influencing the surgeons to choose the antibiotics were efficacy,pathogens and safety,but after intervention more surgeons began to pay attention to drug resistance of bacteria.Surgeons＇self-evaluation on knowledge of antibiotics was all good both before and after intervention.But the survey results showed that surgeons grasped general knowledge well,but cognized professional knowledge poor.By quantitative evaluation on surgeon professional knowledge,the average score was only（3.91±1.12）vs（6.06±1.27）,after intervention.CONCLUSIONS The antibiotics knowledge of surgeons has gained some improvement by intervention,but grows slowly in general,it needs further strengthen the integrated management,communication and training.

关 键 词：外科医师 抗菌药物 合理应用 认知 干预 

分 类 号：R978.1[医药卫生—药品]