单中心医疗机构医师头孢菌素皮试处方行为调研及影响因素分析——规范头孢菌素原液皮试的干预研究(二)  

Investigation and analysis of influencing factors on prescription behavior of cephalosporin skin test of physicians in single-center medical institutions ——Intervention study on de-adoption of routine skin test for cephalosporin prescribing(PART Ⅱ)

作　　者：应颖秋[1] 宋茵茵 路明[2,3] 帅瑗[1] 李楠[4] 杨丽[1] 赵荣生[1] YING Yingqiu;SONG Yinyin;LU Ming;SHUAI Yuan;LI Nan;YANG Li;ZHAO Rongsheng(Peking University Third Hospital,Department of Pharmacy,Beijing 100191,China;Peking University Third Hospital,Department of Respiratory and Critical Care Medicine,Beijing 100191,China;Peking University Third Hospital,Infectious Disease Center,Beijing 100191,China;Peking University Third Hospital,Clinical Epidemiology Research Center,Beijing 100191,China;Department of Pharmacy Administration and Clinical Pharmacy,Pharmaceutical Science,Peking University,Beijing 100191,China)

机构地区：[1]北京大学第三医院药剂科,北京100191 [2]北京大学第三医院呼吸与危重症医学科,北京100191 [3]北京大学第三医院感染疾病中心,北京100191 [4]北京大学第三医院临床流行病学研究中心,北京100191 [5]北京大学药学院药事管理与临床药学系,北京100191

出　　处：《中国医院药学杂志》2023年第17期1887-1892,共6页Chinese Journal of Hospital Pharmacy

基　　金：国家重点研发计划课题项目(编号:2022YFC3401205)。

摘　　要：目的:明确北京大学第三医院医师头孢菌素皮试处方行为原因及其影响因素,为后续规范此类药物皮试实践、完善抗菌药物管理提供参考。方法:采用定性研究与定量研究相结合的混合方法研究设计。使用前期基于定性研究结果开发的定量工具(调查问卷),通过定量方法对北京市某三甲医院的医师进行问卷调查。应用SPSS25.0软件录入数据并进行单因素和多因素(Logistic回归)分析,确定影响医师头孢菌素皮试处方行为的因素。结果:定量研究共回收问卷271份,回收有效问卷261份,有效回收率为96.3%。受调查中进行头孢菌素皮试普遍筛查的医师所占比例为78.2%(204/261)。多因素分析(Logistic回归)结果显示,院内皮试相关文件知晓情况、科室核心组经讨论后一致规定做皮试的情况、护士群体为主导建议或要求皮试的情况以及上级医师经验传授需要皮试的情况可能是影响医师头孢菌素皮试处方行为的主要因素。其他描述性统计结果显示,83.3%(170/204)的行皮试组医师表示他们进行头孢菌素皮试普遍筛查有出于自我保护的顾虑。结论:北京大学第三医院存在头孢菌素皮试普遍筛查问题,多数医师(78.2%)在给患者用药前进行头孢菌素皮试普遍筛查。应结合单因素分析和多因素分析的结果,制定针对性干预措施,规范头孢菌素皮试实践。OBJECTIVE To determine the causes and influencing factors of physicians'routine skin test for cephalosporin prescribing,so as to provide reference for standardizing the practice of skin test and improving the management of antibacterial drugs in Peking University Third Hospital.METHODS The mixed methods research of qualitative study and quantitative study were adopted.Based on the quantitative tool developed by previous qualitative study,we conducted a questionnaire survey among doctors at a tertiary hospital in Beijing by a quantitative method.Univariate analysis and logistic regression analysis were used to determine the factors affecting physicians'prescription behavior of cephalosporin skin test.RESULTS A total of 271 questionnaires were collected,with 261 valid questionnaires and an effective response rate of 96.3%.The proportion of physicians who conducted routine skin test was 78.2%(204/261).The results of logistic regression analysis showed that the main factors influencing the physicians'prescription behavior of cephalosporin skin test were the knowledge of documents related to in-hospital skin test,routine requirements of departments,nurse intervention and experience teaching of senior physicians.Other descriptive statistics showed that 83.3%(170/204)of physicians in the skin test group stated that they conducted cephalosporin routine skin test due to self-protection concerns.CONCLUSION Most physicians(78.2%)conducted cephalosporin routine skin test before administering medication to patients in Peking University Third Hospital.The results of single-factor analysis and multi-factor analysis should be combined to formulate targeted interventions to standardize the practice of skin test of such drugs.

关 键 词：头孢菌素皮试 定量研究 影响因素 LOGISTIC回归分析 

分 类 号：R969[医药卫生—药理学]