临床药师参与某三级甲等医院重症医学科抗菌药物使用管理效果评价  

Effect Evaluation of Clinical Pharmacists′Participation in the Management of Antibiotic Use in the Intensive Care Unit of a Grade-A Tertiary Hospital

作　　者：王洪泽 马名扬 马莹 WANG Hongze;MA Mingyang;MA Ying(The Affiliated Taizhou People's Hospital of Nanjing Medical University,Taizhou,Jiangsu,China 225300;School of Pharmacy,Xuzhou Medical University,Xuzhou,Jiangsu,China 221004)

机构地区：[1]南京医科大学附属泰州人民医院,江苏泰州225300 [2]徐州医科大学药学院,江苏徐州221004

出　　处：《中国药业》2024年第16期30-33,共4页China Pharmaceuticals

摘　　要：目的提高医院临床科室抗菌药物使用合理性。方法通过PASS临床药学管理系统与合理用药监测系统收集医院重症医学科2022年1月至6月(干预前)及2022年7月至12月(干预后)抗菌药物使用数据。建立临床药师参与的抗菌药物使用管理PDCA循环,设定目标值为抗菌药物使用强度(AUD)降至95 DDDs/百人天,并抽取该科室干预前后各200份病历评价抗菌药物合理使用情况。结果干预后,该科室AUD由(107.64±8.79)DDDs/百人天降至(83.25±10.15)DDDs/百人天(P<0.01),抗菌药物的使用率、人均使用金额分别降低9.31%,938.29元;非限制使用级、限制使用级、特殊使用级抗菌药物使用率分别降低0.39%,5.32%,3.60%;出院患者抗菌药物使用率降低9.31%,单用率升高9.66%;抽检病例中抗菌药物不合理使用率降低13.00%,其中干预前主要不合理类型为用法用量不合理、无适应证用药、疗程不合理,干预后为用法用量不合理、疗程不合理。结论临床药师参与抗菌药物使用管理PDCA循环,能有效控制AUD,提升抗菌药物使用合理性。Objective To promote the rational use of antibiotics in clinical departments of hospitals.Methods The data on the antibiotic use in the Intensive Care Unit of a hospital from January to June 2022(before intervention)and July to December 2022(after intervention)were collected by the PASS clinical pharmacy management system and rational drug use monitoring system.A PDCA cycle for antibiotic use management participated by clinical pharmacists was established,with a target value of antibiotics use density(AUD)decreasing to 95 DDDs/100 person-days.A total of 400 medical records before and after intervention(200 for each time period)in the department were extracted to evaluate the rationality of antibiotic use.Results After intervention,the AUD of the department decreased from(107.64±8.79)DDDs/100 person-days to(83.25±10.15)DDDs/100 person-days(P<0.01),the antibiotic use rate and consumption sum per capita decreased by 9.31%and CNY 938.29,respectively.After intervention,the use rates of antibiotics for non-restricted use,restricted use and special use decreased by 0.39%,5.32%,and 3.60%,respectively.After intervention,the use rate of antibiotics in discharged patients decreased by 9.31%,while the proportion of patients with single use of antibiotics increased by 9.66%.After intervention,the irrational use rate of antibiotics in case samples decreased by 13.00%,the main types of irrational use before intervention were inappropriate usage and dosage,medication without indication,and inappropriate treatment course,those after intervention were inappropriate usage and dosage and inappropriate treatment course.Conclusion Clinical pharmacists participating in the PDCA cycle for antibiotic use management can effectively control the AUD and improve the rationality of antibiotic use.

关 键 词：抗菌药物使用强度 重症医学科 临床药师 PDCA循环 合理用药 

分 类 号：R95[医药卫生—药学]