中国药业2024，Vol.33Issue(11)：13-16,4.DOI:10.3969/j.issn.1006-4931.2024.11.003
医院和科室上下联动事前-事中-事后闭环服务抗菌药物管理模式构建与实践
Construction and Practice of a Closed-Loop Antimicrobial Management Model with Prescription Services in Advance,in the Matter and Afterward Based on the Upper and Lower Linkage Between the Hospital and Departments
摘要
Abstract
Objective To promote the rational use of antibiotics.Methods Based on the evidence-based approach,a closed-loop antimicrobial management model with prescription services in advance,in the matter and afterward based on the upper and lower linkage between the hospital and departments was established.The key nodes and service content of closed-loop services were analyzed,the networked service system was implemented,the network intervention system for closed-loop services such as special patients and restricted antibacterial drug special services was improved.The antibacterial use density(AUD)and unreasonable types of medical orders in the hospital before implementation(2020)and after implementation(from 2021 to 2023)were compared.Results The AUD of the hospital in 2021,2022,and 2023 were 39.40 DDDs,32.10 DDDs,and 38.09 DDDs,respectively,which were lower than the 57.80 DDDs in 2020 and met the limited standard of AUD(40 DDDs)for general hospitals in China.In 2021,the top three types of unreasonable medical orders for antibiotics were unreasonable antimicrobial prevention/treatment plans,unreasonable drug selection,and unreasonable combination therapy.In 2022,the top three types of unreasonable medical orders for antibiotics were unreasonable antimicrobial prevention/treatment plans,unreasonable medication duration,and unreasonable administration routes and doses.In 2023,the top three types of unreasonable medical orders for antibiotics were unreasonable administration routes and doses,unreasonable medication courses,and unreasonable antimicrobial prevention/treatment plans.Conclusion The closed-loop antimicrobial management model with prescription services in advance,in the matter and afterward based on the upper and lower linkage between hospitals and departments can effectively reduce the AUD,promote the transformation of unreasonable types of medical orders of antibiotics,and gradually transition from optimizing drug treatment plans to refining antibiotic dosage and course of treatment.关键词
医院和科室上下联动/事前-事中-事后闭环服务/抗菌药物/合理用药/抗菌药物使用强度/医嘱Key words
upper and lower linkage between the hospital and departments/prescription services in advance,in the matter and afterward/antibiotics/rational drug use/antibacterial use density/medical orders分类
医药卫生引用本文复制引用
杨全军,郭澄,刘义成,罗莉,朱文君,干润,屠祎惺,辛博,杨黎,陈燕,张剑萍..医院和科室上下联动事前-事中-事后闭环服务抗菌药物管理模式构建与实践[J].中国药业,2024,33(11):13-16,4.基金项目
国家自然科学基金面上项目[82272925] （）
上海市浦江(A类)人才项目[21PJ1411900] （A类）
上海市第六人民医院院级管理类科研基金[X-4221] （）
上海市第六人民医院医疗服务能级提升工程医政管理优化项目[X-4108]. （）
