提供者专业的变化与退伍军人事务长期护理机构的化诺使用量减少有关
Taissa A Bej1, Brigid M Wilson2, Nadim El Chakhtoura3
1Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System, Cleveland, OH, USA.
Journal of the American Medical Directors Association
|February 6, 2024
概括
当通用医学从业人员接管退伍军人事务社区生活中心的护理时,抗生素处方模式发生了变化,使用的诺基诺较少,使用的多西环素更多. 这一变化与Clostridioides difficile感染的减少一致.
科学领域:
- 老年病的医生 老年病的医生
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 退伍军人事务 (VA) 医疗保健系统在2021年7月将社区生活中心 (CLC) 的居民转换为通用医疗服务的持续护理.
- 这一组织变革旨在将急症护理从业人员与长期护理居民整合起来,可能会影响处方习惯.
研究的目的:
- 调查一般医疗服务对CLC居民的持续护理对抗生素处方模式的影响.
- 为了测试这种假设,即习惯于急性护理的医生可能会在长期护理环境中增加抗生素处方.
主要方法:
- 一项回顾性队列研究使用CLC居民两年 (2020年7月 - 2022年6月) 的行政数据进行.
- 处方的抗生素,每1000个病床治疗日 (BDOC) 的治疗日 (DOT),抗生素开始/1000个BDOC,以及治疗的平均持续时间在人员更换之前和之后进行了比较.
主要成果:
- 总体而言,在通用医学服务过渡之前和之后,抗生素使用指标保持相似.
- 观察到特定抗生素剂的显著转变:诺基诺的减少和多西环素的增加.
- 在过渡后, *Clostridioides difficile* 感染率有所下降.
结论:
- 抗生素使用指标保持稳定,这表明居民人口和设施因素可能比从业者背景更有影响力.
- 观察到的特定抗生素剂的变化凸显了将抗生素管理量身定制为实践者学科的潜力.
- 这些发现强调了在长期护理机构内考虑实践者在抗生素管理计划中的背景的重要性.
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