药剂师设计的临床决策支持系统对抗微生物药物管理的影响
Miguel Ángel Amor-García1, Esther Chamorro-de-Vega2, Carmen Guadalupe Rodríguez-González2
1Pharmacy Service, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain.
实施抗微生物药物管理的临床决策支持系统 (CDSS) 显著减少了抗微生物药物的使用和治疗持续时间. 这种CDSS在优化抗微生物药物处方和改善医院患者的治疗结果方面表现有前途.
科学领域:
- 医疗信息学 医疗信息学
- 临床药房 临床药房
- 传染病管理 传染病管理
背景情况:
- 临床决策支持系统 (CDSS) 有助于抗菌药物管理 (AS),但需要进一步研究以实现最佳实施.
- 有效的AS策略对于打击抗菌素耐药性和改善患者护理至关重要.
研究的目的:
- 分析一家二级医院对AS的药剂师驱动的CDSS的实施情况.
- 评估CDSS对抗微生物消费,治疗持续时间和临床结果的影响.
主要方法:
- 使用了回顾性,干预前后的研究设计.
- 一个由药剂师驱动的CDSS生成了自动警报,供AS专业人员审查.
- 关键指标包括警报接受率,抗菌药物消费 (DDD/1000个月床位),治疗持续时间,住院死亡率和住院时间 (LOS).
主要成果:
- 该AS团队审查了7,543个警报,其中772名患者接受了79.3%的接受率的建议.
- 抗菌药物的消费量下降 (691.1至656.8 DDD/1,000个月床位;p=0.04).
- 治疗持续时间 (3.6至3.3天;p<0.01) 和医院LOS (7.2至6.2天;p<0.01) 显著减少.
结论:
- CDSS的实施导致了抗微生物药物使用和治疗持续时间的显著减少.
- 在实施后,住院时间也显著减少.
- 没有观察到医院内死亡率的显著变化.
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