法国养老院的抗菌素处方和针对抗菌素管理的干预措施:一种定性研究
Marie Hamard1,2,3, Claire Durand4, Laurène Deconinck5
1Department of Geriatrics, APHP Bichat Hospital, University Paris Cité, Paris, France. marie.hamard@aphp.fr.
Antimicrobial resistance and infection control
|November 28, 2024
概括
在养老院处方抗生素是复杂的,受感知风险和机构因素的影响. 量身定制的指导方针和改善的合作是有效的抗菌药物管理干预措施的关键.
科学领域:
- 老年医学 老年医学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 养老院经常过度使用抗生素,导致副作用和抗生素耐药性.
- 现有的抗微生物药物管理干预措施在减少这些环境中不适当使用抗微生物药物方面取得了不同程度的成功.
研究的目的:
- 分析影响养老院抗菌素处方决策的因素.
- 确定养老院医生用于抗菌素处方的资源.
- 了解必要的抗微生物管理干预措施及其在养老院的最佳实施策略.
主要方法:
- 进行了个别的,半导向的采访,对法国伊利德法兰斯养老院的处方医生进行了采访.
- 采用代的主题内容分析来解释采访数据.
主要成果:
- 13名医生参加了会议,他们扮演了各种角色,包括医疗协调员和全科医生.
- 关键的处方决定因素包括感染的感知风险,获取样本的困难和人员短缺.
- 医生使用了国家指南和电子决策支持系统,但由于机构约束,医生通常会"万一"开处方.
- 建议采取干预措施,如定制指南,实践审计和加强多学科合作,医疗协调员发挥中心作用.
结论:
- 在养老院处方抗菌药物是一个多方面的过程,涉及各种因素和利益相关者.
- 有效的抗微生物药物管理需要特定背景的指导方针,实践审计和加强合作.
- 医生强调了医疗协调员的关键作用,其支持是利益相关方的参与,培训和持续支持,以成功实施干预.
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