使用行为科学来改善加拿大长期护理院的抗生素管理:多中心集群随机质量改善研究的协议
Tyler Good1, Jorida Cila1, Rhiannon Mosher1
1Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Ottawa, ON.
概括
这项研究引入了一种新方法,以减少在长期护理院 (LTCH) 治疗尿路感染 (UTI) 的不必要抗生素使用. 该战略包括教育家庭,并向工作人员提供反,以改善抗微生物药物管理 (AMS).
科学领域:
- 老年学是一门学科.
- 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:
- 抗菌素耐药性 (AMR) 带来了巨大的成本,特别是在长期护理家庭 (LTCH) 的老年人身上.
- 尿路感染 (UTI) 是LTCH中抗生素处方的主要驱动因素,其中许多可能是可以避免的.
- 在LTCH中,高达70%的尿路感染抗生素处方可能是不必要的.
研究的目的:
- 开发和评估新的,基于行为的抗微生物药物管理 (AMS) 质量改善策略.
- 减少加拿大LTCH中缺乏明显的尿路感染症状的居民不必要的尿液检测和抗生素治疗.
主要方法:
- 实施了一项双重的质量改进战略.
- 为基本护理提供者 (家庭和朋友) 提供针对性关于尿路感染和AMS的教育.
- 每月对LTCH工作人员提供的尿液培养订单率的反.
- 在八个加拿大LTCH中实施的阶梯随机集群设计.
主要成果:
- 该协议最初在一个LTCH中试点进行了改进.
- 过程评估为最终的研究协议提供了信息.
- 改进后的协议目前正在8个加拿大LTCH中实施.
结论:
- 这种基于行为科学的干预措施旨在增强LTCH中的AMS.
- 成功实施可能会导致一个可扩展的护理模式在加拿大.
- 这种方法使各种利益相关者能够通过抗生素管理来改善健康结果.
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