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基于证据的质量改进在ICU (EQUIPS-ICU) 处方监管:III类混合实施-有效性研究的协议
Duncan Wagstaff1, John Amuasi2,3,4, Sumaiya Arfin5,6,7
1Centre for Preoperative Medicine, University College London, London, UK. d.wagstaff@ucl.ac.uk.
近一半的重症监护病房抗菌药物处方不合适,导致耐药性. 这项研究测试了世卫组织在低收入国家指导的干预措施,以改善处方和减少耐药性. 需要进一步的研究.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 实施科学 实施科学
背景情况:
- 在重症监护室 (ICU) 中不适当的抗菌素处方是常见的,估计约占处方的50%.
- 这种做法导致医疗保健成本增加,患者的副作用,以及抗菌素耐药性 (AMR) 的关键问题,特别是在低收入和中等收入国家 (LMICs).
- 实施改善抗微生物药物处方干预措施的变化需要进一步调查.
研究的目的:
- 评估LMICICICICU中的结构化抗菌素处方审查干预措施.
- 评估实施的有效性,包括干预的忠实性,覆盖范围和采用.
- 了解影响抗微生物管理干预措施在各种医疗保健环境中的成功因素.
主要方法:
- 一个混合型III实施/有效性队列试验,涉及多达11个LMIC的35个ICU.
- 干预包括世界卫生组织推的结构化处方审查,当地协议开发,审计/反和教育.
- 评估利用RE-AIM和实施研究综合框架 (CFIR),进行定性访谈和管理结构的基准调查.
主要成果:
- 主要结果将是一个综合测量干预忠实度,覆盖范围和采用度的综合测量.
- 二次结果将评估干预措施在改善抗菌素处方模式方面的有效性.
- 定性数据将探索干预措施的可接受性,适应性和维持性.
结论:
- 本研究通过研究LMICICICICU中的抗菌药物管理实施来解决全球卫生优先事项.
- 它旨在加强医疗保健专业人员的能力,并了解现有的管理结构如何影响干预成功.
- 调查结果将加强在资源有限的环境中克服实施障碍的战略.
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