便利化作为减少儿童医院过度抗生素预防的有效策略:一个阶梯集群随机对照试验
Research square
|June 12, 2025
概括
促进培训通过支持抗生素管理计划 (ASP) 在减少不必要的术后抗生素使用方面显著改善了儿童医院的抗生素管理. 这一战略提高了抗生素处方实践的适当性.
科学领域:
- 医疗保健 实施 科学 科学
- 抗微生物药物管理委员会
- 提高儿童医疗保健质量 提高儿童医疗保健质量
背景情况:
- 在儿科环境中过度使用手术后抗生素会带来风险,包括C. difficile感染和抗菌素耐药性.
- 抗生素管理计划 (ASP) 旨在优化抗生素的使用,但需要有效的指导方针实施策略.
- 促进,一个支持医疗保健团队在证据与实践整合的过程,被探索为不必要的抗生素的实施.
研究的目的:
- 评估促进的有效性作为一种战略,以消除在儿童医院中不必要的术后抗生素使用.
- 为了比较促进培训与订单的变化,以改善抗生素管理.
- 评估与ASP努力相关的实施结果.
主要方法:
- 一个阶梯集群随机对照试验 (OPerAtiC) 涉及九家医院.
- 两种策略进行了比较:依据i-PARIHS框架进行的订单变化 (基线) 和促进培训 (干预).
- 收集的数据包括实施结果 (可接受性,可行性,适当性),促进技能的使用和订单完成率.
主要成果:
- 这两种策略都显示出高的近距离实施结果和参与者的热情.
- 有效的促进技能,包括沟通和解决冲突,对于成功至关重要.
- 便利化与减少抗生素的订单数量 (76%) 显著增加,改善了抗生素使用的适当性.
结论:
- 便利化是加强抗生素管理计划和减少儿科护理中不必要使用抗生素的有效策略.
- 对ASP团队的持续培训和支持对于促进适当的抗生素处方至关重要.
- 建议进行进一步的研究,以调查促进对管理和患者结果的长期影响.
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