投稿分類 抗生素管制

主委發表種類: 壁報

投稿標題(中): 評估抗生素管理計畫對某醫學中心質量措施的影響

投稿標題(英): A Review of Quality Measures for Assessing the Impact of Antimicrobial Stewardship Programs a Medical Center

投稿摘要: The aim of this study was to develop new consensus quality indicators (QIs) for ASP which was evaluated for internal quality management and external quality assessment in a Medical Center. We developed a set of healthcare associated infection cloud to measure appropriate antibiotic use in hospitalized patients with 39 QIs since 2015 in a 2700-bed medical center. Key strategies include evidence-based antimicrobial prescribing guidelines, quality assurance measures/audits and feedback. Impact and quality of ASP was assessed using process or outcome measures. Outcome measures are categorized as microbiological, clinical or financial outcomes. Analysis of approval rate to audit physicians and rate of clinicians recommend acceptance in order to enhance communication between clinicians in different divisions and establish partnerships. The consumption of antibiotics in the hospital after the start control, overall antibiotic consumption has significantly decreased (p ＜ .001), while significantly reducing the use of broad-spectrum antibiotics (p ＜ .001), the antibiotic expenditures of total medicine ratio also showed a significant decline (p ＜ .001). The rate of healthcare associated infection, overall mortality, readmission for the outcomes indicators are showing positive reduction trend (p ＜ .001). No significant association was found between the increased use of piperacilllin/tazobactam and increasing HAIs due to CR-Acinetobacter spp. Prioritizing indicator settings within ASP is essential if limited resources are to be used most effectively. Indicator development, evaluation and feedback ought to be multi-disciplinary to ensure ownership and long-term benefit.

稿件檔: