Centre MedQual, hôpital St-Jacques, CHU de Nantes, 85, rue St-Jacques, 44093 Nantes, France.
Med Mal Infect. 2013 Dec;43(11-12):475-80. doi: 10.1016/j.medmal.2013.09.005. Epub 2013 Nov 18.
The aim of this study was to consider the implementation of a network of infectious diseases (ID) experts to optimize the antibiotic prescriptions of community and hospital practitioners.
An observational prospective study was conducted among ID experts in the Pays-de-la-Loire Region to evaluate the number of calls and to determine the practitioner's reasons for soliciting ID expertise. For each phone consultation, four criteria were recorded during 5 days: origin of the call (internal/external), kind of question (diagnostic/therapeutic) time spent for the advice provided, type of advice.
A total of 386 phone consultations for 20 infectious disease specialists were recorded during the study period (5 days); 81% were internal to the hospital, 7.7% from another hospital, and 11.3% from private practice, 56.3% of the questions concerned a therapeutic strategy, 21% a diagnostic advice, and 22.6% concerned both diagnosis and therapy. Two third of the questions were answered within 10minutes. In 68.7% of cases, the ID specialist answered immediately, 19.8% of calls required following-up the patient, 6% led to refer the patient to an ID consultation, and 5.5% to hospitalization.
The survey results stress the important need for such ID expertise, both in hospitals and in ambulatory medicine. Collaboration of ID specialists in a regional network would allow an easy and permanent access to antibiotic therapy advice for prescribers. This network would improve the quality and safety of care.
本研究旨在考虑建立传染病(ID)专家网络,以优化社区和医院医生的抗生素处方。
在卢瓦尔河地区(Pays-de-la-Loire Region)对 ID 专家进行了一项观察性前瞻性研究,以评估电话咨询的数量,并确定医生寻求 ID 专业知识的原因。对于每次电话咨询,在 5 天内记录了以下四个标准:来电来源(内部/外部)、问题类型(诊断/治疗)、提供建议所花费的时间、建议类型。
在研究期间(5 天),共记录了 20 名传染病专家的 386 次电话咨询;81%是医院内部的,7.7%来自另一家医院,11.3%来自私人诊所,56.3%的问题涉及治疗策略,21%是诊断建议,22.6%同时涉及诊断和治疗。三分之二的问题在 10 分钟内得到解答。在 68.7%的情况下,ID 专家立即回答,19.8%的电话需要跟进患者,6%的电话导致将患者转介至 ID 咨询,5.5%的电话导致住院。
调查结果强调了这种 ID 专业知识的重要需求,无论是在医院还是在门诊医学中。ID 专家在区域网络中的合作将允许为处方者提供便捷且持续的抗生素治疗建议。该网络将提高护理质量和安全性。