Morris W T, Lamb A M
Department of Surgery, University of Auckland School of Medicine.
N Z Med J. 1989 Sep 13;102(875):472-4.
We examined the cost of antibiotics used prophylactically in the first 25 patients in a controlled clinical trial comparing different antibiotic regimens in the prophylaxis of sepsis. We compared this with the costs of prophylaxis in 25 similar patients immediately before the trial started and found that the costs in the pretrial patients were significantly greater than in the trial patients. The trial is therefore beneficial to the hospital. We also examined the dispensing errors in the same patients. We found none in the trial patients but there were 77 out of 627 doses prescribed in the pretrial patients. We concluded that the abolition of dispensing errors brought about by the trial must be beneficial to the patients. They were also benefitted by the close monitoring which reveals complications at an early stage, and the improved case notes. The Hawthorne effect on medical and nursing staff is the most likely cause of these phenomena.
我们在一项对照临床试验中,对首批25例患者预防性使用抗生素的费用进行了研究,该试验比较了不同抗生素方案预防败血症的效果。我们将此与试验开始前25例类似患者的预防费用进行了比较,发现试验前患者的费用显著高于试验患者。因此,该试验对医院有益。我们还检查了同一批患者的配药错误情况。我们发现试验患者中没有配药错误,但试验前患者所开的627剂药物中有77剂存在配药错误。我们得出结论,试验带来的配药错误的消除肯定对患者有益。患者还受益于密切监测,这种监测能在早期发现并发症,以及改进的病历记录。这些现象最可能的原因是霍桑效应对医护人员产生了影响。