1 Wayne State University, Detroit, Michigan, USA.
2 Ascension St. John Hospital, Detroit, Michigan, USA.
Qual Health Res. 2018 Apr;28(5):745-755. doi: 10.1177/1049732317750863. Epub 2018 Jan 15.
To systematically improve the appropriateness of antibiotic prescribing, antimicrobial stewardship programs have been developed. There is a paucity of literature examining how pharmacists perform antimicrobial stewardship using a clinical decision support system in a hospital setting. The purpose of this qualitative study was to develop a model exploring how pharmacists perform antimicrobial stewardship to identify areas for programmatic improvement. Semistructured interviews were conducted across a health care system until saturation of themes was reached. Pharmacists identified that self-efficacy and time were vital for antimicrobial stewardship to be performed, while culture of the hospital and attitude facilitated the process of stewardship. Antimicrobial stewardship programs using clinical decision support tools should ensure pharmacists have adequate time to address rules, provide easy-to-use resources and training to support self-efficacy, and engage influential physicians to support a culture of collaboration.
为了系统地提高抗生素处方的适宜性，已经开发了抗菌药物管理项目。关于药师在医院环境中使用临床决策支持系统来执行抗菌药物管理的文献很少。本定性研究的目的是开发一个模型，探索药师如何执行抗菌药物管理，以确定计划改进的领域。在整个医疗保健系统中进行了半结构化访谈，直到达到主题的饱和。药师确定自我效能和时间对于执行抗菌药物管理至关重要，而医院的文化和态度则促进了管理过程。使用临床决策支持工具的抗菌药物管理计划应确保药师有足够的时间来解决规则问题，提供易于使用的资源和培训以支持自我效能，并让有影响力的医生参与进来以支持合作文化。
