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使用TARGET抗生素自我评估工具的基层医疗中自我报告的抗菌药物管理实践

Self-Reported Antimicrobial Stewardship Practices in Primary Care Using the TARGET Antibiotics Self-Assessment Tool.

作者信息

Jones Leah Ffion, Verlander Neville Quinton, Lecky Donna Marie, Altaf Sabeen, Pilat Dirk, McNulty Cliodna

机构信息

Primary Care and Interventions Unit, Public Health England, Gloucester GL1 1DQ, UK.

Statistics, Modelling and Economics Department,Public Health England, London NW9 5EQ, UK.

出版信息

Antibiotics (Basel). 2020 May 14;9(5):253. doi: 10.3390/antibiotics9050253.

Abstract

The self-assessment tool (SAT) is a 16-question self-report of antimicrobial stewardship practices in primary care, available in the TARGET (Treat Antibiotics Responsibly, Guidance Education and Tools) Antibiotics Toolkit. This study analysed responses to the SAT and compared them to previous SAT data (2014-2016). Data from June 2016 to September 2019 were anonymised and analysed using Microsoft Excel and STATA 15. Clinicians reported engaging in positive antimicrobial stewardship (AMS) practices including using antibiotic guidance to inform treatment decisions (98%, 98% 2014-2016), discussing antibiotic prescribing within the practice (73%, 67% 2014-2016), using patient-facing resources (94%, 71% 2014-2016), conducting antibiotic audits in the last two years (98%, 45% 2014-2016), keeping written records and action plans (81%, 62% 2014-2016), using back-up prescribing (99%, 94% 2014-2016) and using clinical coding (80%, 75% 2014-2016). Areas for improvement include developing strategies to avoid patients reconsulting to obtain antibiotics (45%, 33% 2014-2016), undertaking infection-related learning (37%, 29% 2014-2016), ensuring all temporary prescribers have access to antibiotic guidance (55%, 63% 2014-2016) and making patient information leaflets easily available during consultations (31%). The findings offer a unique insight into AMS in primary care over time. The SAT gives primary care clinicians and commissioners an opportunity to reflect on their AMS and learning.

摘要

自我评估工具(SAT)是一份包含16个问题的关于初级医疗中抗菌药物管理实践的自我报告,可在TARGET(负责任使用抗生素、指导教育与工具)抗生素工具包中获取。本研究分析了对SAT的回答,并将其与之前的SAT数据(2014 - 2016年)进行比较。2016年6月至2019年9月的数据进行了匿名处理,并使用Microsoft Excel和STATA 15进行分析。临床医生报告称参与了积极的抗菌药物管理(AMS)实践,包括使用抗生素指南来指导治疗决策(98%,2014 - 2016年为98%)、在医疗机构内讨论抗生素处方(73%,2014 - 2016年为67%)、使用面向患者的资源(94%,2014 - 2016年为71%)、在过去两年进行抗生素审计(98%,2014 - 2016年为45%)、保存书面记录和行动计划(81%,2014 - 2016年为62%)、使用备用处方(99%,2014 - 2016年为94%)以及使用临床编码(80%,2014 - 2016年为75%)。有待改进的方面包括制定策略以避免患者再次咨询以获取抗生素(45%,2014 - 2016年为33%)、进行与感染相关的学习(37%,2014 - 2016年为29%)、确保所有临时开处方者都能获取抗生素指南(55%,2014 - 2016年为63%)以及在会诊期间方便地提供患者信息传单(31%)。这些发现为初级医疗中抗菌药物管理随时间的变化提供了独特的见解。SAT为初级医疗临床医生和管理人员提供了一个反思其抗菌药物管理和学习情况的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/268f/7277769/93db689b54e5/antibiotics-09-00253-g0A1.jpg

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