Smith K S, Quercia R A, Chow M S, Nightingale C H, Quintiliani R, Millerick J D
Department of Pharmacy Services, Hartford Hospital, CT 06115.
Am J Hosp Pharm. 1988 Jun;45(6):1338-42.
A multidisciplinary cost-containment program for promoting the use of single prophylactic doses of cefazolin for obstetrical and gynecological surgical procedures is described. Following a one-month review of patient charts to identify the antimicrobial regimens used most frequently for prophylaxis in obstetrical and gynecological surgical procedures, the department of pharmacy services, with the cooperation of the pharmacy and therapeutics (P&T) committee and the departments of obstetrics and gynecology and infectious diseases, implemented an educational program to promote the use of single doses of cefazolin for surgical prophylaxis. The program included inservice education and distribution of letters of support and a therapeutics newsletter. Drug stocking patterns in the operating and delivery rooms were changed to make cefazolin more accessible, and the P&T committee formally restricted the use of prophylactic antimicrobial agents in obstetrical and gynecological surgical procedures to single doses of cefazolin unless a consulting infectious-disease physician recommended otherwise. Compliance with the program increased as each step was implemented; data collected 16 months after the program was initiated demonstrated a compliance rate of 78.8%. Based on comparison of data collected before initiation and six months after initiation of the program, an actual cost savings of +7,125 was realized, which extrapolates to +14,250 annually. No apparent adverse effects on patient care were noted. The multidisciplinary approach to promoting the use of single doses of cefazolin was effective.
本文描述了一个多学科成本控制项目，该项目旨在推广在妇产科手术中使用单剂量预防性头孢唑林。在对患者病历进行为期一个月的审查，以确定妇产科手术中最常用的预防性抗菌方案后，药学服务部门在药学与治疗学（P&T）委员会以及妇产科和传染病科的合作下，实施了一项教育计划，以推广使用单剂量头孢唑林进行手术预防。该计划包括在职教育、分发支持信和一份治疗学通讯。手术室和产房的药品储备模式进行了改变，以使头孢唑林更易获取，并且P&T委员会正式将妇产科手术中预防性抗菌药物的使用限制为单剂量头孢唑林，除非感染病会诊医生另有建议。随着该计划每一步的实施，合规性有所提高；在该计划启动16个月后收集的数据显示合规率为78.8%。根据在该计划启动前和启动后六个月收集的数据进行比较，实际节省成本7125美元，推算至每年节省14250美元。未发现对患者护理有明显不良影响。推广使用单剂量头孢唑林的多学科方法是有效的。
