COMMUNITY CARE OF CORNEAL ULCERS
COMMUNITY CARE OF CORNEAL ULCERS
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DOI：
10.1016/s0002-9394(14)74479-4
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发表时间：
1992-11-15
影响因子：
4.2
通讯作者：
TROUSDALE, M
中科院分区：
文献类型：
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作者：
MCDONNELL, PJ;NOBE, J;TROUSDALE, M
由于越来越多的关注适当的和具有成本效益的使用眼科护理服务和程序，一些组织已经试图达到实践指南或实践模式，医生可以从中获得指导。为了评估这些指南的潜在有效性，我们回顾了角膜溃疡患者的护理。角膜专家建议在开始治疗前进行培养。我们通过以下方式确定眼科医生是否实施了这些指南：（1）回顾79例转诊至三级护理角膜和外部疾病服务机构评估角膜炎的患者的记录，（2）通过邮件对执业眼科医生进行调查。79例角膜溃疡患者中有38例（48.1%）接受了抗生素治疗，但未进行任何培养。我们对普通眼科医生的调查显示，560例角膜溃疡患者中有274例（48.7%）接受了抗生素治疗，但未获得任何培养物。根据这两种方法的测量结果，角膜溃疡护理中推荐实践的依从性较差。这一程序为更有效地执行今后的实践准则提供了见解。
Because of increasing concern about the appropriate and cost-effective use of eye care services and procedures, several organizations have sought to arrive at practice guidelines or practice patterns from which physicians can draw guidance. To assess the potential effectiveness of such guidelines, we reviewed the care of patients with corneal ulcers. Corneal specialists recommend that cultures be obtained before initiation of treatment. We determined whether ophthalmologists implemented these guidelines by the following: (1) a review of records of 79 patients referred to a tertiary care corneal and external disease service for evaluation of keratitis, and (2) a survey by mail of practicing ophthalmologists. Antibiotic therapy without any cultures was observed in 38 of 79 referred patients with corneal ulcers (48.1%). Our survey of general ophthalmologists disclosed that 274 of 560 patients with corneal ulcers (48.7%) were treated with antibiotics without any cultures being obtained. Compliance with recommended practice in the care of corneal ulcers is poor, as measured with either method. This procedure provides insights into more effective implementation of future practice guidelines.