An educational intervention to improve antimicrobial use in a hospital-based long-term care facility
An educational intervention to improve antimicrobial use in a hospital-based long-term care facility
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DOI：
10.1111/j.1532-5415.2007.01251.x
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发表时间：
2007-08-01
影响因子：
6.3
通讯作者：
Weinstein, Robert A.
中科院分区：
文献类型：
--
作者：
Schwartz, David N.;Abiad, Homer;Weinstein, Robert A.
目的：为了改善长期护理（LTC）患者的抗菌药物使用。设计：前瞻性，准实验性的医生教育和指南实施效果的前后评估。设置：公共LTC和急性护理医院。参与者：20名为LTC患者提供大部分医疗护理的受薪内科医生。干预：国家指南医院耐药数据，和医生的反馈被纳入一系列的四个教学会议提出了超过18个月，并成为小册子，详细介绍了机构的指导方针，对共同的最佳管理。LTC感染综合征：测量：100例随机选择的LTC患者接受抗菌药物治疗，这些干预措施实施前和100后进行审查，并比较护理质量的措施。结果：临床异常符合指南诊断标准（62% vs 38%，P = 0.006），初始治疗符合指南建议（39% vs 11%，P = 0.006）。
Objectives: To improve antimicrobial use in patients receiving long-term care (LTC).Design: Prospective, quasi -experimental before-after assessment of the effects of physician education and guideline implementation.Setting: Public LTC and acute care hospital.Participants: Twenty salaried internists who provided most of the medical care to LTC patients.Intervention: National guidelines, hospital resistance data, and physician feedback were incorporated into a series of four teaching sessions presented over 18 months and into booklets detailing institutional guidelines on the optimal management of common LTC infection syndromes.Measurements: One hundred randomly selected LTC patients treated with antimicrobials were reviewed before these interventions were implemented and 100 after, and measures of the quality of care were compared. The effect of the interventions on antimicrobial days and starts were also assessed using interrupted time series analysis.Results: Charted clinical abnormalities met guideline diagnostic criteria (62% vs 38%, P = .006), and initial therapy agreed with guideline recommendations (39% vs 11%, P