比利时医院抗菌药物管理质量指标的制定:兰德-改良德尔菲程序。

IF 1.6 4区 医学 Q2 Medicine
Acta Clinica Belgica Pub Date : 2024-04-01 Epub Date: 2023-12-26 DOI:10.1080/17843286.2023.2297123
Sylvie Legros, Anna Vanoverschelde, Jens van Krieken, Yves Debaveye, Ann Versporten, Diana Huis In 't Veld, Veerle Westelinck, Caroline Briquet, Christelle Vercheval, Isabel Spriet, Olivier Denis, Koen Magerman, Marc De Schepper, Franky Buyle
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引用次数: 0

摘要

导言:抗生素使用不当是导致抗生素耐药性的主要原因。因此,优化抗生素的使用至关重要。在比利时,公共卫生部门通过全国性监测来跟进抗菌药物的优化使用,以对抗耐多药生物(MDROs)。为改善医院抗菌药物的合理使用,有效的国家抗菌药物管理(AMS)计划应包括衡量抗生素使用数量和质量的指标:本研究旨在制定一套流程质量指标(QIs),以评估和改进医院的抗菌药物管理:方法:采用兰德修正德尔菲程序。该程序包括结构化的文献综述以选择质量指标,随后进行两次在线问卷调查,中间与来自比利时综合医院和教学医院的传染病专家进行多学科小组讨论:结果:经过兰德修正德尔菲程序,共选出 38 个量化指标,其中 11 个量化指标被一致选中。这些量化指标涉及抗生素治疗和预防是否符合当地指南、病历中抗生素治疗理由的记录、AMS 计划和门诊外用抗生素治疗的可用性、耐药性模式以及重点查房期间的抗菌药物处方:我们的研究选择了 38 项相关的流程质量指标,其中 11 项获得一致通过。这些 QIs 可以激励医院取得更好的成果,并为如何干预和改善抗菌药物处方提供重点,从而有助于提高抗生素使用质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Development of quality indicators for antimicrobial stewardship in Belgian hospitals: a RAND - modified Delphi procedure.

Introduction: Inappropriate antibiotic use is a major cause of antibiotic resistance. Therefore, optimizing antibiotic usage is essential. In Belgium, optimization of antimicrobials for the fight against multidrug resistant organisms (MDROs) is followed up by national surveillance by public health authorities. To improve appropriate antimicrobial use in hospitals, an effective national Antimicrobial Stewardship (AMS) program should include indicators for measuring both the quantity and quality of antibiotic use.

Objectives: The aim of this study was to develop a set of process quality indicators (QIs) to evaluate and improve AMS in hospitals.

Methods: A RAND-modified Delphi procedure was used. The procedure consisted of a structured narrative literature review to select the QIs, followed by two online questionnaires and an intermediate multidisciplinary panel discussion with experts in infectious diseases from general and teaching hospitals in Belgium.

Results: A total of 38 QIs were selected after the RAND-modified Delphi procedure, from which 11 QIs were selected unanimously. These QIs address compliancy of antibiotic therapy and prophylaxis with local guidelines, documentation of the rationale for antibiotic treatment in the medical record, the availability of AMS Programs and Outpatient Parenteral Antibiotic Therapy, resistance patterns and antimicrobial prescribing during focused ward rounds.

Conclusion: Our study selected 38 relevant process QIs, from which 11 were unanimously selected. The QIs can contribute to the improvement of quality of antibiotic use by stimulating hospitals to present better outcomes and by providing a focus on how to intervene and to improve prescribing of antimicrobials.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica 医学-医学:内科
CiteScore
2.90
自引率
0.00%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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