CN113611397A - Special use-level antibacterial drug use management system and method - Google Patents
Special use-level antibacterial drug use management system and method Download PDFInfo
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- 238000007726 management method Methods 0.000 claims description 40
- 230000001580 bacterial effect Effects 0.000 claims description 22
- 229940079593 drug Drugs 0.000 claims description 15
- 239000004599 antimicrobial Substances 0.000 claims description 9
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- FPZLLRFZJZRHSY-HJYUBDRYSA-N tigecycline Chemical compound C([C@H]1C2)C3=C(N(C)C)C=C(NC(=O)CNC(C)(C)C)C(O)=C3C(=O)C1=C(O)[C@@]1(O)[C@@H]2[C@H](N(C)C)C(O)=C(C(N)=O)C1=O FPZLLRFZJZRHSY-HJYUBDRYSA-N 0.000 description 1
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- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
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Abstract
The invention belongs to the technical field of medicine management, and discloses a special use-level antibacterial medicine use management system and a method. The method can supervise the use of the special use-level antibacterial drugs of the medical institution, and apply the management of the special use-level antibacterial drugs to the management of the antibacterial drugs, so that the management of the antibacterial drugs in hospitals is changed from the former after intervention into the prior intervention, and the intervention limitation is carried out at the source of the specific use-level antibacterial drugs.
Description
Technical Field
The invention belongs to the technical field of medicine management, and particularly relates to a special use-level antibacterial medicine use management system and method.
Background
At present, hospitals face a series of problems of reasonable and safe use of antibacterial drugs, and mainly reflect the aspects of abuse of the antibacterial drugs, drug allergy caused by unreasonable medication, incomplete antibacterial drug use monitoring measures in hospitals and the like.
Disclosure of Invention
The present invention aims to solve the above technical problem at least to some extent. To this end, a first object of the present invention is to provide a special use level antimicrobial drug use management system.
The technical scheme adopted by the invention for realizing the first purpose is as follows:
a special use-level antimicrobial drug use management system comprising:
the drug authority management module is used for carrying out field limitation according to the classification level of the antibacterial drug and limiting the authority of the antibacterial drug in the outpatient service for the antibacterial drug variety with the classification level of the special use level;
the doctor authority management module is used for generating a doctor list with antibacterial prescription authority according to the grades of different doctors;
the department level management module is used for managing the department level and generating a three-party consultation department list;
the consultation module is used for recording the results of the three-party consultation and generating a three-party consultation list;
the submission module is used for generating submission records according to the records of the bacterial culture of the infected part of the patient;
a prescription-making module for making a prescription;
the judging module is used for judging whether the doctor has the antibacterial medicine prescription authority or not according to the doctor list when the doctor makes a prescription, judging the level of a medicine using department according to the three-party consultation department list if the doctor has the antibacterial medicine prescription authority, judging whether the infected part of the patient is subjected to bacterial culture or not according to the inspection record if the doctor does not exist in the three-party consultation department list, and allowing the doctor to make the prescription if the infected part of the patient is subjected to bacterial culture; if the infected part is in the three-party consultation department list, judging whether the opinions of at least two parties are consenting according to the three-party consultation list, judging whether the infected part of the patient is subjected to bacterial culture according to the censorship record, and if the infected part of the patient is subjected to bacterial culture, allowing the prescription to be provided.
Preferably, the special-use grade antibacterial drug use management system further comprises: and the reminding module is used for generating a delivery note when a doctor makes a prescription and does not have a corresponding delivery record.
Preferably, the special-use grade antibacterial drug use management system further comprises: and the evaluation module is used for prompting a doctor to evaluate and generating an evaluation record after the patient uses the antibacterial drug for more than N days.
Preferably, the special-use grade antibacterial drug use management system further comprises: and the override module is used for giving the right of directly making a prescription to a doctor with the prescription authority of the antibacterial drugs when the patients with the critical illness and holidays need to use the antibacterial drugs.
Preferably, the special-use grade antibacterial drug use management system further comprises: and the report generation module is used for generating a checking report according to the variety, time and consultation result of the antibacterial medicines used by the doctor and whether the override module is used.
Preferably, the special-use grade antibacterial drug use management system further comprises: and the supervision module is used for analyzing according to the use condition of the override module in the check report and evaluating the rationality of the use of the override module by a doctor.
The second purpose of the invention is to provide a method for using and managing the special use-level antibacterial drugs.
The technical scheme adopted by the invention for realizing the second purpose is as follows:
a method for using and managing special use-grade antibacterial drugs comprises the following steps:
according to the classification level of the antibacterial drugs, field limitation is carried out, and the permission of the antibacterial drug variety with the classification level of special use level is limited;
opening antibacterial prescription authority for the qualified physicians according to the titles;
dividing departments into common departments and three-party consultation departments according to different departments;
when a doctor makes a prescription, judging whether the doctor has the antibacterial prescription authority or not, if so, judging whether a medicine administration department is a common department or a three-party consultation department, if so, judging whether bacterial culture is carried out on an infected part of a patient, and if so, allowing the prescription to be made; if the department is a three-party consultation department, judging whether a three-party consultation list exists, if so, judging whether the infected part of the patient is subjected to bacterial culture if at least two opinions in the three-party consultation list are consented, and if so, allowing the prescription to be made.
The invention has the beneficial effects that:
the special use-level antibacterial drug use management system and method provided by the invention can supervise the use of special use-level antibacterial drugs in medical institutions, and apply the management of the special use-level antibacterial drugs to the management of the antibacterial drugs, so that the management of the antibacterial drugs in hospitals is changed from former after-the-fact intervention into prior intervention, and the intervention limitation is carried out at the source of the specific use-level antibacterial drugs for use, thereby greatly saving manpower and realizing the purpose of replacing manual operation with information management.
Drawings
FIG. 1 is a schematic block diagram of a particular use level antimicrobial drug use management system of the present invention.
Detailed Description
The invention is further illustrated with reference to specific examples. It should be noted that the embodiments and features of the embodiments may be combined with each other without conflict.
As shown in fig. 1, the system for managing the use of the antibacterial drugs at special use level of the present embodiment includes a drug authority management module, a physician authority management module, a department level management module, a consultation module, a submission module, a prescription issuing module, a judgment module, a reminding module, an evaluation module, an override module, a report generation module, and a supervision module.
And the drug authority management module carries out field limitation according to the classification level of the antibacterial drugs maintained in the system dictionary library, and the authority of the antibacterial drugs in the outpatient service is limited for all antibacterial drug varieties with the classification level of special use level.
The doctor authority management module respectively gives system identification to each antibacterial drug according to the three-level management requirements of no limitation, limitation and special level according to the hospital antibacterial drug grading management catalogue. Doctors above the level of hospitalization can develop unlimited antibacterial drugs, doctors above the level of primary physicians can develop limited antibacterial drugs, and doctors above the level of secondary chief physicians can develop special antibacterial drugs. The doctor authorization management does not simply authorize according to the doctor job title and the antibacterial level, but a hospital medical department and a pharmacy department establish an antibacterial drug assessment system, open antibacterial drug prescription authority and allocation authority for the qualified doctors and pharmacists according to the job titles and maintain the antibacterial drug prescription authority and the allocation authority in the system.
The department level management module is used for managing department levels and generating a three-party consultation department list; specifically, through the medical affairs administration and the therapeutic committee, the hospital finally determines the departments which need the internal consultation to use the special using-grade antibacterial drugs by discussing the characteristics of the infection disease species of each department and the use experience of the special using-grade antibacterial drugs, and mainly comprises the following components: the department of intensive care medicine, department of respiratory and critical medicine, department of hematology, department of pancreas surgery, department of burn, department of neurosurgery, new born pediatrics, pediatrics and all intensive care units, when the department uses the antibacterial drugs with special use level, the department only needs to carry out consultation with doctors with the function of more than the assistant principal and subordinate medical doctors, the department only needs to have the prescription with the function of more than the assistant principal and subordinate medical doctors with the antibacterial drug prescription right, and the department can open the antibacterial drugs with special use level after recording in medical records. The rest departments are three-party consultation departments, and when in use, three-party consultation needs to be carried out by the anti-infectious disease consultation specialists, the inspection specialists and the clinical pharmacists in hospitals.
The consultation module is used for recording the results of the three-party consultation and generating a three-party consultation list; the consultation specialist transmits the consultation opinions agreeing to use the special-level antibacterial drugs back to the system, and through the butt joint of the system and the electronic medical record system, when a doctor takes a special-use-level antibacterial drug, the system can automatically judge whether the patient has a three-party consultation list (at least two parties in the consultation list agree to use the drug), the doctor of the patient with the three-party consultation list can take a long-term medical advice, and meanwhile, the consultation record needs to be written in the electronic medical record system and is stored in the medical record as a part of the medical record.
The submission module is used for generating submission records according to the records of the bacterial culture of the infected part of the patient; in order to standardize the use of special use-level antibacterial drugs, doctors reasonably use the drugs according to the pathogenic censorship conditions, and specially design a forced censorship program when an antibacterial drug injection (containing the special use-level antibacterial drugs) is provided, the doctors are required to firstly carry out bacterial culture on the infected part of a patient before the drugs are used, a system automatically judges whether the patient is subjected to microbiological sample censorship when the doctors provide the drugs, and the doctors are required to firstly provide a censorship list for medical records without censorship and can be provided with the special use-level antibacterial drugs after the medical records are generated.
The prescription issuing module is used for issuing a prescription;
the judgment module is used for judging whether a doctor has antibacterial medicine prescription authority or not according to a doctor list when the doctor makes a prescription, judging the level of a medicine using department according to a three-party consultation department list if the doctor has the antibacterial medicine prescription authority, judging whether the infected part of a patient is subjected to bacterial culture or not according to the inspection record if the doctor does not exist in the three-party consultation department list, and allowing the doctor to make the prescription if the infected part of the patient is subjected to bacterial culture; if the infected part is in the three-party consultation department list, judging whether the opinions of at least two parties are consenting according to the three-party consultation list, judging whether the infected part of the patient is subjected to bacterial culture according to the censorship record, and if the infected part of the patient is subjected to bacterial culture, allowing the prescription to be provided. If the linear judgment is not successful, the prescription is not allowed to be made.
The reminding module is used for generating a delivery note when a doctor makes a prescription and has no corresponding delivery record.
The evaluation module is used for prompting a doctor to evaluate and generating an evaluation record after the patient uses the antibacterial drug for more than 3 days. Combining the inconvenience existing in clinic and communicating with doctors to prescribe antibacterial drugs, recording the time for using the antibacterial drugs for the doctors, reminding the doctors to evaluate the curative effect of the antibacterial drugs (containing special use-level antibacterial drugs), embedding reminding information in a doctor workstation, prompting the system to ' use the antibacterial drugs for more than 3 days ' when the doctors log in the doctor workstation to prescribe the drugs for the patients, please evaluate ' when the doctors log in the doctor workstation, and recording after the doctors evaluate.
The override module is used for giving the right of directly making a prescription to a doctor with the prescription authority of the antibacterial drugs when the patients with the critical illness and holidays need to use the antibacterial drugs. Specifically, doctors of higher level than the assistant principal and ren physicians can directly use the antibacterial drugs by crossing the grade through the grade crossing module, and the prescription amount is one day, and can be continuously used in holidays of continuous festivals. Patients who need to use special antibacterial drugs and are returned from an intensive care unit can continue to use the drug within 72 hours after being transferred into a general ward, consultation is not needed, and doctors need to note reasons.
The report generation module is used for generating a checking report according to the variety, time and consultation result of the antibacterial drugs used by the doctor and whether the override module is used. The supervision module is used for analyzing according to the service condition of the override module in the check report and evaluating the rationality of the use of the override module by a doctor. Specifically, the using condition of the override module is analyzed regularly, the rationality of using the override module by a doctor is evaluated, if the override module is used in a non-holiday period or the override module is continuously used for prescribing medicines, the three-party consultation process is avoided, the consultation result is reported to a medical department according to a relevant system of a hospital, and the treatment is carried out by the medical department according to the relevant system.
A method for using and managing special use-grade antibacterial drugs comprises the following steps:
according to the classification level of the antibacterial drugs, field limitation is carried out, and the permission of the antibacterial drug variety with the classification level of special use level is limited;
opening antibacterial prescription authority for the qualified physicians according to the titles;
dividing departments into common departments and three-party consultation departments according to different departments;
when a doctor makes a prescription, judging whether the doctor has the antibacterial prescription authority or not, if so, judging whether a medicine administration department is a common department or a three-party consultation department, if so, judging whether bacterial culture is carried out on an infected part of a patient, and if so, allowing the prescription to be made; if the department is a three-party consultation department, judging whether a three-party consultation list exists, if so, judging whether the infected part of the patient is subjected to bacterial culture if at least two opinions in the three-party consultation list are consented, and if so, allowing the prescription to be made. If the linear judgment is not successful, the prescription is not allowed to be made.
In the research, data before research implementation (10 months-9 months in 2017) are called by a hospital information system to serve as a control group, data after the research implementation (10 months-9 months in 2018) serve as an experimental group, and research objects are special use-level antibacterial drugs which are commonly used by severe infection patients in medical institutions, have wide antibacterial property and are easily abused, and the research objects comprise: six special use-level antibacterial medicaments such as meropenem and the like (see table 1) are compared and analyzed through the data before and after analysis, and the effects of the special use-level antibacterial medicament use management system and the special use-level antibacterial medicament use management method in antibacterial medicament management and standard use are analyzed.
TABLE 1 catalogue of specific use-level antimicrobial drugs incorporated into this study
| Common name of medicine | Specification of |
| Meropenem for injection | 0.5 g/piece |
| Imipenem cilastatin for injection | 0.5/count |
| Vancomycin for injection | 0.5 g/piece |
| Injection useTeicoplanin | 0.2 g/count |
| Linezolid glucose injection | 600mg, 300 ml/piece |
| Tigecycline for injection | 50 mg/count |
According to the antibacterial drug control index in the national guidelines for clinical application of antibacterial drugs (2015 edition), the method comprises the following steps: the percentage of the special use-level antibacterial drug in the antibacterial drug, the use strength of the special use-level antibacterial drug for the inpatient, the pathogenic censorship percentage (more than or equal to 80%) of the special use-level antibacterial drug for the inpatient before use and the reasonable use rate of the special use-level antibacterial drug.
Index calculation formula:
the percentage of the special use antibacterial drug in the antibacterial drug is the special use antibacterial drug usage (cumulative DDD number)/the contemporaneous antibacterial drug usage (cumulative DDD number)
The using strength of the special using-grade antibacterial drug of the inpatient is equal to the consumption (accumulated DDD number) of the special using-grade antibacterial drug of the inpatient/the number of the people who receive the treatment at the same time
The microorganism inspection rate of the inpatients treated by the special grade antibacterial drug is equal to the inspection number of the microorganism specimens of the inpatients treated by the special grade antibacterial drug/the total number of the inpatients treated by the special grade antibacterial drug at the same period
The reasonable use rate of the special use-grade antibacterial drug is the reasonable number of cases using the special use-grade antibacterial drug/the number of cases using the special use-grade antibacterial drug at the same period
Statistical analysis of the data was performed using SPSS20.0 software, counting data was expressed as a ratio, comparisons were performed using the Chi 2 or Fisher test, calculated data were expressed as mean. + -. standard deviation, and comparisons between groups were performed using the t test. P <0.05 indicates a statistical difference.
As shown in Table 2, there was no statistical difference between the experimental group and the control group in the study, wherein the percentage of the specific-use antibacterial agent and the specific-use antibacterial agent strength X of the hospitalized patients2＝0.000，P>0.05, the etiology submission rate chi of the special use-level antibacterial drug for the inpatient before use2＝0.421，P>0.05, special use level antibacterial drug use reasonable rate chi2＝2.749，P>0.05, the data values of the first two groups are very close, and the data values of the second two groups are increased compared with those of the control group.
The usage statistics table (%) of the special use-level antibacterial drugs from 10 months in 2.2017 to 9 months in 2019 is shown.
Wherein P value < 0.05; p value < 0.01.
The invention is not limited to the above alternative embodiments, and any other various forms of products can be obtained by anyone in the light of the present invention, but any changes in shape or structure thereof, which fall within the scope of the present invention as defined in the claims, fall within the scope of the present invention.
Claims (7)
1. A special use-level antimicrobial drug use management system comprising:
the drug authority management module is used for carrying out field limitation according to the classification level of the antibacterial drug and limiting the authority of the antibacterial drug in the outpatient service for the antibacterial drug variety with the classification level of the special use level;
the doctor authority management module is used for generating a doctor list with antibacterial prescription authority according to the grades of different doctors;
the department level management module is used for managing the department level and generating a three-party consultation department list;
the consultation module is used for recording the results of the three-party consultation and generating a three-party consultation list;
the submission module is used for generating submission records according to the records of the bacterial culture of the infected part of the patient;
a prescription-making module for making a prescription;
the judging module is used for judging whether the doctor has the antibacterial medicine prescription authority or not according to the doctor list when the doctor makes a prescription, judging the level of a medicine using department according to the three-party consultation department list if the doctor has the antibacterial medicine prescription authority, judging whether the infected part of the patient is subjected to bacterial culture or not according to the inspection record if the doctor does not exist in the three-party consultation department list, and allowing the doctor to make the prescription if the infected part of the patient is subjected to bacterial culture; if the infected part is in the three-party consultation department list, judging whether the opinions of at least two parties are consenting according to the three-party consultation list, judging whether the infected part of the patient is subjected to bacterial culture according to the censorship record, and if the infected part of the patient is subjected to bacterial culture, allowing the prescription to be provided.
2. The special-use antimicrobial drug use management system of claim 1 further comprising: and the reminding module is used for generating a delivery note when a doctor makes a prescription and does not have a corresponding delivery record.
3. The special-use antimicrobial drug use management system of claim 1 further comprising: and the evaluation module is used for prompting a doctor to evaluate and generating an evaluation record after the patient uses the antibacterial drug for more than N days.
4. The special-use antimicrobial drug use management system of claim 1 further comprising: and the override module is used for giving the right of directly making a prescription to a doctor with the prescription authority of the antibacterial drugs when the patients with the critical illness and holidays need to use the antibacterial drugs.
5. The special-use antimicrobial drug use management system according to claim 4, further comprising: and the report generation module is used for generating a checking report according to the variety, time and consultation result of the antibacterial medicines used by the doctor and whether the override module is used.
6. The special-use antimicrobial drug use management system according to claim 5, further comprising: and the supervision module is used for analyzing according to the use condition of the override module in the check report and evaluating the rationality of the use of the override module by a doctor.
7. A method for using and managing special use-grade antibacterial drugs is characterized by comprising the following steps:
according to the classification level of the antibacterial drugs, field limitation is carried out, and the permission of the antibacterial drug variety with the classification level of special use level is limited;
opening antibacterial prescription authority for the qualified physicians according to the titles;
dividing departments into common departments and three-party consultation departments according to different departments;
when a doctor makes a prescription, judging whether the doctor has the antibacterial prescription authority or not, if so, judging whether a medicine administration department is a common department or a three-party consultation department, if so, judging whether bacterial culture is carried out on an infected part of a patient, and if so, allowing the prescription to be made; if the department is a three-party consultation department, judging whether a three-party consultation list exists, if so, judging whether the infected part of the patient is subjected to bacterial culture if at least two opinions in the three-party consultation list are consented, and if so, allowing the prescription to be made.
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Citations (5)
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| CN102737165A (en) * | 2012-06-07 | 2012-10-17 | 北京太元通软件科技有限公司 | Clinical medication decision support system |
| WO2013181820A1 (en) * | 2012-06-07 | 2013-12-12 | 北京太元通软件科技有限公司 | Clinical medication decision support system |
| CN104615904A (en) * | 2015-02-28 | 2015-05-13 | 领智控股有限公司 | Antibacterial medicament clinical application decision support system and constructing method thereof |
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| CN112151140A (en) * | 2020-11-25 | 2020-12-29 | 西藏自治区人民政府驻成都办事处医院 | Antibacterial drug clinical application system, electronic device and computer readable storage medium |
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| CN104615904A (en) * | 2015-02-28 | 2015-05-13 | 领智控股有限公司 | Antibacterial medicament clinical application decision support system and constructing method thereof |
| CN112002397A (en) * | 2020-09-15 | 2020-11-27 | 江西安联医疗器械有限公司 | Clinical decision support and clinical cost management system |
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