Welcome to visit Zhongnan Medical Journal Press Series journal website!

Home Articles Vol 27,2024 No.2 Detail

Comprehensive evaluation based on entropy weighted TOPSIS of the management quality of antimicrobial stewardship after application of PDCA cycle —— taking a tertiary hospital as an example

Published on Mar. 21, 2024Total Views: 799 times Total Downloads: 357 times Download Mobile

Author: ZHANG Dengzheng JIANG Qiong ZHANG Congzi RAO Zhiwei

Affiliation: Department of Pharmacy, Xianning Central Hospital (the First Affiliated Hospital of Hubei University of Science and Technology), Xianning 437199, Hubei Province, China

Keywords: Antimicrobial stewardship Plan、do、check、act cycle Entropy weighted technique for order preference by similarity to ideal solution Comprehensive evaluation

DOI: 10.12173/j.issn.1008-049X.202312135

Reference: ZHANG Dengzheng, JIANG Qiong, ZHANG Congzi, RAO Zhiwei.Comprehensive evaluation based on entropy weighted TOPSIS of the management quality of antimicrobial stewardship after application of PDCA cycle —— taking a tertiary hospital as an example[J].Zhongguo Yaoshi Zazhi,2024, 27(2):264-271.DOI: 10.12173/j.issn.1008-049X.202312135.[Article in Chinese]

  • Abstract
  • Full-text
  • References
Abstract

Objective  To explore the strategy of constructing a scientific management system for antibiotics in a tertiary hospital, and to provide reference to strengthen the management and rational use of antibiotic.

Methods  Using PDCA management tools to build a scientifically effective antimicrobial drug management system. Evaluation of management quality of antimicrobial stewardship was constructed by 14 indicators of 5 dimensions. The entropy weight TOPSIS method was used to comprehensively evaluate and analyze the changes in various indicators after the implementation of PDCA improvement.

Results  Based on the entropy weight TOPSIS analysis, the management quality of antibiotics in 2018 was the lowest with the Ci value 0.313  5, and the management quality of antibiotics in 2022 was the highest with the Ci value 0.747 4. The evaluation of antimicrobial stewardship was divided into five dimensions: for the evaluation of antibiotics use density, the Ci value in 2017 was highest; for the evaluation of antibiotics usage rate, the Ci value in 2021 was the highest; for the evaluation of the submission rate before use of antibiotics, the Ci value in 2022 was the highest; for the evaluation of preventive medication for type I incisions, the Ci value was highest in 2022; the evaluation of the cost dimension of antibiotics for hospitalized patients showed the highest Ci value in 2022. The application of PDCA method for antibiotics management had shown an overall improvement trend.

Conclusion  Based on PDCA method, collaboration through multiple departments for antibiotics management had achieved significant results. The entropy weight TOPSIS method can be used to evaluate the effectiveness of antibiotics management, to provide reference for the direction of hospital antibiotics control and policy formulation.

Full-text
Please download the PDF version to read the full text: download
References

1.国家卫生健康委员会. 抗菌药物临床应用管理办法(卫生部令第84号)[EB/OL]. (2012-05-08) [2023-12-15]. http://www.nhc.gov.cn/wjw/bmgz/201205/347e8d20a6d442ddab626312378311b4.shtml.

2.国家卫生健康委员会. 国家卫生健康委关于进一步加强抗微生物药物管理遏制耐药工作的通知(国卫医函[2021]73号)[EB/OL]. (2021-04-07) [2023-12-15]. http://www.nhc.gov.cn/yzygj/s7659/202104/7c59c2c5a80f4b468e646c003e14a150.shtml.

3.Ababneh MA, Nasser SA, Rababa'h AM. A systematic review of antimicrobial stewardship Program implementation in Middle Eastern countries[J]. International Journal of Infectious Diseases, 2021, 105: 746-752. DOI: 10.1016/j.ijid.2021.03.035.

4.国家卫生健康委员会. 关于印发抗菌药物临床应用指导原则(2015年版)的通知(国卫办医发[2015]43号)[EB/OL]. (2015-08-27) [2023-12-15]. http://www.nhc.gov.cn/yzygj/s3593/201508/c18e1014de6c45ed9f6f9d592b43db42.shtml.

5.国家卫生健康委员会. 国家卫生健康委办公厅关于印发药事管理和护理专业医疗质量控制指标(2020年版)的通知(国卫办医函[2020]654号)[EB/OL]. (2020-08-05) [2023-12-15] http://www.nhc.gov.cn/yzygj/s7657/202008/c39639a79f7d4a6b935f33f87c57e2dc.shtml.

6.国务院办公厅. 国务院办公厅关于加强三级公立医院绩效考核工作的意见(国办发[2019]4号)[EB/ OL]. (2019-01-30) [2023-12-15]. https://www.gov.cn/zhengce/content/2019-01/30/content_5362266.htm?ivk_sa=1024320u.

7.王桂凤, 刘锐锋, 廖础欣,等. 基于加权优劣解距离法的门急诊头孢克肟药物利用合理性评价[J]. 中国医院用药评价与分析, 2020, 20(12): 1505-1508. [Wang GF, Liu RF, Liao CX, et al. Evaluation of application rationality of cefixime in outpatient and emergency department based on the weighted technique for order preference by similarity to an ideal solution[J]. Evaluation and Analysis of Drug-Use in Hospitals, 2020, 20(12): 1505-1508.] DOI: 10.14009/j.issn.1672-2124.2020.12.024.

8.湖北省卫生健康委员会. 关于印发《湖北省医疗机构抗菌药物临床应用分级管理目录(2021年版)》的通知(鄂卫通[2021]60号)[EB/OL]. (2021-09-22)[2023-12-15]. http://wjw.hubei.gov.cn/zfxxgk/zc/gkwj/ywh/202109/t20210923_3776428.shtml.

9.艾涛, 陈莉娜, 陈强,等. β内酰胺类-β内酰胺酶抑制剂复方制剂儿科临床应用专家共识[J]. 中国实用儿科杂志, 2023, 38(9): 641-653. [Ai T, Chen LN, Chen Q, et al. Expert consensus on pediatric clinical application of β-lactam-β-lactamase inhibitor compounds[J]. Chinese Journal of Practical Pediatrics, 2023, 38(9): 641-653.] DOI: 10.19538/j.ek2023090601.

10.何艳, 吴广杰, 王璐,等. 应用PDCA法践行临床药师主导的抗菌药物联合用药管理[J]. 医药导报, 2022, 41(4): 588-592. [He Y, Wu GJ, Wang L, et al. Clinical pharmacists dominated management of antibiotic combinations by using PDCA method[J]. Herald of Medicine, 2022, 41(4): 588-592.] DOI: 10.3870/j.issn.1004-0781.2022.04.029.

11.Yukihiro H, Fumiya E, Ken K. A strategy for hospital pharmacists to control antimicrobial resistance (AMR) in Japan[J]. Antibiotics, 2021, 10 (11): 1284. DOI: 10.3390/antibiotics10111284.

12.吴勤德, 吴勇, 谢贤宇,等. 某三甲医院实施抗菌药物科学化管理成效研究[J]. 包头医学院学报, 2021, 37(12): 101-105, 119. [Wu DQ, Wu Y, Xie XY, et al. The practice and effect of antimicrobial stewardship in a tertiary hospital[J]. Journal of Baotou Medical College, 2021, 37(12): 101-105, 119.] DOI: 10.16833/j.cnki.jbmc. 2021.12.024.

13.张树敬, 张燕, 胡晓文,等. 基于熵权TOPSIS法的医院抗菌药物临床应用管理质量评价[J]. 中国医院用药评价与分析, 2021, 21(12): 1520-1523. [Zhang SJ, Zhang Y, Hu XY, et al. Quality evaluation of hospital antimicrobial stewardship based on entropy weight-TOPSIS[J]. Evaluation and Analysis of Drug-Use in Hospitals, 2021, 21(12): 1520-1523.] DOI: 10.14009/j.issn.1672-2124.2021.12.022.

14.龚伟伟, 赵太宏, 肖雨龙,等. 2017—2019年南京市第一医院CMI指数调整抗菌药物使用强度的秩和比法评价[J]. 中国抗生素杂志, 2021, 46(10): 975-979. [Gong WW, Zhao TH, Xiao YL, et al. RSR evaluation of CMI-index-adjusted antimicrobial use intensity in Nanjing First Hospital from 2017 to 2019[J]. Chinese Journal of Antibiotics, 2021, 46(10): 975-979.] DOI: 10.3969/j.issn.1001-8689.2021.10.013.

15.杨立成, 杨洁, 赵道致,等. 基于熵权TOPSIS法的三级医院医疗质量综合评价[J]. 中国医院, 2018, 22(4): 38-39.[Yang LC, Yang J, Zhao DZ, et al. Comprehensive evaluation of medical quality in tertiary hospitals based on entropy weight TOPSIS method[J]. Chinese Hospitals, 2018, 22(4): 38-39.] DOI: 10.19660/j.issn.1671-0592.2018.04.11.

16.国家卫生计生委办公厅. 国家卫生计生委办公厅关于印发麻醉等6个专业质控指标(2015年版)的通知(国卫办医函[2015]252号)[EB/OL]. (2015-04-10) [2023- 12-15]. http://www.nhc.gov.cn/yzygj/s3585/201504/5fa7461c3d044cb6a93eb6cc6eece087.shtml.

Popular papers
Last 6 months