多学科联合分级管理模式在提高住院患者抗菌药物治疗前病原学送检率中的作用OA

Objective To evaluate the intervention effect of a multidisciplinary collaborative hierarchical management model on improving the pathogenic microorganism testing rate before antimicrobial therapy among inpatients in a secondary grade A general hospital,so as to provide evidence for optimizing the management strategy of rational use of antimicrobial agents.Methods A total of 17 920 inpatients who received antimicrobial therapy from January to December 2022 in a sec-ondary hospital were selected as control group(conventional management).The multidisciplinary collaborative hierarchical management intervention was implemented from January to December 2023,and 22 212 inpatients who received antimicrobial therapy from January to December 2024 were selected as intervention group.Differences in core indicators such as the patho-genic microorganism testing rate before antimicrobial therapy were compared between the two groups.Results After inter-vention,the pathogenic microorganism testing rate before antimicrobial therapy increased from 56.18％to 68.80％(χ2=678.749,P<0.001),the testing rate of pathogenic microorganisms related to nosocomial infection diagnosis increased from 62.96％to 85.39％(χ2=13.350,P<0.001),and the testing rates of both targeted and non-targeted pathogens increased significantly(all P<0.001).The pathogen detection rate before the combined use of key drugs(94.16％)showed no statis-tically significant difference compared to that before the intervention(all P>0.05).Conclusion Multidisciplinary collabo-rative hierarchical management can effectively improve the pathogenic microorganism testing rate before antimicrobial therapy among inpatients,but some indicators still do not meet the national standard requirements,and it is necessary to further opti-mize the testing process in acute and critical care scenarios.