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Crit Care Med:重症监护,药师主导干预对患者结局和成本的影响

2018-03-12 吴星 环球医学

2018年2月,发表在《Crit Care Med》的一项由法国和澳大利亚科学家进行的研究,考察了重症监护药师实施的多种质量提升“捆绑”措施对患者结局和成本的影响。

2018年2月,发表在《Crit Care Med》的一项由法国和澳大利亚科学家进行的研究,考察了重症监护药师实施的多种质量提升“捆绑”措施对患者结局和成本的影响。

背景:手术和药物ICU患者的死亡风险很高,且医疗保健系统的成本巨大。本研究的目的是描述药师主导的干预对药物疗法的影响,以及临床策略对ICU患者结局和医院成本的影响。

设计:在法国2个ICUs(分别有16张床和10张床)的干预前后研究。

受试者:ICU患者。

干预:从2013年1月1日至2015年6月30日,将药师观察期与干预期进行比较,期间重症监护药师向临床医师提供关于镇静药物和剂量、机械通气模式和相关装置、抗菌药降阶梯,以及及时移除中心静脉和尿管的推荐。对根据入院时疾病严重程度(APACHE II评分)匹配的患者组之间,入住ICU和住院时长、机械通气时长、死亡率和每位患者的住院成本的差异进行量化。

测量指标和主要结果:在观察期和干预期分别有1519和 1268例患者入院。根据APACHE II评分,对患者进行匹配后,两组均有1164例患者符合评价的标准。干预期与患者住院时长(3.7 d [5.2~2.3 d];p<0.001)、ICU入住时长(1.4 d [2.3~0.5 d];p<0.005)、机械通气时长(1.2 d [2.1~0.3 d];p<0.01),以及每位患者的住院成本(2560欧元[3728~1392欧元];p<0.001)的平均(95% CI[置信区间])降低相关。总成本每月节约10840欧元(10727~10952欧元),主要是由于镇静药物和抗菌药物使用的减少。没有确定可对死亡率产生影响。

原始出处:

Leguelinel-Blache, Géraldine PharmD,Nguyen, et.al. Impact of Quality Bundle Enforcement by a Critical Care Pharmacist on Patient Outcome and Costs. Critical Care Medicine: February 2018

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    2018-03-14 bioon6
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    2018-03-13 1e17414fm02(暂无匿称)

    学习

    0

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    2018-03-12 有备才能无患

    2018年2月.发表在的一项由法国和澳大利亚科学家进行的研究.考察了重症监护药师实施的多种质量提升[捆绑"措施对患者结局和成本的影响.

    0

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