目的:了解我院门诊部抗菌药物的使用情况,防止临床上滥用抗菌药。方法:随机抽取2008年成人普通处方,每季度100份,共计400份,统计所需分析数据。结果:抗菌药物的品种数占处方用药总品种数的1154%;抗菌药物的总金额占处方总金额的比率为1341%;注射剂使用率为4%;每张处方合并用药品种数269种;处方使用通用名为100%;抗真菌药物的使用率低于1%。结论:门诊患者抗菌药物使用合理。
Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
The quality of disinfectant, disinfection devices and disposable medical devices is closely related to the patients' safety. Hospital infection management department must carry out the audit responsibilities for qualification documents of disinfectant, disinfection devices and disposable medical devices, to guarantee legality, safety and effectiveness of products used in hospital. This paper mainly introduces the implementation of qualification documents audit in West China Hospital, Sichuan University, including system construction, process reengineering, documents audit scope and key points, and document management.
ObjectiveTo analyze the effectiveness of PDCA cycle model in antibiotics management by comparison of antibiotics use before and after the use of PDCA in a tertiary hospital. MethodsProspective study was adopted to analyze the using rate of antibiotics in outpatients, emergent patients and inpatients between June 2011 and December 2013. ResultsThe reasonable antibiotics use was improved since the beginning of PDCA cycle model. The antibiotics using rates of outpatients were 33.00%, 29.09% and 19.31%, of emergent patients were 45.00%, 32.81% and 28.94%, and of inpatients were 71.00%, 57.76% and 53.28% in year 2011 (from June to December), 2012 (from January to December) and 2013 (from January to December) respectively. Meanwhile, ClassⅠ incision antimicrobial use also decreased and bacteria examination rate continuously increased during the last three years. As a consequence, patients' cost was reduced. ConclusionThe PDCA cycle model promotes the standardized management of clinical medication application.
目的:通过对可重复使用物（管道类）存放现状的调查，为基层医院感染管理提供一定的理论依据。方法:对本市10家二级及以上医疗机构40个临床科室可重复使用医疗用物（管道类）的管理情况进行问卷调查，2007年2月对可重复使用医疗用物进行微生物监测。结果:共334件管道，其中二级医院218件，菌落超标34件，占10.17%；三级医院116件，菌落超标7件，占2.09%。结论:建立对可重复使用医疗用物管理制度，规范操作规程，才能有效防止医院感染。
ObjectivesTo investigate Chinese health practitioners’ usage and demand for clinical practice guidelines in general so as to improve the development and implementation of guidelines.MethodsWe conducted a cross-sectional questionnaire survey that covered health practitioners from different levels of medical institutions in 17 provinces in China. Attitudes, adherence, usage barriers and demands for clinical practice guidelines were investigated.ResultsA total of 953 health practitioners were involved in the survey in which 931 completed the questionnaires. Respondents generally held positive attitudes toward guidelines and agreed that they improved quality of care and standardized diagnosis and treatment. More than 80% of the respondents reported a fine adherence to guidelines. The most reported barriers to follow the guidelines were " several guidelines are competing” and " lack of facilities and medical resources”. Most respondents agreed that it was necessary to establish a national guideline database, appraise implementation effect of guidelines, develop evaluation tools for guidelines that are applicable for Chinese clinical practice, and provide guidelines training.ConclusionsThis study finds favorable attitudes and fine adherence towards clinical guidelines in general in China. However, internal barriers, such as authority of guidelines, and external barriers, such as supplying system and patients’ preference, can affect guideline dissemination and implementation. It is suggested that establishing a national guidelines database, developing evaluation tools for guidelines that fit for Chinese clinical practice, and provision of guideline training, would facilitate the use of guidelines.
ObjectiveTo investigate the development, production and use of children’s drugs in Sichuan Province, analyze the problems existing in these links, and provide suggestions for ensuring that children’s needs for drugs are met. MethodsThe self-filling electronic questionnaire was used to investigate the production, procurement and use of children’s drugs in 14 pharmaceutical companies producing children’s drugs and 20 general hospitals with pediatric departments or children’s hospitals in Sichuan province. ResultsThe 14 surveyed pharmaceutical companies reported that 116 children’s drugs were being developed or produced (75 first-class children’s drugs with exact medication information for children, 41 second-class children’s drugs only noted as children's discretionary reduction or use according to clinician’s instructions), out of which 109 (93.97%) drugs had been approved for marketing, 21 (18.10%) were national essential medicines and 76 (65.52%) were covered by national basic medical insurance. The dosage forms of first-class children's drugs were mainly tablets (28, 37.34%) and granules (19, 25.34%), while oral solution (3, 4.00%), syrup (5, 6.67%) and other dosage forms suitable for children were less. According to the surveyed results on the use of children's drugs in hospitals, there were 57 children’s drugs whose minimum use units needed to be manually divided into smaller ones on average in each hospital, and it was the most common operation pattern that pharmacists informed nurses, patients or patients’ family members of the dose splitting methods and then splitting drugs’ minimum use units by themselves. ConclusionThere is a great demand for splitting minimum use units of drugs whose strength is too big for children in medical institutions, and some children’s drugs need to be developed and further modified to meet the clinical children’s drug needs. We should further increase investments and policy supports for the children’s drugs, promote children’s clinical trials, and encourage the research and development of children’s drugs.
The development of evidence-based clinical practice guidelines is a sophisticated and systematic process, often requiring multidisciplinary efforts. The traditional approach to developing and updating clinical practice guidelines is usually time-consuming. These limitations obstacle the effective use of guideline recommendations and efficient transformation of most recent research evidence into practice. The MAGIC system is a novel method system for rapid creation and dissemination of high-quality clinical recommendations, including rapid creation of trustworthy recommendations, thus ensuring the scientific and efficient production of clinical practice guidelines; facilitating rapid dissemination and dynamic updating of clinical practice guidelines through recommendation release system (i.e., MAGICapp); and helping promote the production of relevant high-quality original research evidence by identifying the insufficiency of evidence in the process of creation of guideline recommendations. Ultimately, a complete closed-loop digital and trustworthy evidence ecosystem is developed. In order to further promote the effective transformation of research evidence into guideline recommendations, MAGIC China Center was established. We anticipate that the Center will assist the further development and effective use of clinical practice guideline in China.
With the real-world study (RWS) becoming a hotspot for clinical research, health data collected from routine clinical practice have gained increasing attention worldwide, particularly the data related to the off-label use of drugs, which have been at the forefront of clinical research in recent years. The guidance from the National Medical Products Administration has proposed that real-world evidence (RWE) can be an important consideration in supporting label expansions where randomized controlled trials are unfeasible. Nevertheless, how to use the RWE to support the approval of new or expanded indications remains unclear. This study aims to explore the structured process for the use of RWE in supporting label expansions of approved drugs, and to discuss the key considerations in such process by reviewing the documents from relevant regulatory agencies and publications from public databases, which can inform future directions for studies in this area.
Objective To investigate the utilization of platinum drugs in 21 hospitals of Chengdu from 2011 to 2014. Methods The utilization information of platinum drugs in 21 hospitals of Chengdu from 2011 to 2014 was extracted, and the dosage form of drugs, consumption sum, frequency of drug use (DDDs), defined daily cost (DDC), and drug sequence ratio (B/A) were analyzed statistically. Results From 2011 to 2014, the total consumption sums and DDDs of platinum drugs were increased year by year. The consumption sums of oxaliplatin were the highest, and the consumption sums of carboplatin were increased year by year. Oxaliplatin, nedaplatin, and lobaplatin were ranked first, second and fifth respectively in all the four consecutive years; the total DDDs of patinum drugs from 2011 to 2014 showed a trend of increase, DDDs of cisplatin were always ranked first, followed by oxaliplatin; DDC and sorting of platinum drugs were relatively stable, and B/A values of carboplatin and cisplatin were close to 1.00. Conclusion The utilization of platinum drugs in 21 hospitals of Chengdu is in accordance with the principle of safety, effectiveness, economy and convenience.