临床微生物标本采样送检嵌入式信息化管理措施及其效果

Embedded information management measures and their effectiveness for clinical microbial specimen sampling

    摘要
  • 摘要:
    目的  评估某三甲综合医院依托自研的嵌入式管理程序对临床微生物标本采样送检实现信息化综合管控的效果, 为规范微生物标本采样送检提供参考。
    方法  在培训、监测、反馈、微生物实验室改造等基础上, 通过自研嵌入式管理程序针对微生物标本采样实现信息化综合管控。从医院信息系统提取2013年1月-2022年12月患者的基础信息, 从实验室检验系统提取检验医嘱、微生物标本送检信息及检测结果数据, 从嵌入式管理程序后台获取2015-2022年全部出院患者的抗菌药物医嘱、用药目的、医嘱执行时间、手术及手术状态信息, 应用SPSS 24.0软件对数据进行统计分析。
    结果  2013年6月和2014年6月该院住院患者首剂治疗性使用抗菌药物前微生物标本送检率分别为36.50%和41.67%, 实现信息化综合管控后显著升高；2015-2022年平均送检率为78.33%, 与信息化综合管控前2013-2014年的39.39%相比提升了98.89%, 差异有统计学意义(P＜0.001)；微生物标本结构持续优化, 痰标本占比逐年下降, 血标本占比逐年上升, 趋势χ2检验两者差异均有统计学意义(P＜0.001), 其中痰标本占比8年下降26.49%, 血标本占比提高7.30%, 差异均有统计学意义(P＜0.001)。
    结论  在常规管理基础上充分运用信息技术开展微生物标本采样送检的全流程信息化综合管控, 不仅能大幅提高抗菌药物治疗前病原学送检率, 还优化了微生物标本结构, 为临床提供了更可靠的病原学诊断依据, 为切实改进病原学送检提供参考。

     

    Abstract:
    OBJECTIVE  To evaluate the effectiveness of self-developed embedded computer-based comprehensive intervention program on the sampling of clinical microbial specimen in a three-A comprehensive hospital, and to provide references for improving the sampling of microbial specimens.
    METHODS  Based on training, monitoring, feedback and microbiological laboratory renovation, the embedded program was developed for intervening the sampling of clinical microbial specimens. The basic information of patients from the hospital information system and doctor orders sampling and specimen results achieved from the laboratory inspection system from Jan. 2013 to Dec. 2022 were collected. The embedded intervention program provided the antimicrobial orders and related purposes and execution time, and surgical information and status of all patients from 2015 to 2022. The data analysis was conducted by SPSS 24.0.
    RESULTS  The sampling rates before antibiotic therapy in Jun. 2013 and Jun. 2014 were just 36.50% and 41.67%, respectively. After the information-based comprehensive intervention, the average sampling rate before antibiotic therapy from 2015 to 2022 was 78.33%, with an improvement of 98.89% when compared with 39.39% from 2013 to 2014 (P < 0.001). Furthermore, there was a downward trend in the proportion of sputum specimens and an upward trend in blood specimens (χ2 test, P < 0.001). In 8 years, the proportion of sputum specimens decreased by 26.49%, and the proportion of blood specimens increased by 7.30% (P < 0.001).
    CONCLUSION  Information-based comprehensive intervention can not only improve the sampling rates of microbiological specimens before antibiotic therapy, but also optimize the structure of microbiological specimen types, which provide reliable evidence for the etiological diagnosis and references for improving microbial specimens sampling.

     

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