970例住院患者抗菌药物使用情况调查

目的　了解某院抗菌药物使用现状和存在的问题 ,指导临床医师合理应用抗菌药物。方法　对某院2 0 0 2年 12月的 970份出院病历 (不包括结核病患者 )进行回顾性调查 ,记录每例病例抗菌药物使用情况 ,对抗菌药物使用率、用药种类、用药时间、药敏情况等进行分析。结果　 970例出院患者中 ,有 70 9例使用了抗菌药物 ,抗菌药物使用率为 73.0 9% ,其中预防用药占 4 1.6 1% ;只用 1种抗菌药物的有 36 0人 ,占 5 0 .78% ,使用 4种以上抗菌药物的有 72人 ,占 10 .16 % ;使用较多的抗菌药物依次为青霉素类 (包括抑酶联合制剂 )、喹诺酮类、抗厌氧菌药物和三代头孢菌素 ;5 8.5 4 %的患者用药时间 <7d ,15 .37%的患者用药 >14d ;进行药敏试验的患者仅占全部用药人数的 5 .36 %。结论　部分住院患者抗菌药物使用中存在病原送检率低 ,抗菌药物应用起点较高、换药频繁、用药时间较长等不合理现象 ,抗菌药物的使用管理需要加强。     

脑卒中住院患者抗菌药物使用调查分析

目的 了解医院脑卒中患者抗菌药物使用情况,指导临床合理用药.方法 对2008年7月-2009年6月出院的699例脑卒中患者抗菌药物的使用率、使用种类、用药目的及联合用药等情况进行回顾性调查.结果 抗菌药物使用率为34.62%,预防性用药占20.25%,联合用药占19.42%,抗菌药物使用种类涉及10大类26种,使用频次最高的是头孢菌素类210例次(56.45%),其次青霉素类53例次(14.25%);不同类型脑卒中在抗菌药物的使用率、预防用药率及联合用药率比较,差异有统计学意义(P＜0.05).结论 脑卒中患者抗菌药物使用基本合理,但有待于进一步加强管理和提高.     

眼科住院患者抗菌药物使用调查分析

目的 了解眼科抗菌药物的使用和存在问题,促进抗菌药物的合理应用.方法 抽查眼科2008年7月-2009年6月住院患者960例,对抗菌药物的用药目的、药物选择、用法用量、联合应用、给药途径等方面进行调查分析.结果 共使用抗菌药物8类28种,使用最多的是妥布霉素;抗菌药物的使用率为93.33%,其中预防性用药占85.52%;给药途径以眼局部用药最多;联合用药占87.83%(其中二联占68.75%,≥三联占19.08%),且以局部结合全身给药的联合方式居多;抗菌药物费用占药品总费用的比例为18.89%.结论 眼科住院患者抗菌药物的使用在选药、用药次数、围手术期用药时间等方面存在不合理现象,应加强临床合理用药指导,确保临床用药安全、有效、经济.     

内科住院患者抗菌药物使用调查分析

[目的]对临床抗菌药物使用情况进行调查,为抗菌药物的合理使用与管理提供科学依据. [方法]回顾性分析某院2008年7～12月内科住院患者病历400份,调查抗菌药物的使用情况. [结果]内科抗菌药物使用率为61.75%,病原学送检率为29.15%,联合用药占25.91%,抗菌药物的金额占使用药品总金额的25.89%. [结论]应积极采取有效干预措施,合理正确使用抗菌药物,切实加强抗菌药物的应用管理.     

1730份住院病历抗菌药物使用情况分析

目的 了解医院住院患者抗菌药物使用情况,分析不合理用药存在的具体问题,提高医院合理用药水平.方法 从2010年4月～9月住院病历中,按每个诊疗组每月3份的原则,随机抽取1730份,按设计好的项目进行分类、汇总整理.结果 医院抗菌药物使用率过高,为81%.手术科室抗菌药物使用率为100%;病原学检测和药敏试验率过低,仅为5%;抗菌药物使用不合理中无指征用药、围手术期预防用药较为严重.结论 加强医院抗菌药物规范使用的管理与考核,加强临床医生对抗菌药物相关管理规范的学习,减少或避免抗菌药物的滥用和浪费及药物不良反应的发生.     

1724例住院患者抗菌药物使用横断面调查分析

目的 通过对医院住院患者进行抗菌药物使用及细菌学检查情况的调查,分析存在问题,为医院合理使用抗菌药物提供依据.方法 采用横断面调查方法,对2010年8月30日0:00-24:00住院患者进行查阅病历和床旁调查相结合的方法,对抗菌药物使用情况及细菌学检查进行调查分析.结果 1724例接受调查的住院患者中,抗菌药物使用率48.55％,其中治疗使用率为46.72％,预防使用率46.59％,治疗十预防使用率6.69％;细菌学检查率为21.15％.结论 医院存在抗菌药物使用不合理问题,有必要规范抗菌药物的应用.     

抗菌药物使用调查分析

目的：了解医院抗菌药物使用基本情况。方法：随机抽取1430份住院患者病历，按设计好的项目进行回顾性调查。结果：1430份病历中有948份使用了抗菌药物，使用率达66.3%，使用的抗菌药物分为8大类，计55种，居前3位的依次为青霉素类、头孢菌素类、硝咪浴类；治疗用药486例，占51.2%，预防用药232例，占24.5%，无指征用药230例，占24.3%。结论：加强管理，严格掌握用药指征及其合理性。     

抗菌药物在传染病专科医院使用调查

目的了解抗菌药物在传染病专科医院使用的状况,为合理使用抗菌药物提供科学指导依据。方法在2004年9月~2005年3月对1991例住院患者进行抗菌药物使用调查分析。结果1991例患者中使用抗菌药物909例,使用率45.7%;其中单用1种抗菌药物者占66.7%,二联用药28.6%,三联用药4.73%;预防用药占29.3%,治疗用药70.85%;不合理使用为适应证过宽、疗程长、频繁更换等。结论抗菌药物使用不合理;需要加强抗菌药物临床使用的管理。     

0~5岁手足口病住院患儿抗菌药物使用情况分析

目的分析手足口病抗菌药物用药情况,了解用药中不合理之处,促进该院合理用药。方法随机抽取我院手足口病住院病历,统计年龄、诊断、实验室检查结果、抗菌药物名称、联合用药情况,依据《抗菌药物临床应用指导原则》、《临床用药须知》(2010版)以及药品说明书等进行分析。结果该院手足口病抗生素使用率20.14%,其中二联用药占1.38%,抗菌药物前三名为头孢呋辛、头孢曲松、阿奇霉素,主要不合理用药为用药频次不适宜、无指征用药及选药不适宜。结论该院手足口病抗菌药物使用基本合理。     

住院患者抗菌药物的使用实施干预的调查研究

目的 通过综合干预促进住院患者抗菌药物的临床合理应用.方法 抽取手术病历和非手术病历各100份,利用抗菌药物合理使用的国际指标进行抗菌药物使用情况的调查,采用行政管理和宣传教育等多手段进行干预,评价指标中医院整体情况数据通过管理部门和药库获得,处方行为和患者治疗情况通过系统抽样方法采集.结果 接受抗菌药物治疗的住院患者使用抗菌药物的平均品种数从干预前的2.13种降到干预后的1.97种,住院患者接受抗菌药物治疗的平均费用从干预前的1765.23元降到干预后的1136.18元,经统计学处理差异有统计学意义(P＜0.05),使用抗菌药物通用名的百分率从干预前的32.65%上升到干预后的73.21%(P＜0.05),其他各项指标均有改善.结论 本研究采用的合理用药干预措施具有可行性和有效性,对抗菌药物安全、有效、经济的使用起到了积极的促进作用.     

Long-stay patients in a psychiatric hospital in Southern Brazil

OBJECTIVE: To describe the demographic profile, social functioning, and quality of life of a population of long-stay care patients in a psychiatric hospital. METHODS: A study was carried out in Porto Alegre, Southern Brazil, in 2002. A total of 584 (96%) long-stay patients were assessed by means of the following instruments: the World Health Organization Quality of Life, the Social Behavior Schedule, the Independent Living Skills Survey, the Brief Psychiatric Rating Scale and another instrument for assessing disability (Questionnaire for Assessing Physical Disability). RESULTS: The average hospital stay was 26 years (SD: 15.8) and 46.6% of inpatients had no physical disability. Patients had their social functioning skills and autonomy largely impaired. Few of them (27.7%) answered the instrument for assessing quality of life, and showed significant impairments in all domains. The Brief Psychiatric Rating Scale evidenced a low prevalence of positive symptoms in this population. CONCLUSIONS: The institutionalized population studied presented significantly impaired social functioning, autonomy, and quality of life. These aspects need to be taken into consideration while planning for their deinstitutionalization.     

Historicizing nursing and patients at a psychiatric hospital

This is a historical research whose objective is to historicize the nursing team and the patients at the Hospital Col?nia Sant'Ana (HCS), in the period from 1941 to 1960. Five employees that worked at the Hospital in the period of the study were interviewed and other documental sources were used. To analyze the data Foucault's theory was used. HCS was the main pole of psychiatric care in the Santa Catarina. The nursing team was constituted by the nuns, "male nurses" and "watchmen". The institution received indigent, private, and health insurance covered patients, who were diagnosed with many different problems, and some who were more of a social case than anything else. The general conditions of the Hospital were precarious. The studied period made possible visualize that the treatment given to the patients, as well as the work conditions offered to the workers, were distant from the ideal, and that it was part of a national policy, characterized by the creation of state macro psychiatric hospitals.     

Social performance expectations in psychiatric patients of a general hospital ward

OBJECTIVE: To prospectively assess the performance of socially expected activities of psychiatric patients in the first year after their discharge from a psychiatric ward of a general hospital. Also, to evaluate the patients' and their family' expectations on the former's performance. METHODS: The study was carried out in a general hospital in Ribeir?o Preto, Brazil. The Katz Scale was applied to the patient and their family informer at the time of hospitalization regarding to the week preceding admission, and at one, six and 12 months after hospital discharge, regarding to the preceding week. Of the 86 pairs who were initially included in the study, 55 patients (33 women and 22 men) and their respective family informers completed the study. Performance scores and expectations were compared using variance (ANOVA) and t-student test. RESULTS: Expectation did not show significant variations either in the patient's evaluation or in the family's evaluation. According to both evaluations, expectation was significantly higher than performance. A significant improvement in the performance of socially expected activities was observed as early as one month after discharge compared to the pre-admission period and was unchanged along the first year in both evaluations of the patient and their family. CONCLUSIONS: These results suggest that admission to a psychiatric ward of a general hospital, in addition to reducing the psychiatric symptoms, contributed to improving the performance of socially expected activities. The average level of performance was unchanged throughout the first year after discharge, although demographic and medical variables can influence these results.     

Sexual activity among patients in psychiatric hospital wards

In psychiatric hospitals, sexual activity between patients raises special difficulties regarding consent. We undertook a questionnaire survey of inpatients in the mental health units of three hospitals to identify the nature and frequency of sexual activity. A contemporaneous staff questionnaire was used in an attempt to validate the patient reports. Of the 100 patients who participated (response rate 60%), 30 reported engaging in some form of sexual activity including 10 who had sexual intercourse. All sexual intercourse was consensual, but only 2 respondents used condoms. Staff questionnaires suggested levels of sexual activity congruent with patient reports. This survey underlines the conflict between an individual's right to sexual expression and the need to protect vulnerable patients.     

Antimicrobial resistance patterns among urine isolates from patients in a geriatric hospital and from older patients in a general hospital in Jerusalem

INTRODUCTION AND RATIONALE: Urinary tract infection is the most common cause of nosocomial infections in patients hospitalized in chronic care facilities. The changing spectrum of microorganisms involved in urinary tract infections and the emerging resistance require continuous monitoring to provide crucial information to guide empirical therapy and encourage prudent use of antibiotics. The aim of this survey was to assess the antimicrobial resistance profile of urine isolates from patients hospitalized in a geriatric hospital and from elderly patients hospitalized in an acute care hospital in order to guide empirical therapy of urinary tract infections. METHODS: The survey was performed in two hospitals in Jerusalem: a university-affiliated geriatric hospital- Herzog -and an acute secondary- and tertiary-care university hospital- Hadassah. We performed a retrospective analysis of antimicrobial resistance of all positive urine cultures obtained from patients in the geriatric division of Herzog Hospital and from patients aged 65 years and older hospitalized in the Internal Medicine departments in Hadassah Hospital during a 1-year period. RESULTS: The most common bacteria isolated from urine specimens in Herzog Hospital were, in order of frequency, Escherichia coli, Proteus mirabilis, and Pseudomonas aeruginosa. We demonstrated a high rate of antimicrobial resistance of those bacteria in both hospitals. The pattern we observed necessitates recommending ceftazidime as the most appropriate empirical therapy for urinary tract infection in Herzog Hospital. In Hadassah Hospital we recommend cefuroxime for those patients in good general condition and ceftazidime for those who present with clinical sepsis. Antimicrobial resistance patterns should be assessed periodically and recommendations modified accordingly. Infection control guidelines should be implemented in order to try to decrease the rate of antimicrobial resistance. Further research is requested to assess the efficacy of such interventions in long-term care facilities.     

Religion and psychiatric disorders in patients admitted to a university general hospital

In order to evaluate the prevalence of psychiatric disorders in a Brazilian general hospital and their association with religious denomination and religiosity, 253 inpatients were interviewed. A socio-demographic questionnaire and an instrument for diagnosis of mental disorders (MINI-Plus) were applied. Distribution of religious denominations was: Catholic 63.2% (n=177), Evangelical Protestant 20.4% (n=57), Spiritist 4.3% (n=12), traditional Protestant 2.3% (n=8), and "no religion" 7.5% (n=21). Degree of religiosity was: very religious 43.2% (n=116), religious 46.9% (n=129), hardly religious 9.8% (n=27), and not at all religious 1.1% (n=3). Evangelical (Pentecostal) religious affiliation and frequent attendance at worship services were associated with fewer alcohol problems. Membership in an Evangelical (Pentecostal) church may thus have an inhibitory effect on alcohol dependence or abuse. Intensity of religiosity was moderately associated with overall prevalence of disorders, especially bipolar disorder. It is reasonable to conclude that extreme situations (very intense versus very limited religious participation) are related to this finding, associating both an exacerbated pursuit of religion and alienation from it with altered mental states.