Vol.69 No.5 September 2021
Impact of guidelines on the acceptance rate for intervention in the clinical pathway by AST
1)Department of Hospital Pharmacy, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Nagasaki, Japan
2)Infection Control and Education Center, Nagasaki University Hospital
Abstract
At the Nagasaki University Hospital, the pharmacists of the antimicrobial stewardship team (AST) in cooperation with the infection control doctors have intervened in a clinical pathway (CP) for perioperative antimicrobial use from 2012. In 2016, the "Japanese Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery" (GL) was published, with the expectation of more appropriate use of antimicrobial agents. There have been no investigations on the impact of the GL on the acceptance rate by hospital departments of suggestions made by the AST. Therefore, we investigated the impact of the GL on the intervention in CPs by the AST. Within the study period, 129 CPs, including that for antimicrobial prophylaxis in surgery were approved, and 71 CPs needed correction. We suggested correction in 82 cases, and the suggestion was accepted in 49 cases. The acceptance rate was higher with the GL was higher than that without the GL. The recommendations by guidelines may be effective for promoting appropriate use of antimicrobials. On the other hand, the acceptance rate was limited to 63%, and departments rejected our suggestion in consideration of the current situations. So, there are few CPs that we think are inappropriate. Moreover, the assumed operative procedure differs between pharmacists and the clinical department. To reduce this difference, we need to confer with the diagnosis concerned department about the operative procedure.
Key word
guideline, clinical pathway, antimicrobial, appropriate use, acceptance rate
Received
March 18, 2021
Accepted
July 9, 2021
Jpn. J. Chemother. 69 (5): 383-386, 2021
