Construction and application of informatization management system for clinical microbial specimen submission
10.3760/cma.j.cn111325-20230914-00155
- VernacularTitle:临床微生物标本送检信息化管控系统的构建与应用
- Author:
Peng JIANG
1
;
Jie XU
;
Wei FENG
;
Huizhe LU
;
Xinyao ZHANG
;
Jicheng YAN
;
Xuanding WANG
Author Information
1. 浙江大学医学院附属第二医院抗菌药物管理办公室，杭州 310009
- Keywords:
Microbial specimen;
Information system;
Sampling;
Antibiotic;
Antimicrobial stewardship
- From:
Chinese Journal of Hospital Administration
2024;40(5):356-361
- CountryChina
- Language:Chinese
-
Abstract:
To effectively play the guiding role of pathogenic diagnosis in the rational use of antibiotics, hospitals at all levels urgently need to establish an effective control system for clinical microbial specimen submission. In response to the common problems in medical institutions in China, such as the low rate of microbiological specimen submission before antibiotic treatment, unreasonable structure of microbiological specimens, and the majority of morning sputum and urine specimens collected for pathogen testing, the Second Affiliated Hospital of Zhejiang University School of Medicine has constructed a management system for clinical microbiological specimen submission using artificial intelligence technology. It used a built-in intelligent rule engine to implement full process control over the sampling and submission of microbiological specimens by doctors when prescribing antibiotics, urge doctors to implement the requirement of collecting samples before using antibiotics for treatment, and recommend priority the collection of sterile specimens. In addition, the hospital transformed the laboratory and testing process with the goal of receiving microbial samples 24 hours without interruption and inoculating in real-time. The informatization management system began to be applied throughout the hospital in December 2015. The average rate of microbial sample submission before the first therapeutic use of antibiotics from June 2016 to 2023 was 79.2%, an increase of 90.2 percentage points from 41.7% in June 2014 ( χ2=467.781, P<0.01). The structure of microbial specimens continued to be optimized, and the proportion of sterile specimens in all submitted specimens increased from 47.2% in 2014 to 49.9% in 2023 ( χ2=139.119, P<0.01). The proportion of morning sputum and morning urine specimens decreased from 65.2% and 60.6% in 2014 to 11.1% and 16.9% in 2023, respectively ( χ2 values were 19 787.434 and 4 346.664, respectively, P<0.01), providing a more reliable basis for pathogenic diagnosis in clinical practice and providing reference for improving the management of pathogenic specimen submission in medical institutions.
