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| Analysis of the use and influencing factors of cephalosporins after the routine skin test was cancelled in a tertiary hospital |
| PENG Min1, PAN Yong2, DAI Yingchun1, CHEN Li1, YAN Xiao1, LI Wei2, Deng Yinhua1 |
1. Hunan Provincial People's Hospital / The First Affiliated Hospital of Hunan Normal University, Changsha 410005, China;
2. Hunan Cancer Hospital, Changsha 410013, China |
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Abstract Objective A questionnaire survey was used to evaluate the knowledge of medical staff in a certain hospital on cephalosporin skin test, to determine the impact of the policy of “phasing out cephalosporin skin test “ on the use of inpatient cephalosporins, and to provide reference for the sustainable advancement of this work. Methods Statistics and analysis of cephalosporin use in June-September 2020 and June-September 2021. A quesionnaire was distributed to each clinical department by the clinical pharmacy department in the hospital to investigate the attitudes of doctors, nurses and pharmacists to cancel the routine skin test of cephalosporin and the corresponding countermeasures. Results After the skin test was cancelled, the amount of cephalosporins was significantly decreased, and the proportion of total defined daily doses (DDDs) decreased (25.24%vs 24.41%). A total of 328 medical workers were surveyed, and doctors, nurses and pharmacists accounted for 26.83%, 63.72%, and 9.45%, respectively. Only 41.46% knew that the hospital implemented the policy of “phasing out cephalosporin skin test”, and 51.23% of the respondents supported “phasing out cephalosporin skin test”. The main reason for disapproval (53.96%) is that “skin test is an effective screening method to assess whether patients are allergic to cephalosporins”. The univariate chi-square test showed that there was no significant difference in each factor (including gender, age, highest education, department, and working years) for “after canceling the routine skin test, will the patient still be given a skin test?”.81.71% thought that the most common description of the history of cephalosporin allergy was a positive skin test, and 80.49% would avoid the use of cephalosporin because of a positive skin test in the past. Nurses' correct interpretation of the configuration, operation method and results of the cephalosporin skin test solution accounted for 35.58%, 3.37%, and 75.00%, respectively, and the univariate chi-square test showed that there were significant differences between departments. The main influencing factors for the correct “method of preparing cephalosporin skin test solution”. Conclusion There are still many misunderstandings about the knowledge of cephalosporin skin test among medical workers in this hospital, and after the cancellation of routine cephalosporin skin test, routine skin test is still performed or the use of cephalosporin antibiotics is reduced. Clinical pharmacists should actively respond to national policies, strengthen communication and training with clinical clinics, and eliminate the concerns of medical workers. With the assistance of clinical medical care and information systems, we will jointly promote the implementation and promotion of policies.
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Received: 12 June 2023
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2023, Vol. 20 
