摘要
目的:以医院等级评审为契机,探讨某院Ⅰ类切口围手术期预防用药的管理方法,提高抗菌药物的应用合理性。方法:利用FOCUS-PDCA循环法对Ⅰ类切口抗菌药物的预防使用进行干预,选取该院2015年1~12月全部Ⅰ类切口患者出院病例进行回顾性分析,根据干预进程分为4个阶段,对每一阶段的抗菌药物应用指标进行比较,评价围术期抗菌药物的合理使用改进效果。结果:与干预前比较,干预第三阶段的Ⅰ类切口预防用药比例从62.90%降至28.32%,术前给药时机合理率从50.1%升至71.0%,品种选择合理率由53.5%提高至79.5%,预防用药疗程合理率从26.8%上升至56.3%,差异均有统计学意义(P<0.01),而干预前后手术部位感染率无明显差异(P>0.05)。多项指标的好转促进了该院等级评审相关条款评分结果的提升。结论:医院等级评审中利用FOCUSPDCA循环法规范Ⅰ类切口围术期抗菌药物预防使用效果显著。
Objective：To describe the impact of interventions of the perioperative prophylactic antibiotic use in Type I incision operations on improving result of grade accreditation of hospital as an opportunity. Methods ：The FOCUS- PDCA circulation was applied in the interventions of the perioperative prophylactic antibiotic use in Type I incision operations. The patients who received Type I incision operations from January 2015 to December 2015 were assigned into four stages： pre-intervention stage, the 1 st intervention cycle, 2nd intervention cycle and 3rd intervention cycle. The rationality of antibiotic use in Type I incision operations was retrospectively analyzed and evaluated. Results：The study showed that the rate of antibiotic prophylaxis in Type I incision operations was decreased from 62.90% to 28.32% , the reasonable rate of delivery time increased from 50.1% to 71.0%, the reasonable rate for the choice of the drug increased from 53.5% to 79.5% , and the reasonable rate of treatment course increased from 26.8% to 56.3% with highly significant difference between the 4 stages （ P 〈 0.01 ）. But there was no significant difference of the percentage of surgical site infection （ P 〉 0.05）. Achievements from the interventions contributed to enhancement of the hospital＇ s performance in grade assessment. Conclusion： FOCUS-PDCA circulation had a positive influence to the promotion of the perioperative prophylactic antibiotic use in Type I incision operations in hospital grade assessment.
出处
《药物流行病学杂志》
CAS
2017年第5期356-359,共4页
Chinese Journal of Pharmacoepidemiology
