PDCA循环在Ⅰ类切口围手术期抗菌药物预防使用中的干预效果观察

Effect of PDCA Cycle Introduced into the Intervention of Prevention and Use of Antimicrobial Agents in Ⅰ-type Incision Perioperative Period

目的探讨Ⅰ类切口围手术期抗菌药物预防使用中导入PDCA循环的效果观察。方法回顾性分析2019年1月至6月在和平县人民医院外科手术治疗的I类切口病例作为观察组n(=113),2018年1月至6月Ⅰ类切口病例作为对照组(n=236),观察组使用PDCA循环干预抗菌药物预防使用,对照组未干预抗菌药物预防使用,对比两组的抗菌药物使用率及切口感染率、用药时机、用药时间、抗菌药物使用不合理率。结果观察组抗菌药物预防使用率显著低于对照组(P<0.05),但两组在切口感染概率上比较差异无统计学意义(P>0.05);观察组在切皮前0.5〜1 h为主(P<0.05);观察组预防用抗菌药物术后用药时间在术后<24 h比例显著高于对照组(P<0.05);观察组药物品种选择抗菌药物品种选择合理率高于对照组(P<0.05)。结论Ⅰ类切口围手术期抗菌药物预防使用中导入PDCA循环的效果显著,能有效降低抗菌药物预防使用率及不合理用药率,规范用药时机和用药时间,避免抗菌药物的滥用,提升用药安全。

objective To investigate the effect of PDCA cycle in the intervention of prevention and use of anti microbial age nts in the perioperative period of class Ⅰ incision.Methods Between January and June 2019 were retrospectively analyzed in peace county people's hospital of surgical treatmerit of Ⅰ class cases incision as observation group(n=113),between January and June 2018 Ⅰ class incision cases as control group(n=236),the observation group using PDCA cycle antibacterial drug prevention intervention,the control group did not irrtervene in the antibacterial drug prevention,compared two groups of antibacterial drug usage and incision infection,medica tion ti me,duration,irra tio nal rate of antibiot ics.Results The rate of prophy lac tic use of antibiot ics in the observation group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the probability of incision infection between the two groups(P>0.05);the observation group was mainly at 0.5〜1 h before skin incision(P<0.05);the time of prophy lac tic use of antibiot ics in the observation group after operation was<24 The proportion of H in the observation group was significantly higher than that in the corrtrol group(P<0.05),and the reasonable rate of drug variety selection in the observation group was higher than that in the control group(P<0.05).Conclusion The effect of PDCA circulation in the prophylactic use of antibiotics in the perioperative period of type Ⅰ incision is significant,which can effectively reduce the rate of prophylactic use of antibiotics and the rate of irrational drug use,standardize the timing and time of drug use,avoid the abuse of antibiotics,and improve the safety of drug use.