运用失效模式与效果分析干预清洁手术抗菌药物的使用

Application of failure mode and effect analysis to intervene to use of antibiotics in clean operation

目的探索降低手术部位感染风险前提下,降低清洁手术抗菌药物预防使用率综合有效措施。方法使用失效模式和效果分析的方法,分析引起清洁手术后手术部位感染的危险因素和不合理预防使用抗菌药物的原因,根据影响级别制定相应的对策并落实持续改进措施。结果干预前后手术部位感染率均为0,抗菌药物的预防使用率下降61.52%,24h内停用抗菌药物的构成比上升34.37%,抗菌药物品种规范符合构成比上升74.60%。结论落实感染控制措施,持续地监测反馈和教育培训,可以降低清洁手术预防抗菌药物的使用率。

OBJECTIVE To explore the comprehensive effective measures for reducing the utilization rate of prophylactic antibacterials in clean operation and reducing the risk of surgical site infections （SSI）. METHODS By means of the failure mode and effects analysis, the risk factors which caused SSI in clean operation and the causes of the unreasonable use of prophylactic antibiotics were analyzed, then the corresponding countermeasures were formulated, and the continuous improvement measures were implemented according to the impact level. RESULTS The incidence of SSI both before and after the interventions was 0, the utilization rate of prophylactic use of antibiotics dropped by 61. 52%, the constituent ratio of withdrawal within 24h increased by 34. 37%, and the constituent ratio of antibacterials variety conform to norms increased by 74.60 %. CONCLUSION The implementa- tion of the infection control measures, continuous monitoring of feedback, and training can reduce the utilization rate of prophylactic antibacterials in clean operation.