针对问题干预法对骨科围手术期预防性使用抗菌药物的影响

Effects of Problem-Directed Intervention on Prophylactic Use of Antibacterials in Perioperative Period of Orthopedics Surgery

目的:了解针对问题干预法对骨科围手术期预防性使用抗菌药物的影响。方法:从2010年9月开始,根据国家卫生部相关要求查找我院骨科围手术期预防性使用抗菌药物问题,然后应用针对问题干预法进行干预:将问题做成幻灯给医生讲课,对典型案例在医院周会上进行点评,对个别医生进行谈话,临床药师施行实时监控。结果:2010年9月术前用药时机、用药种类、用药剂量、使用抗菌药疗程、联合用药和术前、中、后用药一致性的合格率分别为46.0%、96.0%、68.0%、28.0%、98.0%和95.0%;经过针对性干预,2011年9月各项指标合格率分别上升为77.6%、100.0%、73.5%、61.2%、100.0%和100.0%,尤其术前用药时机和使用抗菌药疗程显著好转(P均<0.01)。结论:针对问题干预方法有效可行,但还需要加强其力度。

Objective： To investigate the effects of problem-directed intervention on prophylactic use of antibacterials in perioperative period of orthopedics surgery. Methods： Problems were evaluated according to related criterias of Ministry of Health. Problem-directed intervention was performed ,i.e., problems were taught to doctors by means of projector; typical cases were judged in the weekly seminar; talking to individual doctor was performed by drug administrators; real-time monitoring was carried out by pharmacists. Results： Qualified rate of medication occasion, medication categories, medication dose, course of treatment, drug combination and consistency of pre-, intra- and post-operative medication was 46.0%, 96.0%, 68.0%, 28.0%, 98.0% and 95.0%, respectively, in Sept,2010, vs. 77.6%（P 〈0.01X100.0%.73.5%, 61.2%（P 〈0.01）, 100.0% and 100.0%, respectively, in Sept.,2011 after intervention. Conclusion： Problem-directed intervention was effective and feasible, but its efforts need to be enhanced.