国际联合委员会评审中的抗菌药物合理应用持续质量改进的实践效果

Practice of continuous quality improvement in rational application of antibacterials by the Joint Commission International evaluation

目的:探讨国际联合委员会评审中持续质量改进(continuous quality improvement,CQI)项目的实践与方法。方法:运用计划(plan)-执行(do)-检查(check)-行动(act)(PDCA)循环理论对抗菌药物的品种、使用百分率和使用强度3个方面进行了调查和干预,并收集数据观察干预效果。结果:抗菌药物种类从89种精简到了52种,品规从147个精简到81个。调查科室的住院病人抗菌药物使用率从59.2%下降到47.0%,抗菌药物使用强度从70.80DDDs/100人天,下降到50.37DDDs/100人天;抗菌药物使用趋于合理,抗菌药物合理应用的CQI达到预期目标。结论:PDCA循环用于抗菌药物合理应用的CQI效果显著,有利于提高医院整体医疗质量。

Objective： To investigate the practice and methods of continuous quality improvement projects by Joint Com- mission International （JCI） evaluation in Huashan Hospital Affiliated to Fudan University. Methods： Plan-do-check-act （PDCA） cycle theory was used to investigate and intervene three indicators of the application of antibacterials,including the variety, percentage of antibacterials used and the antibacterial use density （AUD）. Results： After the application of PDCA cycle theory, the varieties of antibacterials used were reduced from 89 to 52; the type and specifications were decreased from 147 to 81. The percentages of antibacterials used in the investigated departments were decreased from 59.2% to 47.0%, and the AUD dropped from 70.80 DDDs/（100 patient days） to 50.37 DDDs/（100 patient days）. The use of antihacterials tended to he rational. The target of continuous quality improvement of the rational use of antibacterials was achieved. Conclusion： The application of PDCA cycle obviously improved the rational use of antibacterials, enhancing comprehensive medical quality improvement of the hospital.