运用PDCA循环对普外科Ⅰ类切口清洁手术围手术期预防用抗菌药物管理的成效及分析

Perioperative preventive use of antimicrobial drugs in general surgery Ⅰ incision by PDCA cycle

目的 探索PDCA循环对普外科Ⅰ类切口清洁手术围手术期抗菌药物预防应用的管理成效。方法 抽取本院普外科2009年7月～2010年6月Ⅰ类切口清洁手术病历作为对照组,2010年7月～2011年6月、2011年7月～2012年6月、2012年7月～2013年6月Ⅰ类切口清洁手术病历分别作为管理组1～3,应用PDCA循环管理抗菌药物的预防应用,采用卡方检验进行管理前后抗菌药物预防使用率、使用合理率及术后切口感染率的显著性检验,判断是否取得显著成效。结果 通过PDCA循环管理,围手术期预防用抗菌药物使用率由99.23%下降至7.91%（χ2=13 890.16,P〈0.001）,使用合理率从0.77%上升至90.44%（χ2=13 571.10,P〈0.001）,术后切口感染率从0.77%下降至0.66%（χ2=7 547.58,P〈0.001）。结论 运用PDCA循环对普外科Ⅰ类切口清洁手术围手术期预防用抗菌药物进行管理,预防使用率显著下降,使用合理率显著上升,术后切口感染率显著下降,取得良好成效,今后应继续探索应用。

Objective To manage the perioperative preventive use of antimicrobial drugs in general surgery Ⅰclean class incision by PDCA cycle. Methods Ⅰ clean class incision surgery from July 2009 to June 2010 for the management group. The management group 1, 2 and 3 included surgeries from the achievements during July 2010 to June 2011, July 2011 to June 2012, and July 2012 to June 2013. Results After the PDCA cycle, perioperative prophylaxis utilization decreased from 99.23% to 7.91%（χ2= 13 890.16, P 0.001）, reasonable usage rate rose from 0.77% to 90.44%（χ2= 13 571.10, P 0.001）, and the postoperative wound infection rate fell from 0.77% to 0.66%（χ2= 7 547.58, P 0.001）. Conclusion After the PDCA cycle for general surgery Ⅰ clean class incision perioperative preventive use of antimicrobial drugs, perioperative prophylaxis utilization has decreased signifi-cantly. The reasonable age of rate has increased, and the wound infection rate has dropped.