PDCA循环管理模式在抗菌药物临床应用专项整治活动中的效果评价

The Effectiveness Evaluation of Antibiotics Management by Applying PDCA Cycle Model

目的通过对照比较某三级甲等综合医院临床抗菌药物使用干预前后的变化,分析PDCA循环管理模式在抗菌药物临床应用专项整治活动中的效果。方法 2011年6月-2013年12月采用PDCA循环管理模式进行抗菌药物临床应用专项整治活动,并采用前瞻性研究的方法分析门诊患者抗菌药物使用率、急诊患者抗菌药物使用率、住院患者抗菌药物使用率等指标。结果运用PDCA循环管理模式以来,该院临床抗菌药物应用管理日趋规范,2011年6月-12月、2012年1月-12月、2013年1月-12月,门诊患者抗菌药物使用率分别为33.00%、29.09%、19.31%,急诊患者抗菌药物使用率分别为45.00%、32.81%、28.94%,住院患者抗菌药物使用率分别为71.00%、57.76%、53.28%;同时,在3年时间内,Ⅰ类手术切口预防抗菌药物使用率下降,病原学送检率持续上升,人均抗菌药物费用得到下降。结论推行PDCA循环管理模式,促进了抗菌药物临床应用的规范化管理。

Objective To analyze the effectiveness of PDCA cycle model in antibiotics management by comparison of antibiotics use before and after the use of PDCA in a tertiary hospital. Methods Prospective study was adopted to analyze the using rate of antibiotics in outpatients, emergent patients and inpatients between June 2011 and December 2013. Results The reasonable antibiotics use was improved since the beginning of PDCA cycle model. The antibiotics using rates of outpatients were 33.00%, 29.09% and 19.31%, of emergent patients were 45.00%, 32.81% and 28.94%, and of inpatients were 71.00%, 57.76% and 53.28% in year 2011 （from June to December）, 2012 （from January to December） and 2013 （from lanuary to December） respectively. Meanwhile, Class I incision antimicrobial use also decreased and bacteria examination rate continuously increased during the last three years. As a consequence, patients＇ cost was reduced. Conclusion The PDCA cycle model promotes the standardized management nf clinical rneclic^tinn ~nnllr^tinn