PDCA循环对普外科围术期预防用抗菌药物的成效及分析

Analysis of the application effects of PDCA cycle used in preoperative antibiotics prophylaxis of general surgery

目的分析PDCA循环管理对普外科围术期抗菌药物预防应用的情况。方法利用医院信息系统分析应用PDCA(计划、实施、检查、处理)循环管理前后围术期抗菌药物预防使用情况。结果运用PDCA循环管理后,普外科围术期无适应证用药,药物选择不合理,术前用药时机不合理,用法、用量、溶媒不合理,更换药物不合理,联合用药不合理,疗程不合理,出院带药不合理发生率均逐年降低,差异均有统计学意义(P<0.05)。运用PDCA循环管理后,普外科围术期抗菌药物使用率、清洁手术预防用药使用率、使用强度均逐年下降,差异均有统计学意义(P<0.05)。结论 PDCA循环管理法用于普外科抗菌药物管理成效显著,可在医院大范围推广运用。

Objective To analyse the perioperative preventive use of antimicrobial drugs in general surgery by PDCA cycle theory. Methods The intervention program was developed according to the PDCA（ plan,do,check,action） cycle theory so as to check out and summarize by using hospital information system. Results After the application of PDCA cycle management,the incidence of perioperative no indications of medication,irrational drug selection,irrational preoperative medication use time,irrational use,dosage and solvent,drug replacement unreasonable,unreasonable combination therapy,irrational course of treatment,discharge medication unreasonable in department of general surgery were reduced year by year,the differences were statistically significant（ P〈0. 05）. After the application of PDCA cycle management,during the perioperative period,the utilization rate of antimicrobial agents,the utilization rate of preventive medication for clean surgery,and the intensity of use decreased year by year in department of general surgery,the differences were statistically significant（ P〈0. 05）. Conclusion The application of PDCA cycle obviously improves the management of antimicrobial agent. It can be widely used in other management aspects of hospital.