Ⅰ类手术切口抗菌药物预防性应用管理效果评价

Effect evaluation on the preventive application and management of antibacterial drugs for type-I surgical incisions

目的评价我院落实国家卫生和计划生育委员会有关Ⅰ类手术切口抗菌药物预防性应用相关规定的效果。方法将2015年~2016年抗菌药物专项整治后外科Ⅰ类手术切口病例与2012年~2014年的同类病例监测数据进行比较,监测数据包括外科Ⅰ类手术切口预防性应用抗菌药物比例、Ⅰ类手术切口抗菌药物预防性应用时间小于24小时比例、Ⅰ类手术切口术前预防性应用抗菌药物使用时机合格比例、Ⅰ类手术切口抗菌药物预防性应用种类选择合格比例、Ⅰ类手术切口感染率。结果Ⅰ类手术切口抗菌药物预防性应用比例由专项整治前的41.0%降低到26.4%,术后预防使用抗菌药物时间小于24小时比例由64.0%上升到98.0%,抗菌药物品种选择合理比例由专项整治前的90.0%提高到100.0%。使用手术麻醉系统实时监测后,2016年预防性应用抗菌药物使用时机合格比例达到72.0%。专项整治活动后Ⅰ类手术切口感染率有所下降。结论专项整治活动有利于改善Ⅰ类手术切口抗菌药物预防性应用各项指标。Ⅰ类手术切口抗菌药物预防性应用的管理离不开领导的重视、科学的管理方案以及持续的监测与改进。

Objective The paper aims to evaluate the effect of the hospital's implementation of relevant provisions of the National Health and Family Planning Commission of China on the preventive application of antibacterial drugs for type-I surgical incisions.Method The monitoring data of type-I surgical incision cases after the special rectification of antibacterial drugs during2015--2016were compared with those of cases of the same kind from2012to2014;the monitoring data included the proportion of the preventive applications of antibacterial drugs for type-I surgical incisions,proportion of the preventive applications of antibacterial drugs less than24hours for type-I surgical incisions,proportion of the preventive applications of antibacterial drugs at an appropriate time for type-I surgical incisions before operation,proportion of the rational variety selections of antibacterial drugs preventively applied for type-I surgical incisions,and infection rate of type-I surgical incisions.Result The proportion of the preventive applications of antibacterial drugs for type-I surgical incisions decreased from41.0%before special rectification to26.4%;the proportion of the preventive applications of antibacterial drugs less than24hours after operation rose from64.0%to98.0%;the proportion of the rational variety selections of antibacterial drugs was increased from90.0%before special rectification to100.0%.After the real-time monitoring of operation anesthesia system was implemented,the proportion of the preventive applications of antibacterial drugs at an appropriate time reached72.0%in2016.There was a decrease in the infection rate of type-I surgical incisions after special rectification.Conclusion The special rectification is conducive to improving various indicators of the preventive application of antibacterial drugs for type-I surgical incisions,and the management over the preventive application of antibacterial drugs for type-I surgical incisions is inseparable from leaders'attention,scientific management scheme,and persistent monitoring and improvement.