PDCA循环管理法在妇幼专科医院抗菌药物管理中的应用

Application of plan-do-check-action cycle management method in antimicrobial management in a maternity and child healthcare hospital

目的探讨PDCA循环管理法在妇幼专科医院抗菌药物专项管理中的应用与成效。方法运用PDCA循环法,通过多部门联合对某妇幼保健院抗菌药物临床应用的各项指标进行监管,比较应用PDCA方法前后(2014年8月—2015年7月为专项管理前,2017年8月—2018年7月为专项管理后)的效果。结果使用抗菌药物金额比例、门急诊使用抗菌药物金额比例、住院患者使用抗菌药物金额比例和Ⅰ类切口手术预防抗菌药物使用率分别由专项管理前的16.69%、13.18%、58.63%、45.12%,下降至整治后的7.69%、6.75%、38.21%、8.13%,下降趋势均有统计学意义(均P<0.05),均符合国家要求;其他各项指标如抗菌药物使用强度、接受抗菌药物治疗患者微生物检验标本送检率等指标均达到国家要求。结论运用PDCA循环管理法开展抗菌药物专项管理,成效明显,抗菌药物临床应用更规范、合理。

Objective To explore the application and efficacy of plan-do-check-action(PDCA)cycle management method in the special management of antimicrobial agents in a maternity and child healthcare hospital.Methods PDCA cycle method was used to supervise the clinical application of antimicrobial agents in a maternity and child healthcare hospital through multi-department cooperation,efficacy before and after the application of PDCA method was compared(August 2014 to July 2015 was pre-special management,August 2017 to July 2018 was post-special management).Results The proportion of the amount of money in antimicrobial use,antimicrobial use in outpatient and emergency departments,antimicrobial use in hospitalized patients,as well as rate of antimicrobial prophylaxis in class I incision operation decrease from 16.69%,13.18%,58.63%,and 45.12%before the special management to 7.69%,6.75%,38.21%,and 8.13%respectively after management,the downward trend was statistically significant(all P<0.05),all met the national requirements;other indicators,such as antimicrobial use density,the rate of specimen microbiological detection for patients receiving antimicrobial treatment,all meet the national requirements.Conclusion The effect of using PDCA cycle management method to carry out the special management of antimicrobial agents is obvious,clinical application of antimicrobial agents tends to be more standardized and rational.