PDCA质量管理模式在骨科围手术期抗菌药物使用中的具体实践

Practice of PDCA model in the management of orthopedics antibiotics using in perioperative period

目的:探索PDCA质量管理模式在围手术期抗菌药物管理中的应用效果。方法:通过HIS系统抽取骨科病区PDCA干预前(2020年第1季度)、PDCA干预后(2020年2、3、4季度)出院病历,比较分析围手术期抗菌药物使用指标、用药合理性。结果:3个PDCA循环管理模式实施后,骨1病区、骨2病区抗菌药物使用率、抗菌药物使用强度、人均抗菌药费均较前明显下降,Ⅰ类切口抗菌药物使用率均小于35%,达到我院规定。抗菌药物的品种选择从干预前的头霉素类、喹诺酮类,转变为更合理的一、二代头孢菌素。结论:PDCA质量管理模式可作为有效、可行的办法在抗菌药物管理工作中推广。

Objective:To explore the effectiveness of PDCA cycle in the management of antibiotics during the perioperative period.Methods:To extract the medical records of discharged patients from orthopaedic ward before(1st quarter of 2020)and after(2^(nd),3^(rd),4^(th) quarter of 2020)PDCA implementation,and to analyze the indicators and rationality of antibiotics using in perioperative period.Results:After the implementation of three PDCA cycles,the utilization rate and DDDs of antibiotics,and the cost of antibiotics treatment per capita in orthopaedic ward 1 and ward 2 had a significantly decrease than before,the utilization rate of antibiotics in type Ⅰ incision was less than 35% which met the guideline.Meanwhile,the selection of antibiotics became more reasonable,being changed from the cephalosporins and quinolones to the first and second generation cephalosporins.Conclusion:The PDCA model can be promoted as an effective and feasible method in the management of antibiotics.