基于PDCA循环法促进我院头孢菌素及青霉素类抗菌药皮试的合理应用

Promoting Rational Application of Cephalosporins and Penicillins Skin Test in our Hospital Based on PDCA Circulation Method

目的 针对临床盲目扩大头孢菌素及青霉素类抗菌药皮试适应症的问题,积极落实国家《β内酰胺类抗菌药物皮肤试验指导原则(2021年版)》,在确保医疗质量和安全的前提下,减少患者皮试痛苦,规范、合理地皮试。方法 分析我院头孢菌素及青霉素类抗菌药皮试的现状,运用PDCA管理法,通过计划、执行、检查、改进等环节,对不合理皮试进行专项整治。结果 通过PDCA循环法,这两类抗菌药不合理皮试的情况显著减少。主要表现为头孢菌素类皮试率由67.53%降至45.98%,其中,头孢唑肟的下降幅度最高,达43%。患者使用青霉素类抗菌药前均采用了皮试,正确选用青霉素皮试的比率明显提高,由31.72%提高至76.80%。结论 运用PDCA管理模式在头孢菌素及青霉素类抗菌药皮试管理中具有积极作用,可显著减少不合理皮试,促进临床合理用药。

OBJECTIVE To solve the problem of blindly expanding the indications for skin test of cephalosporins and penicillins in clinic, actively implement the National Guidelines for Skin Test of β-lactam Antibacterials(2021 edition),reduce the pain of skin test for patients, and conduct standardized and reasonable land test on the premise of ensuring medical quality and safety.METHODS The current situation of skin tests of cephalosporins and penicillins in our hospital was analyzed, and PDCA management method was used to make special rectification for unreasonable skin tests through planning, implementation, inspection and improvement.RESULTS Through PDCA circulation method, the irrational skin tests of these two kinds of antibacterial drugs were significantly reduced.Mainly, the skin test rate of cephalosporins decreased from 67.53% to 45.98%,among which ceftizoxime decreased the most, reaching 43%.All patients used skin test before using penicillin antibiotics, and the rate of correctly selecting penicillin skin test increased obviously, from 31.72% to 76.80%.CONCLUSION PDCA management mode plays an active role in the skin test management of cephalosporins and penicillins, which can significantly reduce irrational skin tests and promote rational drug use in clinic.