PDCA循环管理在降低住院患者抗菌药物使用强度中的应用

Application of PDCA Cycle Management in Lowering the Antibiotics Use Density in Hospitalized Patients

目的:分析PDCA循环管理在降低医院住院患者抗菌药物使用强度(antibiotics use density,AUD)中的效果,为临床抗菌药物的合理使用提供参考。方法:选取2020年4月—6月实施PDCA循环管理前全院住院患者抗菌药物使用资料设为实施前组,2020年7月—2021年9月实施PDCA循环管理后全院住院患者抗菌药物使用资料设为实施后组,分析实施PDCA循环管理前后全院和各科室AUD的达标情况,以及全院抗菌药物使用率的变化情况。结果:在实施PDCA循环管理前,全院住院患者的AUD均在40以上,并且AUD不达标的科室占比始终在65.00%以上;在实施PDCA循环管理后的15个月内,除有1个月外,其他月份的全院AUD均在40以下,并且AUD不达标的科室占比也逐渐下降,最低至28.57%;此外,随着PDCA循环管理实施,全院住院患者的抗菌药物使用率也有呈下降趋势。结论:PDCA循环管理的实施,可以有效降低医院住院患者的AUD,并且达到国家规定的要求,还可以降低医院的抗菌药物使用率,从而促进临床抗菌药物的规范使用。

Objective:To analyze the effect of PDCA cycle management in lowering the antibiotics use density(AUD)in hospitalized patients in the hospital,and provide a reference for the clinically rational use of antibacterial drugs.Methods:The use data of antibacterial drugs in hospitalized patients in the whole hospital before the implementation of PDCA cycle management from April to June 2020 were set as the pre-implementation group,and the use data of antibacterial drugs in hospitalized patients in the whole hospital after the implementation of PDCA cycle management from July 2020 to September 2021 were set as the post-implementation group.The AUD conformance of the whole hospital and each department before and after the implementation of PDCA cycle management,and the changes in the use rates of antibacterial drugs in the whole hospital were analyzed.Results:Before the implementation of PDCA cycle management,the AUDs of hospitalized patients in the whole hospital were higher than 40,and the proportion of departments with AUD nonconformance was always more than 65.00%;within 15 months after the implementation of PDCA cycle management,except for one month,the AUDs of the whole hospital were less than 40 in other months,and the proportion of departments with AUD nonconformance decreased gradually,reaching a minimum of 28.57%;in addition,with the implementation of PDCA cycle management,the use rates of antibacterial drugs in hospitalized patients in the whole hospital also showed a downward trend.Conclusion:The implementation of PDCA cycle management can effectively reduce the AUD of hospitalized patients in the hospital to meet the national requirements;in addition,it can lower the use rate of antibacterial drugs in the hospital,thereby promoting the clinically standardized use of antibacterial drugs.