系统性医嘱干预提高术前无损备皮依从性

Systematic Medical Order Intervention to Improve Compliance of Preoperative Non-Destructive Skin Preparation

目的探讨系统性医嘱干预对提高术前无损备皮依从性的效果,以提升医院感染管理效率。方法北京市某三甲医院就术前无损备皮这一理念对全院医护人员在2013年进行了传统宣教干预,在2015年利用HIS中备皮医嘱选项进行系统性干预,然后从HIS系统导出干预前后的医嘱数据,分析干预后的依从性。结果 2012年至2017年间该医院共报告Ⅰ类切口手术153915例,在2013年进行传统宣教的干预后,该院Ⅰ类切口手术无损备皮率由2012年的4.58%上升至2013年的14.64%(P<0.05);2015年在系统性医嘱干预后,无损备皮率由2014年的16.47%上升至2015年的40.26%(P<0.05)。直至2017年该院无损备皮率达到59.81%。结论两种干预方法均提高了无损备皮率的依从性,系统性医嘱干预相对于传统宣教干预效果更显著。

Objective To explore the effect of systematic medical order intervention measures on preoperative non-destructive skin preparation order,improving the efficiency of hospital infection management.Methods The concept of non-destructive skin preparation before the operation of a three grade hospital in Beijing has carried out a systematic intervention on the individual intervention and the changes of the medical advice options of the HIS system in 2013 and 2015.The data of doctor’s orders before and after intervention were derived from the HIS system,and the effect of intervention was analyzed.Results A total of 153915 cases of type I incision operation between2012 to 2017.The rate of non-destructive skin preparation for type I incision surgery increased from 4.58%(2012)to 14.64%(2013)(P<0.05);After the systematic intervention in 2015,the rate of non-destructive skin preparation increased from 16.47%(2014)to 40.26%(2015)(P<0.05).The rate of non-destructive skin preparation reached 59.81%until 2017.Conclusion Two intervention methods all played an effective role,and the effect of systematic medical orders was more significant than traditional propaganda intervention.