手术室护士执行预防用抗菌药物流程管理的探讨  

Operating room nurses in executing process management of prophylactic use of antibiotics

作　　者：周学颖[1] 吴桂芬[1] 成昌霞[1] 

机构地区：[1]吉林大学中日联谊医院手术室,吉林长春130033

出　　处：《中华医院感染学杂志》2013年第11期2721-2722,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨手术室护士在术前使用抗菌药物时存在的护理问题,制定其执行流程,以提高护理质量。方法通过对800例手术患者术前使用抗菌药物调查,总结出存在的问题,找出可能发生差错的环节和原因,制定手术室预防用药标准流程并实施,比较实施流程前后情况。结果手术室护士预防应用抗菌药物标准流程实施前400例手术患者,其中切皮前30min内给药282例,手术时间>3h执行181例,失血>1500ml执行30例,执行合格率分别为70.5%、45.0%及45.0%;调查标准流程实施后手术患者400例,切皮前30min内给药384例,手术时间>3h320例,失血>1500ml的21例,执行合格率分别为96.0%、80.0%及84.0%,标准流程实施前后执行合格率差异有统计学意义(P<0.01)。结论术前应用抗菌药物存在一些护理问题,标准流程使护士工作更具条理性和计划性,可以加强抗菌药物合理用药的管理。OBJECTIVE To explore the problems of nursing by the operating room nurses during the preoperative use of antimicrobial drugs so as to develop the implementation process and improve the nursing quality. METHODS Totally 800 patients who took antibiotics before the surgery were investigated, the problems were found out, the links and causes leading to the problems were summarized, then the standard process for antibiotics prophylaxis in the operating room was established and implemented, and the effects before and after the implementation of the standard process were compared. RESULTS Of totally 400 patients who underwent the surgery before the implementation of the standard process for antibiotics prophylaxis, there were 282 cases who were given antibiotics within 30min before the skin incision, 181 cases who were the operation duration more than 3 hours implemented, and 30 cases who were with the blood loss more than 1500 ml implemented, the qualified rates of the implementation were 70. 5%, 45. 0%, and 45. 0%, respectively. Of totally 400 patients who underwent the surgery after the implemeiltation of the standard process for antibiotics prophylaxis, there were 384 cases who were given antibiotics within 30min before the skin incision, 320 cases who were the operation duration more than 3 hours implemented, and 21 cases who were with the blood loss more than 1500ml implemented, the qualified rates of the implementation were 96.0%, 80.0%, and 84.0%, respectively, the difference in the qualified rate of implementation between before and after the implementation of standard process was statistically significant（P〈0.01）. CONCLUSION There are certain problems in the nursing during the preoperative use of antibiotics, a reasonable and standard process enables the nurses a more rational and planned workflow, intensifying the administration of reasonable use of antibiotics.

关 键 词：手术室 预防 抗菌药物 执行流程 

分 类 号：R197.323[医药卫生—卫生事业管理]