PDCA循环在围术期预防使用抗菌药物管理中的应用  

Application of PDCA circulation in perioperative antibiotics prophylaxis

作　　者：余金泉[1] 刘大钺[2] 杨永洁[2] 林澜溪[2] 黄美清[2] 陈虹[2] 

机构地区：[1]香港大学深圳医院内科,广东深圳518053 [2]中山大学附属第一医院医院感染管理科,广东广州510080

出　　处：《中华医院感染学杂志》2014年第14期3465-3467,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划基金资助项目(2008A030201029)

摘　　要：目的探讨PDCA循环在医院I类切口手术和介入治疗抗菌药物预防使用管理中的应用及意义,促进临床抗菌药物的合理使用。方法从2011年5月-2012年12月利用医院信息系统对Ⅰ类切口手术和介入治疗抗菌药物预防使用进行调查分析,根据PDCA循环制定干预计划、检查、总结,对应用PDCA循环前后Ⅰ类切口手术和介入治疗抗菌药物预防使用率进行统计分析,以2011年5-6月住院患者作为干预前组,2011年7-12月住院患者作为干预早期组、2012年1-6月住院患者作为干预中期组、2012年7-12月住院患者作为干预后期组。结果应用PDCA循环管理后,Ⅰ类切口手术和介入治疗抗菌药物预防使用率显著下降,分别从干预前的87.9%和78.5%下降至干预后期的33.9%、16.2%;第一、二代头孢菌素使用率、术前30min^2h给药时机合理率、24h和48h内使用率逐渐提高,分别从干预前的56.6%、37.8%、3.5%和13.0%提高至干预后期的95.7%、91.5%、34.8%和61.9%,差异均有统计学意义(P<0.01)。结论 PDCA循环在I类切口手术和介入治疗抗菌药物预防使用管理应用中持续改进效果显著。OBJECTIVE To explore the application of PDCA circulation in prophylactic use of antibiotics in the type I incision surgery and interventional therapy and analyze its clinical significance so as to promote the reasonable clinical use of antibiotics.METHODS From May 2011to Dec 2012,the antibiotic prophylaxis of the patients who underwent the type I incision surgery and interventional therapy was investigated by using hospital information system,the intervention program was developed according to the PDCA circulation so as to check out and summarize,the rate of prophylactic use of antibiotics was statistically analyzed before and after the implementation of PDCA circulation;the patients who were hospitalized from May to Jun 2011were assigned as the pre-intervention group,the patients who were hospitalized from Jul to Dec 2011as the early intervention group,the patients who were hospitalized from Jan to Jun 2012as the interim intervention group,the patients who were hospitalized from Jul to Dec 2012as the post-intervention group.RESULTS After the application of PDCA circulation,the utilization rate of prophylactic antibiotics in the type I incision surgery significantly decreased from 87.9% before the intervention to 33.9%after the intervention,and the utilization rate of prophylactic antibiotics significantly decreased from 78.5% before the intervention to 16.2% after the intervention.The utilization rate of the first and second generation cephalosporins increased from 56.6% before the intervention to 95.7%after the intervention;the rate of reasonable timing for medication at 30min-2hours before the surgery increased from 37.8%before the intervention to 91.5%after the interventions;the utilization rate of antibiotics within 24hours increased from 3.5% before the intervention to 34.8%after the intervention;the utilization rate of antibiotics within 48hours increased from 13.0% before the intervention to 61.9% after the intervention,and the differences were significant（P0.01）.CONCLUSIONThe PDCA circulation can ach

关 键 词：PDCA循环 围术期 Ⅰ类切口手术 介入治疗 抗菌药物 

分 类 号：R978.1[医药卫生—药品]