PDCA循环管理干预Ⅰ类切口手术预防使用抗菌药物的效果分析  

Analysis on the Effectiveness of Prophylactic Utilization of Antibiotics in TypeⅠIncision Surgeries Intervened by Two PDCA Cycles Management

作　　者：徐小芳[1] 刘敏[1] 朱春黎[1] 康圆超 

机构地区：[1]上海市第二人民医院药剂科,上海200011

出　　处：《中国药房》2015年第17期2426-2428,共3页China Pharmacy

摘　　要：目的:评价PDCA循环管理干预Ⅰ类切口手术预防使用抗菌药物的效果。方法:采用回顾性分析方法,抽取我院PDCA循环管理干预前(2011年1-6月)225份,第一轮PDCA循环管理干预后(2012年1-6月)211份,第二轮PDCA循环管理干预后(2013年1-6月)157份Ⅰ类切口手术出院病历,对比分析持续干预前后抗菌药物预防使用情况。结果:经过两轮PDCA循环管理干预,我院清洁手术围术期抗菌药物使用率由90.67%下降至25.48%(P<0.05);总预防用药时间≤24 h比例由干预前的31.37%提高至50.00%(P<0.05);抗菌药物品种数由干预前的20种下降至5种,二联联合预防用药率由5.88%下降至2.50%,选用第三代头孢菌数的比例由6.48%下降至0,人均抗菌药物总费用占药品总费用的比例也由14.26%降至4.16%。干预前后以上指标比较差异均具有统计学意义(P<0.05)。结论:PDCA循环应用于Ⅰ类切口手术围术期抗菌药物应用的管理是有效的,能持续促进抗菌药物的合理使用。OBJECTIVE： To evaluate the effectiveness of prophylactic application of antibiotics in type I incision surgery. METHODS： 225 records of type I incision surgery during Jan.-Jun. 2011 （group of before PDCA cycle mmaagement intervention） in our hospital, 211 records during Jan.-Jun. 2012 （group of after the first PDCA cycle management intervention） and 157 records during Jan.-Jun. 2013 （group of after the second PDCA cycle management intervention） were randomly collected and retrospectively an- alyzed to compare and analyze the utilization of antibiotics before and after continuous intervention. RESULTS ： After 2 PDCA cy- cles management intervention, the utilization rate of perioperative antibiotics in clean surgery in our hospital was decreased from 90.67% to 25.48% ; the ratio of total prophylactic medication time for no more than 24 h was increased from 31.37% to 50.00% （P〈0-05） ; the varieties of antibiotics were decreased from 20 to 5, the rate of bivalent combination of prophylactic application was decreased from 5.88% to 2.50% and the ratio of selecting third-generation cephalosporin was decreased from 6.86% to 0. The ratio of per capita total cost of antibiotics in the total cost of drugs was decreased from 14.26% to 4.16%. CONCLUSIONS： PDCA cy- cles is effective in the management of perioperative antibiotics utilization in type I incision surgery and can continuously improve the rational use of antibiotics.

关 键 词：PDCA循环 抗菌药物 干预 

分 类 号：R969.3[医药卫生—药理学]