持续质量改进对Ⅰ类切口手术患者围术期预防性使用抗菌药物的效果分析  

Effect of continuous quality improvement on perioperative antibiotic prophylaxis of patients undergoing typeⅠincision surgery

作　　者：洪怡[1] 顾晓红[1] 徐燕丰[1] 虞建华[1] 张国伟[1] 徐茹[1] 

机构地区：[1]上海中医药大学附属市中医医院感染管理科,上海200071

出　　处：《中华医院感染学杂志》2015年第11期2465-2467,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81202958)

摘　　要：目的了解医院Ⅰ类切口手术患者围术期预防性使用抗菌药物情况,探讨持续质量改进对规范Ⅰ类切口手术围术期预防性使用抗菌药物的作用。方法回顾性调查医院2011年1-3月的Ⅰ类切口手术患者168例临床资料,分析其预防用药合理性,作为医院基线数据,通过基线数据,找出Ⅰ类切口手术围术期预防性使用抗菌药物存在的主要问题,实施持续质量改进措施,并对2012年1-3月、2013年1-3月进行评价、反馈。结果通过持续质量改进,Ⅰ类切口手术围术期预防性抗菌药物使用率从81.55%下降至25.48%,差异有统计学意义(P<0.01);抗菌药物选择合理率从53.57%上升至99.52%,差异有统计学意义(P<0.01);疗程合理率从50.60%上升至95.19%,差异有统计学意义(P<0.01);2011年1-3月Ⅰ类切口手术围术期预防性使用抗菌药物137例,2012年1-3月、2013年1-3月分别为使用81、53例。结论通过持续质量改进,规范了Ⅰ类切口手术围术期预防性使用抗菌药物。OBJECTIVE To understand the status of perioperative antibiotic prophylaxis of the patients undergoing type Ⅰ incision surgery and explore the effect of continuous quality improvement on the antibiotic prophylaxis during the perioperative period of type Ⅰ incision surgery .METHODS The clinical data of 168 patients who underwent the type Ⅰ incision surgery from Jan 2011 to Mar 2011 were retrospectively investigated , the rationality of antibiotic prophylaxis was analyzed and served as the baseline data ;the major problems in the perioperative antibiotic prophylaxis were find out through the baseline data ,the measures of continuous quality improvement were taken ,and the effects were evaluated and fed back in Jan -Mar ,2012 and in Jan-Mar ,2013 . RESULTS Through the continuous quality improvement ,the rate of prophylactic use of antibiotics during the perioperative period of type Ⅰ incision surgery dropped from 81 .55% to 25 .48% ,and there was significant difference （P〈0 .01）;the rate of reasonable use of antibiotics increased from 53 .57% to 99 .52% （P〈0 .01）;the rate of reasonable treatment course increased from 50 .60% to 95 .19% （P〈0 .01） .There were 137 patients who used prophylactic antibiotics during the perioperative period of type Ⅰ incision surgery in Jan -Mar ,2011 ,81 cases in Jan‐Mar ,2012 ,and 53 cases in Jan -Mar ,2013 .CONCLUSIONS The continuous quality improvement may contribute to the standard prophylactic use of antibiotics during the perioperative period of type Ⅰ incision surgery .

关 键 词：持续质量改进 Ⅰ类切口手术 围术期 抗菌药物 

分 类 号：R978.1[医药卫生—药品]