抗菌药物专项整治对医院管理的成效分析及持续改进研究  

Effectiveness of antibiotics special rectification in hospital management and continuous improvement

作　　者：周歧骥 周惠芳[2] 韦贤[3] 刘承统[1] 何思陆[1] 

机构地区：[1]右江民族医学院附属医院药剂科,广西百色533000 [2]右江民族医学院附属医院感控科,广西百色533000 [3]右江民族医学院附属医院教学科研科,广西百色533000

出　　处：《中华医院感染学杂志》2016年第21期4971-4974,共4页Chinese Journal of Nosocomiology

基　　金：广西自然科学基金资助项目(2014GXNSFBA118147)

摘　　要：目的探讨医院实施抗菌药物专项整治活动成效与持续改进情况,为建立抗菌药物临床应用管理长效机制提供依据。方法采用回顾性分析方法,对2012年1-6月(整治前)、2012年7-12月(整治后)及2013年1月-2015年12月(持续改进阶段)的抗菌药物临床应用干预措施及用药情况进行统计分析。结果专项整治后,抗菌药物品种数由98种下降至49种;门诊抗菌药物使用率、门诊抗菌药物使用不合理率,住院抗菌药物使用率、Ⅰ类切口预防使用率、抗菌药物使用强度分别由整治前22.90%、4.21%、65.46%、43.56%、75.19DDDs/100人天下降到整治后17.30%、1.78%、52.80%、26.73%、46.38DDDs/100人天,抗菌药物用药结构发生明显变化;持续改进阶段各项干预指标及门诊用药情况保持良好,但住院使用强度及I类切口预防使用率仍小有波动。结论专项整治使抗菌药物临床应用趋于合理,但仍需进一步探索长效管理机制,促进临床持续规范应用抗菌药物。OBJECTIVE To explore the effectiveness of antibiotics special rectification activity and investigate the status of continuous improvement so as to provide guidance for establishment of long-term mechanism for clinical application and management of antibiotics. METHODS By means of retrospective analysis, the intervention meas- ures that were taken for clinical use of antibiotics from Jan 2012 to Jun 2012 （before the rectification）, from Jul 2012 to Dec 2012 （ after the rectification ）, and from Jan 2013 to Dec 2015 （continuous improvement stage）, as well as the status of use of antibiotics, were stiltistically analyzed. RESULTS The varieties of antibacterial drugs dropped from 98 to 49 after the special rectification. The utilization rate of antibiotics of outpatient department, rate of unreasonable use of antibiotics, utilization rate of antibiotics for hospitalization, rate of prophylactic use of antibiotics for type I incision surgery, and intensity of use of antibiotics respectively decreased from 22.90%, 4.21%, 65.46%, 43.56%, and 75.19 DDDs/100 patients per day before the rectification to 17.30%, 1.78%, 52.80 %, 26.73 %, and 46.38 DDDs/100 patients per day after the rectification. The structure of use of antibiot- ics changed significantly. The intervention indicators and use of antibiotics in outpatient department remained good during the continuous improvement stage, however, there were small fluctuations in the intensity of use of antibi- otics for hospitalization and the rate of prophylactic use of antibiotics for type I incision surgery. CONCLUSION The clinical use of antibiotics tends to be reasonable after the special rectification, however, the long-term manage- ment mechanisms need to be further explored so as to promote the continuous, standardized use of antibiotics.

关 键 词：抗菌药物管理 医院管理 抗菌药物干预措施 持续改进 

分 类 号：R194[医药卫生—卫生事业管理]