PDCA循环法用于胸外科抗菌药物使用管理的效果分析  

Effect analysis of PDCA cycle method for the management of antibacterial drug use in thoracic surgery

作　　者：桑文涛 吴瑶 尚天琼 郑琇山 陈志远 姜黎 SANG Wen-tao;WU Yao;SHANG Tian-qiong;ZHENG Xiu-shan;CHEN Zhi-yuan;JIANG Li(Pidu District People's Hospital,Chengdu 611730,Sichuan)

机构地区：[1]成都市郫都区人民医院,四川成都611730

出　　处：《中药与临床》2023年第3期73-78,共6页Pharmacy and Clinics of Chinese Materia Medica

基　　金：四川省哲学社会科学重点研究基地——四川医事卫生法治研究中心立项资助项目(编号:YF21-Q17)。

摘　　要：目的:探讨通过PDCA循环法提高胸外科住院患者抗菌药物使用合理性的应用效果。方法:调查我院胸外科2020年9月-2021年4月(干预前)住院患者抗菌药物使用情况,2021年5月-11月应用PDCA法对胸外科住院患者抗菌药物使用进行管理,对比干预前后胸外科住院患者抗菌药物收入占该科药品收入的比例、人均抗菌药物费用、抗菌药物使用率、抗菌药物使用强度、Ⅰ类切口手术患者预防使用抗菌药物比例、Ⅰ和Ⅱ类切口手术患者预防使用抗菌药物医嘱合理率、接受抗菌药物治疗前患者微生物检验标本送检率等指标变化情况。结果:干预后,胸外科住院患者抗菌药物收入占比、抗菌药物使用强度、Ⅰ类切口手术患者预防使用抗菌药物比例均显著下降(P<0.05),Ⅰ和Ⅱ类切口手术患者预防使用抗菌药物医嘱合理率均显著提高(P<0.05);接受抗菌药物治疗前患者微生物检验标本送检率呈增高趋势,人均抗菌药物费用呈下降趋势。结论:运用PDCA循环法对胸外科住院患者抗菌药物使用情况进行精准、持续化管理,可有效提高胸外科抗菌药物合理用药水平。Objective:To explore the application effect of PDCA cycle method to improve the rationality of antibacterial drug use in inpatients of thoracic surgery.Method:The use of antibacterial drugs in inpatients of thoracic surgery from September 2020 to April 2021(before intervention)was investigated,and PDCA method was used to manage the use of antibacterial drugs in inpatients of thoracic surgery from May to November 2021,comparing the index changes of the inpatients in thoracic surgery before and after intervention,including the proportion of antibacterial drug income in the drug income,the per capita cost of antibacterial drugs,the use rate of antibacterial drugs,the use intensity of antibacterial drugs,the proportion of prophylactic use of antibacterial drugs in patients with class Ⅰ incision surgery,the reasonable rate of medical advice for prophylactic use of antibacterial drugs in patients with class Ⅰ and Ⅱ incision surgery,and the submission rate of microbiological test specimens of patients before receiving antimicrobial treatment.Result:After intervention,the proportion of antibacterial drug income,the use intensity of antibacterial drugs,and the proportion of prophylactic use of antibacterial drugs in patients with class Ⅰ incision surgery were decreased significantly(P<0.05),and the reasonable rate of medical advice for prophylactic use of antibacterial drugs in patients with class Ⅰ and Ⅱ incision surgery was improved significantly(P<0.05).The submission rate of microbiological test specimens of patients before receiving antimicrobial treatment showed an increasing trend,and the per capita cost of antibacterial drugs showed a downward trend.Conclusion:Applying PDCA cycle method to accurately and continuously manage the use of antibacterial drugs in thoracic surgery inpatients can effectively improve the rational use level of antibacterial drugs in thoracic surgery.

关 键 词：PDCA管理法 抗菌药物 胸外科 围手术期 

分 类 号：R95[医药卫生—药学]