RCA法联合戴明循环管理模式对住院患者抗菌药物治疗前病原学送检率的影响  

Impact of the RCA method combined with the PDCA cycle management model on the rate of pathogenic delivery before antimicrobials treatment in hospitalized patients

作　　者：谢素霞 姜克文 黄欣欣 赵姗姗 展慧莉 XIE Su-xia;JIANG Ke-wen;HUANG Xin-xin;ZHAO Shan-shan;ZHAN Hui-li(Luoyang Oriental People's Hospital,Luoyang,Henan 471003,China)

机构地区：[1]洛阳市东方人民医院感染防控与公共卫生科,河南洛阳471003 [2]洛阳市东方人民医院神经外科,河南洛阳471003

出　　处：《中华医院感染学杂志》2024年第2期272-276,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建基金资助项目(LHGJ20220702);洛阳市医疗卫生指导性科技计划基金资助项目(2022041Y)。

摘　　要：目的分析根本原因分析法(RCA)联合戴明循环管理模式对住院患者抗菌药物治疗前病原学送检率的影响。方法选取河南省洛阳市某三级综合医院2021年4—6月治疗性使用抗菌药物的病例2454例作为对照组,2021年8月1日起采取RCA法联合戴明循环管理模式,2022年4—6月治疗性使用抗菌药物的病例2417例作为干预组,比较两组抗菌药物治疗前病原学送检率,包括不同级别抗菌药物、不同病原学项目及各类微生物及显微镜检查项目。结果干预组抗菌药物,限制级抗菌药物,特殊级抗菌药物治疗前病原学标本送检率分别为74.39%、74.50%、89.04%均高于对照组(P<0.001);9个临床科室中妇科除外,其余8个科室的住院患者治疗前病原学送检率均高于对照组(P<0.05);干预组各类病原学项目送检率及各类微生物培养及显微镜检查项目送检率均高于对照组(P<0.05)。结论RCA法联合戴明循环管理模式可有效提高住院患者抗菌药物治疗前病原学送检率。OBJECTIVE To analyze the impact of Root Cause Analysis(RCA)combined with the PDCA cycle man-agement model on the rate of pathogenetic delivery before antimicrobials treatment in hospitalized patients.METHODS 2,454 cases of therapeutic use of antimicrobial drugs in a tertiary general hospital in Luoyang City,Henan Province,from April to June 2021 were selected as the control group,and the RCA method combined with the PDCA cycle management mode was adopted from Aug.1,2021,and 2,417 cases of therapeutic use of antimi-crobial drugs from Apr.to June 2022 were selected as the intervention group,and the pathogenic delivery rate be-fore antimicrobials treatment was compared between the two groups,including different classes of antimicrobial drugs,different pathogenetic items and various types of microorganisms and microscopic examination items.RESULTS The rates of pre-treatment pathogenetic specimen delivery for antimicrobials,restricted antimicrobials,and special antimicrobials in the intervention group were 74.39%,74.50%,and 89.04%,respectively,which were higher than those in the control group at(P<0.001).In the nine clinical departments,except for gynecology,and the pathoge-nicity delivery rate before antimicrobials treatment in hospitalized patients in the remaining 8 departments was higher than that of the control group(P<0.05).The delivery rate of all types of pathogenetic items and all types of microbial cul-ture and microscopic examination items in the intervention group were higher than those in the control group(P<0.05).CONCLUSION The RCA method in combination with the PDCA cycle management model was effective in increas-ing the pathogenetic delivery rate before antimicrobials treatment in hospitalized patients.

关 键 词：病原学送检率 根本原因分析法 戴明循环管理模式 住院 抗菌药物 

分 类 号：R197.32[医药卫生—卫生事业管理]