2012-2020年某院Ⅰ类切口手术围手术期预防用抗菌药物持续性综合规范管理实践及其效果  

Practice of persistent comprehensive standardized management of prophylactic use of antibiotics for typeⅠincision surgery patients during perioperative period in a hospital from 2012 to 2020 and its effect

作　　者：袁可欣 孙薇[1] 翟秀伟 刘净[2] 耿志伟[3] 石永丽[1] 张玉玺[4] 李杨[1] YUAN Ke-xin;SUN Wei;ZHAI Xiu-wei;LIU Jing;GENG Zhi-wei;SHI Yong-li;ZHANG Yu-xi;LI Yang(Daqing Oilfield General Hospital,Daqing,Heilongjiang 163001,China)

机构地区：[1]大庆油田总医院感染管理科,黑龙江大庆163001 [2]大庆油田总医院院长办公室,黑龙江大庆163001 [3]大庆油田总医院医务部,黑龙江大庆163001 [4]大庆油田总医院药学部,黑龙江大庆163001

出　　处：《中华医院感染学杂志》2024年第14期2149-2153,共5页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生健康委科研基金资助项目(20211515020208)。

摘　　要：目的 评价2012-2020年某院Ⅰ类切口手术围手术期预防使用抗菌药物持续性综合规范管理实践及其效果.方法 采取持续性综合规范管理措施,对Ⅰ类切口手术围手术期预防使用抗菌药物进行干预管理.对2011年1月1日-2020年12月31日大庆油田总医院Ⅰ类切口手术病例抗菌药物预防使用情况进行描述性分析.将对照组(2011年1月1日-12月31日)、1阶段干预组(2015年1月1日-12月31日)和2阶段干预组(2020年1月1日-12月31日)预防使用抗菌药物合理性及患者住院总费用及抗菌药物使用费用进行回顾性对比研究.结果 医院2011-2020年Ⅰ类切口手术预防用药使用率呈逐年下降趋势,下降了 34.13%(P<0.05).经过两阶段干预,术前给药时间在0.5~1 h的比例、药品选择合理性及溶媒选择合理性均不同程度提高(P<0.05),术后用药时间也趋于规范化.患者人均预防性使用抗菌药物费用呈下降趋势,人均预防性使用抗菌药物费用占患者人均住院总费用的比例也在逐渐减小(P<0.05).结论 通过医院顶层设计及指标制定到职能科室专项管理及反馈,再到临床科室执行及整改的闭环管理模式,运行临床抗菌药物预防应用的长效管理工作机制,使Ⅰ类切口手术抗菌药物预防使用向规范化、合理化逐渐转变,临床抗菌药物合理使用水平逐渐提升,同时减少了患者的住院费用.OBJECTIVE To evaluate the practice of persistent comprehensive standardized management of prophy-lactic use of antibiotics for typeⅠincision surgery patients during perioperative period in a hospital from 2012 to 2020 and observe its effect.METHODS The persistent comprehensive standardized management measures were taken to intervene the prophylactic use of antibiotics for the typeⅠincision surgery patients during perioperative period.The descriptive analysis was performed for the typeⅠincision surgery patients who were treated with an-tibiotics prophylaxis in Daqing Oilfield General Hospital from Jan 1,2011 to Dec 31,2020.A retrospective com-parative study was conducted for rationality of prophylactic use of antibiotics,total cost of hospitalization and cost of antibiotics among the control group(from Jan 1,2011 to Dec 31,2011),the stage 1 intervention group(from Jan 1,2015 to Dec 31,2015)and the stage 2 intervention group(from Jan 1,2020 to Dec 31,2020).RESULTS The rate of prophylactic use of antibiotics for type incision surgery showed a downward trend from 2011 to 2020 and dropped by 34.13%(P<0.05).The proportion of patients with drug administration time ranging between 0.5 and 1 hour before the surgery,rationality of selection of drugs and rationality of selection of menstruum were im-proved to a various degree after the two stages of intervention(P<0.05).The postoperative medication time tren-ded to be standardized.The per capita cost of prophylactic use of antibiotics showed a downward trend,and the proportion of the per capita cost of prophylactic use of antibiotics among the per capita of total hospitalization cost also showed a downward trend(P<0.05).CONCLUSION The top-level design,formulation of indexes,special management and feedbacks from functional departments,execution of clinical departments,closed-loop manage-ment model of rectification and long-term management and working mechanisms for prophylactic use of antibiotics has made the prophylactic use of antibiotics for type I incision surgery

关 键 词：Ⅰ类切口手术 抗菌药物 围手术期 持续性综合管理措施 效果 

分 类 号：R197[医药卫生—卫生事业管理]