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| FOCUS-PDCA循环法干预对Ⅰ类切口预防使用抗菌药物影响的回顾性分析 |
| Retrospective Analysis of Intervention of Prophylactic Antibiotics in Surgery with Type Ⅰ Incision with FOCUS PDCA Circulation |
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| DOI： |
| 中文关键词: FOCUS-PDCA循环法 医院评审等级 Ⅰ类切口 抗菌药物 预防使用 |
| 英文关键词:FOCUS PDCA circulation Hospital grade assessment Type Ⅰ incision operation Antibiotics Prophylactic use |
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| 中文摘要: |
| 摘 要 目的：以医院等级评审为契机，探讨某院Ⅰ类切口围手术期预防用药的管理方法，提高抗菌药物的应用合理性。方法：利用FOCUS PDCA循环法对Ⅰ类切口抗菌药物的预防使用进行干预，选取该院2015年1～12月全部Ⅰ类切口患者出院病例进行回顾性分析，根据干预进程分为4个阶段，对每一阶段的抗菌药物应用指标进行比较，评价围术期抗菌药物的合理使用改进效果。结果：与干预前比较，干预第三阶段的Ⅰ类切口预防用药比例从62.90%降至28.32%，术前给药时机合理率从50.1%升至71.0%，品种选择合理率由53.5%提高至79.5%，预防用药疗程合理率从26.8%上升至56.3%，差异均有统计学意义（P<0.01），而干预前后手术部位感染率无明显差异（P>0.05）。多项指标的好转促进了该院等级评审相关条款评分结果的提升。结论：医院等级评审中利用FOCUS PDCA循环法规范Ⅰ类切口围术期抗菌药物预防使用效果显著。 |
| 英文摘要: |
| ABSTRACT Objective:To describe the impact of interventions of the perioperative prophylactic antibiotic use in Type Ⅰ incision operations on improving result of grade accreditation of hospital as an opportunity. Methods:The FOCUS PDCA circulation was applied in the interventions of the perioperative prophylactic antibiotic use in Type Ⅰ incision operations. The patients who received Type Ⅰ incision operations from January 2015 to December 2015 were assigned into four stages: pre intervention stage, the 1st intervention cycle, 2nd intervention cycle and 3rd intervention cycle.The rationality of antibiotic use in Type Ⅰ incision operations was retrospectively analyzed and evaluated.Results:The study showed that the rate of antibiotic prophylaxis in Type Ⅰ incision operations was decreased from 62.90% to 28.32%, the reasonable rate of delivery time increased from 50.1% to 71.0%, the reasonable rate for the choice of the drug increased from 53.5% to 79.5%, and the reasonable rate of treatment course increased from 26.8% to 56.3% with highly significant difference between the 4 stages (P<0.01).But there was no significant difference of the percentage of surgical site infection (P>0.05). Achievements from the interventions contributed to enhancement of the hospital’s performance in grade assessment. Conclusion:FOCUS PDCA circulation had a positive influence to the promotion of the perioperative prophylactic antibiotic use in Type Ⅰ incision operations in hospital grade assessment. |
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