PDCA循环在抗菌药物管理难点中的应用研究
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摘要
目的探索PDCA循环在临床抗菌药物管理活动中的应用。方法应用PDCA循环,通过药品管控、完善制度、落实奖惩、软件研发、强化培训考核等措施手段,对联勤保障部队第901医院的抗菌药物管理作持续性干预。将2017年第1季度病历数据作为对照组(PDCA循环前),将2018年第1季度病历数据作为干预组(PDCA循环后),对二者Ⅰ类切口抗菌药物预防使用率、抗菌药物使用强度进行回顾性研究。结果抗菌药物使用强度由干预前的57.1DDDs/100人天下降至39.9DDDs/100人天;Ⅰ类切口手术预防使用抗菌药物比例由干预前的53.3%下降至干预后27.3%,差异均有统计学意义(P<0.01)。结论将PDCA循环应用于该院该轮抗菌药物临床应用专项整治活动中,难点指标明显改善。
Objective To explore the effect of PDCA intervention model on the process of antibacterial management in hospital.Methods The PDCA procedure was used to continuously intervene in the administration of antimicrobials in No.901 Hospital Joint Logistics Support Force,through drug control,perfecting system,implementing rewards and punishments,developing software,strengthening training.The medical records of the first quarter of 2017 were used as the control group(before the PDCA cycle),and the medical records of the first quarter of 2018 were used as the intervention group(after the PDCA cycle),and intensity of use of antimicrobial agents and the preventive usage rate of antibiotics in typeⅠincision operation of two groups were retrospectively studied.Results The intensity of use of antimicrobial agents declined from 57.1 DDDs/100 persons day to 39.9 DDDs/100 persons day,the preventive usage rate of antibiotics in typeⅠincision operation was dropped from 53.3% to 27.3%.The difference was statistically significant(P<0.05).Conclusion After the intervention of PDCA model on the management of antibacterial in the hospital,the antimicrobial application indexes improved significantly.
Objective To explore the effect of PDCA intervention model on the process of antibacterial management in hospital.Methods The PDCA procedure was used to continuously intervene in the administration of antimicrobials in No.901 Hospital Joint Logistics Support Force,through drug control,perfecting system,implementing rewards and punishments,developing software,strengthening training.The medical records of the first quarter of 2017 were used as the control group(before the PDCA cycle),and the medical records of the first quarter of 2018 were used as the intervention group(after the PDCA cycle),and intensity of use of antimicrobial agents and the preventive usage rate of antibiotics in typeⅠincision operation of two groups were retrospectively studied.Results The intensity of use of antimicrobial agents declined from 57.1 DDDs/100 persons day to 39.9 DDDs/100 persons day,the preventive usage rate of antibiotics in typeⅠincision operation was dropped from 53.3% to 27.3%.The difference was statistically significant(P<0.05).Conclusion After the intervention of PDCA model on the management of antibacterial in the hospital,the antimicrobial application indexes improved significantly.
引文
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[8]韩杰霞,杨秀萍.三级医院门诊药房实时审方系统应用前后效果分析[J].天津药学,2017,29(4):51-53.
[9] MCCARTHY K N,HAWKE A,DEMPSEYE M.Antimicrobial stewardship in the neonatal unit reduces antibiotic exposure[J].Acta Paediatr,2018,107(10):1716-1721.
[10]CHESTON B,CUNHA M D.Antimicrobial stewardship programs:principles and practice[J].Med Clin North Am,2018,102(5):797-803.
[11]FLEMING A,TONNA A,CONNOR S,et al.Antimicrobial stewardship activities in hospitals in Ireland and the United Kingdom:a comparison of two national surveys[J].Int J Clin Pharm,2015,37(5):776-781.
[12]苏海燕,胡俐.信息技术在合理用药管理工作中的应用研究[J].重庆医学,2014,43(31):4148-4150.
[2]尚天琼,李波,姜黎,等.采用PDCA循环法促进医院抗菌药物合理使用的成效分析[J].中国医院用药评价与分析,2016,16(3):411-413.
[3]齐秀萍,李小荣,张国如,等.手术抗菌药物使用核查表在规范围术期抗菌药物合理使用中的应用[J].2018,47(11):1528-1530.
[4]陈延杰,朱捷,管文婕,等.基于“军卫一号”的特殊使用级抗菌药物网络会诊平台的应用[J].东南国防医药,2016,18(2):213-215.
[5]苏颖杰,刘晓琰,崔敏,等.持续质量改进围术期抗菌药物使用成效[J].医药导报,2013,32(1):31-33.
[6]肖永红.抗菌药物合理使用技术支撑体系与建设[J].中国实用内科杂志,2012,32(12):973-976.
[7] O′DONNELL L A,GUARASCIO A J.The intersection of antimicrobial stewardship and microbiology:educating the next generation of health care professionals[J].FEMS Microbiol Lett,2017,364(1):281.
[8]韩杰霞,杨秀萍.三级医院门诊药房实时审方系统应用前后效果分析[J].天津药学,2017,29(4):51-53.
[9] MCCARTHY K N,HAWKE A,DEMPSEYE M.Antimicrobial stewardship in the neonatal unit reduces antibiotic exposure[J].Acta Paediatr,2018,107(10):1716-1721.
[10]CHESTON B,CUNHA M D.Antimicrobial stewardship programs:principles and practice[J].Med Clin North Am,2018,102(5):797-803.
[11]FLEMING A,TONNA A,CONNOR S,et al.Antimicrobial stewardship activities in hospitals in Ireland and the United Kingdom:a comparison of two national surveys[J].Int J Clin Pharm,2015,37(5):776-781.
[12]苏海燕,胡俐.信息技术在合理用药管理工作中的应用研究[J].重庆医学,2014,43(31):4148-4150.