摘要
目的优化抗菌药物使用流程,保证连台手术术前预防性抗菌药物的合理使用。方法 2015年12月优化某院抗菌药物使用流程,选择2015年5—11月6 072例连台手术作为对照组,2015年12月—2016年5月5 832例连台手术作为实验组,比较两组抗菌药物的规范使用合格率,分析延迟/提前使用原因。结果抗菌药物使用流程优化前后抗菌药物使用率分别为77.16%、78.80%,两者比较,差异有统计学意义(χ~2=8.305,P=0.004)。抗菌药物使用流程优化后,抗菌药物0.5~1 h内使用率(82.36%)较优化前(41.11%)明显上升;距切皮时间<0.5 h抗菌药物使用率由优化前的57.11%下降至4.32%;但距切皮时间>1 h的抗菌药物使用率由1.78%增加至13.32%。连台手术抗菌药物使用延误/提前原因主要包括医护缺乏有效沟通导致巡回护士对连台手术间隔时间的评估欠准确(62.13%),麻醉医生插管或穿刺时间过长(13.57%)。结论优化流程,可以提高连台手术预防性抗菌药物0.5~1 h内使用率,有助于保障预防性应用抗菌药物的效果。
ObjectiveTo optimize antimicrobial use process,ensure the rational use of preoperative antimicrobial prophylaxis during consecutive operations.MethodsAntimicrobial use process in a hospital in December2015was optimized,6072cases of consecutive operations in May November2015were selected as control group,5832cases of consecutive operations in December2015May2016were as trial group,the qualified rate of rational use of antimicrobial agents was compared between two groups,causes for delayed/prior use was analyzed.ResultsBefore and after the optimization of antimicrobial use process,rates of antimicrobial use were77.16%and78.80%respectively,there was significant difference between two groups(χ2=8.305,P=0.004).After the optimization of antimicrobial use process,rate of antimicrobial use within0.5-1hour was significantly higher than that before the optimization(82.36%vs41.11%);rate of antimicrobial use<0.5hour before skin incision decreased from57.11%before optimization to4.32%after optimization;but rate of antimicrobial use>1hour before skin incision increased from1.78%to13.32%.Causes for delay/prior use of antimicrobial agents was due to the lack of effective communication between doctors and nurses,which resulted in circuit nurses’inaccurate assessment on interval of consecutive operations(62.13%),the duration of intubation or puncture was too long for anesthesiologists(13.57%).ConclusionOptimizing antimicrobial use process in consecutive operations can improve prophylactic antimicrobial use rate within0.5-1hour,and is helpful for ensuring the efficacy of antimicrobial prophylaxis.
作者
贺吉群
聂志芳
肖映平
吴卓珊
谢伏娟
HE Ji-qun;NIE Zhi-fang;XIAO Ying-ping;WU Zhuo-shan;XIE Fu-juan(Xiangya Hospital, Central South University, Changsha 410008, China)
出处
《中国感染控制杂志》
CAS
北大核心
2017年第12期1164-1168,共5页
Chinese Journal of Infection Control
关键词
连台手术
预防性应用抗菌药物
手术室
用药时机
consecutive operation
antimicrobial prophylaxis
operating room
opportunity of medication
