DMAIC模式在规范Ⅰ类切口手术抗菌药物预防使用中的应用
Application of DMAIC procedure in the regulation of prophylactic use of antibiotics in type Ⅰ incision surgery
朱珊珊 1张可兴 1马明明 1张博2
作者信息
- 1. 黑龙江省医院,哈尔滨 150036
- 2. 黑龙江中医药大学附属第二医院,哈尔滨 150040
- 折叠
摘要
目的:分析DMAIC模式对Ⅰ类切口手术抗菌药物预防使用合理性的影响.方法:调取黑龙江省医院2022年1-11月Ⅰ类切口手术病历,作为非干预组.DMAIC模式持续干预6个月后,调取2023年6月—2024年4月Ⅰ类切口手术病历,作为干预组,比较两组的管理效果.结果:干预组抗菌药物预防使用率,用药指征、品种、给药时机、术中追加、疗程、给药方案的不合理率,不良反应总发生率及Ⅰ类切口手术部位感染率均低于非干预组,差异具有统计学意义(P＜0.05).干预后,注射用头孢唑林、克林霉素注射液构成比明显升高,差异具有统计学意义(P＜0.05);依替米星注射液、注射用头孢美唑构成比明显下降,差异具有统计学意义(P＜0.05);预防用药品种逐渐优化.结论:DMAIC模式能提高Ⅰ类切口手术抗菌药物预防性使用的合理性,提升管理质量,降低药品不良反应及Ⅰ类切口感染率,值得推广.
Abstract
Objective:To analyze the effect of DMAIC model on the rationality of prophylactic use of antibiotics in type Ⅰ incision surgery.Methods:Patients with type Ⅰ incision in our hospital from January to November of 2022 were selected as the non-intervention group.After 6 months of continuous intervention with DMAIC model,patients with type Ⅰ incision from June 2023 to April 2024 were recruited as the intervention group,and the management effects of the two groups were compared.Results:All the indicators like utilization rate of antibiotic prophylaxis,irrational rate of drug indication,variety,administration time,intraoperative addition,course of treatment,administration schedule,total incidence of adverse reactions and infection rate of type Ⅰ incision in the intervention group were lower than those in non-intervention group,and the differences were significant(P＜0.05).After the intervention,the composition ratio of cefazolin injection and clindamycin injection increased significantly,and the difference was statistically significant(P＜0.05).The composition ratio of etimicin injection and cefmetazole injection decreased significantly,and the difference was statistically significant(P＜0.05).The varieties of preventive drugs has been gradually optimized.Conclusion:DMAIC model can improve the rationality of prophylactic use of antibiotics in type Ⅰincision surgery,improve management quality,reduce adverse drug reactions and infection rate in class Ⅰ incision,which is worth promoting.
关键词
DMAIC模式/Ⅰ类切口手术/抗菌药物/预防性用药/围手术期Key words
DMAIC model/type Ⅰ incision surgery/antibiotics/prophylactic medication/perioperative period引用本文复制引用
基金项目
黑龙江省卫生健康委科研课题资助项目(20221313010659)
出版年
2024
NETL
NSTL
万方数据