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目的:评价PDCA循环法在医院临床合理使用抗菌药物规范化管理中的作用,为有效遏制细菌耐药,合理控制医疗费用,保证医疗质量和医疗安全提供参考。方法:利用HIS信息系统对近五年内医院抗菌药物使用现状与各项指标进行回顾性对比分析。结果:应用PDCA循环法管理后,医院抗菌药物临床使用各项指标基本达标,个别指标接近目标值;住院患者抗菌药物使用率从原来的81.37%降至50.32%(指标为≤60%);门诊患者抗菌药物处方百分率从原来的32.25%降至16.57%(指标为≤20%);住院患者中抗菌药物治疗的微生物检验样本送检率由原来的13.00%升至56.20%(指标为≥30%);抗菌药物使用强度虽然未达标,但从105.07 DDDs降至45.69 DDDs(指标为<40DDDs);I类切口抗菌药物预防使用率由原来的100%降至39.79%,已明显下降等等;改善总幅度为37.63%~332.31%。结论:PDCA循环法用于医院临床合理使用抗菌药物管理效果较为显著,也可适用于其他合理用药的监控。
OBJECTIVE: To evaluate the role of PDCA circulation in the standardized management of clinical rational use of antimicrobial agents in hospitals and to provide reference for effectively curbing bacterial resistance, controlling medical expenses reasonably, ensuring medical quality and ensuring medical safety. Methods: Using HIS information system in the past five years, the use of antimicrobial drugs and the status of the indicators were retrospectively analyzed. Results: After the administration of PDCA cycle, the indexes of clinical use of antimicrobial agents in hospitals were basically up to standard, and the individual indexes were close to the target values. The inpatients’ antimicrobial use rate dropped from 81.37% to 50.32% (index ≤60%); The percentage of patients receiving antimicrobial prescriptions dropped from 32.25% to 16.57% (index ≤20%). The rate of screening samples for antimicrobial treatment in inpatients rose from 13.00% to 56.20% (index ≥30% ). Although the strength of antibacterials did not reach the standard, the intensity of antimicrobial use dropped from 105.07 DDDs to 45.69 DDDs (index <40DDDs); the preventive use of Class I incision antimicrobials dropped from 100% to 39.79% The total range of 37.63% ~ 332.31%. Conclusion: PDCA circulating method for clinical rational use of antimicrobial agents in clinical management more significant effect, but also can be applied to the monitoring of other rational use of drugs.