Effect Evaluation of PDCA Cycle Management on Perioperative Prophylactic Application of Antibiotics in TypeⅠIncision Surgery of Orthopedics Department
10.6039/j.issn.1001-0408.2017.05.32
- VernacularTitle:PDCA循环管理干预骨科Ⅰ类切口手术围术期抗菌药物预防应用的效果评价
- Author:
Yane QIN
;
Hui ZHONG
;
Biao CHEN
;
Yinge LIANG
;
Huiling ZHANG
;
Guihuan JIANG
;
Junlin WU
- Keywords:
PDCA cycle management;
Orthopedics department;
TypeⅠincision surgery;
Perioperative period;
Antibiotics;
Prophylactic application
- From:
China Pharmacy
2017;28(5):690-693,694
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the effects of PDCA cycle management on perioperative prophylactic application of antibiotics in typeⅠincision surgery of orthopedics department. METHODS:In retrospective analysis,512 discharge medical records, 861 ones and 1 070 ones were selected from our hospital before PDCA cycle management(Jan.-Dec. 2013,before intervention group), after first cycle of PDCA cycle management (Jan.-Dec. 2014,first intervention group) and after second cycle of PDCA cycle management(Jan.-Dec. 2015,second intervention group),respectively. The perioperative prophylactic application of antibiotics was analyzed comparatively before and after continuous intervention. RESULTS:After 2 cycles of PDCA cycle management intervention, the constituent ratio of internal fixation in orthopedics department increased significantly;utilization ratio of antibiotics,the rate of rational type,medication ratio 0.5-1 h before surgery,the rate of rational treatment course,the proportion of antibiotics use in accordance with indications increased from 50.20%,98.08%,93.77%,6.61%,82.10% to 58.41%,100%,99.04%,52.00%, 99.04%,respectively. The number of antibiotics type decreased from 4 to 2;the proportion of cephazolin increased significantly while that of clindamycin decreased significantly compared to before intervention. Postoperative prophylactic medication course decreased from(4.63 ± 2.42)d to(1.61 ± 0.75)d;the proportion of patients with medication course <24 h or ranged 24-48 h increased significantly, while those with medication course>72 h decreased significantly, with statistical significance (P<0.05). CONCLUSIONS:PDCA cycle management improves the rational rate of perioperative prophylactic application of antibiotics in typeⅠincision surgery of orthopedics department in our hospital. The prophylactic medication course of our hospital is not yet fully controlled within 24 h so it should be further intervened.
