MTP-KPI干预模式在患儿Ⅰ类手术切口预防使用抗菌药物中的应用评价

发布时间：2018-04-22 07:10

  本文选题：Ⅰ类手术切口 + 抗菌药物　； 参考：《中华医院感染学杂志》2017年16期

【摘要】：目的观察监测-培训-计划法(MTP)联合关键绩效指标法(KPI)干预模式在儿童Ⅰ类手术切口预防使用抗菌药物中的应用效果,进一步规范抗菌药物在围手术期的合理使用。方法将2014年1-12月的344例Ⅰ类手术切口患儿纳入对照组,2015年1-12月的456例Ⅰ类手术切口患儿纳入干预Ⅰ组,2016年1-12月的426例Ⅰ类手术切口患儿纳入干预Ⅱ组,根据对照组预防用抗菌药物的点评结果,建立清洁手术预防用抗菌药物的合理性评价指标(预防用药率、选用抗菌药物合理率、给药时机合理率、用药疗程合理率和术后感染率),干预Ⅰ组采用MTP干预模式,干预Ⅱ组采用MTP-KPI干预模式,比较干预前后合理性评价指标的改善情况。结果通过MTP-KPI模式干预,干预Ⅱ组Ⅰ类手术切口的预防用药率为9.86%,低于对照组37.79%,低于干预Ⅰ组14.25%,差异有统计学意义(P0.05);干预Ⅱ组的选用抗菌药物合理率、给药时机合理率、用药疗程合理率分别为95.24%、95.24%、88.10%,高于对照组0.8%、75.31%、72.38%,高于干预Ⅰ组58.46%,90.77%,86.15%,同时腹外疝手术的预防用药评价指标均有显著改善;对照组、干预Ⅰ组、干预Ⅱ组的术后感染率分别为0.29%、0.44%和0.23%,差异无统计学意义。结论 MTP-KPI干预模式对提高Ⅰ类手术切口预防用抗菌药物的合理性有显著效果,可行性高。
[Abstract]:Objective to observe the effect of monitoring, training and planning (MTP) combined with key performance index (KPI) intervention model in preventing the use of antimicrobial agents in children with type I surgical incision, and to further standardize the rational use of antibiotics in perioperative period. Methods 344 children with type I incision from January to December 2014 were included in the control group, 456 children with type I incision from January to December 2015 were included in the intervention group, 426 children with type I incision from January to December 2016 were included in the intervention group. According to the evaluation results of prophylactic antimicrobial agents in the control group, the rational evaluation index of prophylactic antimicrobial agents for clean surgery was established (the rate of prophylactic use, the rational rate of selecting antimicrobial agents and the reasonable rate of timing of administration). The reasonable rate of course of treatment and the postoperative infection rate were compared between the intervention group 鈪，

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