Ⅰ类切口管理软件应用前后手术预防用药的合理性比较

发布时间：2018-01-03 12:39

本文关键词：Ⅰ类切口管理软件应用前后手术预防用药的合理性比较　出处：《中国医院药学杂志》2016年18期 　论文类型：期刊论文

更多相关文章： Ⅰ类切口 抗菌药物 预防用药 HIS

【摘要】：目的:为加强围手术期预防性应用抗菌药物管理,通过信息手段干预Ⅰ类切口手术预防用药,开发"Ⅰ类切口手术抗菌药物管理系统",并评价其干预的有效性,为医院抗菌药物管理提供方法学参考。方法:按卫计委相关文件的要求,设计Ⅰ类切口手术围手术期抗菌药物使用控制流程,开发"Ⅰ类切口手术抗菌药物管理系统",并嵌入医院HIS,对Ⅰ类切口手术抗菌药物预防使用的指证、品种选择、给药时机、预防用药疗程等作了具体限制。采用回顾性方法对我院2014年第一季度(软件应用前)与2015年第一季度(软件应用后)3个科室(骨科、神经外科、心血管外科)的Ⅰ类切口手术预防用药的各项指标进行统计,分析实施干预前后Ⅰ类切口围手术期抗菌药物使用情况。结果:软件应用后(干预后)3个科室的Ⅰ类切口手术预防使用抗菌药物的比率显著下降(P0.01),由软件应用前(干预前)的84.08%(169/201)降至干预后的56.52%(117/207);药物选择合理率有了显著提高(P0.01),由干预前的48.52%(82/169)提高到了82.91%(97/117);术后疗程合理率显著提高(P0.01),从干预前的55.03%(93/169)提高到了95.73%(112/117)。对给药时机及单次给药剂量无影响。结论:临床药师通过"Ⅰ类切口手术抗菌药物管理系统"参与Ⅰ类切口围手术期抗菌药物预防应用管理,使得Ⅰ类切口手术不合理使用抗菌药物的现象明显改善,该管理软件设计合理,操作方便,成效显著。
[Abstract]:Objective: to strengthen the management of the application of antibacterial drugs in perioperative period, information by means of intervention in type I incision surgical prophylaxis, the development of "type I incision operation of antibacterial drug management system", and to evaluate the effectiveness of intervention, to provide a methodological reference for the management of antibacterial drugs in our hospital. Methods: according to the Planning Commission related documentation requirements the use of antibacterial drugs, control process design of type I incision "type I incision operation of antibacterial drug management system", and embedded into the hospital HIS, antimicrobial prophylaxis use evidence, of type I incision operation selection and dosing time, made specific restrictions prophylaxis treatment. Using retrospective method in our hospital in the first quarter of 2014 (before application software) and the first quarter of 2015 (after the 3 software application) (Department of cardiovascular surgery, Department of orthopedics, Department of Neurosurgery,) the index class I incision surgery to prevent medication For statistical analysis, implementation of the intervention before and after type I incision perioperative use of antimicrobial agents. Results: after the application of software (intervention) type I incision surgery in 3 sections of the antibiotic prophylaxis ratio decreased significantly (P0.01), a software application (before intervention) to 84.08% (169/201) after the intervention 56.52% (117/207); rational drug selection rate has significantly increased (P0.01), from 48.52% before intervention (82/169) to 82.91% (97/117); postoperative treatment and reasonable rate significantly increased (P0.01), from 55.03% before intervention (93/169) to 95.73% (112/117). The time of administration and the single dosage had no effect. Conclusion: clinical pharmacists' type I incision surgical antimicrobial management system "in type I incision perioperative prophylactic application of antimicrobial agents in the management of type I incision surgery is not rational use of antimicrobial drugs decreased, the management software The design is reasonable, the operation is convenient and the effect is remarkable.

【作者单位】：南京医科大学附属无锡市人民医院药剂科;乐清市妇幼保健院药剂科;南京医科大学附属无锡市人民医院信息处;
【分类号】：R954
【正文快照】： 目前,Ⅰ类切口围手术期不合理使用抗菌药物情况十分普遍,这些不合理使用导致的细菌耐药已成为全球严重的公共卫生问题[1-2]。外科手术预防使用抗菌药物一直是医院管理中的一个难题,卫生部相继制定了《抗菌药物临床应用指导原则》、《关于抗菌药物临床应用管理有关问题的通知(

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