量化考核对围手术期抗菌药物预防性应用的影响

目的 评价量化考核对围术期抗菌药物预防性应用的影响.方法 选择2009-2011年第一季度出院病例,每月随机抽查各手术科室约10.0％当月出院病例,对围手术期抗菌药物应用情况进行质量考核,对是否按围手术期时机用药、用药是否＜3d、是否联合用药等进行量化考核,纳入全院综合目标考核中.结果 1704例手术患者,应用抗菌药物1687例,按围手术期时机使用抗菌药物比率大幅度提高,由2009年第一季度32.4％上升至2011年第一季度94.9％；术后使用抗菌药物＞3 d的使用率下降,由2009年第一季度100.0％下降为2011年1季度56,7％；联合用药使用率下降,由2009年第一季度35.2％下降为2011度年第一季度3.2％.结论 量化考核能改善围术期抗菌药物预防性应用,有效促进按围手术期时机使用抗菌药物,缩短预防用药时间,减少联合用药.

Impact of quantitative assessment on preventive use of antibiotics during perioperative period

OBJECTIVE To evaluate impact of quantitative assessment on preventive use of antibiotics during perioperative period.METHODS Around 10% of the total discharged patients from each surgical department every month between 2009 and 1st Quarter of 2011 were randomly selected and the quality of antibiotic use in perioperative period was assessed.Quantitative assessments were carried out on various aspects,including whether it was in the perioperative period that antibiotics were used,whether duration of the antibiotics usage was less than 3 days,and whether combination drug regimen was adopted.The results of the assessments were reviewed in hospital′s overall assessment.RESULTS Antibiotics were used in 1687 out of 1704 patients.Percentage of cases using perioperative-period antibiotics significantly increased from 32.4% in the 1st Quarter of 2009 to 94.9% in the 1st Quarter of 2011.Percentage of cases using antibiotics for more than three days after surgery decreased from 100.0% in the 1st Quarter of 2009 to 56.7% in the 1st Quarter of 2011.Combination drug use rate dropped from 35.2% in the 1st Quarter of 2009 to 3.2% in the 1st Quarter of 2011.CONCLUSION Quantitative assessments can improve the preventive use of antibiotics during perioperative period,promote the use of antibiotics in perioperative period,and reduce duration of preventive use as well as combination use of antibiotics.