应用项目化管理模式提高病原学送检率

目的 通过应用项目化管理模式，提高住院患者病原学送检率。方法 选取某三级甲等综合性医院2022年1—12月份治疗性使用抗菌药物的住院患者为研究对象，其中1—6月份为对照组，7—12月份为干预组。干预组运用项目化管理模式处理，包括项目启动、计划、执行、监控、收尾5个阶段实施，比较干预前后两组患者病原学送检相关监测指标。结果 共调查治疗性使用抗菌药物的住院患者35 488例，其中对照组15 536例，干预组19 952例。病原学送检率干预组较对照组提高(69.52%VS 44.10%),差异有统计学意义(P<0.001),目标达成率为430.85%,进步率为57.64%。两组住院患者抗菌药物治疗前病原学送检率、抗菌药物使用率、抗菌药物使用强度、多重耐药菌检出率除耐碳青霉烯类肠杆菌(CREC)、耐甲氧西林金黄色葡萄球菌(MRSA)外]比较，差异均有统计学意义(均P<0.05)。相关标志物检查的送检率干预后较干预前提高(53.61%VS 25.01%),增长率达114.35%,高于微生物培养及显微镜检查、免疫学检测及其他检测项目的增长。干预后抽查的87例送检降钙素原(PCT)/白...

Improving the pathogen detection rate through project-based management mode

Objective To improve the pathogen detection rate through project-based management mode. Methods Hospitalized patients who received therapeutic antimicrobial treatment in a tertiary first-class hospital from January to December 2022 were selected as the research subjects. The control group comprised patients from January to June, while the intervention group consisted of patients from July to December. The intervention group adopted a project-based management mode with five stages, including project initiation, planning, execution, monitoring, and closure. The monitoring indicators related to pathogen detection were compared between the two groups of patients before and after the intervention. Results A total of 35 488 hospitalized patients received therapeutic antimicrobial agents were investigated, with 15 536 patients in the control group and 19 952 in the intervention group. Pathogen detection rate in the intervention group was higher than that in the control group (69.52% vs 44.10%), with a statistically significant difference (P < 0.001). The goal achievement rate was 430.85%, and the improvement rate was 57.64%. There were statistically significant differences (all P < 0.05) between the two groups of patients in terms of the pathogen detection rate before antimicrobial use, antimicrobial use rate, antimicrobial use intensity, and the detection rate of multidrug-resistant organisms (except carbapenem-resistant Enterobacteriaceae and methicillin-resistant Staphylococcus aureus). The detection rate of relevant biomarkers increased after intervention (53.61% vs 25.01%), with a growth rate of 114.35%, higher than the growth rates of microbial culture, microscopy examination, immunological detection, and other detection items. Among the 87 cases underwent procalcitonin (PCT)/interleukin-6 (IL)-6 detection after the intervention, 17.24% were detected >3 days before therapeutic antimicrobial use. Among the 68 cases underwent microbial culture after the intervention, 20.59% were detected >3 days before therapeutic antimicrobial use. Conclusion The application of a project-based management mode can improve the pathogen detection rate in hospitalized patients. However, attention should be paid to the quality management of pathogen detection.