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目的探索PDCA循环对普外科Ⅰ类切口清洁手术围手术期抗菌药物预防应用的管理成效。方法抽取本院普外科2009年7月~2010年6月Ⅰ类切口清洁手术病历作为对照组,2010年7月~2011年6月、2011年7月~2012年6月、2012年7月~2013年6月Ⅰ类切口清洁手术病历分别作为管理组1~3,应用PDCA循环管理抗菌药物的预防应用,采用卡方检验进行管理前后抗菌药物预防使用率、使用合理率及术后切口感染率的显著性检验,判断是否取得显著成效。结果通过PDCA循环管理,围手术期预防用抗菌药物使用率由99.23%下降至7.91%(χ2=13 890.16,P<0.001),使用合理率从0.77%上升至90.44%(χ2=13 571.10,P<0.001),术后切口感染率从0.77%下降至0.66%(χ2=7 547.58,P<0.001)。结论运用PDCA循环对普外科Ⅰ类切口清洁手术围手术期预防用抗菌药物进行管理,预防使用率显著下降,使用合理率显著上升,术后切口感染率显著下降,取得良好成效,今后应继续探索应用。
Objective To explore the management effect of PDCA circulation on prevention and application of perioperative antibacterials in general surgical incision Ⅰ clean incision. Methods The general surgical records of our hospital from July 2009 to June 2010 Ⅰ class incision cleaning surgery as a control group, July 2010 ~ June 2011, July 2011 ~ June 2012, July 2012 ~ June 2013 class I incision clean surgical records as the management group 1 to 3, the application of PDCA cycle management of antimicrobial prophylaxis applications, the use of chi-square test before and after the management of antimicrobial prophylaxis and use rate of rational use and incision infection rate The significance test to determine whether significant results achieved. Results According to the PDCA cycle management, the rate of perioperative prophylactic antibiotics decreased from 99.23% to 7.91% (χ2 = 13 890.16, P <0.001), and the rational use rate increased from 0.77% to 90.44% (χ2 = 13 571.10, P <0.001). Incision infection rate decreased from 0.77% to 0.66% (χ2 = 7 547.58, P <0.001). Conclusion The use of PDCA cycle for the management of perioperative prophylactic antimicrobials in general surgical resection of type Ⅰ incision has a significant decrease in the rate of prevention and treatment. The rational use rate is significantly increased, and the infection rate after incision incision is remarkably reduced. Good results have been achieved application.