摘要
目的研究一体化项目型(IPMT)管理模式对抗菌药物管理有效性。方法选取2011年11月1日-2012年10月31日Ⅰ类切口手术出院16 641例,逐月调查Ⅰ类切口手术围术期抗菌药物使用率、合理率(包括选药、疗程及术前给药时机均合理)以及手术部位感染率,并对同期59 951例住院抗菌药物使用率、使用强度、住院用药比例、治疗性抗菌药物微生物送检率进行调查。结果Ⅰ类切口手术抗菌药物使用率逐月下降,从2011年11月的50.35%下降至2012年10月的24.39%,同时合理率由80.13%上升至92.57%;Ⅰ类切口手术部位感染率0.19%～0.36%;同期住院抗菌药物使用率由57.31%下降至48.07%,抗菌药物使用强度由64.9DDD下降至49.8DDD;住院用药比例由35.44%下降至29.97%;治疗性使用限制类抗菌药物微生物送检率由60.78%提高至64.25%,治疗性使用特殊类抗菌药物微生物送检率由71.88%提高至84.65%;经检验手术部位感染率和治疗性使用限制类抗菌药物微生物送检率,差异无统计学意义,其他调查结果差异均有统计学意义(P<0.01)。结论IPMT管理模式可有效降低Ⅰ类切口手术抗菌药物使用率、提高合理率,同时有效降低住院抗菌药物使用率、使用强度以及用药比例,有效提高治疗性使用特殊类抗菌药物微生物送检率。
OBJECTIVE To study the effectiveness of integrated management portfolio team mode in the manage- ment of antimicrobial drug. METHODS Totally 16 641 cases with type I incision, who were discharged from Nov 1, 2011 to Oct 31, 2011, were enrolled in the study. A survey of perioperative use of antibacterial drug was car- ried out monthly to analyze the utilization rate of antibacterial drug, the rate of reasonable use of antibacterial drugs （including selection of drugs, course of antibiotic treatment and preoperative administration time）, and the incidence of surgical site infections, meanwhile, an investigation was conducted on 59951 hospitalized patients for the usage of antibacterial drugs, the intensity of use of antimicrobial agent, proportion of cost of antimicrobial drug, and the submission rate of microbial samples in use of therapeutic antibiotics. RESULTS The rate of periop- erative use of antibiotics in type I incision operation declined month by month, from 50.35% in Nov 2011 to 24.39% in Oct 2012, while the ratio of reasonable use of antibiotics increased from 80.13% to 92.57%. The inci- dence rate of the surgical site infections varied between 0.19% and 0.36% in type I incision operations. In the hospitalized patients during the same period,the utilization rate of antimicrobial drugs decreased from 57.31 % to 48.07%, the intensity of antimicrobial agents use reduced from 64.9DDD to 49.8DDD, and the proportion of anti- biotic durgs decreased from 35.44% to 29.97% in the hospital. The submission rate of microbial samples in use of therapeutic antibiotics increased from 60.78 % to 64.25 %, similarly it increased from 71.88 % to 84.65 % in ther- apeutic use of special antibiotics. After inspection, the difference in the submission rate of microbial sample inuse of therapeutic antibiotics or the incidence of surgical site infections was not statistically significant, while the difference in other findings was statistically significant （P〈0. 01）. CONCLUSION Integrated management portfo- lio team mode management can effectively reduce the utilization rate of antibiotics in type I incision operations, raise the rate of reasonable use of antimicrobial drug, effectively reduce the rate of antibacterial drugs cost in the hospital, reduce intensity of antibacterial drugs use, and effectively improve the submission rate of microbial sam- ple in therapeutic use of special antibiotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第7期1664-1666,共3页
Chinese Journal of Nosocomiology
基金
上海申康医院发展中心市级医院抗菌药物合理使用示范项目资助课题(SHDC2012605)
关键词
一体化项目型管理模式
抗菌药物
研究
Integrated management portfolio team
Antibacterial drugs
Research
