投稿分類 抗生素管制

主委發表種類: 壁報

投稿標題(中): 某醫學中心運用跨領域團隊組合式照護措施提升外科預防性抗生素使用之適當性

投稿標題(英): A multidisciplinary team care bundle for improvement the appropriateness of perioperative antibiotic prophylaxis in a Medical Center

投稿摘要: Objectives: To standardize the antimicrobial prophylaxis (AMP) during perioperative period of surgical operations in this hospital and explore reasonable measures of intervention.
Methods: Patients who underwent eight type I or II incisions in general surgery: including thyroid, breast, inguinal hernia repair surgery, total knee and total hip replacement, coronary artery bypass grafting surgery, caesarean section and hysterectomy were recruited. The patients dismissed from January 2011 to December 2013 were taken as pre-intervention group, and those in year 2014 and 2015 as post-intervention group. The collaborative approach included implementation of continuing in-service education; consensus building of the surgical teams; revising a standard protocol; building a medical information system; setting time-alarming devices; and develop a monitoring system. The rational of antibiotic prophylaxis between pre-intervention group and post-intervention group were compared control study.
Results: The correct rate of administrating the first dose of prophylactic antibiotics in our hospital after the solutions were implemented had increased from 77.9% to 98.9%, and 8.9% to 95.8% for the second doses. The percentage of patients who received antimicrobial prophylaxis for ＞24 h decreased from 12.0% to 4.9%, and the correct of doses of antibiotics given per patient increased from 95.4% to 98.4%. During the study period, a significant reduction in SSIs rates was detected (p ＜ .001).
Conclusions: The intervening measures improve effectively the reasonable use of antibiotic prophylaxis in clinic.

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