Optimization of process for standardizing antimicrobial use opportunity in consecutive operations

Abstract:

ObjectiveTo optimize antimicrobial use process, ensure the rational use of preoperative antimicrobial prophylaxis during consecutive operations.MethodsAntimicrobial use process in a hospital in December 2015 was optimized, 6 072 cases of consecutive operations in MayNovember 2015 were selected as control group, 5 832 cases of consecutive operations in December 2015May 2016 were as trial group, the qualified rate of rational use of antimicrobial agents was compared between two groups, causes for delayed/prior use was analyzed.ResultsBefore and after the optimization of antimicrobial use process, rates of antimicrobial use were 77.16% and 78.80% respectively, there was significant difference between two groups（χ2=8.305，P=0.004）. After the optimization of antimicrobial use process, rate of antimicrobial use within 0.5-1 hour was significantly higher than that before the optimization (82.36% vs 41.11%）; rate of antimicrobial use <0.5 hour before skin incision decreased from 57.11% before optimization to 4.32% after optimization; but rate of antimicrobial use >1 hour before skin incision increased from 1.78% to 13.32%. Causes for delay/prior use of antimicrobial agents was due to the lack of effective communication between doctors and nurses, which resulted in circuit nurses’ inaccurate assessment on interval of consecutive operations（62.13%）, the duration of intubation or puncture was too long for anesthesiologists（13.57%）.ConclusionOptimizing antimicrobial use process in consecutive operations can improve prophylactic antimicrobial use rate within 0.5-1 hour, and is helpful for ensuring the efficacy of antimicrobial prophylaxis.