在清洁手术中基于证据的抗生素预防:一种教育干预措施,以减少使用
Kevin M McKay1, Raoul Burchette2, Jiaxiao M Shi2
1Department of Orthopedic Surgery, Loma Linda University Health, Loma Linda, CA.
一个由外科医生领导的项目显著减少了手腕道释放手术中的抗生素预防,将使用量从51%降至14%. 这突显了在手术抗生素使用中实施基于证据的实践的障碍.
科学领域:
- 手术感染预防 手术感染预防
- 基于证据的医学基于证据的医学.
- 抗生素管理局 抗生素管理局
背景情况:
- 在干净手术中预防性使用抗生素缺乏确的证据.
- 外科医生经常使用抗生素,尽管其适用性有限.
- 手术后感染仍然是外科手术中的一个问题.
研究的目的:
- 评估一项旨在减少对干净手术的抗生素预防的计划.
- 为了确定继续使用预防性抗生素的原因.
- 评估干预对手腕道释放手术中抗生素处方的影响.
主要方法:
- 在一年内,在10个医疗中心实施了一项由外科医生领导的干预计划.
- 该计划包括外科医生教育和每月进行抗生素使用审计.
- 带道释放作为清洁手手术的代理来跟踪抗生素使用.
主要成果:
- 在干预一年中,抗生素预防的使用量从51%降至21%,在最后一个月达到14%.
- 糖尿病和年龄较大的外科医生与干预后更高的抗生素使用有关.
- 外科医生愿意开抗生素与患者的BMI和HbA1c水平相关.
结论:
- 一项由外科医生主导的倡议有效地减少了手腕道释放中的预防性抗生素使用.
- 确定了在手术抗生素预防中采用基于证据的实践的障碍.
- 患者因素和外科医生的看法影响了抗生素处方决定.
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