周术期抗生素管理审查:俄俄州卫生医生医院门诊手术的分析
Rayyan Bhutta1, Thomas Shneker1, Samantha Currier2
1Medical School, Ohio University Heritage College of Osteopathic Medicine, Dublin, USA.
Cureus
|November 27, 2025
概括
遵守外科手术期间使用抗生素的时间准则非常低,增加了手术部位感染的风险. 实施系统层面的变化,如EHR集成的检查清单,可以提高合规性.
科学领域:
- 传染性疾病 传染性疾病
- 外科手术的安全性
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 术后抗生素预防对于预防手术部位感染 (SSIs) 至关重要.
- 最佳的抗生素疗效需要在手术切口前15-60分钟内给予.
- 与时间协议的偏差会增加SSI风险.
研究的目的:
- 评估遵守外科手术期间抗生素使用指导方针.
- 专注于时间,剂量,并根据外科手术类型在门诊机构的变化.
- 识别协议执行中的系统级漏洞.
主要方法:
- 在OhioHealth医生医院 (2018-2021) 进行448次门诊手术的回顾性研究.
- 从电子医疗记录中提取的数据.
- 分析包括抗生素类型,时间,剂量准确性和手术类型.
主要成果:
- 只有3.3%的患者在建议的切口前窗口内接受了抗生素.
- 内静脉推送 (IVP) 给药 (4.6%) 比输液 (0.7%) 更及时.
- 塞法索林是最常见的 (65.6%),88.8%是适当的体重调整剂量;按专业的时间遵守有显著差异 (0%至7.9%).
结论:
- 尽管进行了适当的选择和剂量,但外科手术期间的抗生素时间遵守率惊人地低.
- 在系统层面存在显著的工作流程和协议执行差距.
- 建议包括实时EHR警告,检查清单和简化管理以减少SSI.
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