Application Evaluation of Closed-loop Management Model in the Prevention of Antibiotics in Children’s Type I Incision

OBJECTIVE To evaluate the application effect of closed-loop management mode based on key index monitoring in improving the rationality of preventive medication for type I incision in children. METHODS From Jan. 2018 to Dec. 2021, all cases of type I incision in Hangzhou Children's Hospital were selected to evaluate the rationality of the preventive use of antibiotics, and the data of four key indicators, such as the rate of preventive use, the rational rate of drug selection, the rational rate of administration time and the duration. Based on the monitoring data before the improvement in 2018, analyzed the problems of irrational drug use and formulate corresponding countermeasures to implement the improvement. Took the monthly monitoring data as the main line, carried out various continuous quality improvement projects in real time, and compared the changes of key indicators before and after the improvement. RESULTS From 2018 to 2021, the drug use rates of class I incision prevention were 19.67%, 21.69%, 22.52% and 24.56% respectively. There was no significant decrease, but the use rates of other class I incision prevention decreased from 10.99% to 8.56%, 8.83% and 6.50%. The rational rates of selected drugs were 94.68%, 99.24%, 99.50% and 100.00% respectively. The rational rate of administration time increased from 80.85% to 89.31%, 99.00% and 99.66%, and the rational rate of medication course increased from 70.21% to 87.79%, 99.50% and 97.29%(P<0.05). CONCLUSION The closed-loop management mode based on key index monitoring can promote the rational use of antibiotics in the perioperative period of class I incision in children. It is feasible and worth popularizing.