Research On The Application Of Reasonable Use Of Antibiotics In Quality Continuous Improvement Strategy In NICU

Objective: To explore the feasibility of applying the quality continuous improvement strategy of rational use of antibiotics(PDSA model)in hospitalized patients in NICU.Methods: In the first stage,the baseline data were collected,and the antibiotic utilization rate(AUR)and antibiotic use intensity(AUD)of inpatient in NICU of our hospital in2019 were summarized to determine the expected AUR and AUD,as improvement targets.In the second stage,the continuous improvement project of antibiotic quality was implemented,and the NICU inpatients in 2020 were included.During the improvement period,they were divided into two groups according to the order of admission.The intervention group was improved by PDSA mode,and the control group was treated according to the previous diagnosis and treatment routine.The observation indexes included: AUR,AUD,average length of hospital stay,the percentage of antibiotic cost in hospital drug cost,fungal infection rate,incidence of bronchopulmonary dysplasia(BPD),necrotizing enterocolitis(NEC)and other diseases.Whether the difference of observation index between the two groups was statistically significant.Results: In the intervention group,the AUR was 63%,the AUD was 41.90,the average length of hospital stay was7.28 ± 4.41 days,and the percentage of antibiotic cost in hospital drug cost was47.67±9.59%;in the control group,the AUR was 69.3%,the AUD was 46.75,the average length of hospital stay was 11.52 ± 5.06 days,and the percentage of antibiotic cost in hospital drug cost was55.38±9.94%.The AUR,AUD and the percentage of antibiotic cost in the hospitalization drug cost of the intervention group was shorter than the control group(p < 0.05).There was no significant difference in the average length of hospital stay,fungal infection rate,incidence of BPD and NEC between the two groups(p > 0.05).Conclusion: The implementation of quality continuous improvement strategy on rational use of antibiotics in NICU inpatients can reduce AUR and AUD,reduce the percentage of antibiotic costs in hospitalization costs,and do not increase the incidence of BPD,NEC and other diseases.