中国医院用药评价与分析2025，Vol.25Issue(11)：1286-1290,5.DOI:10.14009/j.issn.1672-2124.2025.11.002
多部门联合运用FOCUS-PDCA模型在取消儿科头孢菌素类抗菌药物皮试中的实践研究
Application of FOCUS-PDCA Model Through Interdepartmental Collaboration to Standardize Cephalosporin Skin Testing in Pediatrics
摘要
Abstract
OBJECTIVE:To explore the management methods and outcomes of implementation of standardized cephalosporin skin testing policy in Pediatrics.METHODS:Under the leadership of the Pharmacy Department,the FOCUS-PDCA cycle was employed to establish the continuous quality improvement(CQI)team.Surveys were conducted among healthcare staff,Pareto charts and fishbone diagrams were utilized to identify and analyze challenges in implementing the standardized cephalosporin skin testing policy.Based on these findings,improvement plans were developed and executed.Based on the intervention process,the period from Aug.2021 to Nov.2022 was divided into two stages,namely before intervention(from Aug.2021 to Mar.2022)and after intervention(from Apr.to Nov.2022).Data were collected and analyzed statistically,including the number of pediatric patients receiving intravenous cephalosporins,skin testing rates,positive skin test rates,allergy rates,allergic manifestations,and the use of special-grade antibacterial drugs,the implementation effectiveness of the policy was assessed.RESULTS:From Aug.2021 and Nov.2022,a total of 11 036 children in Pediatrics received intravenous cephalosporins.The skin testing rate decreased significantly from 100％before intervention to 25.55％after intervention,with a reduction of 74.45％(P＜0.01).The positive rates of skin tests before and after intervention were respectively 3.26％and 2.72％,and the incidence rates of allergic reactions were respectively 0.34％and 0.41％,there was no statistically significant difference(P＞0.05).Allergic manifestations were predominantly rashes,with no severe allergic reactions reported.The usage rate of special-grade antibacterial drugs in Pediatrics dropped from 7.05％before intervention to 4.26％after intervention,with statistically significant difference(P＜0.01).Cost analysis revealed savings of approximately 10 300 RMB in direct costs after intervention,alongside reduction of about 2 446 h in patient waiting time,7 340 h in skin testing time,and 245 h in nursing time.Furthermore,team members demonstrated notable improvements in professional skills,team cohesion,and problem-solving capabilities.Pediatric healthcare staff also developed a deeper understanding of the purpose and significance of cephalosporin skin testing.CONCLUSIONS:During the process of implementing standardized cephalosporin skin testing policy,the FOCUS-PDCA model can rapidly and effectively reduce the rate of cephalosporin skin tests,save medical costs,improve the patients'medical experience,increase the rational use rate of antibacterial drugs,enhance team cohesion,and improve the quality of medical services.关键词
FOCUS-PDCA模式/皮试/头孢菌素/儿童Key words
FOCUS-PDCA model/Skin test/Cephalosporin/Children分类
医药卫生引用本文复制引用
张向辉,户晓婷,柳思宇,夏梦凡,刘婷,沈倩,王岩,张抗怀,余静洁..多部门联合运用FOCUS-PDCA模型在取消儿科头孢菌素类抗菌药物皮试中的实践研究[J].中国医院用药评价与分析,2025,25(11):1286-1290,5.基金项目
国家自然科学基金面上项目(No.72274153) （No.72274153）
陕西省药学会医院药学高质量发展研究项目(No.2023-1-1-5) （No.2023-1-1-5）
吴阶平基金会药物治疗专项(No.320.6750.2025-18-34) （No.320.6750.2025-18-34）
