Sustained Improvement of Appropriateness in Surgical Antimicrobial Prophylaxis with the Application of Quality Control Circle

Jian Zou; Jia-Yun Zhong; Yan-Xin Liu; Yu Liu; Dan Huang; Bian-Tiao Xu; Xi-Wen Li; Wen-Jun Gong; Jia Tao

doi:10.2147/RMHP.S398692

Sustained Improvement of Appropriateness in Surgical Antimicrobial Prophylaxis with the Application of Quality Control Circle

Risk Manag Healthc Policy. 2023 Mar 9:16:347-356. doi: 10.2147/RMHP.S398692. eCollection 2023.

Authors

Jian Zou^#¹, Jia-Yun Zhong^#¹, Yan-Xin Liu¹, Yu Liu¹, Dan Huang¹, Bian-Tiao Xu¹, Xi-Wen Li¹, Wen-Jun Gong¹, Jia Tao¹

Affiliation

¹ Department of Clinical Pharmacy, The People's Hospital of Pengzhou, Chengdu, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in surgical antimicrobial prophylaxis (SAP) remains unknown. This study aimed to implement QCC interventions to improve the appropriateness of SAP.

Methods: A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulate corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied.

Results: The appropriateness of antibiotic prophylaxis before (January to December 2020) and after (January to December 2021) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The overall SAP appropriateness was significantly improved from 68.72% before QCC to 93.7% post QCC implementation (P<0.01). A significant improvement (P<0.05) was also determined for each category: selection (from 78.82% to 96.06%), duration (from 90.15% to 96.46%), indication (from 94.09% to 97.64%), timing of first dose (from 96.55% to 99.21%), antimicrobial usage (from 96.8% to 99.41%), re-dosing of antimicrobial (from 96.55% to 99.21%).

Conclusion: Implementation of a QCC program can optimize the use of antibiotics and improve the appropriateness of SAP and is of practical importance to their standardization.

Keywords: appropriateness; quality control circle; surgical antimicrobial prophylaxis.

Grants and funding

This work was supported by the grants from the project of Chengdu Municipal Health Commission (No.2020106 and 2022236), and the project of Sichuan Hospital Management and Development Research Center (No.SCYG2022-03).