ABSTRACT
OBJE CTIVE To explore the rational application and management of antibiotics in burn department of our hospital based on disease diagnosis related groups （DRGs）. METHODS Patients discharged from the burn department of our hospital from July 2020 to June 2021 were selected as the research objects to collect DRG data. The overall application of antibiotics in DRG group with more than 10 cases were analyzed ，and the application of antibiotics in typical disease groups were evaluated horizontally and vertically. RESULTS Among 3 732 discharged cases in the burn department of our hospital ，a total of 3 515 cases were included in 66 DRG groups ，21 DRG groups of which were included in the study. Among 21 DRG groups ，the maximum antibiotics use density （AUD）of antibiotics was 102.20 DDDs/（100 person·d）in AH 11 group，the utilization ratio of antibiotics was 100％，and the combined use rate of antibiotics was 81.82％；case-mix index （CMI）value was 11.49. The minimum AUD was 1.01 DDDs/（100 person·d）in XR 19 group，the utilization ratio of antibiotics was 5.06％，and the combined use rate of antibiotics was 0；CMI value was 0.81. Within the same core group ，AUD increased with the increase of CMI. The horizontal comparison and analysis of WB 11 group showed that there was a large gap in AUD among different physicians. The vertical comparison of AUD in WB11 group showed relatively small changes over time. CONCLUSIONS The horizontal and vertical evaluation of antibiotics based on DRGs can provide new clues for the control of antibiotics and help to realize the fine specialized management of antibiotics.
ABSTRACT
Objective To study the effect of skin protective membrane, semi-transparent dressing and combination of the two in critically ill patients with incontinence associated dermatitis (IAD) skin protection. Methods A total of 114 patients who were admitted into ICU and NICU of Hebei Xingtai People′s Hospital from December 2013 to November 2014 were selected. These subjects were divided into 3 groups randomly. All three groups received routine skin care, on this basis, skin protective membrane group (34 cases) used skin protective membrane for skin protection, semi-transparent dressing group (40 cases) adopted semi-permeable dressing for skin protection, while the combination group (40 cases) used skin protective membrane combined with semi-transparent dressing for skin protection. The incidence, occurrence and severity of IAD in the three groups were compared. Results The incidence rate of IAD in the combination group was 20.0%(8/40), 20.6%(7/34) in the skin protective membrane group, and significantly lower than 47.5% (19/40) in the semi-transparent dressing group, the difference was significant ( χ2=9.201, P<0.05). The occurrence time of IAD in the combination group was (4.75±0.46) days, which was significantly longer than those of the skin protective membrane group [(3.86±1.35) days] and the semi-transparent dressing group [(2.74±0.73) days], the difference was significant (F=17.120, P < 0.05). The IAD severity of the combination group scored 3.63 ±0.92, which was significantly lower than those of the skin protective membrane group (5.29±1.11) and the semi-transparent dressing group (6.74±1.79), the difference was significant (F=12.240, P<0.05). Conclusions Skin protective membrane combined with semi-transparent dressing have priority in decreasing IAD incidence rate, and delaying the occurrence time of IAD, and relieving the severity of IAD, which is better than either of the two.
ABSTRACT
Objective To find a safer and more effective facial care method,reduce the incidence rate of facial skin injury,and improve patients' comfort level,as well as work efficiency of nursing.Methods 90 patients with orotracheal intubation were divided into the control group,transparent dressing group and skin protecting membrane group by random number table method.The control group was conducted with basic facial nursing;the transparent dressing group was applied with protective transparent dressing on the basis of basic facial nursing;the skin protecting membrane group was applied with skin protecting membrane on the basis of basic facial nursing.This research was conducted by observing and recording the incidence rate of skin injury,severity of skin injury,patients' comfort level,duration of skin care and the results.Results The incidence rate of facial skin injury was as follows:skin protecting membrane group 6.89％ (2/29)and transparent dressing group 15.15％(5/33)were better than the control group 50.00％(14/28),statistical significance was found among the three groups (X2=16.75,P ＜ 0.05);The times of facial skin nursing was as follows:the skin protecting membrane group (4.28±0.53) times was less than transparent dressing group (4.52±0.76) times and the control group (6.04±1.35) times,statistical significance was found among the three groups (Hc=32.65,P ＜ 0.05).Patients' comfort level comparison were as follows:the skin protecting membrane group was better than transparent dressing group and the control group,statistical significance was found among the three groups (Hc=22.42,P ＜ 0.05);Duration of skin care were as follows:skin protecting membrane group (10.40±1.35) minutes was less than transparent dressing group (14.09±1.27) minutes and the control group (12.35±1.28) minutes,statistical significance was found among the three groups (F=85.87,P＜ 0.05).Conclusions Skin protective membrane can effectively reduce the incidence and severity of facial skin injury on patients with orotracheal incubation,improve patients' comfort level,and greatly reduce operation time for nurses through its easer operation and less time consumption.