抗生素PPT课件（英文精品）Application of Six Sigma in a Surgical Infection Prevention .pptVIP

Six Sigma Methodology Challenges System and Structure Changes Level of Employee Computer Skills Multiple Information Systems Acquiring Raw Data Communication Across System Roles and Accountabilities Education Utilization of Trained Employee Resources Electronic Project Tracking Transition to Six Sigma Methodology Number of Surveys for VOC Application of Six Sigma in a Surgical Infection Prevention Project Six Sigma in Quality Initiatives Collaborative Quality Indicators Antibiotic given between 0-60 min. prior to incision (except Vancomycin 60-120) Patient given appropriate antibiotic Patient given appropriate antibiotic dose Perioperative temperature ? 360 C FIO2 ? 80% intraoperatively Blood Glucose 200mg intraoperatively Blood Glucose 200mg postoperatively for 48 hours Discontinuation of antibiotic within 24 hours of surgery stop time Surgical Site Infection (SSI) Account for 14-16% of all hosp-acq infections 2-5% of surgical patients will develop SSI 40 million operations annually in the U.S. 0.8 - 2 million SSI’s occur annually in the U.S. SSI increases LOS in hospital average 7.5 days Excess cost per SSI: *$2,734-26,019 (1985, US$) US national costs: $130-845 million/year Case Control* Study of 255 Pairs How Do You Define The Problem? Critical To Quality Indicators Patient given antibiotic 0-60 minutes prior to incision (Vancomycin 0-120 minutes) Patient given appropriate antibiotic (based on approved list) Patient given appropriate dose of antibiotic (increased dose if 90 kg)* Patient given redose of antibiotic if surgery greater than 4 hours* Building Team Member Buy-In How Do You Measure The Problem? Possible Causes for Defects Data Collection Plan How Do You Analyze The Problem? What did we want to know? Did prompting the physician for an antibiotic order improve meeting the appropriate antibiotic and dose indicators? Action Plan:Building Stakeholder Buy-In Summary of Causal Variables How Do You Improv