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Preventing Surgical Infections Through Effective Perioperative Antibiotic Administration. Project Team Members: Anesthesia Infectious Disease Pharmacy Surgical Services Center for Clinical Effectiveness. Opportunity Statement.

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preventing surgical infections through effective perioperative antibiotic administration

Preventing Surgical Infections Through Effective Perioperative Antibiotic Administration

Project Team Members:

Anesthesia

Infectious Disease

Pharmacy

Surgical Services

Center for Clinical Effectiveness

opportunity statement
Opportunity Statement
  • Current evidence and expert consensus call for administration of prophylactic antibiotic dosing within 60 minutes of surgical incision.
  • LUHS chart review showed that only 73% of cases received the initial antibiotic within 60 minutes of incision
  • Goal: To ensure that perioperative antibiotics are administered appropriately for all LUHS surgical patients
national focus cms cdc on reduction of surgical infections
National Focus (CMS/CDC) on Reduction of Surgical Infections

Performance Measures:

Prophylactic antibiotics within 1 hour before surgical incision (current LUHS measure)

Antibiotics consistent with current published recommendations (added LUHS measure –11/02)

Antibiotics are discontinued within 24 hours after the end of surgery (not measured at this time)

Recommended Surgeries:

CABG, Other Cardiac, Hip & Knee Arthroplasty, Colon Abdominal & Vaginal hysterectomy, Vascular

most likely causes
Most Likely Causes
  • Accountability for process is not clearly defined (Surgeon, Anesthesia, Nurse)
  • Variation in physician ordering practices
  • Order for antibiotic not written prior to surgery
  • Variable practices of anesthesiologist’s drug administration and documentation
solutions implemented
FY02 Activities

Project Team assembled

Literature review & data collection

Guideline & reference tools developed

Un-restriction of Vancomycin

Standardized documentation

Education of all providers

FY03 Activities

Guidelines on the EMR

Anesthesia record revised

Standard order sheets

Anesthesia department education

Shared results with departments

Solutions Implemented
next steps
Next Steps
  • Education of physicians regarding use of the correct antibiotic
  • Implement standard order sheet in SAC
  • Share results with individual departments
  • Measure use of antibiotics post-operatively
  • Review existing and new surgical order sets to ensure appropriate antibiotic prophylaxis