Improving intraoperative administration of surgical antimicrobial prophylaxis: a quality improvement report

Abstract

Despite widespread adoption of the Surgical Care Improvement Programme, the incidence of surgical site infections (SSIs) remains high. It is possible that lapses in appropriate administration of antimicrobial prophylaxis may play a role. We noted significant discordance with national guidelines with regards to intraoperative antibiotic administration at our institution, leading to implementation of a quality improvement initiative using multidisciplinary education and reminder-based interventions to improve prescribing practices and increase compliance with national guidelines. We observed a significant improvement in adherence to all aspects of antibiotic administration guidelines as a result of such interventions. Targeted multidisciplinary interventions may help improve prescribing practices of surgical antimicrobial prophylaxis and provide an opportunity to potentially decrease the burden of SSI and the related morbidity and mortality.

Keywords: antibiotic management; infection control; quality improvement; surgical wound infection.

Figure 1

Preintervention and revamped surgical safety checklist posters depicting the inclusion of choice, dose and re-dosing intervals for antibiotics in the ‘time out’ process. SCD, sequential compression device; DVT, deep vein thrombosis; ID, identity; H&P, history and physical examination; HCG, human chorionic gonadotropin

Figure 2

Poster depicting correct weight-based dosing and re-dosing intervals of commonly used antibiotics.

Figure 3

Adherence to guidelines between the preintervention and postintervention patient groups.