Preventing Surgical Infections Through Effective Perioperative Antibiotic Administration Project Team: Anesthesia Infect...
Opportunity Statement <ul><li>Surgical site infections are a major complication after surgery resulting in considerable mo...
Project Goals <ul><li>To achieve 100% compliance for targeted surgeries for the following measures: </li></ul><ul><li>Admi...
Most Likely Causes <ul><li>Accountability for process not clearly defined (surgeon, anesthesia, nurse) </li></ul><ul><li>V...
Solutions Implemented <ul><li>Developed and implemented guidelines and supporting documentation tools </li></ul><ul><ul><l...
Targeted Surgeries - per CMS & CDC guidelines <ul><li>Abdominal and Vaginal Hysterectomy </li></ul><ul><li>Hip and Knee R...
Antibiotics given within 60 minutes prior to incision have improved Percent of Patients Baseline 00 Nov 01 Feb 02 Apr 02...
Use of the appropriate antibiotic has improved significantly 98% 58% 86% 97% 50% 60% 70% 80% 90% 100% Nov-02 Jun-03 Sep-03...
Discontinuation of antibiotics within 24 hours has improved
Next Steps <ul><li>Share department specific results and explore opportunities to achieve 100% compliance with each measur...
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Preventing Surgical Infections Through Effective ...

Published on: Mar 4, 2016
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  • 1. Preventing Surgical Infections Through Effective Perioperative Antibiotic Administration Project Team: Anesthesia Infectious Disease Pharmacy Surgical Services Center for Clinical Effectiveness Loyola University Chicago LOYOLA UNIVERSITY HEALTH SYSTEM
  • 2. Opportunity Statement <ul><li>Surgical site infections are a major complication after surgery resulting in considerable morbidity, mortality, and resource utilization. Proper use of antibiotics – giving the right drug at the right time – is effective in preventing infections after surgery. </li></ul>
  • 3. Project Goals <ul><li>To achieve 100% compliance for targeted surgeries for the following measures: </li></ul><ul><li>Administer antibiotics within one hour before surgical incision </li></ul><ul><li>Administer the appropriate antibiotic </li></ul><ul><li>Stop antibiotics within 24 hours after surgery </li></ul>
  • 4. Most Likely Causes <ul><li>Accountability for process not clearly defined (surgeon, anesthesia, nurse) </li></ul><ul><li>Variation in physician ordering practices </li></ul><ul><li>Antibiotic not administered within recommended time intervals </li></ul><ul><li>Variability in documentation of antibiotic administration </li></ul>
  • 5. Solutions Implemented <ul><li>Developed and implemented guidelines and supporting documentation tools </li></ul><ul><ul><li>Surgical anti-microbial prophylaxis guidelines on the EMR </li></ul></ul><ul><ul><li>Unrestricting of vancomycin for penicillin allergic patients </li></ul></ul><ul><ul><li>Standardized documentation </li></ul></ul><ul><ul><li>Education for attendings, residents, CRNA’s, and nurses </li></ul></ul>
  • 6. Targeted Surgeries - per CMS & CDC guidelines <ul><li>Abdominal and Vaginal Hysterectomy </li></ul><ul><li>Hip and Knee Replacement </li></ul><ul><li>Cardiac Bypass </li></ul><ul><li>Other Cardiac surgery </li></ul><ul><li>Vascular surgery </li></ul><ul><li>Colon surgery </li></ul>
  • 7. Antibiotics given within 60 minutes prior to incision have improved Percent of Patients Baseline 00 Nov 01 Feb 02 Apr 02 May 02 Jul 02 Sep 02 Nov 02 Jun 03 Sep 03 Jan 04 50 60 70 80 90 100 110 UCL = 107.24 Mean = 88.1 LCL = 68.94 Project Started
  • 8. Use of the appropriate antibiotic has improved significantly 98% 58% 86% 97% 50% 60% 70% 80% 90% 100% Nov-02 Jun-03 Sep-03 Jan 04 Chart Review Time Percent of Patients
  • 9. Discontinuation of antibiotics within 24 hours has improved
  • 10. Next Steps <ul><li>Share department specific results and explore opportunities to achieve 100% compliance with each measure </li></ul><ul><li>Review and revise order sets as needed </li></ul><ul><li>Plan for public reporting of data </li></ul>

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