Adherence to surgical antibiotic prophylaxis remains a challenge despite multifaceted interventions
Background Adherence to prophylactic antibiotics guidelines is challenging and poorly documented. We hypothesized that a multiphase, multifaceted quality improvement initiative would engage relevant stakeholders, address known barriers to adoption, and improve overall adherence. Methods From 2011 to...
Gespeichert in:
| Veröffentlicht in: | Surgery 2015-08, Vol.158 (2), p.413-419 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 419 |
|---|---|
| container_issue | 2 |
| container_start_page | 413 |
| container_title | Surgery |
| container_volume | 158 |
| creator | Putnam, Luke R., MD Chang, Courtney M., BA Rogers, Nathan B., BA Podolnick, Jason M., BS Sakhuja, Shruti, BS Matusczcak, Maria, MD Austin, Mary T., MD, MPH Kao, Lillian S., MD, MS Lally, Kevin P., MD, MS Tsao, KuoJen, MD |
| description | Background Adherence to prophylactic antibiotics guidelines is challenging and poorly documented. We hypothesized that a multiphase, multifaceted quality improvement initiative would engage relevant stakeholders, address known barriers to adoption, and improve overall adherence. Methods From 2011 to 2014, a series of interventions were introduced in the pediatric operating rooms. After each interventional period, prospective assessments were performed to record the antibiotic type, dose, timing, and redosing according to the guidelines. Perioperative factors that may influence guideline adherence were analyzed. Spearman's rank correlation, analysis of variance, and χ2 tests were performed. Results A total of 1,052 operations were observed, and 629 (60%) required prophylactic antibiotics. Adherence to all 4 guideline components remained unchanged (54−55%, P = .38). Redosing significantly improved (7−53%, P = .02), but correct type decreased (98−70%, P |
| doi_str_mv | 10.1016/j.surg.2015.04.013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1693732060</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0039606015003049</els_id><sourcerecordid>1693732060</sourcerecordid><originalsourceid>FETCH-LOGICAL-c481t-46dbae64783c4c7ec735191e407e53fd61359bf2a1eb4954203403b47ea0f3353</originalsourceid><addsrcrecordid>eNp9kU1v1DAURS0EotPCH2CBvGST8Bx_ZCIhpKoCilSpC8racpyXjgfHGWynYv59HU1hwaIre3HvkX0uIe8Y1AyY-riv0xLv6waYrEHUwPgLsmGSN1XLFXtJNgC8qxQoOCPnKe0BoBNs-5qcNQqk4KzdEHs57DBisEjzTFees8ZTE7Lr3ZydpYc4H3ZHb_64RCNOxoVEDbU74z2Ge6QDpoPLSKfFZzcaixkH6kLG-ICFMof0hrwajU_49um8ID-_frm7uq5ubr99v7q8qazYslwJNfQGlWi33Arbom25ZB1DAS1KPg6Kcdn1Y2MY9qKTogEugPeiRQMj55JfkA8nbnny7wVT1pNLFr03AeclaaY63vKm-CjR5hS1cU4p4qgP0U0mHjUDvcrVe73K0KtcDUIXuaX0_om_9BMO_yp_bZbAp1MAyy8fHEadrFvdDi6izXqY3fP8z__VrXdh3eMXHjHt5yWG4k8znRoN-sc677ouk-UGouOPMY6hSA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1693732060</pqid></control><display><type>article</type><title>Adherence to surgical antibiotic prophylaxis remains a challenge despite multifaceted interventions</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Putnam, Luke R., MD ; Chang, Courtney M., BA ; Rogers, Nathan B., BA ; Podolnick, Jason M., BS ; Sakhuja, Shruti, BS ; Matusczcak, Maria, MD ; Austin, Mary T., MD, MPH ; Kao, Lillian S., MD, MS ; Lally, Kevin P., MD, MS ; Tsao, KuoJen, MD</creator><creatorcontrib>Putnam, Luke R., MD ; Chang, Courtney M., BA ; Rogers, Nathan B., BA ; Podolnick, Jason M., BS ; Sakhuja, Shruti, BS ; Matusczcak, Maria, MD ; Austin, Mary T., MD, MPH ; Kao, Lillian S., MD, MS ; Lally, Kevin P., MD, MS ; Tsao, KuoJen, MD</creatorcontrib><description>Background Adherence to prophylactic antibiotics guidelines is challenging and poorly documented. We hypothesized that a multiphase, multifaceted quality improvement initiative would engage relevant stakeholders, address known barriers to adoption, and improve overall adherence. Methods From 2011 to 2014, a series of interventions were introduced in the pediatric operating rooms. After each interventional period, prospective assessments were performed to record the antibiotic type, dose, timing, and redosing according to the guidelines. Perioperative factors that may influence guideline adherence were analyzed. Spearman's rank correlation, analysis of variance, and χ2 tests were performed. Results A total of 1,052 operations were observed, and 629 (60%) required prophylactic antibiotics. Adherence to all 4 guideline components remained unchanged (54−55%, P = .38). Redosing significantly improved (7−53%, P = .02), but correct type decreased (98−70%, P < .01). The percentage of cases in which only one antibiotic guideline component was missed remained unchanged (35−34%, P = .46). Adherence to guidelines was not significantly associated with American Society of Anesthesiologists class, surgical specialty, patient weight, anesthesia provider, or surgical wound class. Conclusion Despite multiple interventions to improve antibiotic prophylaxis, overall adherence did not improve. Most interventions were directed at the point of administration in the operating room; future implementation strategies should focus on the perioperative setting.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2015.04.013</identifier><identifier>PMID: 26054317</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Antibiotic Prophylaxis - statistics & numerical data ; Antibiotic Prophylaxis - utilization ; Checklist ; Child ; Guideline Adherence - statistics & numerical data ; Humans ; Practice Guidelines as Topic ; Prospective Studies ; Quality Improvement ; Surgery ; Surgical Wound Infection - prevention & control ; Texas</subject><ispartof>Surgery, 2015-08, Vol.158 (2), p.413-419</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-46dbae64783c4c7ec735191e407e53fd61359bf2a1eb4954203403b47ea0f3353</citedby><cites>FETCH-LOGICAL-c481t-46dbae64783c4c7ec735191e407e53fd61359bf2a1eb4954203403b47ea0f3353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0039606015003049$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26054317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Putnam, Luke R., MD</creatorcontrib><creatorcontrib>Chang, Courtney M., BA</creatorcontrib><creatorcontrib>Rogers, Nathan B., BA</creatorcontrib><creatorcontrib>Podolnick, Jason M., BS</creatorcontrib><creatorcontrib>Sakhuja, Shruti, BS</creatorcontrib><creatorcontrib>Matusczcak, Maria, MD</creatorcontrib><creatorcontrib>Austin, Mary T., MD, MPH</creatorcontrib><creatorcontrib>Kao, Lillian S., MD, MS</creatorcontrib><creatorcontrib>Lally, Kevin P., MD, MS</creatorcontrib><creatorcontrib>Tsao, KuoJen, MD</creatorcontrib><title>Adherence to surgical antibiotic prophylaxis remains a challenge despite multifaceted interventions</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Background Adherence to prophylactic antibiotics guidelines is challenging and poorly documented. We hypothesized that a multiphase, multifaceted quality improvement initiative would engage relevant stakeholders, address known barriers to adoption, and improve overall adherence. Methods From 2011 to 2014, a series of interventions were introduced in the pediatric operating rooms. After each interventional period, prospective assessments were performed to record the antibiotic type, dose, timing, and redosing according to the guidelines. Perioperative factors that may influence guideline adherence were analyzed. Spearman's rank correlation, analysis of variance, and χ2 tests were performed. Results A total of 1,052 operations were observed, and 629 (60%) required prophylactic antibiotics. Adherence to all 4 guideline components remained unchanged (54−55%, P = .38). Redosing significantly improved (7−53%, P = .02), but correct type decreased (98−70%, P < .01). The percentage of cases in which only one antibiotic guideline component was missed remained unchanged (35−34%, P = .46). Adherence to guidelines was not significantly associated with American Society of Anesthesiologists class, surgical specialty, patient weight, anesthesia provider, or surgical wound class. Conclusion Despite multiple interventions to improve antibiotic prophylaxis, overall adherence did not improve. Most interventions were directed at the point of administration in the operating room; future implementation strategies should focus on the perioperative setting.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotic Prophylaxis - statistics & numerical data</subject><subject>Antibiotic Prophylaxis - utilization</subject><subject>Checklist</subject><subject>Child</subject><subject>Guideline Adherence - statistics & numerical data</subject><subject>Humans</subject><subject>Practice Guidelines as Topic</subject><subject>Prospective Studies</subject><subject>Quality Improvement</subject><subject>Surgery</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Texas</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAURS0EotPCH2CBvGST8Bx_ZCIhpKoCilSpC8racpyXjgfHGWynYv59HU1hwaIre3HvkX0uIe8Y1AyY-riv0xLv6waYrEHUwPgLsmGSN1XLFXtJNgC8qxQoOCPnKe0BoBNs-5qcNQqk4KzdEHs57DBisEjzTFees8ZTE7Lr3ZydpYc4H3ZHb_64RCNOxoVEDbU74z2Ge6QDpoPLSKfFZzcaixkH6kLG-ICFMof0hrwajU_49um8ID-_frm7uq5ubr99v7q8qazYslwJNfQGlWi33Arbom25ZB1DAS1KPg6Kcdn1Y2MY9qKTogEugPeiRQMj55JfkA8nbnny7wVT1pNLFr03AeclaaY63vKm-CjR5hS1cU4p4qgP0U0mHjUDvcrVe73K0KtcDUIXuaX0_om_9BMO_yp_bZbAp1MAyy8fHEadrFvdDi6izXqY3fP8z__VrXdh3eMXHjHt5yWG4k8znRoN-sc677ouk-UGouOPMY6hSA</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Putnam, Luke R., MD</creator><creator>Chang, Courtney M., BA</creator><creator>Rogers, Nathan B., BA</creator><creator>Podolnick, Jason M., BS</creator><creator>Sakhuja, Shruti, BS</creator><creator>Matusczcak, Maria, MD</creator><creator>Austin, Mary T., MD, MPH</creator><creator>Kao, Lillian S., MD, MS</creator><creator>Lally, Kevin P., MD, MS</creator><creator>Tsao, KuoJen, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150801</creationdate><title>Adherence to surgical antibiotic prophylaxis remains a challenge despite multifaceted interventions</title><author>Putnam, Luke R., MD ; Chang, Courtney M., BA ; Rogers, Nathan B., BA ; Podolnick, Jason M., BS ; Sakhuja, Shruti, BS ; Matusczcak, Maria, MD ; Austin, Mary T., MD, MPH ; Kao, Lillian S., MD, MS ; Lally, Kevin P., MD, MS ; Tsao, KuoJen, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-46dbae64783c4c7ec735191e407e53fd61359bf2a1eb4954203403b47ea0f3353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotic Prophylaxis - statistics & numerical data</topic><topic>Antibiotic Prophylaxis - utilization</topic><topic>Checklist</topic><topic>Child</topic><topic>Guideline Adherence - statistics & numerical data</topic><topic>Humans</topic><topic>Practice Guidelines as Topic</topic><topic>Prospective Studies</topic><topic>Quality Improvement</topic><topic>Surgery</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Texas</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Putnam, Luke R., MD</creatorcontrib><creatorcontrib>Chang, Courtney M., BA</creatorcontrib><creatorcontrib>Rogers, Nathan B., BA</creatorcontrib><creatorcontrib>Podolnick, Jason M., BS</creatorcontrib><creatorcontrib>Sakhuja, Shruti, BS</creatorcontrib><creatorcontrib>Matusczcak, Maria, MD</creatorcontrib><creatorcontrib>Austin, Mary T., MD, MPH</creatorcontrib><creatorcontrib>Kao, Lillian S., MD, MS</creatorcontrib><creatorcontrib>Lally, Kevin P., MD, MS</creatorcontrib><creatorcontrib>Tsao, KuoJen, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Putnam, Luke R., MD</au><au>Chang, Courtney M., BA</au><au>Rogers, Nathan B., BA</au><au>Podolnick, Jason M., BS</au><au>Sakhuja, Shruti, BS</au><au>Matusczcak, Maria, MD</au><au>Austin, Mary T., MD, MPH</au><au>Kao, Lillian S., MD, MS</au><au>Lally, Kevin P., MD, MS</au><au>Tsao, KuoJen, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adherence to surgical antibiotic prophylaxis remains a challenge despite multifaceted interventions</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>158</volume><issue>2</issue><spage>413</spage><epage>419</epage><pages>413-419</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract>Background Adherence to prophylactic antibiotics guidelines is challenging and poorly documented. We hypothesized that a multiphase, multifaceted quality improvement initiative would engage relevant stakeholders, address known barriers to adoption, and improve overall adherence. Methods From 2011 to 2014, a series of interventions were introduced in the pediatric operating rooms. After each interventional period, prospective assessments were performed to record the antibiotic type, dose, timing, and redosing according to the guidelines. Perioperative factors that may influence guideline adherence were analyzed. Spearman's rank correlation, analysis of variance, and χ2 tests were performed. Results A total of 1,052 operations were observed, and 629 (60%) required prophylactic antibiotics. Adherence to all 4 guideline components remained unchanged (54−55%, P = .38). Redosing significantly improved (7−53%, P = .02), but correct type decreased (98−70%, P < .01). The percentage of cases in which only one antibiotic guideline component was missed remained unchanged (35−34%, P = .46). Adherence to guidelines was not significantly associated with American Society of Anesthesiologists class, surgical specialty, patient weight, anesthesia provider, or surgical wound class. Conclusion Despite multiple interventions to improve antibiotic prophylaxis, overall adherence did not improve. Most interventions were directed at the point of administration in the operating room; future implementation strategies should focus on the perioperative setting.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26054317</pmid><doi>10.1016/j.surg.2015.04.013</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0039-6060 |
| ispartof | Surgery, 2015-08, Vol.158 (2), p.413-419 |
| issn | 0039-6060 1532-7361 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1693732060 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Anti-Bacterial Agents - therapeutic use Antibiotic Prophylaxis - statistics & numerical data Antibiotic Prophylaxis - utilization Checklist Child Guideline Adherence - statistics & numerical data Humans Practice Guidelines as Topic Prospective Studies Quality Improvement Surgery Surgical Wound Infection - prevention & control Texas |
| title | Adherence to surgical antibiotic prophylaxis remains a challenge despite multifaceted interventions |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-20T04%3A17%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Adherence%20to%20surgical%20antibiotic%20prophylaxis%20remains%20a%20challenge%20despite%20multifaceted%20interventions&rft.jtitle=Surgery&rft.au=Putnam,%20Luke%20R.,%20MD&rft.date=2015-08-01&rft.volume=158&rft.issue=2&rft.spage=413&rft.epage=419&rft.pages=413-419&rft.issn=0039-6060&rft.eissn=1532-7361&rft_id=info:doi/10.1016/j.surg.2015.04.013&rft_dat=%3Cproquest_cross%3E1693732060%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1693732060&rft_id=info:pmid/26054317&rft_els_id=S0039606015003049&rfr_iscdi=true |