Achieving 100 percent compliance to perioperative antibiotic administration: a quality improvement initiative
Singapore medical journal
;
: 130-135, 2019.
Article
in English
| WPRIM
| ID: wpr-777562
ABSTRACT
INTRODUCTION@#Timely administration of prophylactic antibiotics within 60 minutes before surgical incision is important for reducing surgical site infections. This quality improvement initiative aimed to work towards achieving 100% compliance with perioperative antibiotic administration.@*METHODS@#We examined the workflow in our Anaesthesia Information Management System (AIMS) and proposed interventions using cause-and-effect analysis of anonymised anaesthetic records from eligible surgical cases extracted from AIMS. This ultimately led to the implementation of an antibiotic pop-up reminder. The overall process was done in a few small plan-do-study-act cycles involving raising awareness, education and reorganisation of AIMS before implementation of the antibiotic pop-up reminder. Data analysis took place from August 2014 to September 2016. Compliance was defined as documented antibiotic administration within 60 minutes before surgical incision, or as documented reason for omission.@*RESULTS@#The median monthly compliance rate, for 33,038 cases before and 28,315 cases after the reminder was implemented, increased from 67.0% at baseline to 94.5%. This increase was consistent and sustained for a year despite frequent personnel turnover. Documentation of antibiotic administration also improved from 81.7% to 99.3%, allowing us to identify and address novel problems that were initially not apparent, and resulting in several department recommendations. These included administering antibiotics later for cases with predicted longer-than-expected preparation times and bringing forward antibiotic administration in lower-segment Caesarean sections.@*CONCLUSION@#The use of information technology and implementation of an antibiotic pop-up reminder on AIMS streamlined our work processes and brought us closer to achieving 100% on-time compliance with perioperative antibiotic administration.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Reference Standards
/
Surgical Procedures, Operative
/
Surgical Wound Infection
/
Software
/
Drug Administration Schedule
/
Reminder Systems
/
Antibiotic Prophylaxis
/
Guideline Adherence
/
Documentation
/
Electronic Health Records
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Singapore medical journal
Year:
2019
Type:
Article
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