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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.
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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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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