Surgical Site Infections continue to be source of morbidity and mortality leading to longer hospital and ICU stays . Current recommendations state that infusion of first dose of antibiotics should begin within 60 minutes prior to the incision. The period can be lengthened to 120 minutes for drug Vancomycin to avoid complications. The aim of study is to evaluate compliance of antibiotics administration in the perioperative setting.
Retrospective chart review of the anesthesia records on 3 randomly chosen weekdays was done to measure compliance of antibiotics administration. All elective/emergency cases were evaluated for this study. Compliance was defined as when the patients received antibiotics on time or when documented appropriately if no antibiotics were requested by the surgeon (NRS). Patients who received antibiotics outside the OR (i.e. preop/ER) and not by the anesthesiologist or by oral route were excluded from the study.
Of total 124 surgeries (116 elective and 8 emergent cases) performed in the 3 days, 5 were excluded from study. Out of 119 patients, 16 patients did not meet the compliance guidelines. Net compliance was 103/119 (86.55%). Of 16 noncompliant cases 9 patients (9/16=56.25%) received antibiotics within 60 min. after the surgical incision. 4 cases were noncompliant due to lack of documentation (4/16=25%) and 3 patients received antibiotics more than 60 min. after surgical incision (3/16=18.75%). Out of 16 noncompliant cases 3 cases were emergency cases and 13 cases were elective. Emergent cases non compliance was 3/8 =37.5% and elective cases non-compliance was 13/111=11.7%.
Study demonstrates that overall compliance was 86.55% which is above the national average of 82% . Being an emergent case was a risk factor for poor compliance .
Areas of improvement include emphasis on better documentation and aggressive approach in administering antibiotics before the surgical incision. Sharing this data with departmental members may help improve success . Documentation is anticipated to improve with a recent modification of the OR record to prompt anesthesia care providers to provide appropriate details.
Praveen Kalra, No Financial Disclosure Information; No Product/Research Disclosure Information