Reducing surgical site infections through a multidisciplinary computerized process for preoperative prophylactic antibiotic administration

• Published in: The American journal of surgery Vol. 192; no. 5; pp. 663 - 668
• Main Authors: Webb, Alexandra L.B., Flagg, Rene L., Fink, Aaron S.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2006; Elsevier; Elsevier Limited
• Subjects: Anesthesia Department, Hospital - standards; Antibacterial agents; Antibiotic Prophylaxis - methods; Antibiotic Prophylaxis - standards; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Clinical Protocols; Compliance; Computer-guided decision support; Decision making; Decision Support Systems, Clinical - organization & administration; General aspects; Georgia; Hospital costs; Hospitals, Veterans - standards; Humans; Management Quality Circles; Medical Records Systems, Computerized; Medical sciences; Mortality; Nosocomial infections; Nursing; Patients; Pharmacology. Drug treatments; Pharmacy; Pharmacy Service, Hospital - standards; Preoperative Care - standards; Surgery; Surgical infection prophylaxis; Surgical Wound Infection - prevention & control; Wound infection; Georgia; Wound infection; Surgical infection prophylaxis; Computer-guided decision support; Surgical wound; Nosocomial infection; Chemoprophylaxis; Decision making; Decision; Guidance; Medicine; Prevention; Antibiotic; Treatment; Surgery; Preoperative; Antibacterial agent; Computer aid; Multidisciplinary; Computerization
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2006.08.014

Surgical site infections (SSIs) result in significant postoperative morbidity and mortality. Although many of these infections can be prevented by timely administration of preoperative antibiotics, data suggest that many patients do not receive such therapy. A multidisciplinary team was convened that reviewed published guidelines, made antibiotic recommendations, and addressed administration issues. Responsibility for antibiotic administration was shifted from preoperative nursing staff to the anesthetist. Electronic quick orders were developed to encourage appropriate antibiotic selection and simplify order creation. Timely administration of preoperative antibiotics improved from 51% to 98% from February 2005 to February 2006. Appropriate antibiotic administered improved from 78% to 94%. The clean wound infection rate decreased from 2.7% to 1.4% over the same time period. A multidisciplinary approach to prophylactic antibiotic use, including computer-guided decision support, facilitates appropriate preoperative antibiotic use, resulting in a significant decrease in surgical wound infections.