Transcript Preventing Surgical Infections Through Effective

Preventing Surgical Infections
Through Effective Perioperative
Antibiotic Administration
Project Team:
Anesthesia
Infectious Disease
Pharmacy
Surgical Services
Center for Clinical Effectiveness
LOYOLA
UNIVERSITY
HEALTH SYSTEM
Loyola University Chicago
Opportunity Statement
Surgical site infections are a major
complication after surgery resulting in
considerable morbidity, mortality, and
resource utilization. Proper use of
antibiotics – giving the right drug at
the right time – is effective in
preventing infections after surgery.
Project Goals
To achieve 100% compliance for targeted
surgeries for the following measures:
1. Administer antibiotics within one hour
before surgical incision
2. Administer the appropriate antibiotic
3. Stop antibiotics within 24 hours after
surgery
Most Likely Causes
Accountability for process not clearly
defined (surgeon, anesthesia, nurse)
Variation in physician ordering
practices
Antibiotic not administered within
recommended time intervals
Variability in documentation of
antibiotic administration
Solutions Implemented
Developed and implemented guidelines
and supporting documentation tools
Surgical anti-microbial prophylaxis
guidelines on the EMR
Unrestricting of vancomycin for penicillin
allergic patients
Standardized documentation
Education for attendings, residents,
CRNA’s, and nurses
Targeted Surgeries -
per CMS & CDC guidelines
Abdominal and Vaginal Hysterectomy
Hip and Knee Replacement
Cardiac Bypass
Other Cardiac surgery
Vascular surgery
Colon surgery
Antibiotics given within 60 minutes
prior to incision have improved
110
UCL = 107.24
Project Started
100
Percent of Patients
90
Mean = 88.1
80
70
60
50
LCL = 68.94
Use of the appropriate antibiotic
has improved significantly
100%
97%
Percent of Patients
90%
98%
86%
80%
70%
60%
58%
50%
Nov-02
Jun-03
Sep-03
Chart Review Time
Jan 04
Discontinuation of antibiotics
within 24 hours has improved
100%
Percent of Patients
90%
80%
71%
70%
58%
60%
50%
50%
40%
Jun-03
Sep-03
Chart Review Time
Jan-04
Next Steps
Share department specific results and
explore opportunities to achieve 100%
compliance with each measure
Review and revise order sets as needed
Plan for public reporting of data