Format

Send to

Choose Destination
See comment in PubMed Commons below
Am J Surg. 2013 Oct;206(4):451-6. doi: 10.1016/j.amjsurg.2013.02.009. Epub 2013 Jun 27.

Beyond surgical care improvement program compliance: antibiotic prophylaxis implementation gaps.

Author information

1
Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, TX, USA; The Children's Memorial Hermann Hospital, Houston, TX, USA.

Abstract

BACKGROUND:

Despite increased compliance with Surgical Care Improvement Project infection measures, surgical-site infections are not decreasing. The aim of this study was to test the hypothesis that documented compliance with antibiotic prophylaxis guidelines on a pediatric surgery service does not reflect implementation fidelity or adherence to guidelines as intended.

METHODS:

A 7-week observational study of elective pediatric surgical cases was conducted. Adherence was evaluated for appropriate administration, type, timing, weight-based dosing, and redosing of antibiotics.

RESULTS:

Prophylactic antibiotics were administered appropriately in 141 of 143 cases (99%). Of 100 cases (70%) in which antibiotic prophylaxis was indicated, compliance was documented in 100% cases in the electronic medical record, but only 48% of cases adhered to all 5 guidelines. Lack of adherence was due primarily to dosing or timing errors.

CONCLUSIONS:

Lack of implementation fidelity in antibiotic prophylaxis guidelines may partly explain the lack of expected reduction in surgical-site infections. Future studies of Surgical Care Improvement Project effectiveness should measure adherence and implementation fidelity rather than just documented compliance.

KEYWORDS:

Adherence; Antibiotic prophylaxis; Compliance; Implementation fidelity; SCIP; Surgical site infection

PMID:
23809676
DOI:
10.1016/j.amjsurg.2013.02.009
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center