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Implementing a policy for pneumococcal prophylaxis in a haematology unit after splenectomy
Quality in Health Care : QHC
|August 6, 1995
Summary
Splenectomy patients face high infection risks. A formal policy for pneumococcal immunisation and antibiotic prophylaxis significantly improved preventative care for these vulnerable individuals.
Area of Science:
- Hematology
- Infectious Diseases
- Public Health
Background:
- Splenectomy significantly increases the risk of overwhelming post-splenectomy infection (OPSI), particularly pneumococcal infections and sepsis.
- Patients undergoing splenectomy are 40 times more likely to develop severe infections and 17 times more likely to experience fatal sepsis.
- Preventative measures, including pneumococcal vaccination and antibiotic prophylaxis, can reduce the incidence of these life-threatening infections.
Purpose of the Study:
- To audit the effectiveness of a formal policy for pneumococcal immunisation and antibiotic prophylaxis in patients undergoing elective splenectomy.
- To assess the impact of implementing a standardized care protocol on preventative measures for post-splenectomy infection risk.
Main Methods:
- Retrospective analysis of patient case notes.
- Audit conducted in July 1993, evaluating data from patients who had undergone splenectomy.
- Comparison of prophylaxis rates before and after the implementation of a formal policy in June 1988.
Main Results:
- Before the policy (June 1988), only 24% of splenectomy patients received both pneumococcal immunisation and antibiotic prophylaxis.
- After policy implementation, 62% received immunisation and 86% received antibiotic prophylaxis or a fever-activated antibiotic supply.
- All but one of the 20 patients who had splenectomies after the policy was enacted received appropriate prophylaxis.
Conclusions:
- Establishing a formal, agreed-upon policy for pneumococcal prophylaxis in splenectomy patients demonstrably improved the quality of care.
- Standardized protocols are effective in increasing the uptake of essential preventative measures for high-risk patient groups.
- The policy led to a significant increase in the provision of immunisation and antibiotic prophylaxis for patients undergoing splenectomy.
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