Related Experiment Video

Updated: Apr 28, 2026

Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis
06:45

Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis

Published on: December 18, 2010

21.3K

Standardization and improvement of care for pediatric patients with perforated appendicitis

Joyce Slusher1, Christina A Bates1, Catherine Johnson1

  • 1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Journal of Pediatric Surgery
|June 4, 2014
PubMed

Insights

Implementing an evidence-based guideline for perforated appendicitis improved immediate appendectomy rates and reduced antibiotic use, leading to more efficient care without compromising patient outcomes.

Area of Science:

  • Surgery
  • Quality Improvement
  • Evidence-Based Medicine

Background:

  • Healthcare aims to reduce treatment variation and enhance evidence-based care.
  • Quality improvement methods are crucial for standardizing medical practices.

Purpose of the Study:

  • To implement and evaluate an evidence-based guideline for managing perforated appendicitis.
  • The guideline focused on optimizing surgical timing and antibiotic duration.

Main Methods:

  • Established a guideline for immediate appendectomy and postoperative antibiotic duration.
  • Collected 12 months of baseline data and prospectively collected data post-implementation.
  • Utilized control charts to monitor adherence and outcomes, including readmissions.

Main Results:

  • Increased immediate appendectomy rates from 79% to 94%.
  • Decreased postoperative IV antibiotic use from 25% to 4%.
  • Observed no significant changes in length of stay or abscess formation, with a slight decrease in readmissions and overall charges.

Conclusions:

  • Evidence-based guideline implementation significantly changed perforated appendicitis management practices.
  • The changes indicate more efficient patient care without negatively impacting outcomes.
  • Quality improvement methodologies facilitate effective implementation, tracking, and future enhancements.
Abstract

Keywords:
Evidence based practiceInterval appendectomyPerforated appendicitis

Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
931
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
4.4K
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
29
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
1.1K
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
912
Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
1.3K