A Performance Improvement Project in Antibiotic Administration for Open Fractures

Area of Science:

• Trauma surgery
• Infectious disease prevention
• Healthcare quality improvement

Background:

• Open fractures present a high risk of infection, necessitating timely antibiotic administration.
• Standardized protocols are crucial for optimizing care in trauma settings.
• Previous care pathways at a level one trauma center lacked efficiency in antibiotic delivery.

Purpose of the Study:

• To evaluate the impact of a standardized antibiotic administration protocol on open fracture patients.
• To assess improvements in the timing and appropriateness of antibiotic therapy.
• To identify factors contributing to delays in antibiotic delivery.

Main Methods:

• Retrospective comparative cohort study design.
• Comparison of two groups: pre-protocol (2013-2015) and post-protocol (2016-2017) implementation.
• Analysis of patient and injury factors, and time intervals for antibiotic administration.

Main Results:

• Antibiotic administration time reduced from 97 to 46 minutes post-protocol (P < 0.0001).
• Time from admission to evaluation improved from 10 to 3 minutes (P < 0.0001).
• Adherence to 1-hour antibiotic administration increased from 34% to 84% (P < 0.0001).

Conclusions:

• A multifaceted performance improvement protocol significantly enhanced antibiotic administration efficiency for open fractures.
• The protocol led to more coordinated and timely care.
• The successful protocol is recommended for adoption by other healthcare facilities.