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Evaluating the implementability of Antibiotic Surgical Prophylaxis guidelines.

Courtney Ierano1, Darshini Ayton2, Trisha Peel3

  • 1National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Peter Doherty Research Institute for Infection and Immunity Melbourne, VIC, Australia; University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Department of Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.

Infection, Disease & Health
|September 17, 2019
PubMed
Summary

Australian surgical prophylaxis guidelines are generally implementable, with clear recommendations being key facilitators. However, concerns regarding evidence quality, flexibility, and data access present borderline barriers to optimal uptake and patient care.

Keywords:
Guideline complianceGuideline implementabilitySurgical antimicrobial prophylaxis

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Area of Science:

  • Healthcare Policy
  • Clinical Practice Guidelines
  • Antimicrobial Stewardship

Background:

  • Noncompliant prescribing of antimicrobials for surgical prophylaxis is a concern in Australia.
  • The study aimed to assess the implementability of national surgical prophylaxis (SAP) guidelines.

Purpose of the Study:

  • To identify facilitators and barriers to compliance with Australian SAP guidelines.
  • To evaluate the practical application of existing surgical prophylaxis recommendations.

Main Methods:

  • Stakeholders used the GuideLine Implementability Appraisal (GLIA) tool to evaluate the guidelines.
  • Facilitators were defined as recommendations with 100% 'Yes' agreement; barriers had 100% 'No' agreement.
  • Borderline facilitators/barriers were identified by majority consensus (40-60% agreement).

Main Results:

  • Recommendations were largely seen as identifiable, concise, measurable, and aligned with user abilities, acting as facilitators.
  • Clarity and explicitness of recommendations were borderline facilitators.
  • Evidence quality (validity), inflexibility, and lack of patient data (computability) were borderline barriers.

Conclusions:

  • The Australian SAP guidelines demonstrate overall implementability.
  • Measurability and clarity are strengths, but validity, flexibility, and computability require attention.
  • Addressing borderline barriers can optimize guideline adoption and improve patient care.