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Multidisciplinary program for promoting single prophylactic doses of cefazolin in obstetrical and gynecological
K S Smith1, R A Quercia, M S Chow
1Department of Pharmacy Services, Hartford Hospital, CT 06115.
Insights
A cost-containment program successfully promoted single prophylactic doses of cefazolin for obstetrics and gynecology surgeries. This initiative achieved high compliance and significant annual cost savings without impacting patient care.
Area of Science:
- Pharmacology
- Healthcare Management
- Infectious Disease Prevention
Background:
- Antimicrobial prophylaxis is crucial in obstetrical and gynecological surgeries.
- Current practices may involve suboptimal dosing strategies, impacting cost and efficacy.
- A need exists for cost-effective and evidence-based antimicrobial prophylaxis protocols.
Purpose of the Study:
- To describe a multidisciplinary program aimed at promoting single prophylactic doses of cefazolin.
- To evaluate the program's impact on compliance, cost savings, and patient care.
- To assess the effectiveness of a standardized approach to surgical antimicrobial prophylaxis.
Main Methods:
- Conducted a one-month chart review to identify current antimicrobial prophylaxis regimens.
- Implemented an educational program including inservice training and informational materials.
- Modified drug stocking patterns and established formal restrictions via the Pharmacy and Therapeutics (P&T) committee.
- Monitored compliance and cost savings over a 16-month period.
Main Results:
- Achieved a 78.8% compliance rate with single-dose cefazolin prophylaxis.
- Realized an initial cost saving of +7,125, extrapolating to +14,250 annually.
- Observed no apparent adverse effects on patient care outcomes.
Conclusions:
- A multidisciplinary approach effectively promotes the use of single prophylactic doses of cefazolin.
- The program demonstrated significant cost containment and high compliance.
- Standardizing antimicrobial prophylaxis can lead to improved resource utilization without compromising patient safety.
Abstract:
A multidisciplinary cost-containment program for promoting the use of single prophylactic doses of cefazolin for obstetrical and gynecological surgical procedures is described. Following a one-month review of patient charts to identify the antimicrobial regimens used most frequently for prophylaxis in obstetrical and gynecological surgical procedures, the department of pharmacy services, with the cooperation of the pharmacy and therapeutics (P&T) committee and the departments of obstetrics and gynecology and infectious diseases, implemented an educational program to promote the use of single doses of cefazolin for surgical prophylaxis. The program included inservice education and distribution of letters of support and a therapeutics newsletter. Drug stocking patterns in the operating and delivery rooms were changed to make cefazolin more accessible, and the P&T committee formally restricted the use of prophylactic antimicrobial agents in obstetrical and gynecological surgical procedures to single doses of cefazolin unless a consulting infectious-disease physician recommended otherwise. Compliance with the program increased as each step was implemented; data collected 16 months after the program was initiated demonstrated a compliance rate of 78.8%. Based on comparison of data collected before initiation and six months after initiation of the program, an actual cost savings of +7,125 was realized, which extrapolates to +14,250 annually. No apparent adverse effects on patient care were noted. The multidisciplinary approach to promoting the use of single doses of cefazolin was effective.