Improving Small-Volume Antibiotic Administration for Surgical Prophylaxis: A Quality Improvement Project

Area of Science:

• Anesthesiology
• Pharmacology
• Healthcare Quality Improvement

Background:

• Lack of standardized policy for small-volume intravenous antibiotic administration (≤ 100 mL) for surgical prophylaxis resulted in practice variability.
• Medication losses due to dead volumes in intravenous tubing are a concern for small-volume antibiotic administration.

Purpose of the Study:

• To evaluate the impact of an educational intervention promoting secondary tubing use on reducing dead volume losses of small-volume antibiotics.
• To assess changes in anesthesia provider practice regarding the administration of small-volume intravenous antibiotics.

Main Methods:

• Observation of current practices and measurement of dead volumes.
• Implementation of an educational intervention focused on best practices for administering small-volume antibiotics using secondary tubing.
• Post-intervention evaluation over a 6-week period with three cycles to assess practice change and dead volume reduction.

Main Results:

• Statistically significant decrease in mean dead volume losses from 8.48 mL to 0.93 mL post-intervention (P = .0012).
• Shift in common practice from primary to secondary tubing use, with significantly lower dead volume losses for secondary tubing (0.79 mL vs. 13.45 mL; P < .0001).
• Preintervention methods led to incomplete antibiotic administration, which was resolved by the intervention.

Conclusions:

• Changing practice to utilize secondary tubing for small-volume antibiotic administration significantly reduces medication wastage.
• The educational intervention was effective in improving practice and reducing dead volume losses, demonstrating a beneficial new standard of care.
• The intervention showed strong provider acceptance and sustained reduction in medication wastage, highlighting its value in clinical practice.