Implementation of a Trauma Bay Checklist Improves Antibiotic Prophylaxis Compliance in Open Extremity Fractures

Area of Science:

• Trauma Surgery
• Patient Safety
• Antibiotic Stewardship

Background:

• American College of Surgeons (ACS) guidelines recommend antibiotics within 1 hour for open fractures.
• Checklists enhance safety and compliance in surgical environments.
• The study evaluated the MARTY checklist for antibiotic administration in open extremity fractures.

Purpose of the Study:

• To assess the impact of the MARTY trauma bay checklist on antibiotic administration timeliness.
• To improve adherence to best practices for open fracture management.

Main Methods:

• Retrospective pre-post study design.
• Analysis of trauma alerts for open fractures from 2021 (pre-MARTY) and 2022 (post-MARTY).
• Comparison of antibiotic administration rates within 1 hour and within the trauma bay.

Main Results:

• Antibiotic administration within 1 hour increased from 57.5% to 65.5% post-MARTY.
• Administration within the trauma bay rose from 46.0% to 54.5% post-MARTY.
• Adjusted models showed significantly higher odds of timely antibiotic administration post-MARTY (OR=1.654, P=.038).

Conclusions:

• The MARTY checklist implementation led to improved compliance with antibiotic administration guidelines.
• Compliance is still suboptimal for patients with higher injury severity scores.
• Findings can inform strategies for enhancing trauma care protocols.