A Quality Improvement Project to Increase Compliance With a Facility Protocol on Surgical Antimicrobial Prophylaxis

Area of Science:

• Infection Control
• Healthcare Quality Improvement
• Surgical Safety

Background:

• Surgical site infections (SSIs) lead to adverse patient outcomes and increased healthcare costs.
• Adherence to clinical practice guidelines is crucial for preventing SSIs.
• A regional referral center identified a need to improve its preoperative antibiotic protocol compliance.

Purpose of the Study:

• To reduce SSIs by enhancing compliance with the facility's preoperative antibiotic selection, dosing, timing, and redosing protocol.
• To implement a quality improvement initiative targeting antibiotic administration in the perioperative setting.

Main Methods:

• An interdisciplinary team implemented interventions including adding antibiotic details to the OR schedule, conducting staff education, and posting reference guides.
• The project focused on improving adherence to the established protocol for preoperative antibiotic use.
• Data on compliance and SSI rates were collected and analyzed.

Main Results:

• Compliance with preoperative antibiotic selection, dosing, and timing significantly improved following the interventions.
• However, overall SSI rates and compliance with antibiotic redosing recommendations did not show significant changes.
• The addition of antibiotic order information to the OR schedule was made permanent.

Conclusions:

• While improving adherence to certain aspects of antibiotic protocols is achievable, it may not directly translate to reduced SSI rates or improved redosing compliance.
• Sustained efforts and potentially revised strategies, such as off-site antibiotic administration education, may be necessary to further impact SSI prevention.
• Continuous quality improvement is essential in optimizing perioperative antibiotic stewardship.