Using Children's Artwork to Improve Adherence with Timely Antibiotic Administration in Open Fractures

Area of Science:

• Trauma Surgery
• Infectious Disease Prevention
• Patient Safety

Background:

• Early antibiotic administration within 60 minutes of emergency department (ED) arrival is crucial for reducing infection risk in open fracture (OF) patients.
• Adherence to timely antibiotic protocols can be challenging in busy trauma settings.
• Novel interventions are needed to improve clinician compliance with evidence-based guidelines for OF management.

Purpose of the Study:

• To evaluate the effectiveness of displaying children's artwork as a novel method to improve clinician adherence to early antibiotic administration for open fractures (OFs).
• To assess the impact of this intervention on the time to antibiotic administration in open fracture patients.

Main Methods:

• A registry-based, pre- and post-intervention study was conducted at a level 1 trauma center.
• The intervention involved displaying children's artwork depicting open fractures in the ED, alongside guidelines, and emailing reminders to clinicians.
• The primary outcome measured was the proportion of OF patients receiving antibiotics within 60 minutes of ED arrival, with time to antibiotics analyzed as a continuous variable.

Main Results:

• A total of 554 open fracture patients were analyzed (281 pre-intervention, 257 post-intervention).
• The percentage of patients receiving antibiotics within 60 minutes significantly increased from 58% (95% CI, 52%-63%) pre-intervention to 79% (95% CI, 74%-84%) post-intervention (P = 0.001).
• The median time to antibiotic administration decreased from 46 minutes pre-intervention to 25 minutes post-intervention (P = 0.001).

Conclusions:

• Displaying children's artwork in the emergency department is an effective and novel strategy to improve adherence to open fracture guidelines.
• This intervention significantly reduced the time to antibiotic administration for open fracture patients.
• The findings suggest that simple, visually engaging methods can positively impact clinical practice and patient outcomes in trauma care.