Adherence to Surgical Antimicrobial Prophylaxis Guidelines and Improvement Efforts: A Single-Center, Pre- and...

Area of Science:

• Infectious Diseases
• Surgical Care
• Healthcare Quality Improvement

Background:

• Adherence to surgical antimicrobial prophylaxis (SAP) guidelines is crucial for reducing surgical site infections (SSIs).
• Poor adherence impacts patient prognosis and healthcare economics.
• This study evaluated SAP guideline adherence and implemented interventions to improve it.

Purpose of the Study:

• To investigate adherence to SAP guidelines, focusing on antimicrobial administration timing, drug selection, dosage, and duration.
• To assess the impact of interventions on SAP adherence and SSI incidence.
• To identify effective strategies for improving SAP adherence in surgical departments.

Main Methods:

• A single-center, pre- and post-intervention comparative study was conducted.
• SAP protocols for 228 procedures across 18 departments were evaluated against established guidelines.
• An educational approach and a new antimicrobial initiation index were implemented in low-adherence departments.

Main Results:

• Overall adherence to appropriate antimicrobial administration timing was 92.3%.
• Adherence was notably lower in specific surgical departments (82.6% in gastroenterological, cardiovascular, orthopedic, and neurosurgery).
• Intervention significantly improved adherence in low-adherence departments (82.6% to 95.0%) and led to a substantial reduction in SSI incidence in cardiovascular surgery (6.9% to 0%).

Conclusions:

• Department-specific antimicrobial initiation indexes, linked to surgical preparation stages, can effectively improve SAP timing adherence.
• Further research is needed to fully understand the impact on SSI incidence.
• Optimizing SAP protocols is essential for enhancing patient outcomes and healthcare efficiency.