Korean J Nosocomial Infect Control.  2014 Dec;19(2):64-70. 10.14192/kjnic.2014.19.2.64.

Appropriateness of Surgical Antibiotic Prophylaxis in a Tertiary Hospital

• Nam EY
• Kim HB
• Bae H
• Moon S
• Na SH
• Kim SY
• Yoon D
• Lee HY
• Kim J
• Kim CJ
• Song KH
• Kim ES
• Kim NJ

• KMID: 1834996
• DOI: http://doi.org/10.14192/kjnic.2014.19.2.64

Abstract

BACKGROUND
This study aimed to evaluate the quality of surgical antibiotic prophylaxis (SAP) in a tertiary hospital.
METHODS
Medical, anesthetic, and nursing records from the 27,320 procedures conducted in a tertiary hospital during 2012 were retrospectively reviewed. Three clinical performance indicators of SAP (selection of antibiotic, timing of the first administration, duration of prophylaxis) were included as part of the National Hospital Evaluation Program (NHEP) of the Health Insurance Review and Assessment Service. In addition, 2 other parameters were assessed according to recent guidelines (weight-based initial dosing for obesity, intraoperative re-dosing for excessive blood loss, and prolonged duration of procedures).
RESULTS
Prophylactic antibiotics were administered in 19,637 (71.8%) of 27,320 total procedures. Quality of the 3 performance indicators was higher in the types of operations included in NHEP than in other procedures. However, additional doses were administered in 15 (1.2%) of 1,299 surgical procedures that lasted more than twice the half-life of the antibiotic used, and in 9 (3.3%) of 273 procedures with excessive blood loss greater than 1,500 mL. NHEP and non-NHEP results did not differ significantly.
CONCLUSION
Three SAP quality indicators showed more improvement in NHEP surgical procedures than in non-NHEP, but the other parameters did not perform well regardless of NHEP assessment. Therefore, more measures to improve the appropriateness of SAP should be developed.

Keyword

Clinical performance indicator; Quality; Surgical antibiotic prophylaxis

MeSH Terms

Anti-Bacterial Agents
Antibiotic Prophylaxis*
Half-Life
Insurance, Health
Nursing Records
Obesity
Quality Indicators, Health Care
Retrospective Studies
Tertiary Care Centers*
Anti-Bacterial Agents

Reference

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