Improvement of intraoperative antibiotic prophylaxis in prolonged cardiac surgery by automated alerts in the operating room.

Details

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Serval ID
serval:BIB_A68EAE64D981
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Improvement of intraoperative antibiotic prophylaxis in prolonged cardiac surgery by automated alerts in the operating room.
Journal
Infection Control and Hospital Epidemiology
Author(s)
Zanetti G., Flanagan H.L., Cohn L.H., Giardina R., Platt R.
ISSN
0899-823X
Publication state
Published
Issued date
01/2003
Peer-reviewed
Oui
Volume
24
Number
1
Pages
13-16
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Randomized Controlled Trial
Abstract
OBJECTIVE: To assess the impact of an automated intraoperative alert to redose prophylactic antibiotics in prolonged cardiac operations. DESIGN: Randomized, controlled, evaluator-blinded trial. SETTING: University-affiliated hospital. PATIENTS: Patients undergoing cardiac surgery that lasted more than 4 hours after the preoperative administration of cefazolin, unless they were receiving therapeutic antibiotics at the time of surgery. INTERVENTION: Randomization to an audible and visual reminder on the operating room computer console at 225 minutes after the administration of preoperative antibiotics (reminder group, n = 137) or control (n = 136). After another 30 minutes, the circulating nurse was required to indicate whether a follow-up dose of antibiotics had been administered. RESULTS: Intraoperative redosing was significantly more frequent in the reminder group (93 of 137; 68%) than in the control group (55 of 136; 40%) (adjusted odds ratio, 3.31; 95% confidence interval, 1.97 to 5.56; P < .0001). The impact of the reminder was even greater when compared with the 6 months preceding the study period (129 of 480; 27%; P < .001), suggesting some spillover effect on the control group. Redosing was formally declined for 19 of the 44 patients in the reminder group without redosing. The rate of surgical-site infection in the reminder group (5 of 137; 4%) was similar to that in the control group (8 of 136; 6%; P = .42), but significantly lower than that in the pre-study period (48 of 480; 10%; P = .02). CONCLUSION: The use of an automatic reminder system in the operating room improved compliance with guidelines on perioperative antibiotic prophylaxis.
Keywords
Antibiotic Prophylaxis, Automation, Cardiovascular Surgical Procedures/adverse effects, Drug Administration Schedule, Guideline Adherence, Humans, Intraoperative Care, Odds Ratio, Quality Assurance, Health Care, Reminder Systems, Single-Blind Method, Surgical Wound Infection/prevention &amp, control
Pubmed
Web of science
Open Access
Yes
Create date
21/01/2008 11:04
Last modification date
01/10/2019 7:19
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