• Login
    View Item 
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) Projects
    • View Item
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) Projects
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UMB Digital ArchiveCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    Display statistics

    Appropriate Operating Room Antibiotic Re-Dosing for General Surgery Patients

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    Lock_ORAntibioticRe-Dosing_2020.pdf
    Size:
    142.4Kb
    Format:
    PDF
    Download
    Author
    Lock, Kelly M.
    Advisor
    Piscotty, Ronald
    Date
    2020-05
    Type
    DNP Project
    
    Metadata
    Show full item record
    Other Titles
    Antibiotic Re-Dosing for General Surgery Patients
    Abstract
    Problem & Purpose: Antibiotic prophylaxis is a necessary measure aimed at decreasing the number of perioperative infections. Surgical antibiotic prophylaxis is defined as the use of antibiotics to prevent infections at the surgical site (Khan, 2018). Such infections result in roughly $3.5 to $8 billion dollars in yearly costs, in addition to longer hospital stays for patients (Heuer, Kossick, Riley and Hewer, 2017). For patients, who are in long surgical procedures, it is recommended that they receive appropriate re-dosing of antibiotics throughout the remainder of the case. The most common antibiotic used for surgical prophylaxis is Cefazolin. Current Surgical Care Improvement Guidelines (SCIP), recommend re-dosing of Cefazolin every four hours while in surgery or if blood loss is greater than 1500mL (Heuer, Kossick, Riley and Hewer, 2017). Methods: A retrospective quality improvement project was conducted at a large academic teaching institution in Baltimore, Maryland. Data was obtained from a three-month period of time and focused on inpatient general surgery patients that underwent surgical procedures longer than 4 hours in length. Descriptive statistics were used to evaluate the data gathered. Interviews were conducted with staff Certified Registered Nurse Anesthetists and Pharmacists to obtain qualitative data about their perception of barriers towards re-dosing of antibiotics. Interviews also focused on strategies for improvement of re-dosing at the appropriate times. Results: From August to November 2019 there were a total of 243 general surgery cases. Of those cases, 25% (n=61) received antibiotics that did not require re-dosing. A total of 74.5% (n=182) of patients received Cefazolin for antibiotic prophylaxis. Of those 182 patients, 4.3% (n=8) did not receive proper antibiotic re-dosing during the procedure. Also, 2 of those 8 patients had surgical procedures that ended a few minutes past what is considered the “4-hour mark”. SCIP guidelines state that re-dosing of intra-operative Cefazolin should occur every 4 hours (Heuer, Kossick, Riley and Hewer, 2017). Interviews with staff members showed that further prompts within the documentation system, continued chart audits, peer comparison and ongoing education would be beneficial to increasing compliance with antibiotic re-dosing. Conclusion: Continued education, changes to the documentation system, peer comparison and continued staff education all have the potential to increase compliance with re-dosing of intraoperative antibiotics. Implementation of these strategies and follow-up data collection are the next steps in this initiative. Data collection after implementation of these strategies should focus on the number of patients that received appropriate prophylaxis dosing and the measures that were in place to ensure compliance. A comparison with the data collected for this project would be beneficial in measuring the effectiveness of the proposed strategies.
    Keyword
    Antibiotic Prophylaxis--standards
    Cefazolin--administration & dosage
    Surgical Wound Infection--prevention & control
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/13012
    Collections
    Doctor of Nursing Practice (DNP) Projects

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Policies | Contact Us | UMB Health Sciences & Human Services Library
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.