Compliance with surgical antibiotic prophylaxis - reporting from a statewide surveillance programme in Victoria, Australia
Compliance with surgical antibiotic prophylaxis - reporting from a statewide surveillance programme in Victoria, Australia
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DOI：
10.1016/j.jhin.2006.01.018
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发表时间：
2006-06-01
影响因子：
6.9
通讯作者：
Richards, MJ
中科院分区：
文献类型：
--
作者：
Bull, AL;Russo, PL;Richards, MJ
对澳大利亚维多利亚州大型公立医院的外科抗生素预防 (SAP) 指南合规性进行了全州范围的评估。这是利用作为医院获得性感染监测系统的一部分收集的数据进行的。研究人群包括在拥有超过 100 个床位的维多利亚州公立医院 (N = 27) 接受心脏外科手术、髋关节或膝关节置换术、胆囊切除术、阑尾切除术、结肠手术或子宫切除术超过 21 个月的患者。澳大利亚指南推荐 SAP 用于本研究中包含的所有 10643 例外科手术。综合所有手术，87% 的患者接受了 SAP，53.3% 的手术抗生素的选择与指南一致，23.9% 的手术抗生素的选择被认为“足够但不一致”。 SAP 被认为不足以完成 18.9% 的程序。大量抗生素治疗方案被用于心脏和骨科手术。超过一半的程序未提交给药时间的文件。 76.4% 的程序记录时的时间安排与指南一致。与其他类型的手术相比，预防性抗生素的选择通常更符合心脏和骨科手术的指南。然而，即使对于这些感染发病率很高的手术，SAP 有时也不够。根据医院获得性感染监测期间收集的数据定期报告 SAP 合规情况是可以实现的。这应该会导致合规性和文档方面的改进。 (c) 2006 年医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
A statewide assessment of the compliance of surgical antibiotic prophylaxis (SAP) with guidelines was undertaken for large public hospitals in Victoria, Australia. This was carried out using data collected as part of a surveillance system for hospital-acquired infections. The study population comprised patients in Victorian public hospitals with > 100 beds (N = 27) undergoing cardiac surgical procedures, hip or knee arthroplasty, cholecystectomy, appendectomy, colon surgery or hysterectomy over a 21 month period. Australian guidelines recommend SAP for all 10643 surgical procedures included in this study. Combining all procedures, 87% received SAP, the choice of antibiotic was concordant with guidelines for 53.3% of procedures, and the choice of antibiotic was considered to be 'adequate but not concordant' for 23.9% of procedures. SAP was considered to be inadequate for 18.9% of procedures. A large number of antibiotic regimens were utilized for cardiac and orthopaedic surgery. Documentation of timing of administration was not submitted for more than half of all procedures. Timing was concordant with guidelines for 76.4% of procedures when documented. Prophylactic antibiotic choice was generally more concordant with guidelines for cardiac and orthopaedic procedures than for other types of surgery. However, even for these procedures, where infections carry high morbidity, SAP was sometimes inadequate. Regular reporting on SAP compliance from data collected during surveillance for hospital-acquired infections is achievable. This should lead to improvements in both compliance and documentation. (c) 2006 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.