An anesthesia information system designed to provide physician-specific feedback improves timely administration of prophylactic antibiotics
An anesthesia information system designed to provide physician-specific feedback improves timely administration of prophylactic antibiotics
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DOI：
10.1213/01.ane.0000237272.77090.a2
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发表时间：
2006-10-01
影响因子：
5.7
通讯作者：
Burney, Richard
中科院分区：
文献类型：
--
作者：
O'Reilly, Michael;Talsma, AkkeNeel;Burney, Richard
手术部位感染是发病率和死亡率的常见原因，并大大增加了护理成本。国家外科感染预防(SIP)计划的一个组成部分是确保及时给予预防性抗生素，这是减少术后感染的关键因素。我们的麻醉科决定承担抗生素预防的时间和管理责任，我们启动了一个多层次的方法来提醒麻醉医生使用预防性抗生素。我们使用我们的麻醉临床信息系统来实施及时给药的实践指南，并从数据库中生成报告，向个别护理人员提供具体的反馈，以确保患者在手术切开后1 h内接受抗生素预防。在这个项目开始之前，69%的符合条件的患者在切开后60分钟内接受了抗生素治疗。计划开始后，一年后依从性稳步上升至92%。提供者特定的反馈增加了与及时给予预防性抗生素相关的实践指南的遵从性。麻醉信息系统为实施和监测新的实践指南提供了希望，麻醉师可能通过确保可能与麻醉护理没有直接关系的适当治疗，在影响手术结果方面发挥关键作用。
Surgical site infections are a frequent cause of morbidity and mortality and add significantly to the cost of care. One component of the national Surgical Infection Prevention (SIP) program is to ensure timely administration of prophylactic antibiotics, a key factor to reduce postoperative infection. Our anesthesia department decided to assume the responsibility for timing and administration of antibiotic prophylaxis and we initiated a multitiered approach to remind the anesthesiologist to administer the prophylactic antibiotics. We used our anesthesia clinical information system to implement practice guidelines for timely antibiotic administration and to generate reports from the database to provide specific feedback to individual care providers with the goal of ensuring that patients receive antibiotic prophylaxis within I h of incision. Before the initiation of this project, 69% of eligible patients received antibiotics within 60 min of the incision. After the program began, there was a steady increase in compliance to 92% 1 yr later. Provider-specific feedback increases compliance with practice guidelines related to timely administration of prophylactic antibiotics. Anesthesia information systems hold promise for implementing and monitoring new practice guidelines and the anesthesiologist may play a key role in influencing surgical outcomes by ensuring appropriate therapy that may not be directly related to anesthesia care.