Assessment of antibiotic use and impact of an intervention intended to modify the prescribing behaviour in surgical prophylaxis in 6 hospitals in the metropolitan area of Monterrey, Mexico

Palacios-Saucedo, Gerardo del Carmen; Garza-Camargo, Mauricio de la; Briones-Lara, Evangelina; Carmona-González, Sandra; García-Cabello, Ricardo; Islas-Esparza, Luis Arturo; Saldaña-Flores, Gustavo; González-Cano, Juan Roberto; González-Ruvalcaba, Román; Valadez-Botello, Francisco Javier; Muñoz-Maldonado, Gerardo Enrique; Montero-Cantú, Carlos Alberto; Díaz-Ramos, Rita Delia; Solórzano-Santos, Fortino

doi:10.1016/j.circen.2016.10.011

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…Palacios-Saucedo et al implemented an intervention that included both hard and electronic copies of the guidelines and notification of every doctor over their individual compliance rate. Results showed significant improvement (P < 0.05) to all parameters of PAP [13]. In a similar study by Brink et al, face to face sessions were used as quality improvement techniques; and a 24.7% (P < 0.0001) increase in overall compliance with PAP guidelines was found [14].…”

Section: Discussionmentioning

confidence: 74%

Perioperative Antibiotic Prophylaxis: An Educative Intervention Significantly Increases Compliance

et al. 2021

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Background: Implementation of guidelines in daily clinical practice is often suboptimal, mainly due to doctors' poor compliance with them. Perioperative antibiotic prophylaxis (PAP) is many times administered in patients undergoing elective surgery without proper indication or for longer time than needed. Aim of this study is to investigate the effect of a simple intervention on the compliance of the medical staff with the American Society of Health-System Pharmacists (ASHP) guidelines concerning PAP administration. Methods: A prospective 3-month audit took place including routine surgical procedures (laparoscopic cholecystectomy, inguinal hernia repair and thyroidectomy). An intervention aiming to educate the medical staff was implemented. The intervention included the demonstration of a poster and the training of the medical staff over the guidelines. A re-audit recorded the changes in daily clinical practice. Results: The compliance rate regarding the number of PAP doses significantly increased from 0% before the intervention to 68.8% after the intervention for hernia repair and to 53.1% for laparoscopic cholecystectomy. The adherence rate in thyroidectomies increased from 25% to 50%, but without statistical significance. No significant difference was found for other parameters of PAP administration, namely the type of antibiotic used and the timing of the dose administration. Regarding secondary outcomes, hospitalization days were reduced, and cost of antibiotics was significantly decreased (P < 0.05). Conclusions: A simple intervention intending to educate the medical staff was successful in achieving significant improvement on the compliance rate with the PAP guidelines, highlighting the importance of promoting adherence to the already existing, well-established guidelines.

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Section: Discussionmentioning

confidence: 74%

Perioperative Antibiotic Prophylaxis: An Educative Intervention Significantly Increases Compliance

et al. 2021

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“…Therefore, surgeons may be extending SP to discharge prescriptions because they are concerned about an infectious complication that might develop and that might fail to be detected in time. Nonetheless, one important point to bear in mind is that since most wound infections are acquired during surgery, starting SP at the appropriate time is more effective than prolonging SP during the postoperative period [13,28]. In addition, if patients should develop a fever or there is an increase in their white blood cell count, a rigorous investigation for different infection foci in order to combat the source of infection is a far more efficient response than changing or prolonging the antibiotic [29].…”

Section: Discussionmentioning

confidence: 99%

Assessment of prophylactic antibiotic usage habits of the general surgeons in Turkey

Karaalı

Emiroğlu

Esin

et al. 2020

J Infect Dev Ctries

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Introduction: One of the most important aspects of inappropriate antibiotic use among general surgeons in Turkey is the use of surgical antibiotic prophylaxis (SP). In order to shed light on the current situation, we conducted a survey of general surgeons in our country. Our aim was to evaluate the approach taken by our general surgeons in prescribing SP, while providing data pertinent to the effectiveness of the ‘Rational Drug Use’ (AIK) national action plan. Methodology: A questionnaire on the subject of personal SP usage and compliance with guidelines was distributed amongst general surgeons between 2018-2019. The questions related to individual approaches taken by surgeons when treating patients with either clean or clean-contaminated wounds. Results of the questionnaires were collated and compliance with ASHP guidelines was evaluated. Results: A total of 317 completed questionnaires were evaluated. According to the questionnaire results, the rate of total compliance with ASHP guidelines was 26.8%. The compliance rate for preoperative SP was 69.7% in the clean wound group and 54.6% in the clean-contaminated wound group. Although 96.5% of the participants reported correct timing for the first dose of SP, this number dropped to 79.5% apropos the adminstration of further doses of prophylaxis. The percentage of surgeons prescribing continued antibiotics at discharge for clean and clean-contaminated cases was 22.7% and 38.5%, respectively. Conclusions: The results of this study indicate that inappropriate use of SP is widespread in our country, and that antibiotics continue to be prescribed at discharge.

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Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness

et al. 2022

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BackgroundGlobally, 5 billion people lack access to safe surgical care with more deaths due to lack of quality care rather than lack of access. While many proven quality improvement (QI) interventions exist in high-income countries, implementing them in low/middle-income countries (LMICs) faces further challenges. Currently, theory-driven, systematically articulated knowledge of the factors that support successful scale-up of QI in perioperative care in these settings is lacking. We aimed to identify all perioperative safety and QI interventions applied at scale in LMICs and evaluate their implementation mechanisms using implementation theory.MethodsSystematic scoping review of perioperative QI interventions in LMICs from 1960 to 2020. Studies were identified through Medline, EMBASE and Google Scholar. Data were extracted in two phases: (1) abstract review to identify the range of QI interventions; (2) studies describing scale-up (three or more sites), had full texts retrieved and analysed for; implementation strategies and scale-up frameworks used; and implementation outcomes reported.ResultsWe screened 45 128 articles, identifying 137 studies describing perioperative QI interventions across 47 countries. Only 31 of 137 (23%) articles reported scale-up with the most common intervention being the WHO Surgical Safety Checklist. The most common implementation strategies were training and educating stakeholders, developing stakeholder relationships, and using evaluative and iterative strategies. Reporting of implementation mechanisms was generally poor; and although the components of scale-up frameworks were reported, relevant frameworks were rarely referenced.ConclusionMany studies report implementation of QI interventions, but few report successful scale-up from single to multiple-site implementation. Greater use of implementation science methodology may help determine what works, where and why, thereby aiding more widespread scale-up and dissemination of perioperative QI interventions.

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Assessment of antibiotic use and impact of an intervention intended to modify the prescribing behaviour in surgical prophylaxis in 6 hospitals in the metropolitan area of Monterrey, Mexico

Cited by 5 publications

References 26 publications

Perioperative Antibiotic Prophylaxis: An Educative Intervention Significantly Increases Compliance

Perioperative Antibiotic Prophylaxis: An Educative Intervention Significantly Increases Compliance

Assessment of prophylactic antibiotic usage habits of the general surgeons in Turkey

Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness

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