Sustained improvement of appropriateness in surgical antimicrobial prophylaxis with the application of quality control circle

Abstract

Administration of surgical antimicrobial prophylaxis (SAP) is considered one of the most effective measures to reduce the incidence of surgical site infection (SSI) after various surgical procedures. Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in SAP remains unknown. Our present study utilized the QCC activity to improve the appropriate administration of SAP. A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied. The appropriateness of SAP before (July to December 2018) and after (January to June 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The appropriate rate of SAP was significantly improved from 68.72% before QCC to 93.7% post QCC implementation (P༜0.01). A significant improvement (P༜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antimicrobial usage (from 96.8 to 99.41%), re-dosing of antimicrobial (from 96.55 to 99.21%). The appropriate application of SAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial misuse and overuse.