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Does the use of prophylactic antibiotics ensure the prevention of surgical site infections - Research Paper Example

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Does the use of prophylactic antibiotics ensure the prevention of surgical site infections? An analysis of evidence-based nursing research Sheila Johnson Nursing Research Nur: 430 Dayle Comar May 2nd, 2011 Introduction Surgical site infection (SSI) is one of the most common complications of surgery, characterized by a constellation of clinical findings occurring within 30 days of surgery and mainly due to Gram-positive bacteria (Bucher, Warner & Dillon, 2011)…
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Does the use of prophylactic antibiotics ensure the prevention of surgical site infections
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Download file to see previous pages Several strategies have been suggested to improve antibiotic prophylaxis (AP), including: providing education or individualized feedback to clinicians; establishing multidisciplinary protocols to ameliorate team-level communication; implementing institutional antibiotic prophylaxis programs involving integrated systems to reduce, curtail or control the administration of antibiotics (Gagliardi, Fenech, Eskicioglu, Nathens & McLeod, 2009). With the goal of optimizing antibiotic prophylaxis of surgical-site infections a multidisciplinary approach has been recently revised by Olin (Olin, 2006). The author presents the main points in prescribing, dispensing, and administration practices to achieve 100% compliance with antibiotic prophylaxis, and he cites in particular: initiating prophylactic antimicrobials within one hour of surgical incision, by choosing them according to guidelines, and discontinuing antimicrobial prophylaxis within 24 hours after surgery (Olin, 2006). A crucial issue in antibiotic-based peri-operative prophylaxis is the timing of antibiotic delivery. Although there is a general agreement on recommending antibiotic treatment within one to two hours of incision for patients undergoing surgery, contrasting results demand further research. Several clinical studies continue to be published yearly, aiming at optimizing the timing of antibiotic treatments (Gupta, Hote, Choudhury, Kapil & Bisoi, 2010). The purpose of my assay is to evaluate a recently published evidence-based nursing research aimed to assess the effects of the SURPASS checklist on implementation on antibiotic prophylaxis (de Vries, Dijkstra, Smorenburg, Meijer & Boermeester, 2010). SURPASS is the acronym for SURgical Patient Safety System, a checklist previously developed by the same authors of the study hereby analyzed, which was aimed to increase standardization surgical procedures and patient safety (de Vries, Hollmann, Smorenburg, Gouma & Boermeester, 2009). Research study synopsis and analysis De Vries et al. (2010) performed a retrospective analysis on two cohorts of patients who underwent surgery before and after implementation of the SURPASS checklist, with the specific aim to determine whether the introduction of the implemented SURPASS checklist affected the timing of antibiotic prophylaxis. Importantly, the retrospectively collected data (including those extracted from the electronic patient data management system) were validated by observations, in which actual times of antibiotic administration and incision were recorded. This approach validated the use of electronic records of hospitalized patient management. A total of 772 surgical procedures were included in the study, divided in two cohorts treated with pre- and post-implementation (PI) checklist, respectively. Patient characteristics were listed in Table 1 of the paper. The latter and the use of a PI checklist were independent variables. Dependent variables were the intervals between antibiotics administration and incision (Figure 2 of the paper), expressed as a function of checklist implementation, i.e. in surgery performed before or after checklist implementation. Since in the PI cohort the checklist was actually used in ...Download file to see next pagesRead More
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