MEAN ANTIBIOTIC ADMINISTRATION TIME
PRIOR TO PROCEDURE START TIME
2016
2017
PERIOPERATIVE ANTIBIOTICS
The administration of prophylactic antibiotics before surgery is a nationally
established best practice for preventing surgical site infections. To be
maximally effective, the patient must receive the right antibiotic at the right
dose within 30-60 minutes prior to surgery.
Historically, prophylactic antibiotics at UAB were ordered by surgeons
– often residents – after the patient entered the operating room and
administered within a few minutes prior to surgery, with provider variations
in product selection and dosing. Perioperative Services and Anesthesia
leadership recognized an opportunity to improve the care of surgery
patients by standardizing antibiotic administration.
In summer 2016, an interdisciplinary team of surgeons, anesthesiologists,
infection prevention specialists, nurses, and pharmacists came together to
evaluate national best practices and develop an antibiotic protocol for UAB
surgery patients. The resulting protocol was implemented in September
2016. It allows nurses in the preoperative holding area to administer the
right antibiotic for the procedure at the right dose for the patient at the right
time for it to be maximally effective. Surgeons retain the ability to override
or customize the protocol if the patient’s need dictate.
One important measure of success is the timing of antibiotic administration
relative to the start of surgery. In the three months prior to implementation
of the new protocol (June-August 2016), prophylactic antibiotics were
administered an average of 12 minutes prior to the start of surgery. Within
a year following implementation (October 2015-October 2016), timing
improved to an average of 32 minutes prior to surgery start.
18
UAB Quality and Safety Annual Report