Implementing an anesthesia information system with provider-specific feedback increased the proportion of patients receiving prophylactic antibiotics within 60 minutes of incision from 69% to 92%.
Absolute Event Rate: 92% vs 69%
In Brief 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 1 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. IMPLICATIONS: Assuring reliable, timely administration of prophylactic antibiotics before elective surgery is difficult. Using an electronic documentation system and practice guidelines to provide feedback to individual anesthesia providers significantly increased the proportion of patients receiving antibiotics within 60 min of incision for all types of surgery. This methodology lends itself to application with additional performance measures, such as blood glucose and normothermia management.
Reilly et al. (Tue,) conducted a other in Elective surgery. Anesthesia clinical information system with provider-specific feedback vs. Historical baseline (before project initiation) was evaluated on Administration of prophylactic antibiotics within 60 minutes of incision. Implementing an anesthesia information system with provider-specific feedback increased the proportion of patients receiving prophylactic antibiotics within 60 minutes of incision from 69% to 92%.