Pediatric Operative Administration Of Antibiotics For Surgical Patients

It is thought that overuse of antibiotics is related to the development of antimicrobial resistance (AMR) (Austin). As a consequence, there has been an increasing trend to promote appropriate prescribing of antibiotics so as to maximise their therapeutic efficacy and minimise the outbreak of resistance. Antimicrobial stewardship (AMS) programs in hospitals are exemplary of a method used to promote rational prescription of antibiotics. In this review, we will briefly introduce some examples of AMR to illustrate the extent of this issue. We will then move on to describe AMS programs and the strategies required to

5. Poulin,P., et al.(2014) Preoperative Skin Antiseptics for preventing surgical site infections: What to do?

The Joint Commission Accreditation Body assesses health care organization’s compliance with National Patient Safety Goals. The goal of the Joint Commission Body is to focus on critical aspects and patient safety issues in health care organizations, which can vary according to the setting of the health care being performed (Chassin, 2008). Infections occurring in surgical sites of patients account for 15% of all infections that transpire in a hospital setting, and the risk of death doubles in patients who develop infections. The dangers of surgical site infections include superficial, deep, and organ or space infections. The different infections include cellulitis, gangrene, MRSA, and wound sinus, which can lead to amputation, organ

The unit utilizes an evidence-based testing and pre-surgical evaluation processes, thereby making it ideal to do the required assessment, testing, and treatment effectively. Although, there continues to be resistance from some surgeons, majority are taking notice of the major impacts of inadequate pre-operative patient preparation. The JC risk assessment recommendations dictate institutions are responsible to reduce infections caused by Multi Drug Resistant Organisms (MDRO) and the initial occurrence of an epidemiologically significant organism (2016).

Hospital-acquired infections (HAI) affect 1.7 million Americans each year with as many as 98,000 dying annually as a result of hospital-acquired conditions (HAC) (Kavanagh, 2007). In 2008, the Centers for Medicare and Medicaid Services (CMS) implemented policy to include non-payment for HAC in order to improve quality patient care and contain costs. This non-payment disincentive refuses to pay for complications of care that are considered preventable. Two other paradigms of this policy used to promote quality include pay-for-performance initiatives and public disclosure of HAC.

Meanwhile, the quality improvement team selected potential subjects and added their medical record numbers to the database. The team decided to utilize a quality improvement toolbox technique to create surveys for physicians to complete on a daily basis. The survey form requested patient demographics along with the patient’s medical history. The physicians were asked to estimate the patient’s risk of ARTI complications due to chronic illnesses such as diabetes or cardiovascular disease. Finally, the physician recorded the patient’s final diagnosis and the type of antibiotic prescribed. The data collected from the physician forms was entered into a database (REDCaps) for statistical analysis. The working hypothesis stated that the overall antibiotic prescription rate would be reduced by 5% through education and intervention. Overall, their final results support their hypothesis, all of their stated goals met expectations. The overall prescription rate was reduced from 69% to 55%, and broad spectrum antibiotic prescriptions fell from 68% to 59%. The interventions also reduced antibiotic use in otherwise healthy patients and delayed treatment with antibiotics from a baseline of 8.3 days to 9.7 days (Grover DO, et al.,

Pain…fever…oozing pus. Who would want to experience that? The answer is no one. Yet, out of the sixty to seventy of women who undergo a cesarean section, twelve percent will experience these symptoms due to a surgical site infection (SSI) ("Adjunctive Azithromycin Prophylaxis for Cesarean Delivery", 2017). SSI are the primary cause of mortality and morbidity amongst cesarean section women. SSI are linked to increased length of stay, hospitalization rate, and healthcare costs. Many cases of SSIs are preventable with appropriate preoperative preparation and surgical technique (McKibben et. al, 2015). One specific prophylactic method is the use of antibiotics preoperatively. Using an EBP model, PICO,

Many of the former patients have been told that the hospital is recommending them to be evaluated as the infection is easily treatable. Several of the convalescents already diagnosed and hospitalized for treatment, as nearly ready to be discharged. Some of the symptoms of the surgical site infection are swelling of the surgical incision, "wound drainage," redness and fever. The hospital has since disposed of and replaces the piece of affected equipment, and has sterilized the entire operating room responsible for the outbreak. They have also set up a 24-hour hotline for inquiries concerning the infection and their health in connection to it. Similarly, they are contacting other hospitals with

Hospitals aim to provide quality and satisfactory patient care while simultaneously trying to reduce costs. This means that as nurses, we have to strive to provide holistic care for our patients and avoid making preventable mistakes because it is very expensive. Medicare used to pay for errors that were made by healthcare providers during a patient’s hospital stay, but now Medicare will not reimburse for preventable errors (Andel, Davidow, Hollander, & Moreno, 2014). Many hospitals are enforcing guidelines to prevent patients from obtaining hospital-acquired infections.

As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work

Perioperative prophylactic antibiotics for total joint replacements have been proven to reduce rates of surgical site infections.2-3 It is recommended that prophylactic antibiotics are administered within one hour prior to surgical incision and are discontinued within 24 hours following the end of surgery.4 First generation cephalosporins, such as cefazolin, are the agents most commonly utilized for antimicrobial prophylaxis in joint replacement procedures.2,5 Vancomycin may be used in addition to a first generation cephalosporin in institutions considered to have a high rate of methicillin-resistant staphylococcus aureus (MRSA) surgical site infections. 2 If there is local data to suggest gram-negative pathogens as a cause of PJI then it is recommended to consider the addition

Thornhill et al.’s article on the cessation of antibiotic prophylaxis and its impact on infective endocarditis examined, both, prescriptions for antibiotics of a standard premedication dose (3g amoxicillin or 600mg clindamycin) and diagnoses or deaths due to infective endocarditis between January 2000 and April 2010. The time frame chosen for this study was critical due to the release of updated NICE guidelines, stating providers should cease use of any antibiotic prophylaxis for dental and other medical procedures. By examining the time surrounding the NICE guidelines, the researchers hoped to evaluate any relationship between premedicative prescriptions and incidents of infective endocarditis. They hypothesized that in order to see evidence that the NICE guidelines were valid, there would be minimal to no change in rate of infective endocarditis after the NICE guidelines became effective compared to before, even though the amount of prescription decreased. The researchers felt that this study was necessary due to the limited large-scale studies relating to recent changes in

Eighty percent of antibiotic prescribing takes place in general practice (Haddox, 2013). Therefore, focus of limiting antibiotic

Ethical challenges are the most profound when dealing with patient safety; compliance with the prophylaxis antibiotic administration guidelines is paramount to a surgical patient in order to decrease the possibility of a post operative surgical site infection. Antibiotic timing requires

Postoperative surgical site infections according to Nichol (2001) remain a major source of illness in surgical patients. Beaver, (2008) point out that surgical infection is one of the side effects that occur after a patient has gone for surgery.