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General and Risk Management, Patient Safety (including: medication errors, quality control)
Quality management of antimicrobial prophylaxis for surgery
  1. C. Vilaboa Pedrosa,
  2. M. Mateos Salvador,
  3. J.M. Gutierrez Urbon,
  4. C. Seco Vilariño,
  5. M.I. Martin Herranz
  1. 1Complejo Hospitalario Universitario A Coruña, Pharmacy, A Coruña, Spain

Abstract

Background The surgical site infection (SSI) is one of the most important issues affecting the safety of the surgical patient. Surgical antimicrobial prophylaxis (SAP) is a protective factor for SSI. Proper application of SAP is a surgical units quality indicator.

Purpose To describe the process of implementing a quality management system (QMS) in the implementation of SAP in a tertiary general hospital.

Materials and methods SAP was based on kit of prophylaxis (KP), which is prepared in the pharmacy and contains the antibiotic dosages required for each SAP. There are four different KP available to cover all surgical procedures. The KP contains cefazolin, vancomycin or amoxicillin -clavulanate. The phial containing the antimicrobial is connected to a saline solution that allows the reconstitution and dilution without needles. The KP incorporates a form that provides administration information. Fill in the form is used to justify the administration of the drug.

Results QMS consists of the implementation of a strategy to measure and improve the SAP. QMS was implanted in a progressive way in the hospital. It was based on the following sequential steps: 1) development of SAP protocols based on KP. Protocols were consensus among the surgical unit and the pharmacy department and validated by pharmacy and infectious committees. 2) Circuit implementation of a prescription-dispensing-administration of KP. The KP are prepared at pharmacy department when requested and sent to the surgical units so that each dose is administered in the appropriate time and place. 3) Conducting the assessment of quality standards of SAP through an annual audit. Audit results are sent to the hospital's medical management and each surgical unit and it is usefully as a measure of evaluation of objectives and to take action for improvement.

Conclusions The implementation of a QMS based on KP promotes proper application of SAP.

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