Article Text
Abstract
Background Antibiotic preventive care in a surgical hospital is very important: the main cause of surgical infections is the endogenous bacteria flora of patients. For this reason, in 2009, a multidisciplinary team defined the new guideline (LG) providing: one single shot of cefazolina 2 g, replaced by clindamicyn 600 mg in allergic patients; and the administration of prophylaxis from 30 to 60 min before the incision. The team also identified indicators to monitor the correct prevention of hospital infections: comply with LG, timing respect , and use of hydroalcoholic solution for hand-washing, defined correctly by OMS between 10 to 20 litres for 1,000 days of hospitalisation.
Purpose Indicators were monitored to verify the accuracy of prevention measures and on the basis of obtained results, a programme was possible for improving interventions.
Material and methods In order to verify LG adherence of prophylaxis, antibiotics prescription has been controlled in a sample of 189 medical records. Timing administration registered by the operating theatre programme had been verified and the consumption of hydroalcoholic solution for hand-washing has been controlled according to the pharmacy management programme for 2016.
Results Medical records indicate an adherence of nearly 100% to LG: in 189 medical records only two resulted in not complying with prophylaxis continuation up to patient discharge. Timing administration was respected only in 65% of cases: 5% received cefazolina after 60 min and the other 30% received it before 30 min. Gel consumption for handwashing was 23 litres gel/100 hospitalisation days.
Conclusion Adherence to prophylaxis has been achieved, therefore only periodic monitoring is to be continued. The use of hydroalcoholic solution for hand-washing is slightly higher than the OMS guideline and to make sure that hand-washing is carried out in the correct way, dedicated timers will be mounted on faucets. Timing administration, on the contrary, is still poor, so that is why there will be a meeting with anaesthesiologists in order to decide future strategy.
No conflict of interest