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The identification of barriers preventing the successful implementation of a surgical prophylaxis protocol

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Abstract

Aim: The aim of this study was to introduce a protocol for the use of antimicrobials in surgical prophylaxis for the described procedures in Antrim Area Hospital. Method: Historical data of antimicrobial use were obtained from retrospective analysis of patients" charts, for those patients identified as having one of the following ‘clean / contaminated’ surgical procedures over the previous six months; cholecystectomy or abdominal hysterectomy. These data were analysed, and a protocol was introduced providing guidelines for the choice of antimicrobial agent, its administration time, route, dose, duration and frequency of treatment. Main outcome measure: The main outcome measure was the success of the uptake of the protocol following its implementation. Results: There was a total of 285 patients identified, 105 prior to and 180 post implementation. Overall, 68% of patients received some form of prophylaxis in the first cycle, and 72% in the second. Conclusion: Although the introduction of the protocol led to slight improvements in compliance with standard prescribing procedures, with an increase in single‐dose prophylaxis, and a reduction in prolonged prophylactic treatment, the improvements did not reach expectations. This paper attempts to identify the possible barriers to protocol implementation.

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Authors and Affiliations

  1. Antrim Hospital Academic Pharmacy Practice Unit, Antrim Area Hospital, Bush Road, Antrim, BT41 2RL, UK

    Kathryn M. Burnett & Michael G. Scott

  2. Antrim Microbiology Department, Antrim Area Hospital, Antrim, UK

    Patricia M. Kearney

  3. Surgical Directorate, Antrim Area Hospital, Antrim, UK

    W. George Humphreys

  4. Woman and Child Health Directorate, Antrim Area Hospital, Antrim, UK

    Robert M. McMillen

Authors
  1. Kathryn M. Burnett
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  2. Michael G. Scott
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  3. Patricia M. Kearney
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  4. W. George Humphreys
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  5. Robert M. McMillen
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Burnett, K.M., Scott, M.G., Kearney, P.M. et al. The identification of barriers preventing the successful implementation of a surgical prophylaxis protocol. Pharm World Sci 24, 182–187 (2002). https://doi.org/10.1023/A:1020565000571

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  • DOI: https://doi.org/10.1023/A:1020565000571

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