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Prophylactic antibiotics Audits

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https://www.readbyqxmd.com/read/27822762/clinical-practice-audit-concerning-antimicrobial-prophylaxis-in-paediatric-neurosurgery-results-from-a-german-paediatric-oncology-unit
#1
Katja Weiss, Arne Simon, Norbert Graf, Jakob Schöpe, Joachim Oertel, Stefan Linsler
BACKGROUND: Perioperative antimicrobial prophylaxis (PAP) has been identified as an important target for internal audits, concerning the judicious use of antibiotics. Paediatric oncology patients with brain tumours face an increased risk of surgical site infection (SSI) after neurosurgery and receive routine PAP in this setting. PATIENTS AND METHODS: All patients younger than 18 years admitted to the paediatric oncology centre (POC) with a neurosurgical intervention...
November 7, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27562986/primary-ventriculoperitoneal-shunting-outcomes-a-multicentre-clinical-audit-for-shunt-infection-and-its-risk-factors
#2
P Ym Woo, H T Wong, J Ks Pu, W K Wong, L Yw Wong, M Wy Lee, K Y Yam, W M Lui, W S Poon
OBJECTIVES: To determine the frequency of primary ventriculoperitoneal shunt infection among patients treated at neurosurgical centres of the Hospital Authority and to identify underlying risk factors. METHODS: This multicentre historical cohort study included consecutive patients who underwent primary ventriculoperitoneal shunting at a Hospital Authority neurosurgery centre from 1 January 2009 to 31 December 2011. The primary endpoint was shunt infection, defined as: (1) the presence of cerebrospinal fluid or shunt hardware culture that yielded the pathogenic micro-organism with associated compatible symptoms and signs of central nervous system infection or shunt malfunction; or (2) surgical incision site infection requiring shunt reinsertion (even in the absence of positive culture); or (3) intraperitoneal pseudocyst formation (even in the absence of positive culture)...
October 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27561596/antibiotic-resistance-in-early-periprosthetic-joint-infection
#3
Saiprasad Ravi, Mark Zhu, Christopher Luey, Simon W Young
BACKGROUND: Prophylactic antibiotics significantly reduce prosthetic joint infection (PJI) rates after hip and knee arthroplasty. However, rising antibiotic resistance has raised concerns over the adequacy of conventional prophylaxis. This study aimed to identify organisms causing PJIs in hip and knee arthroplasty secondary to perioperative contamination and their susceptibility to current prophylactic antibiotics. METHODS: We performed a retrospective audit of 4009 primary hip and knee arthroplasties (1852 hips and 2157 knees) at three tertiary referral hospitals...
December 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27349469/external-ventricular-drain-infections-at-the-canberra-hospital-a-retrospective-study
#4
Kevin Phan, Konrad Schultz, Christopher Huang, Stephen Halcrow, John Fuller, David McDowell, Peter J Mews, Prashanth J Rao
External ventricular drains (EVD) are crucial for the emergency management of hydrocephalus and raised intracranial pressure. Infection is the most morbid and costly cause of EVD malfunction and can cost up to $50,000 US to treat per case. In 2007, Canberra Hospital changed EVD management protocols requiring set-up of EVD transducer systems in theatre, cessation of prophylactic antibiotics after 24hours, cerebrospinal fluid (CSF) samples second or third daily and discontinuation of elective EVD changes. The current study aimed to retrospectively audit EVD inserted between 2006 and 2010 in order to determine the impact of these changes...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/26621675/compliance-with-evidence-based-guidelines-in-acute-pancreatitis-an-audit-of-practices-in-university-of-toronto-hospitals
#5
J A Greenberg, J Hsu, M Bawazeer, J Marshall, J O Friedrich, A Nathens, N Coburn, H Huang, R S McLeod
Despite existing evidence-based practice guidelines for the management of acute pancreatitis, clinical compliance with recommendations is poor. We conducted a retrospective review of 248 patients admitted between 2010 and 2012 with acute pancreatitis at eight University of Toronto affiliated hospitals. We included all patients admitted to ICU (52) and 25 ward patients from each site (196). Management was compared with the most current evidence used in the Best Practice in General Surgery Management of Acute Pancreatitis Guideline...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/26403670/study-of-the-early-management-of-acute-pancreatitis
#6
Maryam Nesvaderani, Guy D Eslick, Shadi Faraj, Daniel Vagg, Michael R Cox
BACKGROUND: Acute pancreatitis (AP) is a common acute surgical presentation with evidence-based guidelines for early management. The aim of this study was to assess the compliance to the published guidelines in patients presenting with AP in Western Sydney. METHODS: A retrospective case note audit was conducted for all patients with a confirmed diagnosis of AP from 2008 to 2011 in Western Sydney. RESULTS: There were 932 patients. The mortality was low for mild (0...
September 24, 2015: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/26343840/prophylactic-antibiotics-after-acute-stroke-for-reducing-pneumonia-in-patients-with-dysphagia-stroke-inf-a-prospective-cluster-randomised-open-label-masked-endpoint-controlled-clinical-trial
#7
RANDOMIZED CONTROLLED TRIAL
Lalit Kalra, Saddif Irshad, John Hodsoll, Matthew Simpson, Martin Gulliford, David Smithard, Anita Patel, Irene Rebollo-Mesa
BACKGROUND: Post-stroke pneumonia is associated with increased mortality and poor functional outcomes. This study assessed the effectiveness of antibiotic prophylaxis for reducing pneumonia in patients with dysphagia after acute stroke. METHODS: We did a prospective, multicentre, cluster-randomised, open-label controlled trial with masked endpoint assessment of patients older than 18 years with dysphagia after new stroke recruited from 48 stroke units in the UK, accredited and included in the UK National Stroke Audit...
November 7, 2015: Lancet
https://www.readbyqxmd.com/read/25876299/improving-surgical-site-infection-prevention-practices-through-a-multifaceted-educational-intervention
#8
P Owens, S McHugh, M Clarke-Moloney, D Healy, F Fitzpatrick, P McCormick, E Kavanagh
As part of the National Clinical Programme on healthcare-associated infection prevention, a Royal College of Surgeons in Ireland (RCSI) and Royal College of Physicians of Ireland (RCPI) working group developed a quality improvement tool for prevention of surgical site infection (SS). We aimed to validate the effectiveness of an educational campaign, which utilises this quality improvement tool to prevent SSI in a tertiary hospital. Prior to the SSI educational campaign, surgical patients were prospectively audited and details of antibiotic administration recorded...
March 2015: Irish Medical Journal
https://www.readbyqxmd.com/read/25431623/description-of-a-multidisciplinary-initiative-to-improve-scip-measures-related-to-pre-operative-antibiotic-prophylaxis-compliance-a-single-center-success-story
#9
Tori Sutherland, Jennifer Beloff, Marie Lightowler, Xiaoxia Liu, Luigino Nascimben, Alan D Kaye, Richard D Urman
BACKGROUND: The Surgical Care Improvement Project (SCIP) was launched in 2005. The core prophylactic perioperative antibiotic guidelines were created due to recognition of the impact of proper perioperative prophylaxis on an estimated annual one million inpatient days and $1.6 billion in excess health care costs secondary to preventable surgical site infections (SSIs). An internal study was conducted to create low cost, standardized processes on an institutional level to improve compliance with prophylactic antibiotic administration...
2014: Patient Safety in Surgery
https://www.readbyqxmd.com/read/25142492/a-national-trainee-led-audit-of-inguinal-hernia-repair-in-scotland
#10
S O'Neill, A G Robertson, A J Robson, C H Richards, G A Nicholson, D Mittapalli
PURPOSE: This audit assessed inguinal hernia surgery in Scotland and measured compliance with British Hernia Society Guidelines (2013), specifically regarding management of bilateral and recurrent inguinal hernias. It also assessed the feasibility of a national trainee-led audit, evaluated regional variations in practise and gauged operative exposure of trainees. METHODS: A prospective audit of adult inguinal hernia repairs across every region in Scotland (30 hospitals in 14 NHS boards) over 2-weeks was co-ordinated by the Scottish Surgical Research Group (SSRG)...
October 2015: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/25102516/an-audit-of-clinician-compliance-with-best-practice-recommendations-to-repair-severe-obstetric-anal-sphincter-injuries
#11
Shamir O Cawich, Santosh Kulkarni, Michael Ramdass, Dale Hassranah, Ian Bambury, Loxley R Christie, Vijay Naraynsingh
CONTEXT: Obstetric anal sphincter injuries occur uncommonly in Caribbean practice but are accompanied by substantial morbidity. OBJECTIVE: To evaluate clinicians' compliance with management guidelines at a national referral hospital in Jamaica. DESIGN: Retrospective review of the records of all consecutive obstetric patients with anal sphincter injuries between November 1, 2007, and December 30, 2012. MAIN OUTCOME MEASURES: The primary end point was the completion of each of 8 tasks from existing management guidelines: 1) interdisciplinary consultation, 2) perineal examination with the patient under anesthesia, 3) injury repair in the operating room, 4) prophylactic antibiotics at induction, 5) repair by an experienced clinician, 6) repair method appropriate for injury grade, 7) slowly absorbable suture chosen for sphincter repair, and 8) rapidly absorbable suture for mucosal repair...
2014: Permanente Journal
https://www.readbyqxmd.com/read/25079680/prevalence-of-ciprofloxacin-resistant-enterobacteriaceae-in-the-intestinal-flora-of-patients-undergoing-transrectal-prostate-biopsy-in-norwich-uk
#12
Marcelino Yazbek Hanna, Catherine Tremlett, Gurvir Josan, Ali Eltom, Robert Mills, Mark Rochester, David M Livermore
OBJECTIVE: To determine the efficacy of fluoroquinolone prophylaxis in patients undergoing transrectal ultrasonography (TRUS)-guided biopsy of the prostate in the Norwich population, and its correlation with ciprofloxacin resistance in the faecal flora. We also aimed to determine the usefulness of a pre-biopsy rectal screen for resistant bacteria in these patients. PATIENTS AND METHODS: The incidence and microbiology of sepsis after TRUS-guided prostate biopsies between 2007 and 2011 was audited retrospectively...
July 2015: BJU International
https://www.readbyqxmd.com/read/24641537/maternal-and-institutional-characteristics-associated-with-the-administration-of-prophylactic-antibiotics-for-caesarean-section-a-secondary-analysis-of-the-world-health-organization-multicountry-survey-on-maternal-and-newborn-health
#13
MULTICENTER STUDY
N Morisaki, T Ganchimeg, E Ota, J P Vogel, J P Souza, R Mori, A M Gülmezoglu
OBJECTIVE: To illustrate the variability in the use of antibiotic prophylaxis for caesarean section, and its effect on the prevention of postoperative infections. DESIGN: Secondary analysis of a cross-sectional study. SETTING: Twenty-nine countries participating in the World Health Organization Multicountry Survey on Maternal and Newborn Health. POPULATION: Three hundred and fifty-nine health facilities with the capacity to perform caesarean section...
March 2014: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/24606529/postsurgery-wound-assessment-and-management-practices-a-chart-audit
#14
Brigid M Gillespie, Wendy Chaboyer, Evelyn Kang, Jayne Hewitt, Paul Nieuwenhoven, Nicola Morley
AIMS AND OBJECTIVES: To examine wound assessment and management in patients following surgery and to compare these practices with current evidence-based guidelines for the prevention of surgical site infection across one healthcare services district in Queensland, Australia. BACKGROUND: Despite innovations in surgical techniques, technological advances and environmental improvements in the operating room, and the use of prophylactic antibiotics, surgical site infections remain a major source of morbidity and mortality in patients following surgery...
November 2014: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/24551629/prophylactic-antibiotics-and-wound-infection
#15
Abubaker Ibrahim Elbur, Yousif M A, Ahmed S A El-Sayed, Manar E Abdel-Rahman
INTRODUCTION: Surgical site infections account for 14%-25% of all nosocomial infections. The main aims of this study were to audit the use of prophylactic antibiotic, to quantify the rate of post-operative wound infection, and to identify risk factors for its occurrence in general surgery. METHODOLOGY: A cross-sectional study was conducted in the General Surgery Department in Khartoum Teaching Hospital- Sudan. All Adult patients (age ≥18 years) admitted during March 1(st) to 31(st) October 2010 were recruited...
December 2013: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/24129284/a-review-of-the-factors-influencing-antimicrobial-prescribing
#16
Esther Calbo, Luis Alvarez-Rocha, Francisco Gudiol, Juan Pasquau
There are multiple benefits of appropriate antimicrobial prescribing: it has a direct impact on clinical outcomes, avoids adverse effects, is cost effective and, perhaps most importantly, it helps to prevent the emergence of resistance. However, any physician can prescribe antibiotics, which is not the case with other clinically relevant drugs. There is great variability in the prescribing physician's (PP) training, motivation, workload and setting, including accessibility to infectious diseases consultants and/or diagnostic techniques, and therefore there is a high risk of inappropriate prescription...
September 2013: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/23678210/preventing-deep-wound-infection-after-coronary-artery-bypass-grafting-a-review
#17
REVIEW
Charles S Bryan, William M Yarbrough
The consequences of deep wound infections before, during, and after coronary artery bypass grafting have prompted research to clarify risk factors and explore preventive measures to keep infection rates at an irreducible minimum. An analysis of 42 studies in which investigators used multivariate logistic regression analysis revealed that diabetes mellitus and obesity are by far the chief preoperative risk factors. A 4-point preoperative scoring system based on a patient's body mass index and the presence or absence of diabetes is one practical way to determine the risk of mediastinitis, and other risk-estimate methods are being refined...
2013: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/23542369/the-utilization-of-standardized-order-sets-using-aasld-guidelines-for-patients-with-suspected-cirrhosis-and-acute-gastrointestinal-bleeding
#18
Kunut Kijsirichareanchai, Saowanee Ngamruengphong, Ariwan Rakvit, Kenneth Nugent, Sreeram Parupudi
To improve the adherence to AASLD (American Association for the Study of Liver Diseases) guidelines for variceal bleeding, we developed and implemented standardized order sets for gastrointestinal bleeding in our hospital on October 1, 2009. We performed medical record reviews of hospitalized patients with gastrointestinal bleeding with suspected cirrhosis from October 2009 to October 2010 to determine the use of octreotide, prophylactic antibiotics, and endoscopy. We reviewed 300 Medical records and identified 26 patients with suspected cirrhosis and gastrointestinal bleeding who had adequate information to determine whether or not the order set was used...
April 2013: Quality Management in Health Care
https://www.readbyqxmd.com/read/23477613/conservative-antibiotic-policy-in-patients-undergoing-non-trauma-cranial-surgery-does-not-result-in-higher-rates-of-postoperative-meningitis-an-audit-of-nine-years-of-narrow-spectrum-prophylaxis
#19
R K Moorthy, H Sarkar, V Rajshekhar
OBJECTIVE: To audit the efficacy of a conservative prophylactic antibiotic policy in patients undergoing non-trauma cranial surgery. MATERIALS AND METHODS: Prospectively collected infection data in consecutive patients who underwent non-trauma cranial surgeries in one neurosurgical unit between 1 January 2003 and 31 December 2011 were reviewed. Depending on the surgery performed, a one-day course of intravenous chloramphenicol or a single dose of ceftriaxone was used as the prophylactic antibiotic therapy...
August 2013: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/23317726/should-prophylactic-antibiotics-be-used-routinely-in-epistaxis-patients-with-nasal-packs
#20
T C Biggs, K Nightingale, N N Patel, R J Salib
INTRODUCTION: The current mainstream practice in otolaryngology departments relating to the use of prophylactic antibiotics in epistaxis patients requiring nasal packing is highly variable. This is due primarily to the lack of any validated guidelines. As such, we introduced a new treatment algorithm resulting in significant reduction of use in the systemic antibiotics, with emphasis instead on the use of topical antibiotics. The results were validated through a complete audit cycle. METHODS: A total of 57 patients undergoing nasal packing for spontaneous epistaxis were studied...
January 2013: Annals of the Royal College of Surgeons of England
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