antibiotics preop

stevierae · Jun 24, 2004

At what time do you administer the pre op antibiotics. What about if you aren't sure exactly when the case is going to start? Should the antibiotics be running in as pt is prepped or at least an hour before?

Usually 30 minutes before incision is what we strive for--unless it's Vanco or Cipro, which each need to go in over an hour.

Never less than 30 minutes, ideally--not to say it isn't done, but that's not how the CDC would like to see it done.

MelissaRN · Jun 24, 2004

I've been trying to find literature on this subject on the AORN website. Haven't had much luck. Got any literature that I could look at?

stevierae · Jun 25, 2004

I've been trying to find literature on this subject on the AORN website. Haven't had much luck. Got any literature that I could look at?

Sure! I just got this in today's email, and it says within the hour--as I said, where I have worked we try for 30 minutes, but that may change based on this advisory.

http://www.premierinc.com/all/safety/publications/06-04_full_txt.htm

>

CMS Surgical Infection Prevention Project issues antimicrobial prophylaxis

advisory

CMS' National Surgical Infection Prevention Project (SIPP) recently

published a joint advisory statement on "Antimicrobial Prophylaxis for

Surgery: An Advisory Statement from the National Surgical Infection

Prevention Project," in the June 15 issue of Clinical Infectious Diseases.

Premier, Inc. joins numerous other national healthcare and professional

organizations in officially endorsing these guidelines; organizations

include the American College of Surgeons, the American Academy of

Orthopaedic Surgeons, and the Society of Thoracic Surgeons.

The quality improvement project is co-sponsored by the Centers for

Medicare & Medicaid Services and the Centers for Disease Control and

Prevention (CDC) and is conducted through the CMS Health Care Quality

Improvement Program. Its goal is to reduce the occurrence of

post-operative infection by improving the selection and timing of

preventative antibiotic administration.

When the National Surgical Infection Prevention Project was launched in

2002, clinical experts identified areas of inconsistency among the

existing surgical infection prevention practice guidelines, as well as

issues that were not addressed in any of the guidelines. Areas of focus

included selection of antibiotics for patients with certain antibiotic

allergies, and the duration of antibiotic therapy after completion of the

operation.

Project leaders hosted a forum of national medical organizations in

January 2003. The two-day meeting led to initial consensus concerning

antibiotic selection, timing, and duration for select types of surgery.

The resulting advisory statement was subsequently accepted by all of the

participating organizations, as well as additional national medical

organizations. Its most important features were recommendations that

antibiotics used to prevent surgical infection should be given during the

hour before surgery and that they should not be used for more than 24

hours after the end of the operation. Timely administration results in

more effective infection prevention, while short duration is less likely

to produce antibiotic-resistant bacteria.

Download copy:

http://www.premierinc.com/all/safety/publications/06-04-downloads/07-cid-bratzler-consensus-2004.doc

or

http://makeashorterlink.com/?J104255A8

MelissaRN · Jun 25, 2004

Thanks Stevie! We've been debating it at work because we never know right when to give it because the cases run behind all the time. We may give it right when the patient comes to the pre-op area and then they sit there for an hour because the doc is behind and then we're waiting to turn over the operating room.

mcmike55 · Jun 28, 2004

At our hospital, we try to get the antibiotics in between 30 to 60 mins before incision, or tourniquet up time. Different of course for Vanco.

We have the IVPB hung, ready to go, but turned off until the pt actually moves towards the OR, or just before.

Our holding area holds just 3, and is run by the charge nurse, so she has a real good idea when the right time is to start the antibiotics.

Our may problem is doc that come in at the last sec and order an antibiotic (especially Vanco)! :angryfire

mcmike55 · Jul 9, 2004

I've been trying to find literature on this subject on the AORN website. Haven't had much luck. Got any literature that I could look at?

Melissa

I can't put my hands on the exact name, but there is an infection magazine that we get, that has a website with lots of info.

Infection control, or something like that.

Hope that helps.