1432 Simplifying Processes to Improve Rate of Surgical Site Infections

Abstract

Abstract Aim Surgical site infection (SSI) is a common healthcare associated infection, complicating 10-15% of operations. These have the potential to cause significant harm to patients, prolong hospital stays and are costly to the NHS. Although the cause is multifactorial, appropriate antibiotic prophylaxis plays a role in reducing SSIs. Due to a higher-than-average rate of SSIs at ASPH, an audit was performed to review the use of antibiotics prior to surgery. Method Local antibiotic policies for surgical prophylaxis were used as the audit standard. Data was collected prospectively over a two-week period. Recovery nurses filled out a proforma identifying type of surgery, patients’ weight, antibiotics received and dose. Results 120 datasets were collected. Due to incomplete data, 113 were analysed; 81 patients required prophylactic antibiotics. The audit identified that current practice was not aligned with local policy. Where antibiotic use was indicated, all bar one patient received appropriate antibiotics. The primary issue identified was incorrect gentamicin dosing when a 5mg/kg dose based on creatine clearance was required. Gentamicin was dosed appropriately in 15 out of 49 cases, with 160mg administered in most cases regardless of policy. Conclusions Reasons underlying this are likely to be multifactorial, including ototoxicity risk, dose calculation and administration time; at present, the scheduling of theatre cases does not allow for a 30-minute gap from induction of anaesthesia to start of surgery. Working in partnership with the microbiologists we plan to create a gentamicin dose reference chart for display in all anaesthetic rooms to simplify dosing and improve compliance.