Automated Electronic Reminders to Improve Redosing of Antibiotics during Surgical Cases: Comparison of Two Approaches

Abstract

Timely re-dosing of antibiotic for prolonged surgical cases is an important measure in reducing the risk of surgical site infections. For the anesthesia team, which generally administers the antibiotic re-doses, it is difficult to keep track of and remember the exact timing requirements. We explored the efficacy of two types of electronic reminders to aid the anesthesia team in performing timely antibiotic re-doses. The first electronic reminder was a timer-triggered "blinking button" feature in the Anesthesia Information Management System (AIMS). The second was generated with a real-time decision support system, the Smart Anesthesia Messenger (SAM). The AIMS reminder was applied for the first five months of the study, whereas the SAM reminder was applied for the second five months. A retrospective analysis was performed to evaluate the efficacy of the reminder messages in improving the antibiotic re-dose success rate. In a total of 940 cases, the anesthesia team was reminded of the need for antibiotic re-dosing with AIMS, whereas in 922 cases, the SAM system gave the reminder. The AIMS reminders achieved a timely re-dose success rate of 62.5% ± 1.6%, whereas the SAM reminders achieved a significantly higher success rate: 83.9% ± 3.4% (p < 0.001). Compared with the simple reminders generated with AIMS, the relevant, informative messages generated with SAM were more effective in improving compliance with timely antibiotic re-doses.