Improving Timely Surgical Antibiotic Prophylaxis Redosing Administration Using Computerized Record Prompts

Jacques, Paul St.; Sanders, Neal; Patel, Nimesh; Talbot, Thomas R.; Deshpande, Jayant K.; Higgins, Michael S.

doi:10.1089/sur.2005.6.215

Cited by 62 publications

(34 citation statements)

References 13 publications

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“…108 Automation with computerized prompts in the anesthesia record system is efficacious in increasing compliance with this redosing and should be routinely employed. 88,107 Perioperative antibiotics are therefore those that are administered immediately before surgery, during surgery, and following an operation, and their proven efficacy is sufficient enough to warrant systems-based approaches to ensure timely consideration and dosing in all 3 time periods.…”

Section: Antibiotic Administrationmentioning

confidence: 99%

Infection following operations on the central nervous system: deconstructing the myth of the sterile field

Walcott

Redjal²,

Coumans³

2012

FOC

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Neurosurgical patients are at a high risk for infectious sequelae following operations. For neurosurgery in particular, the risk of surgical site infection has a unique implication given the proximity of the CSF and the CNS. Patient factors contribute to some degree; for example, cancer and trauma are often associated with impaired nutritional status, known risk factors for infection. Additionally, care-based factors for infection must also be considered, such as the length of surgery, the administration of steroids, and tissue devascularization (such as a craniotomy bone flap). When postoperative infection does occur, attention is commonly focused on potential lapses in surgical “sterility.” Evidence suggests that the surgical field is not free of microorganisms. The authors propose a paradigm shift in the nomenclature of the surgical field from “sterile” to “clean.” Continued efforts aimed at optimizing immune capacity and host defenses to combat potential infection are warranted.

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Section: Antibiotic Administrationmentioning

confidence: 99%

Infection following operations on the central nervous system: deconstructing the myth of the sterile field

Walcott

Redjal²,

Coumans³

2012

FOC

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“…For example, AIMS can allow point-of-care access to other medical and laboratory information. Some systems have been designed to provide alerts for allergies [5] or to improve timely surgical antibiotic re-dosing by offering the clinician reminder prompts [28]. Other potential applications in which the anesthesia information system plays an active role in improving patient care are likely limited only by one's imagination.…”

Section: Quality Of Care Toolmentioning

confidence: 99%

The Anesthetic Record: How Content and Design Influence Function In Anesthetic Practice and Beyond

Raymer¹

2011

J Anesth Clin Res

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IntroductionThe original anesthetic record was developed during the early days of the practice of Anesthesia to record pulse, as part of an effort to improve outcomes which at the time were poor. Though many aspects of our modern anesthesia practice would be unrecognizable to the pioneers of our specialty, the current handwritten anesthesia record looks remarkably similar to the original charts produced over a century ago [1]. Despite the superficial similarities, today's anesthetic record serves myriad functions beyond its central role as a medical record of anesthetic care. It is a key interdisciplinary communication tool, a source of information for research and quality assurance projects and a legal document that can be used in a wide range of medico-legal proceedings. The evolution of the record from handwritten to electronic form has advanced these roles, while at the same time bringing forth new challenges.The anesthetic record should promote the user's ability to achieve specific goals. Although it is an essential tool used by the Anesthesiologist on a daily basis, there is relatively little literature to guide its design and use. This article will describe the history of the anesthetic record and outline its use in our practice today. The content requirements, driven by legislative, medico-legal, professional and clinical factors, will be summarized. Finally, the impact of formatting choices, including handwritten and electronic media, is discussed. History and TerminologyThe first anesthetic records were devised in 1894 by two medical students, Harvey Cushing and Amory Codman. Often charged with delivering anesthetics for their surgical supervisor, Dr. F.B. Harrington, their descriptions of the use of those first charts offers a glimpse into the harrowing early days of the practice of Anesthesiology [1]. Cushing credits the charts with formalizing what had been, to that point "the very casual administration of a dangerous drug" [1]. His writings reveal how the recording of vital signs (pulse, respiratory rate, and later, blood pressure) along with the amount of ether administered was key in developing the understanding of cause and effect that modern-day anesthesiologists take for granted. The formative role that the anesthetic record played in both patient safety and the development of the specialty itself was noted by several observers, including Harold Griffith [2].The amount of information collected continued to increase and with the dawn of the digital age, the first electronic anesthetic records were introduced in the 1980's [3,4]. The electronic record allows automated capture of a large volume of physiologic and mechanical data. It also allows manual inputting of information by the clinician (by keyboard, mouse, touch-screen or microphone) and together, the automated and inputted data are organized to become the electronic anesthetic record which can be both stored in a database as well as printed out in paper form to be put on a physical chart. The electronic anesthetic record, in its current ...

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“…A variety of options are available for assisting providers in adhering to surgical AMP administration. Computer-aided systems for reminding providers to administer and/or redose AMP have been successful in increasing the appropriate redosing of AMP [5,6]. A preprinted checklist that accompanies the patient as they travel through the preoperative process and surgery can serve to remind clinicians to perform the essential tasks necessary to optimize AMP administration.…”

Section: Who Should Receive Amp?mentioning

confidence: 99%

Who, what, when, where, why, and how? The unanswered questions of surgical antimicrobial prophylaxis

Daniels

Talbot²,

Schaffner³

2006

Curr Infect Dis Rep

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Improving Timely Surgical Antibiotic Prophylaxis Redosing Administration Using Computerized Record Prompts

Abstract: A computerized reminder system is an effective tool to assist in appropriate intraoperative redosing of prophylactic antibiotics during lengthy surgical procedures.

Cited by 62 publications

References 13 publications

Infection following operations on the central nervous system: deconstructing the myth of the sterile field

Infection following operations on the central nervous system: deconstructing the myth of the sterile field

The Anesthetic Record: How Content and Design Influence Function In Anesthetic Practice and Beyond

Who, what, when, where, why, and how? The unanswered questions of surgical antimicrobial prophylaxis

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