Preventing infection in general surgery: improvements through education of surgeons by surgeons

McHugh, Seamus; Corrigan, Mark; Dimitrov, Borislav D.; Cowman, Seamus; Tierney, Sean; Hill, Arnold D.; Humphreys, H.

doi:10.1016/j.jhin.2011.03.023

Cited by 17 publications

(10 citation statements)

References 38 publications

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“…PVC-associated infection is considered to be implicated in 5% of cases of nosocomial bacteraemia which has a prevalence of 670 per 100,000 patients with PVCs [2]. Although PVC-related infections may not result in increased mortality, they contribute considerably to the burden of the health-care system by increasing morbidity and treatment costs [1,3,4].…”

Section: Introductionmentioning

confidence: 99%

Molecular investigation of bacterial communities on the inner and outer surfaces of peripheral venous catheters

Zhang

Morrison

Nimmo

et al. 2013

Eur J Clin Microbiol Infect Dis

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Peripheral venous catheters (PVCs) are some of the most widely used medical devices in hospitals worldwide. PVC-related infections increase morbidity and treatment costs. The inner surfaces of PVCs are rarely examined for the population structure of bacteria, as it is generally believed that bacteria at this niche are similar to those on the external surface of PVCs. We primarily test this hypothesis and also study the effect of antibiotic treatment on bacterial communities from PVC surfaces. The inner and outer surfaces of PVCs from 15 patients were examined by 454 GS FLX Titanium 16S rRNA sequencing and the culture method. None of the PVCs were colonised according to the culture method and none of the patients had a bacteraemia. From a total of 127,536 high-quality sequence reads, 14 bacterial phyla and 268 diverse bacterial genera were detected. The number of operational taxonomic units for each sample was in the range of 86-157, even though 60 % of patients had received antibiotic treatment. Stenotrophomonas maltophilia was the predominant bacterial species in all the examined PVC samples. There were noticeable but not statistically significant differences between the inner and outer surfaces of PVCs in terms of the distribution of the taxonomic groups. In addition, the bacterial communities on PVCs from antibiotic-treated patients were significantly different from untreated patients. In conclusion, the surfaces of PVCs display complex bacterial communities. Although their significance has yet to be determined, these findings alter our perception of PVC-related infections.

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Section: Introductionmentioning

confidence: 99%

Molecular investigation of bacterial communities on the inner and outer surfaces of peripheral venous catheters

Zhang

Morrison

Nimmo

et al. 2013

Eur J Clin Microbiol Infect Dis

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“…Such methods included pre-surgical checklists or safety timeouts [18][19][20] and training sessions for perioperative personnel. [21][22][23] By comparison, our interventions are inexpensive; do not require clinician training, continuing manpower, or financial investment to maintain; do not increase the duration of surgery; and do not interfere with the clinicians' activities. As an inexpensive nonintrusive intervention, the current approach has the advantage of achieving increased perioperative safety without significant drawbacks.…”

Section: Discussionmentioning

confidence: 99%

Electronic medical record interventions and recurrent perioperative antibiotic administration: a before-and-after study

Hincker

Abdallah

Avidan

et al. 2017

Can J Anesth/J Can Anesth

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“…Effective interventions are often multifaceted and have included interdisciplinary guideline development, prescriber feedback, educational initiatives, posters, checklists, and forced functions. [36][37][38][39][40][41] In the acute surgical setting, Weiser and colleagues 42 showed that the use of a surgical checklist is feasible, effectively improves adherence to antibiotic prophylaxis guidelines and reduces surgery-associated complications and mortality. A 3-phase surgical safety checklist (surgical briefing, surgical time out and surgical debriefing) has recently been implemented at our institution and may address some of these issues.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic use among older adults on an acute care general surgery service

Pollmann

Bailey

Davis³

et al. 2017

CJS

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Background: Antibiotics play an important role in the treatment of many surgical diseases that affect older adults, and the potential for inappropriate use of these drugs is high. Our objective was to describe antibiotic use among older adults admitted to an acute care surgery service at a tertiary care teaching hospital.Methods: Detailed data regarding diagnosis, comorbidities, surgery and antibiotic use were retrospectively collected for patients 70 years and older admitted to an acute care surgery service. We evaluated antibiotic use (perioperative prophylaxis and treatment) for appropriateness based on published guidelines.Results: During the study period 453 patients were admitted to the acute care surgery service, and 229 underwent surgery. The most common diagnoses were small bowel obstruction (27.2%) and acute cholecystitis (11.0%). In total 251 nonelective abdominal operations were performed, and perioperative antibiotic prophylaxis was appropriate in 49.5% of cases. The most common prophylaxis errors were incorrect timing (15.5%) and incorrect dose (12.4%). Overall 206 patients received treatment with antibiotics for their underlying disease process, and 44.2% received appropriate first-line drug therapy. The most common therapeutic errors were administration of second-or third-line antibiotics without indication (37.9%) and use of antibiotics when not indicated (12.1%). There was considerable variation in the duration of treatment for patients with the same diagnoses. Conclusion:Inappropriate antibiotic use was common among older patients admitted to an acute care surgery service. Quality improvement initiatives are needed to ensure patients receive optimal care in this complex hospital environment.Contexte : Les antibiotiques jouent un rôle important dans de nombreux cas de chirurgie chez les adultes âgés, et le risque d'utilisation inappropriée de ces médicaments est élevé. Notre objectif était de décrire l'utilisation des antibiotiques chez les patients âgés admis au service chirurgical d'urgence d'un centre hospitalier universitaire de soins tertiaires.Méthodes : Nous avons recueilli de manière rétrospective les données détaillées sur le diagnostic, les comorbidités, la chirurgie et l'utilisation d'antibiotiques chez les patients de 70 ans et plus admis dans un service chirurgical d'urgence. Nous avons évalué le bien-fondé du recours aux antibiotiques (prophylaxie et traitement périopératoire) en fonction des lignes directrices publiées.

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Preventing infection in general surgery: improvements through education of surgeons by surgeons

Cited by 17 publications

References 38 publications

Molecular investigation of bacterial communities on the inner and outer surfaces of peripheral venous catheters

Molecular investigation of bacterial communities on the inner and outer surfaces of peripheral venous catheters

Electronic medical record interventions and recurrent perioperative antibiotic administration: a before-and-after study

Antibiotic use among older adults on an acute care general surgery service

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