title: The identification of barriers preventing the successful implementation of a surgical prophylaxis protocol.
abstract: OBJECTIVE
  The aim of this study was to introduce a protocol for the use of antimicrobials in surgical prophylaxis for the described procedures in Antrim Area Hospital.
  
  
  METHODS
  Historical data of antimicrobial use were obtained from retrospective analysis of patients' charts, for those patients identified as having one of the following 'clean/contaminated' surgical procedures over the previous six months; cholecystectomy or abdominal hysterectomy. These data were analysed, and a protocol was introduced providing guidelines for the choice of antimicrobial agent, its administration time, route, dose, duration and frequency of treatment.
  
  
  METHODS
  The main outcome measure was the success of the uptake of the protocol following its implementation.
  
  
  RESULTS
  There was a total of 285 patients identified, 105 prior to and 180 post implementation. Overall, 68% of patients received some form of prophylaxis in the first cycle, and 72% in the second.
  
  
  CONCLUSIONS
  Although the introduction of the protocol led to slight improvements in compliance with standard prescribing procedures, with an increase in single-dose prophylaxis, and a reduction in prolonged prophylactic treatment, the improvements did not reach expectations. This paper attempts to identify the possible barriers to protocol implementation.
authors.affiliation: Antrim Hospital Academic Pharmacy Practice Unit, Antrim Area Hospital, Bush Road, Antrim, BT41 2RL, UK.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Burnett
authors.forename: Michael G
authors.initials: MG
authors.lastname: Scott
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kearney
authors.forename: W George
authors.initials: WG
authors.lastname: Humphreys
authors.forename: Robert M
authors.initials: RM
authors.lastname: McMillen
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods* / Q000706:statistics & numerical data; D002444:Cefuroxime / Q000627:therapeutic use*; D002763:Cholecystectomy / Q000706:statistics & numerical data; D002985:Clinical Protocols; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies
chemical_list: D002444:Cefuroxime