The identification of barriers preventing the successful implementation of a surgical prophylaxis protocol.
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.
Burnett
Kathryn M
KM
Antrim Hospital Academic Pharmacy Practice Unit, Antrim Area Hospital, Bush Road, Antrim, BT41 2RL, UK.
Scott
Michael G
MG
Kearney
Patricia M
PM
Humphreys
W George
WG
McMillen
Robert M
RM
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
D002444:Cefuroxime