Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth.
BACKGROUND
Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth.


OBJECTIVE
This paper is a report of a study of the effect of empowering surgical nurses to ensure that patients receive antibiotic prophylaxis after caesarean birth.


BACKGROUND
Despite the consensus that single dose antibiotic prophylaxis is beneficial for women have either elective or non-elective caesarean delivery, hospitals need methods to increase compliance rates.


METHODS
In a study in Israel in 2007 surgical nurses were empowered to ensure that a single dose of cefazolin was given to the mother after cord clamping. A computerized system was used to identify women having caesarean births, cultures sent and culture results. Compliance was determined by chart review. Rates of compliance, suspected wound infections, and confirmed wound infections in 2007 were compared to rates in 2006 before the policy change. Relative risks were calculated dividing 2007 rates by those in 2006, and 95% confidence intervals were calculated using Taylor's series that does not assume a normal distribution. Statistical significance was assessed using the chi-square test.


RESULTS
The compliance rate was increased from 25% in 2006 to 100% in 2007 (chi-square test, P < 0.001). Suspected wound infection rates decreased from 16.8% (186/1104) to 12.6% (137/1089) after the intervention (relative risk 0.75, 95% confidence interval, 0.61-0.92).


CONCLUSIONS
Surgical nurses can ensure universal compliance for antibiotic prophylaxis in women after caesarean birth, leading to a reduction in wound infections.
Shimoni
Zvi
Z
Infectious Disease Unit, Laniado Hospital, Netanya, Israel.
Kama
Naama
N
Mamet
Yaakov
Y
Glick
Joseph
J
Dusseldorp
Natan
N
Froom
Paul
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000517:prevention & control; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D055118:Medication Adherence; D013527:Perioperative Nursing; D011209:Power, Psychological; D011247:Pregnancy; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents