title: Applying validated quality indicators to surgical antibiotic prophylaxis in a Brazilian hospital: learning what should be learned.
abstract: BACKGROUND
  Compliance with the best surgical antibiotic prophylaxis practice is usually low despite many published guidelines.
  
  
  OBJECTIVE
  This study investigated compliance with the Hospital Infection Control Committee guideline for antibiotic prophylaxis in a Brazilian hospital using quality indicators.
  
  
  METHODS
  A retrospective study was carried out from November 2009 to March 2010. Medical records from adult inpatients undergoing cardiac, neurologic, and orthopedic clean surgeries were included. The full compliance index was considered 100% when the antibiotic prophylaxis showed adequacy in all evaluated attributes. Analyses were conducted with 5% significance.
  
  
  RESULTS
  Medical records from 101 cardiac, 128 neurologic, and 519 orthopedic surgical patients were evaluated. The compliance index was 4.9%, and the compliance index according to specialty was 5.8%, 3.1%, and 3.0%, respectively, for orthopedic, neurologic, and cardiac surgeries. The attribute route of administration produced the best outcomes, whereas the attribute duration of antibiotic prophylaxis produced the worst. No association was identified between compliance to the attributes and patient characteristics.
  
  
  CONCLUSIONS
  This study showed a low level of adherence to Hospital Infection Control Committee guidelines for antibiotic prophylaxis. This suggests that different strategies should be implemented to promote the best possible practice in the field of antibiotic prophylaxis with greater surgeon engagement.
authors.affiliation: Department of Medical-Surgical Nursing, University of São Paulo, Vergueiro Street 8424, São Paulo, Brazil. cristianeschmmitt@yahoo.com.br
authors.forename: Cristiane
authors.initials: C
authors.lastname: Schmitt
authors.forename: Rubia Aparecida
authors.initials: RA
authors.lastname: Lacerda
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Padoveze
authors.forename: Ruth Natalia Teresa
authors.initials: RN
authors.lastname: Turrini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis / Q000379:methods* / Q000592:standards*; D001938:Brazil; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods* / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D012189:Retrospective Studies