title: Antibiotic prophylaxis audit and questionnaire study: Traffic Light Poster improves adherence to protocol in gastrointestinal surgery.
abstract: OBJECTIVE
  To measure adherence to antibiotic prophylaxis (AP) protocol amongst surgeons and anesthetists and explore their understanding of AP prescribing in practice.
  
  
  METHODS
  A prospective audit of AP in gastrointestinal surgery and re-audit after intervention. A questionnaire survey of practice.
  
  
  RESULTS
  58 (38%- clean; 62%- clean contaminated) operations were audited and 73 (48%-clean; 51%-clean contaminated) operations were re-audited after intervention with "Traffic Light Poster" (TFP) .55 colleagues (32 consultants and 23 trainees) were recruited for questionnaire survey in three West Midlands hospitals. Audit and Re-Audits. Only 31% of procedures followed the protocol correctly in the initial audit and this increased to 73% in the re-audit. 73% of patients undergoing clean procedures received AP inappropriately in the initial audit but reduced significantly to 20% (p < 0.002) in the re-audit. In the initial audit, 62% of clean contaminated procedures did not receive the appropriate first line AP but this fell to 35% (p < 0.05) in the re-audit. Questionnaire Survey- Only 30% of respondents would not give AP in clean surgery as recommended. 45% would use appropriate AP for clean-contaminated wounds. 73% of respondents will give AP at induction, 20% 1 h pre op and 7% just before incision.
  
  
  CONCLUSIONS
  There is poor compliance with AP protocols in gastrointestinal surgery in part due to general lack of awareness. An educational intervention in the form of a 'Traffic Light Poster' improved adherence to AP protocol two fold. There was improved rationalizing of AP. Clean procedures, in particular, had less inappropriate prescribing.
authors.affiliation: Foundation Year Two Doctor, University Hospital Lewisham, London, United Kingdom.
authors.forename: Michaella
authors.initials: M
authors.lastname: Cameron
authors.affiliation: Foundation Year Two Doctor, University Hospital Lewisham, London, United Kingdom.
authors.forename: Stacey
authors.initials: S
authors.lastname: Jones
authors.affiliation: University Hospital Birminghma, United Kingdom.
authors.forename: Olufunso
authors.initials: O
authors.lastname: Adedeji
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D054869:Clinical Audit; D013505:Digestive System Surgical Procedures; D006801:Humans; D010349:Patient Compliance; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Audit cycle; Prophylaxis; Traffic light chart