56 Antibiotic Prescribing for Open Fractures - A Quality Improvement Project to Enhance BOAST 4 Attainment
Abstract Introduction Open fractures are associated with increased infection rates and the evidence shows timely administration of prophylactic antibiotics within one hour of injury improves the outcomes. Method A multi-cycle audit was carried out retrospectively for patients presenting to Brighton...
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| Published in: | British journal of surgery 2021-05, Vol.108 (Supplement_2) |
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| Main Authors: | , , , |
| Format: | Article |
| Language: | eng |
| Online Access: | Get full text |
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| Summary: | Abstract Introduction Open fractures are associated with increased infection rates and the evidence shows timely administration of prophylactic antibiotics within one hour of injury improves the outcomes. Method A multi-cycle audit was carried out retrospectively for patients presenting to Brighton and Sussex University Hospitals NHS Trust (BSUH) with an open limb fracture in 2018-2020. Targeted teaching was carried out for orthopaedic trainees, prompt posters created and alterations to the trauma clerking proforma were implemented. Results In first cycle, 48 (92.3%) out of total 52 patients were prescribed antibiotics prior to definitive surgical management, with a mean time to administration of 271 minutes. Of these, 41 (78.8%) received prescriptions according to BSUH guidelines. The use of STAT ‘once-only’ prescriptions was found to significantly reduce the mean time to administration for 154 minutes. In second cycle, all of 29 patients (100%) were prescribed antibiotics prior to definitive surgical management, with a reduced mean time to administration (233 minutes). Of these, 26 (89.7%) received prescriptions according to BSUH guidelines, and a significantly greater proportion received initial STAT prescriptions (51.7% vs. 15.4%). Conclusions This quality improvement project has demonstrated the successful implementation of targeted changes to improve the attainment of BOAST 4 guidelines. |
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| ISSN: | 0007-1323 1365-2168 |