Guidelines for the use of antibiotic prophylaxis to prevent surgical site infection have been available since 1993 and were summarized and amended by the National Surgical Infection Project (SIP) in 2004. The timing of when an antibiotic is given both before and after the surgery as well as the choice of antibiotic is important in the prevention of infection.  Other measures are coming to the foreground in the prevention of infection and will be incorporated into our EBM project: proper hair removal, intraoperative temperature control for patients having colon surgery, and glucose control in cardiac surgery patients.

Performance Measures

Since 2002, CKHS has been identifying opportunities to improve the use of preventive antimicrobials for patients undergoing surgery. As part of the Collaborative on Surgical Infection Prevention created in conjunction with the Centers for Disease Control (CDC) and the Centers for Medicare and Medicaid Services (CMS), CKHS collects data on compliance with the antibiotic prophylaxis guidelines for hip/knee arthroplasties and colon surgeries.

CKHS has just started to publicly report performance results for the timing of antibiotic administration while we have been following them internally for about two years.  Over the next few months this project will expand in two ways.  In addition to incorporating the new measures noted above, CKHS will also be expanding the project into other surgical arenas such as vascular surgery, cardiac surgery and hysterectomy.

CKHS participates and publicly reports performance for the following measures.

Percent of surgery patients:

Who receive preventative antibiotics one hour before incision

Whose preventative antibiotic(s) are stopped within 24 hours after surgery