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Adding Antibiotics to Pre-Op Checklist Improves Compliance

Ninety-nine percent of patients in study received antibiotic prophylaxis, compared to 65 percent previously

FRIDAY, Feb. 8 (HealthDay News) -- A simple and effective way to ensure that patients receive prophylactic antibiotics an appropriate length of time before surgery is to add verification of receipt of the antibiotics to a pre-operative "time-out" protocol, in which operating room staff verifies the correct surgical site, researchers report in the February issue of the Journal of Bone & Joint Surgery.

Andrew D. Rosenberg, M.D., of the New York University Hospital for Joint Diseases in New York City, and colleagues reviewed data from 319 consecutive patients undergoing spine surgery or primary total knee or hip joint arthroplasty. During the study, an item was added to the time-out verification checklist to require notation of the timing and dose of pre-operative antibiotics as well as drug names.

The protocol resulted in antibiotic administration at the optimal time to 316 patients (99.1 percent). In the three months prior to the study period, only 65 percent of a group of 40 hip or knee replacement patients had received prophylactic antibiotics, contrary to the expectations of the authors, who had presumed a high rate of compliance.

"Since the time-out protocol for wrong-site surgery is already in place nationwide, simply adding verification of antibiotic administration to this protocol can ensure that antibiotics are administered at the appropriate time prior to incision. The addition of verification of antibiotic administration to the time-out sheet has not met any resistance by those performing the time-out in the operating room. In contrast, those understanding its purpose have been enthusiastic about incorporating it into the protocol," the authors write.

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