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Antimicrobial stewardship: 9a-Surgical antibiotic prophylaxis in accordance with guidelines

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 9a-Surgical antibiotic prophylaxis in accordance with guidelines
METeOR identifier:Help on this term612228
Registration status:Help on this termHealth, Standard 12/09/2016
Description:Help on this term

Proportion of patients for whom surgical prophylactic antibiotics were prescribed in accordance with Therapeutic guidelines: antibiotic (Antibiotic Expert Group 2014) or locally-endorsed antibiotic prescribing guidelines.

Rationale:Help on this term

Health services should regularly audit surgical prophylaxis practices to ensure that:

  • surgical patients should receive timely prophylaxis when indicated;
  • correct antibiotics, route of administration and dosage are used;
  • the duration of prophylaxis is appropriate.
Indicator set:Help on this termClinical care standard indicators: antimicrobial stewardship Health, Standard 12/09/2016
Outcome area:Help on this termSurgical prophylaxis Health, Standard 12/09/2016

Collection and usage attributes

Computation description:Help on this term

Prophylaxis is the use of antibiotics to prevent surgical site infection and, in some circumstances, bacteraemia.

The numerator and denominator include patients undergoing surgery for which there are documented guidelines for the administration of prophylactic antibiotics, that is, the Therapeutic guidelines: antibiotic or locally-endorsed antibiotic prescribing guidelines.

The numerator and denominator exclude patients undergoing surgery for which there are no documented guidelines for the administration of prophylactic antibiotics, that is, the Therapeutic guidelines: antibiotic or locally-endorsed antibiotic prescribing guidelines, or where prophylaxis is not indicated due to the patient’s current antibiotic therapy.

For the numerator, 'in accordance' with guidelines means that the choice of antimicrobial is in accordance with guidelines. Timing of dose is dealt with in Antimicrobial stewardship: 9b-Timely administration of prophylactic antibiotics prior to surgery, and duration of antibiotic therapy is dealt with in Antimicrobial stewardship: 9c-Cessation of prophylactic antibiotics following surgery.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of admitted patients undergoing surgery who received prophylactic antibiotics in accordance with Therapeutic guidelines: antibiotic or locally-endorsed antibiotic prescribing guidelines.

Denominator:Help on this term

Number of admitted patients undergoing surgery for which there are documented guidelines for the administration of prophylactic antibiotics.

Comments:Help on this term

The Therapeutic guidelines: antibiotic provides guidance on administration of prophylactic antibiotics for the following types of surgery:

  • abdominal surgery, including:
    • colorectal surgery, appendicectomy, and upper gastrointestinal tract or biliary surgery (including laparoscopic approaches)
    • endoscopic procedures
    • hernia repair
  • burns, extensive skin loss
  • cardiac surgery
  • head, neck and thoracic surgery
  • lower limb amputation
  • neurosurgery
  • obstetric and gynaecological surgery, including:
    • hysterectomy and termination of pregnancy
    • caesarean section
  • orthopaedic surgery
  • urological surgery, including:
    • prostatectomy
    • transrectal prostatic biopsy
  • vascular surgery.

Services may select specific procedures to focus on as part of the audit process, based on their own mix of patients and priorities.

This indicator is based on surgical antibiotic prophylaxis indicators developed by the then Victorian Hospital Acquired Infection Surveillance System Coordinating Centre (VICNISS) (Department of Human Services 2007) (now the Healthcare Associated Infection Surveillance Coordinating Centre), and the Western Australian Safety and Quality Investment for Reform (SQuIRe) Program (Department of Health WA 2009).

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN]

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

Antibiotic Expert Group 2014. Therapeutic guidelines: antibiotic. Version 15. Melbourne: Therapeutic Guidelines Limited.

Department of Health WA 2009. SQuIRe 2 CPI guide: Surgical site infection prevention. Perth: DHWA.

Department of Human Services 2007. Type 2 surveillance manual version 10. Melbourne: Victorian Hospital Acquired Infection Surveillance System Coordinating Centre, DHS.

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