Antimicrobial stewardship: 9c-Cessation of prophylactic antibiotics following surgery
Identifying and definitional attributes
|Metadata item type:||Indicator|
|Short name:||Indicator 9c-Cessation of prophylactic antibiotics following surgery|
|Registration status:||Health, Standard 12/09/2016|
Proportion of patients whose prophylactic antibiotics were discontinued within 24 hours following surgery.
One-third to one-half of antibiotic use in hospitals is for surgical antibiotic prophylaxis. Surgical antibiotic prophylaxis is used inappropriately 30–90 per cent of the time, especially with respect to timing and duration (Antibiotic Expert Group 2014).
|Indicator set:||Clinical care standard indicators: antimicrobial stewardship Health, Standard 12/09/2016|
|Outcome area:||Surgical prophylaxis Health, Standard 12/09/2016|
Collection and usage attributes
The numerator excludes patients for whom longer antibiotic prophylaxis is indicated by the Therapeutic guidelines: antibiotic (Antibiotic Expert Group 2014) or locally-endorsed antibiotic prescribing guidelines, or for the treatment of specific conditions (e.g. a patient undergoing a complex operation, where antibiotic treatment is required for a pre-existing infection, or a patient who is immunocompromised).
The denominator excludes patients for whom longer antibiotic prophylaxis is indicated by the Therapeutic guidelines: antibiotic or locally-endorsed antibiotic prescribing guidelines, or for the treatment of specific conditions.
Presented as a percentage.
(Numerator ÷ denominator) x 100
Number of admitted patients who received prophylactic antibiotics prior to surgery whose antibiotics were discontinued within 24 hours following surgery.
Number of admitted patients who received prophylactic antibiotics prior to surgery for which there are documented guidelines for the administration of prophylactic antibiotics.
Prophylaxis is the use of antibiotics to prevent surgical site infection and, in some circumstances, bacteraemia (Antibiotic Expert Group 2014).
Deliberate continuation of antibiotics after 24 hours for the treatment of an infection does not constitute surgical prophylaxis.
Services may select specific procedures to focus on as part of the audit process, based on their own casemix 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).
|Unit of measure:||Service event|
Source and reference attributes
Australian Commission on Safety and Quality in Health Care
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.