Quality Initiative for the Administration of Vancomycin Prophylaxis in Penicillin-Allergic Neurosurgery Patients

IntroductionVancomycin may be used as an alternative perioperative antibiotic for penicillin-allergic patients but follows a different infusion timing. At the institution presented herein, noncompliance with recommended vancomycin infusion timing has been hypothesized to contribute toward increased...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2021-10, Vol.13 (10), p.e18623-e18623
Main Authors: Borja, Austin J, Sharma, Nikhil, Amendolia, Olivia, Cimoch, Jennifer, Callahan, Danielle, Durkan, Jennifer, Hoke, Nicole, Maloney, Eileen, Grady, M. Sean, Malhotra, Neil R
Format: Article
Language:English
Subjects:
Algorithms
Allergies
Antibiotics
Disease prevention
Electronic health records
Hospital costs
Initiatives
Intensive care
Neurosurgery
Nursing
Patient safety
Penicillin
Pharmacists
Quality control
Quality Improvement
Surgery
Surgical site infections
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:IntroductionVancomycin may be used as an alternative perioperative antibiotic for penicillin-allergic patients but follows a different infusion timing. At the institution presented herein, noncompliance with recommended vancomycin infusion timing has been hypothesized to contribute toward increased risk of surgical site infections and avoidable expenditures. The objective of this project was to utilize the Performance Improvement In Action methodology to identify, address, and solve the problem of vancomycin administration timing.MethodologyThis study took place at a multi-hospital, urban academic medical center. The protocol was developed by neurosurgery and anesthesia faculty, advanced practice providers, nursing, and pharmacy. Timing of the following points was recorded: initial order, order release, pharmacy verification, vancomycin infusion, and surgical incision. Fifty consecutive penicillin-allergic patients undergoing neurosurgical intervention were prospectively enrolled. Data comparison was made between the pilot and retrospective review cohorts.ResultsThe pilot cohort achieved correct administration of vancomycin in 100% of cases. Average infusion start time prior to incision increased by 257% (p
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.18623