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Effect of Educational, Managerial and Regulatory Interventions on Cardiac Surgeon’S Adherence to the Guidelines for Preoperative Antibiotic Prophylaxis



Najari H1 ; Afhami S2 ; Bazaz NE2 ; Mandegar M3 ; Rastgoo M4
Authors
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Authors Affiliations
  1. 1. Department of Infectious diseases, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
  2. 2. Department of Infectious diseases, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Cardiac Surgery, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Physical Therapy, Faculty of rehabilitation sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Journal of Mazandaran University of Medical Sciences Published:2016

Abstract

Background and purpose: To prevent Surgical Site Infection (SSI), a short duration of antimicrobial agents is prescribed just before the surgery which is known as preoperative antibiotic prophylaxis (PAP). In spite of evidenced-based guidelines for PAP administration, many studies have shown poor adherence to the guidelines. The aim of this study was to determine an effective intervention in improving surgeons’ adherence to the standard guideline of PAP administration in cardiac surgeries. Materials and methods: An interventional prospective study (before-after design) was performed in 335 patients undergoing cardiac surgery during 2011-2012. Three consecutive interventions were conducted including educational, managerial and regulatory interventions. The outcome measures were the duration and type of the PAP administration which was measured before and after each intervention. The changes were also monitored through a 5 months follow up. Results: No significant changes were detected after the educational intervention. After the managerial intervention significant changes in the type and duration of the PAP were detected in coronary artery bypass grafting (CABG) (P= 0.03), but no significant change was observed for PAP administration in valve repair/replacement surgeries (P= 0.54). Regulatory intervention caused significant changes in the type and duration of PAP in both CABG and the valve repair/replacement surgeries (P=0.01). The improvements lasted for at least 5 months after the regulatory intervention. Conclusion: Managerial and regulatory interventions in addition to educational intervention could be of benefit in optimizing the PAP administration. © 2016, Mazandaran University of Medical Sciences. All rights reserved.
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