1078 / Antibiotic prophylaxis implementation at G. Pini Hospital, Milano

ITALY
Classification of the PSP
Type of Patient Safety Practice Not Proven Effective
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Education in Patient Safety
Implementation of Patient Safety initiatives / Activities There is no specified text here
Topic of the reported practice
Clinical guidelines or pathways
Aim and the benefit of the Patient Safety Practice
 
Surgical site infections in orthopedic surgery represent a demanding complication both from the patient and the economic point of view. Although many guidelines are available on antibiotic prophylaxis as an effective preventive measure they are often ignored in practice. A surveillance national study showed a percentage of compliance <50%. In this hospital the value measured was 36%.
The aim of the practice is to prevent post-operatuve infection in an orthopedic unit by promoting and supporting compliance toavailable guidelines and procedures
Description of the Patient Safety Practice
 
Information and training are considered a great tool for implementation and sharing of guidelines (GLs), leading to significant improvements in clinical practice. A multidisciplinary team (infectious disease specialists, orthopedists, nurse epidemiologists, public health specialists) was established at G Pini hospital in Milano to revise GLs, organize educational events for their implementation, sharing and dissemination. A checklist was implemented for continuous monitoring of the process. GLs, reviewed with a multidisciplinary team, were presented to orthopedic surgeons and nurse coordinators during two educational events. Meetings were organized in each unit in order to present the results of the surveillance of SSIs in arthroplasty and to discuss the reasons why prophylaxis procedures were not correctly adopted by the teams It was emphasized that the most obvious and critical issues on which there is a consensus in scientific literature is related to the duration of prophylaxis beyond 24 hours confirmed by a second survey conducted in each unit. The review process of GLs was presented and a pocket-size version was given emphasizing the importance of motivating a different choice on medical records. The analysis of medical records during the following year showed an improvement of compliance with GLs that reached the value of 94%
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
The results of the study will be submitted shortly
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Pharmacists
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Regular data feed back to involved staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Francesco Auxilia
Country: ITALY
Organisation: University of Milano
E-mail: francesco.auxilia@unimi.it
Phone: +393383131896
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