The effect of change in educational model on surgical antimicrobial prophylaxis

Abstract

Background/Aim: Surgical antibiotic prophylaxis is one of the important steps in preventing surgical site infections. Compliance with the guidelines is particularly important and there are problems in this regard. Innovative approaches are needed in education. In our study, the effects of the novel face-to-face training and feedback model, with which we obtained positive results, were shown. Methods: In this retrospective cross-sectional study, surgical site infections and the use of antibiotics in surgical prophylaxis in all patients undergoing certain operations were examined in pre-determined departments. The quarterly or annual changes in compliance rates were compared with the new education model. Results: A total of 3697 clean surgeries were assessed in three departments. The cardiovascular surgery department had annual compliance rates of 2.5% and 8.6% in 2010 and 2011, respectively, which increased between 2012-2017 from 64.5%, 90.7%, 85.4%, 98.8%, 90.6% to 97.4%, respectively (P<0.001), with the new training model. In the Orthopedics and Traumatology department, within eight 3-month periods between 2014 and 2016, compliance rates increased from zero to 92.4% (P<0.001). The general surgery department had a 3.3% compliance rate at the beginning of 2015, which increased up to 98.3%, 95.3%, 96.8% and 93.5% in three-month intervals in 2017 (P<0.001). No significant changes were identified in surgical site infection rates. Conclusion: Continuous training, monitoring and feedback is required for guideline compliance in surgical antibiotic prophylaxis. We think narrow-scoped and target-oriented face-to-face training is effective and applicable.

Keywords

• Antibiotics
• surgical site infection
• Prophylaxis
• Education
• Intervention

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