Antibiotic redosing is a best practice that decreases the risk of surgical site infection (SSI). The team at Metro Health in Grand Rapids experienced an unfortunate event when a patient did not receive redosing during a procedure and was subsequently readmitted for an SSI. As a result, they took a close look at their protocol for antibiotic redosing and came up with a plan that raised their antibiotic redosing rate from 75% in 2019 to 100% in 2020.
The first step was to make sure that the redose timer was working properly in Epic. The timer is designed to begin at the start of a procedure and alert 4 hours later as a reminder to redose the patient if the procedure is still in process. While the timer was working adequately, there were some inconsistencies regarding at what point a procedure is considered complete. A decision was made to define “complete” as the point when the surgical incision is entirely closed.
There were also some discrepancies in who the decision to redose falls to, with some confusion over whether the surgeon or anesthesiologist should make the call. A plan was put in place for the responsibility to go to the anesthesiologist so there would not be a debate or question about whether or not a patient would be redosed. The anesthesiologists were also given a refresher about redosing guidelines so that everyone was on the same page. Metro Health’s antibiotic redosing rate continues to be 100%.