Definition and Description of Clinical Nursing Problem.
Despite evidence of effectiveness of antimicrobials to prevent SSIs, previous studies have demonstrated inappropriate timing of prophylactic antibiotics within one prior to surgical incision. Studies performed in the 1960's and 1970's demonstrated that a common reason for failure of prophylaxis was delay of antibiotic administration until after the operation. Recent publication of the National Surgical Infection Prevention Project supports established guidelines for prophylactic antibiotics within one hour prior to surgical incision, yet timeliness is not regularly achieved" (Backster, Teo, Swift, Polk, & Harken, 2007).
Surgical site infections (SSIs) are a major component to patient injury, mortality, and health care costs. Mortality rates are 2 to 3 times higher in patients in whom an SSI develops compared with uninfected patients, and hospital readmission rates are significantly increased. Surgical site infections "increase length of stay by an average of 7 days and charges by approximately $3000 " (Bratzler et al., 2005, p. 174). Several studies have shown that administering prophylactic antibiotics immediately before the surgical incision has been made significantly decreases the incidence of postoperative SSIs in surgical procedures (White & Schneider, 2007). Appropriate administration of antibiotics is also "one of several quality measures identified by the Surgical Care Improvement Project as important processes for health care facilities to implement to prevent SSIs"" (White & Schneider, p. 173).
The purpose of this paper is to describe the efficacy and timeliness of prophylactic antibiotics within one hour prior to surgical incision in the Surgical Services Department that this writer practices nursing, and to determine if there is enough evidence in the research the writer has reviewed to improve or change the current practice.