Defense Date

7-17-2025

Graduation Date

Summer 8-8-2025

Submission Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Dr. Deborah Dillon

Keywords

surgical site infection, pre-surgical incision antibiotic, intraoperative antibiotic redose, intraoperative antibiotic compliance

Abstract

Purpose: Surgical site infections (SSIs) have been associated with poor pre-surgical incision antibiotic and intraoperative redosing practices and are the leading cause of postoperative readmissions and healthcare-acquired infections. A Quality Improvement (QI) project was developed to evaluate SSIs rates and pre-surgical incision antibiotic dosing and intraoperative redosing practices of anesthesia providers at a Level 1 trauma center in the Midwest. Methods: A pre- and post-intervention knowledge, attitudes, and practices (KAP) survey addressing intraoperative antibiotic stewardship was administered to 138 anesthesia providers. Interventions included education, a reference sheet, and a clinical pathway. Data analysis for surgical procedures involving anesthesia services, performed in the main operating room and outpatient surgery center, was included. Endoscopy and obstetric procedures and surgeries were excluded. Audits were analyzed for a three-month period of the prior two years and compared against the same three-month period following the QI to identify noncompliant intraoperative antibiotic dosing and redosing practices, and rates of SSIs. Results: Descriptive data demonstrated an improvement in post-implementation pre-surgical incision antibiotic administration from 87% to 90%, which is the goal for the medical center. Missed intraoperative antibiotic redoses decreased from 6% to 5%, and late redoses remained at 3%. Additionally, there was a decrease in SSIs when compared to the prior two years. Conclusion: Providing education, an accessible reference sheet, and a clinical pathway improved on-time pre-surgical incision antibiotic administration, intraoperative redosing, and reduced SSIs with noncompliant intraoperative antibiotic practices.

Language

English

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