Performance improvement programs improved early antibiotic treatment for open fractures
Implementation of a multifaceted performance improvement program concentrating on education, accountability and antibiotic availability for the treatment of open fracture patients improved early and appropriate antibiotic prophylaxis treatment, according to study results.
Researchers divided patients with open fractures treated by orthopedic surgery into those treated before the placement of an open fractures performance improvement program, from January 2012 to December 2012 (group one), and those treated after the program was instituted, from January 2013 to December 2013 (group two). The researchers evaluated patient demographics, injury factors and performance measures relating to early open fracture care.
Results showed group one received intravenous (IV) antibiotics at an average of 70.5 minutes after hospital arrival vs. an average of 32.4 minutes in group two.
The researchers found an improvement in the average times from emergency department arrival to physician evaluation from 6.5 minutes to 4.5 minutes, as well as improvement in antibiotic order to antibiotic delivery from 37 minutes to 13 minutes for group one compared with group two. There was also a trend toward improvement in the average time between physician evaluation and antibiotic.
According to study results, 50% of patients in group one had antibiotics initiated within 1 hour of hospital arrival vs. 78% of patients in group two. Similarly, 85% of patients in group one had antibiotics initiated within 3 hours of hospital arrival vs. 95% of patients in group two.
Among patients receiving standard antibiotics, the researchers found 79% of patients in group one and 91% of patients in group two received the recommended dose of IV antibiotic for their body weight.
Disclosure: Collinge is a consultant for Smith & Nephew and Biomet and received royalties from Biomet, Smith & Nephew, Advanced Orthopedic Solutions and Synthes.