Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth

Authors: Shimoni, Zvi¹; Kama, Naama²; Mamet, Yaakov³; Glick, Joseph⁴; Dusseldorp, Natan⁵; Froom, Paul⁶

Source: Journal of Advanced Nursing, Volume 65, Number 11, November 2009 , pp. 2345-2349(5)

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Abstract:

shimoni z., kama n., mamet y., glick j., dusseldorp n. & froom p. (2009) Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth. Journal of Advanced Nursing65(11), 2345-2349. Abstract Title.

Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth. Aim.

This paper is a report of a study of the effect of empowering surgical nurses to ensure that patients receive antibiotic prophylaxis after caesarean birth. Background.

Despite the consensus that single dose antibiotic prophylaxis is beneficial for women have either elective or non-elective caesarean delivery, hospitals need methods to increase compliance rates. Method.

In a study in Israel in 2007 surgical nurses were empowered to ensure that a single dose of cefazolin was given to the mother after cord clamping. A computerized system was used to identify women having caesarean births, cultures sent and culture results. Compliance was determined by chart review. Rates of compliance, suspected wound infections, and confirmed wound infections in 2007 were compared to rates in 2006 before the policy change. Relative risks were calculated dividing 2007 rates by those in 2006, and 95% confidence intervals were calculated using Taylor's series that does not assume a normal distribution. Statistical significance was assessed using the chi-square test. Findings.

The compliance rate was increased from 25% in 2006 to 100% in 2007 (chi-square test, P < 0·001). Suspected wound infection rates decreased from 16·8% (186/1104) to 12·6% (137/1089) after the intervention (relative risk 0·75, 95% confidence interval, 0·61-0·92). Conclusion.

Surgical nurses can ensure universal compliance for antibiotic prophylaxis in women after caesarean birth, leading to a reduction in wound infections.

Keywords: antibiotic prophylaxis; caesarean birth; compliance; surgical nursing empowerment; wound infections

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2648.2009.05096.x

Affiliations: 1: Zvi Shimoni MDHead of DepartmentInternal Medicine B,and Head of DepartmentInfectious Disease Unit, Laniado Hospital, Netanya, Israel 2: Naama Kama RNInfection Control NurseNursing Department, Laniado Hospital, Netanya, Israel 3: Yaakov Mamet MDHeadObstetrics and Gynecology Department, Laniado Hospital, Netanya, Israel 4: Joseph Glick PhDDirector of Laboratories and Blood BankMicrobiology Laboratory, Laniado Hospital, Netanya, Israel 5: Natan Dusseldorp CIOComputer DepartmentLaniado Hospital, Netanya, Israel 6: Paul Froom MDDepartment of Epidemiology and Preventive Medicine and Department of Occupational and Environmental Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel

Publication date: 2009-11-01

Empowering surgical nurses improves compliance rates for antibiotic prophylaxis after caesarean birth

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