Study reveals need for change in surgical procedures

IPRO has announced progress in surgical infection prevention after the Archives of Surgery published a study highlighting the need for better, more consistent practices to address infection risk factors.

IPRO plans to intensify its work with local hospitals to redesign procedures and protocols so that surgical patients are given antibiotics within sixty minutes before surgery begins, the timeframe most effective for preventing infections.

The precise timing of administering antibiotics to prevent surgical infections is critical, but often not strictly regulated. In the Archives of Surgery study, titled "Use of Antimicrobial Prophylaxis for Major Surgery: Baseline Results From the National Surgical Infection Prevention Project," researchers found that only a little more than half of Medicare beneficiaries undergoing major surgery received antibiotics in the optimal timeframe.

In the article, researchers report the results of their analysis of medical records from 2965 acute care hospitals throughout the United States, involving a random sample of 34,133 Medicare inpatients undergoing major surgeries during 2001-including open cardiac, vascular, colorectal, total hip, total knee, and hysterectomy. Data was collected in conjunction with the 2002 launch of a surgical infection prevention project jointly sponsored by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC).

"IPRO recognizes the importance of this research and, seeing the opportunity for significant improvement, already has efforts underway to address the problem of surgical infection prevention," says Clare B. Bradley MD, MPH, Chief Medical Officer, IPRO.

As IPRO works with local hospitals to improve delivery and administration of preventative antibiotics, it is reporting progress across the state as well as plans for an expanded focus on surgical infection prevention in the near future.

IPRO conducted a New York Statewide voluntary SIP collaborative with 22 hospitals; attached is a description of one hospital's success.

As part of Medicare's Hospital Quality Initiative, Quality Improvement Organizations (QIOs) like IPRO promote rapid resolution of hospital quality issues and sharing of "best practices" to assist hospitals in improving their quality of care in several areas. In addition to surgical infection prevention, focus areas include heart attack, heart failure and pneumonia.