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• W1959682508 abstract "Objective To ensure that antibiotic prophylaxis will occur 100% of the time within the one‐hour window prior to incision for women with scheduled cesarean births at Children's Memorial Hermann Hospital Women's Services by July 30, 2014. Design A quality‐improvement team of anesthesiologists, nurses, and pharmacists used quality‐improvement methods to understand the problem and develop a new process for antibiotic delivery. Sample Women with scheduled cesareans at Children's Memorial Hermann Hospital Women's Services comprised the sample. Methods Baseline data were collected to define the scope of the problem of antibiotics being delivered according to evidence‐based guidelines. A fishbone diagram was developed to understand the potential causes of antibiotic delivery failure in 18% of patients from anesthesiologist and nursing staff perspectives. A waste walk was performed to identify inefficiencies. A map of the current process was created to detect potential stages at which interventions might improve the ability to give antibiotics on time. A spaghetti map was drawn after a nurse wearing a pedometer walked to all areas where nurses must travel to gather intravenous tubing and antibiotics to make a packet for anesthesia. A test of change in one pod was tested with positive results and then the new process was implemented in the entire unit. Postimplementation data were collected. Implementation Strategies Anesthesia, medicine, and nursing leaders approved the project. The new process was taught to all nurses and anesthesiologists with the goal to reduce surgical site infections by delivering antibiotics within one hour prior to incision. Specific resources and supplies needed for the process to work smoothly and efficiently were also implemented. Pyxix MedStations were purchased for operating rooms (ORs). The pharmacy supplied antibiotics and altered practice to support the new process. Information systems collaborated on the implementation of Power Chart Maternity Care4 (PCM), a new electronic charting method, to reduce the incidence of charting in different software and to support the convenience of charting medications in the ORs for the anesthesiologists. Results The goal of 100% compliance was not met, although at 99%, the goal is within reach. The new process is in place and Power Chart Maternity has been implemented. Conclusion/Implications for Nursing Practice A control plan to maintain gains will need to be in place. Implications for nursing practice include the elimination of time wasted in finding tubing and antibiotics and the ability of the nursing staff to focus on laboring women without leaving the bedside. To ensure that antibiotic prophylaxis will occur 100% of the time within the one‐hour window prior to incision for women with scheduled cesarean births at Children's Memorial Hermann Hospital Women's Services by July 30, 2014. A quality‐improvement team of anesthesiologists, nurses, and pharmacists used quality‐improvement methods to understand the problem and develop a new process for antibiotic delivery. Women with scheduled cesareans at Children's Memorial Hermann Hospital Women's Services comprised the sample. Baseline data were collected to define the scope of the problem of antibiotics being delivered according to evidence‐based guidelines. A fishbone diagram was developed to understand the potential causes of antibiotic delivery failure in 18% of patients from anesthesiologist and nursing staff perspectives. A waste walk was performed to identify inefficiencies. A map of the current process was created to detect potential stages at which interventions might improve the ability to give antibiotics on time. A spaghetti map was drawn after a nurse wearing a pedometer walked to all areas where nurses must travel to gather intravenous tubing and antibiotics to make a packet for anesthesia. A test of change in one pod was tested with positive results and then the new process was implemented in the entire unit. Postimplementation data were collected. Anesthesia, medicine, and nursing leaders approved the project. The new process was taught to all nurses and anesthesiologists with the goal to reduce surgical site infections by delivering antibiotics within one hour prior to incision. Specific resources and supplies needed for the process to work smoothly and efficiently were also implemented. Pyxix MedStations were purchased for operating rooms (ORs). The pharmacy supplied antibiotics and altered practice to support the new process. Information systems collaborated on the implementation of Power Chart Maternity Care4 (PCM), a new electronic charting method, to reduce the incidence of charting in different software and to support the convenience of charting medications in the ORs for the anesthesiologists. The goal of 100% compliance was not met, although at 99%, the goal is within reach. The new process is in place and Power Chart Maternity has been implemented. A control plan to maintain gains will need to be in place. Implications for nursing practice include the elimination of time wasted in finding tubing and antibiotics and the ability of the nursing staff to focus on laboring women without leaving the bedside." @default.
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• W1959682508 date "2015-06-01" @default.
• W1959682508 modified "2023-09-29" @default.
• W1959682508 title "Improving Antibiotic Prophylaxis Prior to Cesarean Birth" @default.
• W1959682508 doi "https://doi.org/10.1111/1552-6909.12607" @default.
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