Clinical Audit for NABH doctor uuse only

nabh

1. CLINICAL AUDIT Prophylactic Antibiotics in patients undergoing LSCS on the same day of admission By Dr.

2. Prophylactic Antibiotics in patients undergoing LSCS on the same day of admission Dr. (Accreditation Coordinator ) Ms (Quality Manager )

3. AIM To provide an uneventful recovery in surgical cases

4. OBJECTIVE % of patients receiving Prophylactic antibiotics within one hour

5. METHOD OF STUDY Retrospective Analysis by Independent observer( Dr Sadiqua Sohail )

6. DATA COLLECTION Study period: Feb – March 2021 Sample Size: 25cases Type of sampling: LSCS

7. LSCS Audit on Antibiotic Prophylaxis Sl.No Date IP.ID Age Time of given to antibiotic Time of surgery TAT 1 3/3/2021 21/689 28 1:30 2:30 1:00 2 3/22/2021 21/932 20 0:45 1:00 0:15 3 3/28/2021 21/671 28 8:40 9:20 0:40 4 3/2/2021 21/667 28 10:45 11:15 0:30 5 3/9/2021 21/774 35 2:15 2:30 0:15 6 2/19/2021 21/616 26 8:10 9:10 1:00 7 3/6/2021 21/626 30 12:50 13:50 1:00 8 2/27/2021 21/629 31 12:30 14:00 1:30 9 3/1/2021 21/652 29 1:45 2:30 0:45 10 3/4/2021 21/697 28 9:30 11:05 1:35 11 3/5/2021 21/710 24 2:15 2:45 0:30 12 3/12/2021 21/781 37 2:00 3:00 1:00 13 3/10/2021 21/813 35 12:00 13:10 1:10 14 2/21/2021 21/826 32 9:00 10:00 1:00 15 2/25/2021 21/878 28 9:55 10:20 0:25 16 3/14/2021 21/885 24 1:30 2:30 1:00 17 3/20/2021 21/899 32 1:45 2:30 0:45 18 3/8/2021 21/899 26 4:00 5:00 1:00 19 3/6/2021 21/903 26 8:40 9:20 0:40 20 2/19/2021 21/913 24 8:10 9:30 1:20 21 2/26/2021 21/910 31 11:00 12:00 1:00 22 2/27/2021 21/983 24 1:00 2:00 1:00 23 3/18/2021 21/1015 28 1:30 2:30 1:00 24 3/29/2021 21/1022 35 2:30 3:30 1:00 25 3/30/2021 21/744 30 4:00 5:00 1:00

8. Prophylactic Antibiotic Administered before 1hr of Surgery cont.…

9. Prophylactic Antibiotic Administered before 1hr of Surgery

10. observation The prophylactic antibiotic for SSI prevention was given with in one hour in no. of cases. This adherence was not found to be strict in 10 no. of cases. In the month of Feb In the month of March, the audit has appropriately completed,

11. Rca The reasons can be elaborated as patients already in Labor are given prophylactic antibiotic cover because multiple P/V Examinations are a high risk for SSI when taken for caesarean due to maternal or foetal indications . Few of the patients had pre-Induction high leucocyte counts and medical risk factors like diabetes hence has to be covered with antibiotics to avoid the risk of SSI.

12. As Corrective and preventive action :- I t would be now a part of our best practices that injection Augmentin 1.2g IV be given within half to one hour prior to the incision of LSCS. This would give max prevention against SSI.

13. CONCLUSION AS PER WHO GUIDELINES If prophylactic antibiotics have been administered within 60 minutes prior to knife to skin, ( eg : If OT at 12:00 P.M medicine should be administered at 11:00-11:15m) consideration should be given to redoing the patient. The exceptions to this are: Patients whose procedure involves the inflation of a tourniquet Women who require a caesarean section when antibiotic administration is withheld until after the umbilical cord has been clamped.

14. RECOMMENDATION It is recommended that the prophylactic antibiotics should be given in pre-operative area rather than in wards so that we can maintain the required timeline Antibiotic policy will be strictly adhere , as per the guidelines If the procedure/surgery exceeds more than an hour then we change the antibiotic to a higher group to prevent resistance and hence the occurrence of SSI Training given to staff members to prevent SSI

15. Thank you