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LETTER TO THE EDITOR

Preoperative Antibiotic Administration and the Surgical "Time Out"

Evanston Northwestern Healthcare, Feinberg School of Medicine, Northwestern University, Evanston, IL, JMarymont{at}enh.org

To the Editor:

Recently, O’Reilly et al. (1) described the use of an electronic medical record to track the incidence of preoperative antibiotic administration. Our similar experience is that antibiotics are frequently administered prematurely in relation to the surgical incision and we surmise that inappropriate timing of antibiotic administration occurs for at least two reasons. First, the anesthesiologists want to expeditiously complete the antibiotic administration enabling them to concentrate on other tasks such as intubation, regional block administration, and patient positioning. Second, anesthesiologists do not want to forget to give the antibiotics prior to incision. As a consequence, we have added the question "antibiotics given?" to the verbal checklist performed in the operating room immediately prior to the surgical incision. The circulating nurse will ask all present in the operating room to confirm that this is the correct patient, procedure, surgical site, and that the antibiotics were given. At our institution, this procedure provides another reminder pertaining to antibiotic administration. We believe that a formal verbal checklist considering antibiotics, which involves everyone immediately prior to the incision, will mitigate the incidence of untimely or total lack of antibiotic administration.

View larger version (5K): [in this window] [in a new window]   Figure 1. Posterior intertendinous popliteal block with two needles.

Footnotes

Dr. O’Reilly does not wish to respond.

REFERENCE

1. O’Reilly M, AkkeNeel T, VanRiper S, et al. An anesthesia information system designed to provide physician-specific feedback improves timely administration of prophylactic antibiotics. Anesth Analg 2006;103:908–12.[Abstract/Free Full Text]

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