887 Design and Implementation of a Standardised Protocol to Assess the Pre-Operative Prophylactic Antimicrobial Guidelines in Vascular Surgery – a Trust-Wide Experience. (19th August 2022)

• Record Type: Journal Article
• Authors: Ford, A; Charlwood, N; Morton, H
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 6
• Publication Date: 2022-08-19
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac269.365
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aim: The project's aim was to design and implement a replicable protocol in order to assess the pre-operative prophylactic antimicrobial prescribing that could be universally applied to all patients undergoing major vascular surgery. Method: A retrospective audit was undertaken to establish existing guidelines in circulation and current practice trends at Worcestershire Acute Hospitals NHS Trust. Multiple theoretical models to stratify procedure and infection risks were designed including clean verses dirty site surgery, procedure specific surgery, procedures with or without utilisation of prosthesis, universal one size fits all guidelines. A panel consisting of consultant vascular surgeons, the antimicrobial stewardship lead consultant microbiologist, and a core surgical trainee co-ordinating the project appraised the results. Criteria included ease of implementation minimising prescribing errors, anaphylaxis, and the need for a tailored guideline for different major vascular procedures to determine suitability of the guideline. Results: The initial audit signified a need to standardised guidelines in order to provide patients with a standardised care pathway that utilises best practice. In this instance an anatomical approach to the pre-operative prophylactic antimicrobial guideline for major vascular surgery was adopted and implemented at Trust level. Conclusions: A replicable protocol has been established in order to appraise, design, and implement antimicrobial guidelines that can be transferable between departments and trusts alike.