Kirsty Sim1, Mr Philip Rawson-Harris1,2, Rachael Leng1, Kelly Cairns1,2, Dr Trisha Peel1,2
1Alfred Health, Melbourne, Australia, 2Monash University, Melbourne, Australia
Biography:
Kirsty is the Antimicrobial Stewardship Data Analyst in the Infectious Diseases Department at Alfred Health. She has a bachelors with honours in biomedical science and post graduate in Computer Science and Data Analytics. Kirsty loves beach days and spending time with her family.
Abstract:
Introduction
Antimicrobial stewardship (AMS) in surgical prophylaxis is concerned with many complex measures of appropriateness. Auditing these measures has previously been a “high detail, low breadth” investigation by an AMS pharmacist, limiting the impact of these audits to 100 surgeries a year. In collaboration with the Epidemiology and Data Management Service, the AMS team automated data pulls from the electronic medical record focusing on key metrics for a “high breadth, less depth” approach.
Methodology
Hip and knee replacement and coronary artery bypass graft surgeries with solely cefazolin prophylaxis were extracted from the data warehouse using SQL scripts which were validated and visualised on a dashboard that refreshed daily. Results are described from 2024 as an example with timing and duration measures.
Results
The rapid data collection facilitated a high number of reviews, with 881 procedures in 2024, of which 847 (96%) received a prophylactic dose of cefazolin in the 60 minutes prior to “knife to skin”. Cefazolin was discontinued within 24 hours of surgery end in 764 surgeries (87%). The dashboard’s production allowed rapid assessment of key metrics without manual data collection for surgeries 2018 onwards. Changes in prophylaxis practice over time are now measurable and allow understanding of intervention efficacy.
Conclusion
A broad approach means more data can be reviewed giving meaningful insight into the practices at the hospital with further complexity incrementally added. Reduction in manual data collection frees the AMS pharmacist and team to further investigate cases of non-compliance and add the detail where it is required.