Dr Christopher Henry1, Dr Jonathan Gray1
1Redland Hospital, Brisbane, Australia
Biography:
Chris is a doctor currently working in anaesthetics at the Redland Hospital in South East Queensland. He has previous clinical experience in intensive care and emergency medicine and prior to becoming a doctor, worked as a pharmacist in hospital settings for several years.
Abstract:
Introduction
Surgical site infections (SSI) are one of the most common healthcare associated infections and can result in severe sequelae. One strategy to decrease SSI is the use of surgical antimicrobial prophylaxis (SAP). Antibiotic overuse can also cause significant harm. Redland Hospital is a 200-bed facility in south-east Queensland which provides general surgery, orthopaedics, obstetrics, gynaecology, plastic surgery, dental, ophthalmology, and endoscopy. Local SAP guidelines are published by Metro South Hospitals Health Service network.
Methods
Chair of the Metro South Human Research Ethics Committee reviewed this project and deemed it to be exempt from full ethical review (reference number EX/2025/QMS/118212). Data extracted via retrospective chart review for all procedures 1st-31st December 2024, filtered according to inclusion (all surgical procedures) and exclusion criteria (endoscopy, cardioversion, ophthalmology, local anaesthetic only, pre-existing infection/antibiotic regimen). Manual chart review performed to extract patient demographics, surgical procedure details, relevant co-morbidities, pre-existing infection/antimicrobial use, and SAP details. Guideline adherence defined as correct drug, dose, and time of administration.
Results
Two hundred patients included. SAP guidelines adherence for only 57% of cases. Incorrect drug administered to sixty-five patients. Cefazolin inappropriately administered to forty-seven patients (23.5%). Incorrect dose administered to four patients. Incorrect time of administration for forty patients. General Surgery, Gynaecology and Orthopaedics had poorest rates of adherence.
Conclusion
Overall adherence to SAP guidelines at Redland Hospital was poor and fell short of reported national rates. Previous literature has identified several factors that influence poor adherence to SAP guidelines, further research is required to explore these barriers.