by Bill Wilson, PharmD
Last year, a multidisciplinary group (surgery, anesthesiology, perioperative nursing, infectious diseases, and pharmacy) came together to optimize the management and delivery of perioperative antibiotics for pediatric patients. This work group identified gaps in the overall delivery process that they are addressing to bring about positive change for patients. One gap identified early was that many patients do not have orders for perioperative antibiotics placed until they arrive the day of surgery. Changes in pre-surgery antibiotic ordering were implemented in July 2020.
With the help of Annemarie Funt and her team of perioperative nurses reviewing surgery cases daily, there has been a dramatic increase in the number of patients who have orders placed prior to arrival (see graph). This improvement was also made possible thanks to the continued provider education and morale boosts by Sara Pittenger and Mike Phillips, physician champions from the anesthesiology and surgery groups, respectively.
In July, only 45% of patients had orders placed prior to arrival for surgery. Less than three months later, that number increased to 80%, reflecting a meaningful improvement in patient care. This has allowed the pharmacy to better anticipate what antibiotics will be necessary, which ultimately allows the patient to receive the right drug at the right dose at the right time. Future plans with this work group include piloting a new checklist process with the pediatric and neonatal critical care units that will allow for improved communication among all members of the patient care team as well as improved delivery of perioperative antibiotics.
Bill Wilson, PharmD leads CASP’s strategy to optimize pediatric perioperative antibiotics.