The impact of irrational perioperative antibiotic prophylaxis on the nursing workload

Background: The evidence for effectiveness of perioperative antibiotic prophylaxis is well established. However, despite evidence of effectiveness and the publication of guidelines for antimicrobial prophylaxis, use is often suboptimal. Aim: The aim of the present study was to explore the impact of irrational perioperative antibiotic prophylaxis use on the nursing workload in a surgical ward. Methods and Material: Α prospective observational study took place for a period of one month in a surgical ward of a general hospital in Athens, Greece. Patient data consisted of demographic characteristics, underlying diseases and data for antibiotic agent, the timing of administration and the duration of prophylaxis. In each shift, structured observational data for nursing workload were collected by the registered nurses of the surgical ward. Results: A total of 51 patients undergoing surgery operations were prospectively evaluated. Patients received in total 1604 doses. Of these doses, 1106 (69%) were newer antibiotics under restriction. Antibiotic prophylaxis was inappropriately given to 3,9%. The timing indicator was 88,2 %. The use of antibiotic prophylaxis was misuse in 94% and overuse in 96%. The mean daily nursing workload due to irrational antibiotic prophylaxis was 5,05 hours. Conclusion: Irrational antibiotic prophylaxis use increase the daily nursing workload 5,05 hours. The adherence with perioperative antibiotic prophylaxis is poor. The education and discussion of our results with surgical team and infection control committee will contribute to reducing the nursing workload, increasing the adherence with prescribing and administering perioperative antimicrobial prophylaxis, and improving the safety and quality care in studied population.