How to improve antimicrobial stewardship & infection prevention in ASCs: 4 details

Increasing antimicrobial stewardship and infection prevention resources may improve patient safety in ASCs and hospital outpatient departments, according to research published in Antimicrobial Resistance & Infection Control.

Researchers studied a multi-center Veterans Health Administration retrospective cohort from October 2015 to September 2017 of veterans undergoing outpatient general surgery, urology, ophthalmology, ENT and orthopedic procedures. The data included 153,097 outpatient surgeries, which researchers analyzed for facility complexity and compliance with discontinuation of antimicrobials within 24 hours of incision closure.

The key details to know:

1. ASCs and HOPDs were associated with higher odds of prolonged antimicrobial prophylaxis compared to more complex settings like hospitals.

2. Surgeries with the greatest high prolonged antimicrobial prophylaxis odds were ENT and genitourinary surgeries.

3. Patient factors contributing to higher odds of antimicrobial discontinuation noncompliance were female sex, young age and white race.

4. Researchers concluded, "Facility complexity appears to play a role in adherence to surgical infection prevention guidelines. Lower complexity facilities with limited infection prevention and antimicrobial stewardship resources may be important targets for quality improvement. Such interventions may be especially useful for genitourinary and ENT surgical subspecialties. Increasing pharmacy, antimicrobial stewardship and/or infection prevention resources to promote more evidence-based care may support surgical providers in lower complexity ambulatory surgery centers and hospital outpatient departments in their efforts to improve this facet of patient safety."

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