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dc.contributor.authorEveritt, Daniel E.
dc.contributor.authorSoumerai, Stephen Bertram
dc.contributor.authorAvorn, Jerry Lewis
dc.contributor.authorKlapholz, Henry
dc.contributor.authorWessels, Michael Robert
dc.date.accessioned2017-05-16T19:15:28Z
dc.date.issued1990
dc.identifier.citationEveritt, Daniel E., Stephen B. Soumerai, Jerry Avorn, Henry Klapholz, and Michael Wessels. 1990. “Changing Surgical Antimicrobial Prophylaxis Practices through Education Targeted at Senior Department Leaders.” Infection Control and Hospital Epidemiology 11 (11) (November): 578–583. doi:10.1086/646098.en_US
dc.identifier.issn0899-823Xen_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:32696180
dc.description.abstractPrescribing antibiotics for perioperative prophylaxis in common surgical procedures presents an ideal target for educational intervention. In this situation, antibiotics are often used inappropriately, with consequent excess expense and risk of morbidity. We developed an educational intervention aimed at the choice and appropriate dosing of antibiotics for the prophylaxis of cesarean sections. Person-to-person educational messages targeted at authoritative senior department members were supplemented by brief reminders on a structured antibiotic order form. Time-series analyses were conducted on 34 months of antibiotic use data for 2,783 cesarean sections to estimate the trend of magnitude and significance of discontinuities associated with the start of the program. Prior to the intervention, 95% of sections receiving prophylaxis were given cefoxitin and 3% were given cefazolin. After the intervention, these proportions were reversed, with the shift in use occurring immediately after the intervention (p<.001). Two years after the intervention, virtually all patients undergoing cesarean sections who receive antibiotic prophylaxis are given cefazolin. Savings from this change alone accounted for over $26,000 each year, or $47.36 per patient-day of prophylaxis. Substantial changes in prescribing practices for routine procedures can be accomplished through the implementation of a coordinated educational program that enlists influential senior staff members in a department in which policy-making is highly centralized, coupled with a structured educational ordering system. Lasting improvements in clinical practices may be brought about by means that are noncoercive, inexpensive and well-accepted by medical staff.en_US
dc.language.isoen_USen_US
dc.publisherCambridge University Press (CUP)en_US
dc.relation.isversionofdoi:doi.org/10.1086/646098en_US
dash.licenseLAA
dc.titleChanging Surgical Antimicrobial Prophylaxis Practices through Education Targeted at Senior Department Leadersen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalInfection Control and Hospital Epidemiologyen_US
dash.depositing.authorSoumerai, Stephen Bertram
dc.date.available2017-05-16T19:15:28Z
dc.identifier.doi10.1086/646098*
dash.contributor.affiliatedKlapholz, Henry
dash.contributor.affiliatedWessels, Michael
dash.contributor.affiliatedAvorn, Jerome
dash.contributor.affiliatedSoumerai, Stephen


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