A Quality Improvement Project to Improve Weight-Based Dosing of Cefazolin in the Perioperative Setting Among Patients Undergoing Knee Arthroplasty

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Doctor of Nursing Practice (DNP) Projects
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Total Knee Arthroplasty
Obesity
Cefazolin
Ancef
Surgical Site Infection
Nursing
Post-BSN for Nurse Anesthetists (DNP-NA)
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Surgical site infections (SSIs) continue to be a problem that affect the healthcare system not only on a national level, but on a local level as well. Adequate weight-based prophylactic antibiotic dosing is imperative in prevention of surgical site infections. Cefazolin is the most prevalent perioperative antibiotic administered. According to current guidelines, patients weighing greater than or equal to 120 kilograms (kg) should receive three grams of cefazolin. This project is a quality improvement project using the Plan-Do-Study-Act model for creation and dissemination of an original educational video on antibiotic stewardship and implementation of an electronic medical record (EMR) intervention for patients undergoing knee arthroplasty. Based on chart-reviewed data, it was determined that there is decreased compliance with current antibiotic dosing guidelines regarding both prescribing and administration. Evidence-based interventions included a web-based educational video discussing the institution’s current perioperative antibiotic prophylaxis guidelines; additionally, an embedded hyperlink was created in the EMR in both the anesthesia record and Epic ordering screen to offer an easy access reference to both the ordering provider and administering provider. Pre- and post-implementation data were analyzed. Post-implementation data did not reveal increased compliance with prescribing and administration of cefazolin in patients undergoing knee arthroplasty.

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2020-12-13
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