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Description of Workplace/Practice Setting.
CRMC is a 100-bed not-for-profit hospital in Kentucky. The Surgical Services Department consists of three operating room suites, one cystoscopy suite, and an endoscopy suite. The surgical team began to investigate how they could improve patient outcomes using techniques that are designed to streamline patient care delivery. The practice of prophylactic antibiotic administration sixty minutes prior to surgical incision has been through process changes in the last four years. Original administration of prophylactic administration was done in the Outpatient Department prior to the patient being sent to the Operating Room (OR). This was not successful due to the antibiotic being given too early prior to surgery or delays in surgeries.
The prophylactic antibiotic administration was then moved to the OR holding room with the circulating nurse responsible for starting the appropriate antibiotic after the nurse completed the intra-operative interview. This process was unsuccessful because it was often difficult to ensure when there would be unforeseen delays in surgical start time. The process was then changed to the circulating room nurse initiating the start of the antibiotic when the patient was wheeled in the OR suite. This was more successful, yet was not without flaws, because sometimes it took longer to position and prep patients therefore having the antibiotic finished before the surgical incision. There were also some compliance issues with the circulating nurses documenting route and or time, so the antibiotic administration would fall out for core measures.
Description of Search Strategy for Supportive Research.
To prepare research suitable for the research problem the writer accessed the Agency for Healthcare Research and Quality, as well as the Cumulative Index to Nursing & Allied Health Literature (CINAHL) with full text data base. Finally the writer went to National Institute of Nursing Research website which led to research in the Association of Operating Room Nurses (AORN), which specializes in perioperative nursing.
