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NUR909 Module 5 (Antibiotics) Exam Questions And Accurate Answers
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NUR909 Module 5 (Antibiotics) Exam QuestionsAnd Accurate Answers
Dr. John Burke found that when it came to the use of preoperative antibiotics, a large
percentage was associated with error. These errors fell into what categories? (2)
1. Omission
2. Comission
What errors are an act of OMISSION? (2)
1. Antibiotics were not ordered
2. Antibiotics were not administered
"Something not done"
What errors are an act of COMMISSION? (3)
1. Antibiotics were administered but not at the right timing & best evidence
2. Antibiotics were administered when not needed & not as per the policy of the hospital
3. Antibiotics were continued much after they were needed, or patients remained on
antibiotics for too long
"Something done, but incorrectly timed or should not have been done"
Statistics As Per The National Institute of Health in 2019:
-40-60% of SSI are PREVENTABLE w/ appropriate use of ABX
-Overuse, underuse, & improper timing occurs in 25-50% of operations
-16% of surgical patients develop C. dif which is attributed to inappropriate use of ABX
What does prolonged (inappropriate) antibiotic use put everyone at risk for?
Antibiotic resistance
In several studies what complicates antibiotic use?
, Role ambiguity
At most institutions, it is the surgeon's responsibility to order preoperative antibiotics.
However, in most cases, the surgeon plays a role as a consultant versus the primary
provider. This is especially true in those patients who are admitted to the hospital and
are discovered to have a surgical pathology. Alternatively, this may be an ICU patient
who is admitted to either the medical or critical care service but who has a need for
surgical intervention.
This is where surgeons preferentially focus on the operation & informed consent, but
often forget to order an antibiotic. This can vary significantly from institution to
institution & from surgeon to surgeon. In this scenario, antibiotics become an
afterthought & are ordered right before the operation or given in the wrong timing.
What is critical to outcomes in terms of antibiotics?
Timing of an antibiotic
True or False: The preoperative administration of antibiotics is often performed or
supported by anesthesia. It is often our responsibility to make sure the antibiotic was
given. The timing of the antibiotic can be tricky as surgical rooms can run ahead or
behind schedule. This may be given outside of an appropriate window providing good
tissue saturation if preoperative nurses do not initiate the antibiotic, or give it too early,
depending upon the situation.
True
As a result, two camps of thought form. Some anesthesia providers insist that antibiotic
orders are the role of the surgeon while others feel that it should be the role of the
anesthesia provider. Ideally, institutions have clear protocols & guidelines that identifies
the roles of each party although this is often not the case.
True or false: Studies show, in addition, that anesthesia providers are not educated to
choose the drug of choice based on the surgical procedure & understand dosing.
True
What else could be an incentive to deliver antibiotics?
Our incentive to deliver antibiotics is mostly predicated on MONEY & REIMBURSEMENT
versus outcomes improved.
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