RESUMEN
BACKGROUND: Improper compliance with antibiotic prophylaxis (AP) in surgery is associated with an increased risk of surgical site infection (SSI), and impacts the efficiency of healthcare. OBJECTIVE: Evaluate the impact of an intervention in compliance with AP in selected surgical procedures and its effect on antibiotic consumption and cost. METHODS: A prospective interventional study was performed in a community hospital from January to December 2022. The baseline period was considered January-April 2022 and the intervention period May-December 2022. All patients who underwent cesarean section, appendectomies, hernia surgery, open reduction and internal fixation (ORIF), abdominoplasty, and cholecystectomy during the study period were selected. The intervention includes staff education, pharmacy interventions, monitoring the quality of prescriptions and feedback, and improved role of anesthesia staff, and department champions. RESULTS: The study involved 192 and 617 surgical procedures in the baseline and intervention periods respectively. The compliance with timing, selection, dose, and discontinuation achieved 100%, 99.2%, and 97.6% from baseline figures of 92.7%, 95.8%, and 81.3%, respectively. The antibiotic consumption was reduced by 55.1% during the intervention with a higher contribution of other antibiotics (94.1% reduction) in comparison with antibiotics as per policy (31.2% reduction). The cost was reduced by 47.2% (antibiotic as per policy 31.9%, other antibiotics 94.2%). CONCLUSION: The implemented strategy was effective in improving the quality of antibiotic prophylaxis with a significant impact in reducing antibiotic consumption and cost.
Asunto(s)
Antibacterianos , Profilaxis Antibiótica , Mejoramiento de la Calidad , Infección de la Herida Quirúrgica , Humanos , Profilaxis Antibiótica/economía , Estudios Prospectivos , Infección de la Herida Quirúrgica/prevención & control , Antibacterianos/administración & dosificación , Antibacterianos/economía , Antibacterianos/uso terapéutico , Femenino , Masculino , Adhesión a Directriz , Hospitales Comunitarios , Procedimientos Quirúrgicos Operativos , Adulto , Persona de Mediana EdadRESUMEN
The key findings of a solid waste characterisation study conducted at the Guadalajara Metropolitan Zone, Mexico, are reported. Objectives of the study were to estimate the daily generation rate of household (HSW) and municipal solid waste (MSW), characterise and compare their composition by type of material, determine the proportion that HSW contributes to MSW, explore changes in MSW composition through time after final disposal, and estimate the types and amount of MSW that are sorted out for recycling at final disposal sites. HSW generated during seven days by a sample of 300 households chosen through a two-stage stratified sampling design was collected, weighed and classified. MSW entering the four local disposal sites was recorded for 12 weeks, and materials' sorting was quantified. MSW samples taken by excavating trenches in two final disposal sites were also characterised. The average per capita daily HSW generation rate was 508 g. HSW mainly consisted of putrescible waste (53%), paper (10%) and plastic (9%). The average daily generation rate of MSW was 3119.2 metric tonnes. HSW represented 55.9% of MSW, and the main difference between HSW and MSW was a lower proportion of organic materials (53% vs. 16.5%, respectively). The major changes in MSW composition through time after final disposal, were the result of the quick decomposition of putrescible materials. Only 2.2% of total MSW generated in Guadalajara (mainly package waste) was sorted for recycling.