Nurse-Initiated Protocol to Improve Timely Antibiotic Administration in Pediatric Open Fractures.
BACKGROUND: Early administration of antibiotics in the presence of open fractures is critical in reducing infections and later complications. Current guidelines recommend administering antibiotics within 60 min of patient arrival to the emergency department, yet trauma centers often struggle to meet...
| Publicado en: | Journal of Trauma Nursing Vol. 31; no. 3; pp. 158 - 164 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
May/Jun2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=177366815&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 177366815 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10787496 39B jtl: Journal of Trauma Nursing issn: 10787496 maglogo: N pubinfo: dt: May/Jun2024 vid: 31 iid: 3 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 177366815 177366815 177366815 10.1097/JTN.0000000000000789 177366815 ppf: 158 ppct: 6 formats: tig: atl: Nurse-Initiated Protocol to Improve Timely Antibiotic Administration in Pediatric Open Fractures. aug: au: Scallon, Kylie Lee, Jessica Spencer, Meghan Schissel, Makayla Timmons, Zebulon Hanna, Angela Sneller, Hannah affil: Department of Trauma (Mss Scallon and Lee), Children's Nebraska, Omaha, Nebraska; Department of Emergency (Ms Spencer), Children's Nebraska, Omaha, Nebraska; Division of Emergency Medicine (Drs Timmons and Sneller), Children's Nebraska, Omaha, Nebraska; Division of Pediatric Surgery (Dr Hanna), Children's Nebraska, Omaha, Nebraska; Department of Biostatistics (Ms Schissel), University of Nebraska Medical Center, Omaha, Nebraska; Department of Pediatrics (Drs Timmons and Sneller), University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery (Dr Hanna), University of Nebraska Medical Center, Omaha, Nebraska. sug: subj: Fractures, Open In Infancy and Childhood Nursing Protocols Pediatric Care Time Factors Antibiotics Administration and Dosage Treatment Outcomes Evaluation Trauma Nursing Human Male Female Child Infection Treatment Complications, Delayed Practice Guidelines Emergency Service Trauma Centers Retrospective Design Record Review Bone and Bones Amputation Implementation Science Triage Quality Improvement Fisher's Exact Test Data Analysis Software Descriptive Statistics Child: 6-12 years Male Female ab: BACKGROUND: Early administration of antibiotics in the presence of open fractures is critical in reducing infections and later complications. Current guidelines recommend administering antibiotics within 60 min of patient arrival to the emergency department, yet trauma centers often struggle to meet this metric. OBJECTIVES: This study aims to evaluate the impact of a nurse-initiated evidence-based treatment protocol on the timeliness of antibiotic administration in pediatric patients with open fractures. METHODS:A retrospective pre-post study of patients who met the National Trauma Data Standard registry inclusion criteria for open fractures of long bones, amputations, or lawn mower injuries was performed at a Midwestern United States Level II pediatric trauma center. The time of patient arrival and time of antibiotic administration from preimplementation (2015-2020) to postimplementation (2021-2022) of the protocol were compared. Patients transferred in who received antibiotics at an outside facility were excluded. RESULTS:A total of N = 73 participants met the study inclusion criteria, of which n = 41 were in the preimplementation group and n = 32 were in the postimplementation group. Patients receiving antibiotics within 60 min of arrival increased from n = 24/41 (58.5%) preimplementation to n = 26/32 (84.4%) postimplementation (p < .05). CONCLUSIONS: Our study demonstrates that initiating evidence-based treatment orders from triage helped decrease the time from arrival to time of antibiotic administration in patients with open fractures. We sustained improvement for 24 months after the implementation of our intervention. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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