Retningslinjer for antibiotikaprofylakse og råd for temperaturkontroll, blir de etterlevd ved hofteprotesekirurgi?

Abstract

Background This quality improvement project examined adherence to national guidelines for antibiotic prophylaxis and recommendations for temperature control in hip replacement surgery. It also explored whether adherence was associated with postoperative surgical site infections at two hospitals during 2022–2024. Research question To what extent are national guidelines for antibiotic prophylaxis and temperature control followed in hip arthroplasty? Is there an association between adherence to these guidelines and the incidence of postoperative surgical site infections? And are there differences in adherence between the two hospitals? Materials and methods Data were collected from the MRS-POSI quality registry and through manual chart review. A total of 79 patients were included, of whom 27 developed POSI. Most underwent elective surgery (78%) and received a total hip replacement (81%). The majority were women (59%) and aged 60–79 years (64%). Statistical analysis was conducted using Stata/MP 18. Results All patients received the correct antibiotic and dose, but deviations were found in the number of doses and combinations of prophylactic regimens. In total, 71 % of patients received antibiotic prophylaxis at the correct time. Adherence to temperature control before and after surgery was 74 %. No statistically significant association was found between adherence and the occurrence of POSI. Kristiansund Hospital had significantly higher adherence to timely administration of the first antibiotic dose (p=0.002) and preoperative temperature control (p=0.001) compared to Volda Hospital. Conclusion and implications The results show high adherence to the choice and dosage of antibiotics, while adherence to timely administration of antibiotic prophylaxis (71%) and temperature control (74%) could be improved. There were differences in adherence between the two hospitals, indicating a need for better implementation, training, and follow-up of recommendations to ensure consistent practice and patient safety across institutions.