sooner you can get patients off ventilators and remove endotracheal
tubes, the better they do.
Don't continue surgical prophylactic antibiotics after the patient has left the OR.
It's become increasingly clear that absent evidence of infection,
antibiotics don't provide any benefit after surgery is over.
Don't continue antibiotics beyond 72 hours in hospitalized patients unless the patient
has a clear evidence of infection.
This is something that's been talked about increasingly in the past 5
years or so, but which is rarely done. In hospitals, maybe a quarter of
the time antibiotics are reassessed and either stopped or downgraded
to a safer antibiotic. At the beginning, you want to make sure you
treat everyone who might benefit, but once there's been time to col-
lect more information, it often turns out that there was no infection
and that the patient was sick from something else. We're recommend-
ing that patients be reassessed after 3 days.
Embrace good practices
So, where did this list originate? Members of the Society for
Healthcare Epidemiology of America (SHEA) recommended these 5
items. Some are already well recognized and far from controversial,
but that doesn't mean they're being universally observed. There's no
question that care would be vastly improved if more widespread
adherence came about. To the extent that we can all adhere to these
recommendations, we can begin to reduce waste and harm, and
focus more on the things that have really been shown to improve
quality of care.
4
5
Infection Prevention
IP
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