# Impact of a multifaceted intervention including a smart reminder system for intraoperative antibiotic re-dosing on surgical site infections in a Chinese tertiary care hospital

## TL;DR

A multifaceted intervention with a smart reminder system improved antibiotic re-dosing and reduced surgical site infections in a Chinese hospital.

## Contribution

A smart reminder system integrated into hospital systems effectively improved antibiotic re-dosing compliance and reduced SSIs.

## Key findings

- Prophylactic antibiotic administration before surgery increased significantly after the intervention.
- Timing of antibiotic administration improved, with a shorter median time before surgery.
- Surgical site infection rates decreased significantly after the intervention.

## Abstract

Surgical site infections (SSIs) are among the most common healthcare-associated infections worldwide. This study evaluated the effectiveness of a multifaceted intervention, which included a smart reminder system for prophylactic intraoperative antibiotic re-dosing in the Anesthesia Information Management Systems, modifications to the preoperative application form, and enhanced review of medical orders, on improving prophylactic intraoperative antibiotic re-dosing and reducing SSIs.

A retrospective study on the epidemiology of healthcare-associated SSIs was conducted to compare outcomes before and after the implementation of the bundled intervention, with a focus on compliance with intraoperative antibiotic re-dosing and the rate of SSIs.

The proportion of prophylactic antibiotic administration before surgery significantly increased after the intervention (p = 0.005). The timing of prophylactic antibiotic administration before surgery was shorter after the intervention, with a median (IQR) of 0.8 (0.6–1.0) h, compared to the before intervention period (p < 0.001). The proportion of intraoperative additional antibiotic administration also increased significantly (p = 0.003). Furthermore, the rate of SSIs decreased significantly after the intervention (p = 0.038).

The multifaceted intervention, comprising a smart reminder system for prophylactic intraoperative antibiotic re-dosing in the Anesthesia Information Management Systems, preoperative application form modifications, and enhanced medical order review, effectively improved intraoperative antibiotic re-dosing compliance and reduced surgical site infection rates.